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Hello, and welcome to the Becker's Healthcare podcast

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recorded live at the 21st annual ASC and

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Spine Conference in Chicago.

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I'm joined today by doctor Jamon Shah, medical

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director at Mercyhealth Pain Center. Jamon, thank you

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very much for joining us today on the

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show. Could you begin by telling us a

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little bit about yourself and your role in

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your organization?

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Sure. Sure. So I'm a interventional pain physician.

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I came from an engineering

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background and also was a pharmacist for a

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while, worked in the retail setting,

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also managed a multimillion dollar pharmacy,

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and then switched over to medical school, went

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to medical school, paid for it using my

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pharmacy earnings. So continue working, basically, and then,

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was anis I went in my anesthesia residency

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and then an interventional pain fellowship at Loyola

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University in Chicago.

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And I practice mostly interventional pain, currently.

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So throughout your career,

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how has the patient provider dynamic evolved over

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time?

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So it's changed quite a bit, and, you

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know, yeah, I have to look back to

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when I started, you know, as a pharmacist

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and how it evolved through medical school and,

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you know, what I saw,

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our preceptors doing.

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It used to be what we would,

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you know, call a priestly type of relationship

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where

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patients will come to a doctor and say,

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doctor, tell me what I need to do.

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Whatever you say is, you know, I trust

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you, and I'll do whatever you say to

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where we started getting patients more involved in

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the decision making process

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and and went to what I think some

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people describe as an engineering type of model

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where they're more involved in their decisions.

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Me as a physician, my job is to

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tell them what their options are, educate them

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on things that we can do, and then

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let them decide what they wanna do, more

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of an informed patient

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making a decision model.

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So with

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the increasing cost of health care

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and, you know, the the ease of inconvenience

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of people going out and searching for their

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own medical answers on

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Google or social media or whatever, you know,

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we've seen an increasing trend in that. Can

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you tell us a little bit about what

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you're seeing and why you think that

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is? Well, there's a few reasons for that.

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You know? 1st and foremost, it's cheap. It's

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free. You can go on and turn it

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and search for anything.

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Sometimes you can find what you're looking for.

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So not necessarily what you need to hear,

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but what you're looking for, and then you

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start

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using that advice out of context a lot

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of times. And so there's good and bad

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to come out of there. Good news is,

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yes, it is,

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patients are more educated now. They do their

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research, which is excellent.

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But the problem is a lot of times

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what they're reading and, what they think they're

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reading is different. What, they're usually taking it

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out of context. The implications

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are,

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you know,

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their trust for the,

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physician is a little bit different because now

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they read something else that's said something opposite

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of what their doctor's recommending, and they automatically

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start thinking that the doctor's lying to them

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or not telling them the full truth.

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So it has eroded the relationship a little

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bit, but at the same time,

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if you guide them properly and if you

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talk to them and educate them,

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it actually is a good thing because a

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lot of times patients do educate themselves on

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their pain conditions. Then you can guide and

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say these are proper websites to use, to

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learn about your condition, then they review that.

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And when you see them again, you can

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tell they review, they understand their condition better.

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And when they're you're discussing the options, they're

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able to make more of an informed decision.

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So you mentioned that the patient provider relationship

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has eroded.

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When we think of rebuilding this relationship, where

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do you think the industry should start?

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Well, there's a lot of different things that

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have, you know, changed in the last 10,

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15 years.

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I think a lot of, things that

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health care measures now and how, you know,

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health care has changed.

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Physicians used to work on their own a

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lot before, and now majority of the physicians

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are a big portion of the physicians

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are employed by hospital systems. And so they

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don't necessarily

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take the ownership,

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or they're not given the opportunity to take

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the ownership. Ship. Sometimes they're told what to

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do based on, you know, metrics that somebody

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else might be able to measure. Not necessarily

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good,

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but, you know, something that

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for example, patient satisfaction surveys, depending on what,

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form they use, what questions they use,

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that could skew

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a lot of things. Patient's expectations may change.

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You know? There

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a lot of times people forget that when

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they go see a doctor, they're not seeing

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a doctor

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just so that they can be done in

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15 minutes, have no wait time whatsoever. Everything

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is on time. Everybody's nice to them and

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answers their questions, and they're done. They're going

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there because

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they're in pain. They have a medical condition

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that they need treated, and they want to

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find the best person that can treat them.

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And a lot of times, it doesn't matter

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if they have to wait longer, if they

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have to sit in a tight room. They

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don't care if you can actually help them

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get better. And so I think that's how

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we're gonna try coming back is,

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allowing that to be a focus, taking away

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all the other noise and focusing on what's

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important for the patients. What is it that

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they're there for? How can they get better?

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And how can we enable doctors not to

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worry about other things and let them focus

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on making a patient better, making,

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decisions that are not based on other things,

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but more medically based, you know, things that

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actually have an impact on the patient's lives.

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So looking ahead, if the macroeconomic

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challenges that health care is facing don't change,

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how do you anticipate the industry might evolve?

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Do you think, care will shift more to

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a consumer based service than a personal one?

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And, how might that impact care groups versus

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individual practices?

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Yeah. I mean, health care is getting expensive.

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There's no doubt about it. And how long

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this is sustainable for? That's a question that,

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you know, we all have to answer. And

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I think there are gonna be a lot

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of different models that come out of this.

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People have been, you know, trying different things

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as you know, a lot of,

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big corporations have their own,

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healthcare

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versions. They have tried doing things where,

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it will be a group,

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treatment program where they first go on a

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website to learn what to do, what their

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options are. And then,

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once they're failed all that, then they get

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diverted to some,

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center, for example, for spine

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care, you know, and they're

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more established and have connections with the corporation.

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So, unfortunately, it may go towards it, but

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I think what might end so end up

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or might end up helping everybody is,

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where

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AI and current,

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technology

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might

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lead us to have options where we didn't

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have that before. So patients, for example, might

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be able to get answers to their questions

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through, you know, good,

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databases that are vouched for and are, you

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know, checked by their information is checked by

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physicians and, medical professionals.

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And then at first, they would do what

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it says. For example, if you have back

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pain, you try physical therapy first

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and try anti inflammatories if appropriate and all

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that, and it they will be guided as

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a group,

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by

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some program that is, you know, again, designed

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by physicians.

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But instead of them having to see patients

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1 on 1, this will be more of

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a group practice.

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I can see that happening, and then once

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they fail and then they identify a certain

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percent of people, we have whether through some

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wearable technology

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or some, you know,

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continuity technology where they're monitoring them on a

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daily basis and say, okay. You failed everything

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else. Now you need a specialist.

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It might triage them to that particular or

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a certain specialist that can actually help them.

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And by doing so, it might be able

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to cut health care costs. I can see

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models like that coming through. It's hard to

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see where it's gonna I you know, what

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exactly is going to happen down the road.

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But I think, with, how expensive everything's getting,

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people are gonna have to look for ways

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to save money without,

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hopefully,

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impacting our patient outcomes in a negative way.

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Well, Jamen, thank you so much for joining

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us today on the show. And before I

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let you go, I just wanted to ask,

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do you have any final thoughts you wanna

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leave our audience with? Yeah. So, I mean,

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talking about what we talked about today, I

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think physicians

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have have usually have spent a lot of

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time,

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lifetime, some of for for a lot of

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us, you know, training to do what they

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wanna do, which is help patients.

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And

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sometimes all that get lost once, you know,

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they start working in different, work models,

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hospitals,

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ASCs,

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private practice, whatever whatever it may be.

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And then all these other things such as

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surveys that the government indirectly, you know, imposes

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on them through the CMS or whatever payer

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system might do,

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it ends up taking them away from what

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they need to focus on. And I think

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sooner or later, people are gonna realize that,

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you know, we don't need to waste our

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time with some of these things. Yes, they're

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good. We need to all take care of,

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or be taken care of in a friendly,

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timely way, and that's all important. But at

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the end of the day, what is it

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that our patients need? It's getting better,

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getting their health problems taken care of. And

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when we start focusing on that and not

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all of the other things, I think it's

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gonna,

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lead to a better health care for office.

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Mhmm.

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Well, thank you again, Jamen, for joining us

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today on the show, and I hope you

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have a lovely rest of your day. You

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too. Thank you.