Physician and Integrative Medicine Fellow Dr. Nicole Alexander-Spencer Releases Debut Book Challenging Americans to Stop Surviving and Start Designing Their Lives
Live By Design, Not Default: A Doctor’s Guide to Health, Wealth, and Purpose Arrives as a Practical Roadmap Covering Every Dimension of Human Flourishing
United States, 20th May 2026 — Dr. Nicole Alexander-Spencer, MD, board-certified physician and integrative medicine fellow trained under Dr. Andrew Weil at the University of Arizona, has released her debut book, Live By Design, Not Default: A Doctor’s Guide to Health, Wealth, and Purpose, now available on Amazon. The book arrives as chronic disease, burnout, financial stress, and loneliness have reached epidemic proportions in the United States, and offers a concrete, eight-chapter system for rebuilding health and purpose from the ground up.
Written from more than two decades of clinical practice and Dr. Alexander-Spencer’s own journey through physician burnout, the book bridges a gap most health and wellness guides leave wide open. Where most books focus on one pillar of wellness, nutrition, mindfulness, personal finance, or relationships, Live By Design addresses all of them as an interconnected whole. The result is a rare book that reads like a conversation with a physician who has navigated the same challenges her readers face, and found a way through.
From Burning Out to Building Something Different
Dr. Alexander-Spencer does not write from a position of theoretical knowledge. The book opens with her own account of physician burnout: the crushing pressure of fifteen-minute patient visits, the emotional weight of holding people’s lives in her hands while running on empty, the period when she gave a TEDx talk on burnout while still living inside it. That experience became the catalyst for everything the book teaches.
“I was living by default,” she writes. “Life was happening to me. I was a ship sailing in open waters without any direction.”
Rather than leave medicine, she redesigned her relationship with it. She transitioned to a four-day work week. She built clinic cultures that felt peaceful and family-centered. She diversified her income across multiple roles: medical school faculty, urgent care physician, hospital panel clinician, and private wellness practice. The transformation she describes is not inspirational abstraction. It is a documented sequence of specific decisions, and the book shows readers how to make similar decisions in their own lives.
What the Book Covers
Live By Design moves through eight chapters that together form a complete framework for intentional living. The book is organized around two core themes: cultivating your inner world and building your external world.
The inner world sections cover the science of meditation and stress reduction, the neuroscience of morning rituals and intentional practice, and the specifics of managing chronic stress without numbing it. Dr. Alexander-Spencer draws on her integrative medicine training to explain why the mind, body, and spirit cannot be treated as separate systems, and what happens to each when the others are neglected.
The nutrition chapter is where Dr. Alexander-Spencer’s clinical voice is most direct. After thirteen years of medical training, she found herself unable to help patients with chronic headaches, constipation, fatigue, and sleep problems until she completed her integrative medicine fellowship and learned a fundamental truth: food is information, not just fuel. The chapter covers the anti-inflammatory diet in practical detail, the role of the gut microbiome in mental health and chronic disease, meal planning strategies that work in real life, and a patient case study in which dietary changes alone eliminated the need for diabetes medication within one year.
The movement chapter argues that exercise is the most powerful prescription available and that the word “movement” is more useful than “exercise” precisely because it removes the clinical weight from something that should feel like celebration. Dr. Alexander-Spencer addresses exercise across the lifespan with specific guidance for premenopausal women, menopausal and postmenopausal women, diabetic patients, and pregnant women, filling a gap that most general wellness guides leave unaddressed.
On relationships, the book draws on Blue Zones research showing that community is one of the five pillars of longevity, and that loneliness increases the risk of heart disease by 29 percent, stroke by 32 percent, and dementia by 50 percent. Dr. Alexander-Spencer is characteristically direct: social connection is not optional for wellness. It is as critical as diet and exercise, and it requires the same intentionality.
The financial chapter is one of the most distinctive sections of the book. Dr. Alexander-Spencer grew up in subsidized housing in San Diego, raised by a single mother who could not afford the thousand-dollar summer program that would have given her daughter a head start at UCLA. That experience shaped a conviction that runs through the entire chapter: financial health is health. The chapter covers the 50-30-20 budgeting framework, emergency fund construction, credit management, retirement planning using the 25x Rule, multiple income streams, and the art of living below your means. It is, she writes, the conversation she wishes someone had with her.
The book closes with a 7-Day Kickstart and 30-Day Challenge, a structured day-by-day program that translates every principle into concrete action. Each day has a theme, specific assignments, and reflection questions designed to build momentum before habits are established.
A Doctor Who Has Lived the Material
What distinguishes Live By Design from the crowded wellness category is the credibility behind it. Dr. Alexander-Spencer is not a wellness influencer or productivity coach. She is a physician who graduated from UCLA, earned her medical degree from Howard University College of Medicine, a historically Black institution whose mission to serve underrepresented communities has shaped how she practices, and completed an Integrative Medicine Fellowship at the University of Arizona under the direct mentorship of Dr. Andrew Weil.
She has seen the consequences of poor sleep, inflammatory diet, financial stress, and social isolation in her clinic every week for more than two decades. She has also experienced burnout, redesigned her career, and built a practice around whole-person care at Life Design, the health and wellness clinic she founded. The book is the synthesis of everything she knows from both sides of the examination room.
She is also an adoptee who spent her twenties searching for her biological parents, a biracial woman navigating identity in a country defined by race, and a mother who talks openly to her daughters about credit scores and financial literacy because no one did that for her. The personal sections of the book carry weight because they are genuinely personal.
About the Author
Dr. Nicole Alexander-Spencer, MD, is a physician, integrative medicine specialist, and founder of Life Design, a health and wellness practice dedicated to whole-person care. She completed her undergraduate studies at UCLA, earned her medical degree from Howard University College of Medicine, and completed an Integrative Medicine Fellowship at the University of Arizona under Dr. Andrew Weil. She is a medical school faculty member, a former TEDx speaker on physician burnout, and the mother of two daughters. Live By Design, Not Default is her first book.
Publication Details
Title: Live By Design, Not Default: A Doctor’s Guide to Health, Wealth, and Purpose Author: Nicole Alexander-Spencer, MD Publisher: Writers of the West Available: Amazon (eBook, paperback, and hardcover) Genre: Health, Wellness, Personal Development, Personal Finance
Amazon: https://www.amazon.com/dp/B0GT24DWGB
Live By Design, Not Default is available now on Amazon.
Media Contact Writers of the West www.writersofthewest.net
Company Details
Organization: Writers of the West
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Website: https://www.writersofthewest.net/
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Release Id: 20052645247