Somewhere in between

On April 1, 2021, Houston Methodist announced a mandatory COVID-19 vaccination policy for its employees. It rolled out in two phases: managers first, then everyone else. Workers could be vaccinated or apply for an exemption on medical or religious grounds. Anyone who did neither by the deadline was placed on a two-week unpaid suspension, and anyone still out of compliance when it ended was dismissed. No hospital system in the country had gone first.

Jennifer Bridges and 116 other employees sued on May 28, arguing that the available vaccines were experimental and dangerous and likening the threat of termination to forced medical experimentation during the Holocaust. Judge Lynn N. Hughes of the Southern District of Texas dismissed the case on June 12, 2021, in five pages that dispatched the central claim in seven words. It was false and irrelevant. The Nuremberg Code did not apply, Hughes wrote, because Methodist is a private employer rather than a government, and equating the requirement to the concentration camps was reprehensible. The Fifth Circuit affirmed a year later in an unpublished opinion.

About 150 employees were fired or quit. Penn, Louisville, New York-Presbyterian and many hospitals in Washington followed within weeks. When Greg Abbott moved that October to ban vaccine mandates statewide, Boom said Houston Methodist was deeply disappointed in the governor's order, and that he was worried about the Texas hospitals that would now have to abandon their own.

It is a strange record for a man whose central conviction is that the right answer almost never sits at either end.

He said as much the day the American Hospital Association elected him. As chair, Boom promised, he would work to convince others that the right answer is almost never one-sided, but rather somewhere in between. He put it more compactly in the next sentence. The right answer is rarely an OR. It is an AND.

He now holds that job. Boom is the 2026 chair of the AHA, the top elected official of an organization representing more than 5,000 hospitals and health systems, and writes its Chair File column. He continues to run Houston Methodist, an academic medical center in the Texas Medical Center plus seven community hospitals, a research institute and a physician group covering a service area he describes as about the size of Massachusetts. He has led it since 2012, after 15 years in other executive roles there. He also still keeps about 120 primary care patients, and mentioned on the CEO.com Podcast that he saw one the day before, between the parts of the job that involve 32,000 employees.

The middle is a discipline, not a temperament

Boom's argument for the middle is not a plea for splitting differences. It is closer to a method, and he learned it running hospitals through hurricanes.

"I know that we'll make a decision at eight in the morning watching the thing barreling down at us," he said on the CEO.com Podcast, "and five hours later you're like, oh, that was a stupid decision." You revise on the facts on the ground. Anyone who has been in an armed conflict would tell you the same. Houston Methodist ran COVID that way, he said, staying data-driven and telling people plainly that what was true in March might not hold in June.

What frustrates him is that the political system rewards the opposite. Boom is careful here, and repeats himself to make sure it lands: people with strongly conservative views deserve a voice, people with strongly progressive views deserve a voice, and so does everyone in the enormous bulk of the curve between them. His complaint is structural. Voting and the primaries have migrated to the tails, while most of the country lives in the middle.

He reached for Homer to describe the pull. Odysseus lashed himself to the mast so the sirens could not steer the ship onto the rocks. The siren song for politicians now, Boom said, is the retreat into one way of doing things.

His evidence that the alternative is possible is the building he runs. Houston Methodist named its values in 2000, the year before he became an executive there. They are integrity, compassion, accountability, respect, and excellence, which the system calls I CARE, and Boom has spent a quarter century adding to a structure he did not design. Thirty-two thousand people spread across the full spectrum of political opinion share it. He tells his board that culture is the most important job either of them has, and he wants to know why what works inside one institution cannot work at national scale. He thinks business is a large part of the answer.

The institution has been improvising this way for a long time. As Boom tells it, a physician named Oscar Norsworthy built a small wing next to his house in 1908 because his patients needed beds. In 1919, he sold the operation to the Methodist Episcopal Church, South, which chartered it as the first Texas hospital owned and run by the Methodist church. It had 30 beds, near downtown, and was bought in part to help the city through the Spanish flu. Josie Roberts kept it solvent through the Depression and moved it to the Texas Medical Center in 1951, where it gave Michael DeBakey his operating room for decades afterward. Boom holds a chair named for Roberts and for Ella Fondren, who sat on the board more than 30 years.

Where the middle costs him something

Boom's health policy views are the hardest test of his own rule, because holding both halves of them is expensive.

Start with what he concedes. If you have coverage and you can physically reach care, he says, the American system is the envy of the world, and people fly to Houston to prove it. Everything turns on that if. Texas never expanded Medicaid and now carries the highest uninsured rate in the country among people under 65, at 19.2 percent, nearly double the national rate. Houston Methodist absorbs the consequence. Boom put the system's direct charity care at more than $400 million a year at cost, on top of roughly $1 billion in other community benefit including graduate medical education and Medicare underpayment.

Then he says what hospital executives in non-expansion states generally do not say out loud: that the country should cover everybody. "If other countries can do this," he said, "certainly the United States can do this and lead the way."

The uncomfortable part is that he is describing a system his own finances currently depend on. Somebody pays for that $400 million, and Boom is blunt about who. It is a hidden tax on employers, a cross-subsidy standing in for a conversation the country has declined to have about who is covered, what is included, and how it gets paid for. The shell game, as he calls it, is also his top line.

His second demand is reimbursement that resembles cost. Every provider of care, physician or hospital, is paid below what it costs to deliver it, and the gap shifts to private payers. He notes the asymmetry in how that gets set. Washington negotiates with pharmaceutical companies over a short list of drugs. It does not negotiate with doctors or health systems. "They just tell us what they're going to pay us," he said. "Hey, if it costs you $100, we'll pay you $81 or $82."

Drug pricing produces the same split verdict. Boom calls pharmaceutical companies heroes and their pricing indefensible in almost the same breath, and doesn't seem to think this needs reconciling. GLP-1 drugs belong in a line with statins and the collapse in smoking rates, the interventions that bent the death rate from heart disease across decades. He remembered a scientist friend telling him a decade ago that a diabetes compound seemed to be doing something else besides. The companies that got there, he said, deserve to make a great deal of money. And no mortal can afford these drugs individually, no society can afford them at scale, and employers are already restricting them to the patients most certain to benefit.

Hepatitis C is his cautionary case. A cure arrived, priced near six figures, calculated against what the disease was already costing society. Boom's read is that this was a missed opportunity: price the cure at $20,000 or $30,000, keep a healthy profit, and the savings stay in the system instead of evaporating. "We can't have rampant capitalism," he said. "We need appropriate capitalism."

He has kept pressing the AHA chair for coverage. Speaking in April at POLITICO's Health Care Summit, Boom described watching people lose insurance after last year's budget reconciliation bill and made the clinical version of the argument, not the fiscal one. Losing coverage does not stop anyone from getting sick. It moves them to the emergency room, later, and worse.

What he wants AI to give back

Ask most health system CEOs about artificial intelligence and the answer arrives in units of throughput. Boom's answer is about eye contact.

He finished medical school 30 years ago, when the record was paper, and he watched digitization do the opposite for medicine of what it did for banking and aviation. It slowed the work and put a screen in the room. "I'm sitting here typing right now looking at a patient across the room instead of having that interaction."

The application he is most excited about is ambient documentation, software that listens to a visit and writes the note, keeping the clinical material and discarding the human conversation that should never have been documentation in the first place. He describes the payoff in relational terms, as a way of handing the physician back the reason the job was worth taking, and only then mentions that it may also help with the workforce shortages projected across nearly every specialty.

Houston Methodist has been building toward this for years. A group started meeting informally about digital technology and called itself DIOP, for Digital Innovation Obsessed People. Boom liked the name enough to forbid changing it. The group became the Center for Innovation and now sits inside a network spanning a dozen departments. In June, the system announced a $110 million gift from the Brockman Medical Research Foundation, the largest single commitment in its history, for neuroscience, neurological care and women's health, and named a 26-story tower opening in 2027 in recognition.

What keeps him up is the part nobody anticipated. He thinks the country let social media run unsupervised and is now trying to build structure around it after the fact, and he does not want to repeat that with AI. Asked whether we will someday regard social media the way we regard cigarettes, Boom declined the comparison outright. Cigarettes have no use and were among the dumbest things ever invented. Social media has many good ones. The work is figuring out where the boundaries go.

His model for doing that better is CRISPR. The gene editing field convened its scientists, ethicists, and educators early, before the technology outran the conversation, because the same tools that can transform sickle cell disease can be turned toward bioterrorism or eugenics. He does not claim that field solved it. He thinks it at least started on time.

He also enforces a smaller discipline on himself. Walking the halls of his own hospitals, the phone stays in his pocket. Eyes up, phone down. Patients notice what an employee's hands are doing, and so do employees, and Boom is aware that a CEO scrolling on the way to a meeting has already answered the question for everybody watching.

Who took the chance

Every conversation on the CEO.com Podcast ends the same way, on the premise that the chances one gives matter as much as the chances one takes.

Boom was named Ralph Feigin, physician-in-chief at Texas Children's Hospital from 1977 until his death in 2008, and one of the most revered figures in American pediatrics. Boom had followed him around as a medical student. Years later, finishing a residency and an MBA and looking for work, he mailed Feigin an actual letter, because it was still mostly that kind of era. Feigin read it and paged him in Philadelphia.

"Hey, Marc, I think I have a job for you."

Boom's own assessment of that first job is that it was over his head and he drank from a fire hose. Feigin knew that when he made the call.

00:00:00 Introducing Dr. Marc Boom
00:01:18 Overview of Houston Methodist Today
00:02:39 Building the ICARE Culture
00:04:53 The History of Houston Methodist
00:07:53 AI and the Future of Medicine
00:11:50 How to Improve the Healthcare System
00:16:57 Shifting Toward Wellness and Prevention
00:21:44 Weight Loss Drugs and Drug Pricing
00:27:08 Rebuilding Trust in Medicine and Science
00:35:14 Social Media, Polarization, and Society
00:38:24 Societal and Individual Mental Health
00:43:31 The Mentor Who Took a Chance on Him

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How<00:02:59.915> do<00:03:00.140> you<00:03:01.280> and<00:03:01.424> how<00:03:01.665> have<00:03:02.067> you<00:03:02.388> defined<00:03:02.805> culture?

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Thanks.

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That's<00:03:04.989> a<00:03:05.117> great<00:03:05.374> question.

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And<00:03:06.033> you<00:03:06.161> make<00:03:06.354> a<00:03:06.498> really<00:03:07.044> critical<00:03:07.462> point,<00:03:07.703> which<00:03:07.943> is,<00:03:08.586> you<00:03:08.650> know,<00:03:08.730> this<00:03:08.987> is<00:03:09.164> not<00:03:10.528> fluffy<00:03:10.993> work.

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This<00:03:11.554> is<00:03:11.779> really<00:03:12.051> serious<00:03:12.516> work.

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And<00:03:12.917> every<00:03:13.382> moment<00:03:13.703> of<00:03:13.799> every<00:03:14.040> day,<00:03:15.002> literally,<00:03:15.547> people<00:03:15.868> have<00:03:17.006> other<00:03:17.231> individuals'<00:03:18.048> lives<00:03:18.369> in<00:03:18.513> their<00:03:18.593> hands.

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And,<00:03:19.876> you<00:03:19.908> know,<00:03:20.357> countless<00:03:20.838> people<00:03:21.159> come<00:03:21.400> to<00:03:21.576> us<00:03:22.618> expecting<00:03:23.163> us<00:03:23.260> to<00:03:23.340> be<00:03:23.436> our<00:03:23.580> best<00:03:24.125> each<00:03:24.286> and<00:03:24.366> every<00:03:24.542> day.

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Culture<00:03:25.889> is<00:03:25.985> something<00:03:26.531> that<00:03:26.691> I<00:03:26.851> believe<00:03:27.573> is<00:03:27.733> created<00:03:28.310> very<00:03:28.695> intentionally.

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And<00:03:29.753> so<00:03:30.074> we<00:03:30.315> have<00:03:30.555> very<00:03:30.956> intentionally<00:03:31.742> done<00:03:32.014> so<00:03:33.506> for<00:03:33.922> now,<00:03:34.644> you<00:03:34.740> know,<00:03:34.788> 104<00:03:35.366> years,<00:03:35.686> but<00:03:35.831> particularly<00:03:36.392> almost<00:03:36.728> the<00:03:36.809> last<00:03:37.113> quarter<00:03:37.450> century.

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In<00:03:38.814> the<00:03:38.958> year<00:03:39.135> 2000,<00:03:40.402> moving<00:03:40.659> into<00:03:40.820> 2001,<00:03:41.606> there<00:03:41.766> was<00:03:42.264> really<00:03:42.569> an<00:03:42.729> effort<00:03:43.532> to<00:03:43.773> call<00:03:44.174> out<00:03:44.495> what<00:03:44.752> is<00:03:44.848> our<00:03:44.992> culture,<00:03:45.377> what's<00:03:45.618> the<00:03:45.698> culture<00:03:46.035> we<00:03:46.276> want,<00:03:46.677> what's<00:03:46.838> the<00:03:46.918> culture<00:03:47.159> we<00:03:47.255> don't<00:03:47.480> want.

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And<00:03:48.764> a<00:03:48.780> set<00:03:48.988> of<00:03:49.117> values<00:03:49.486> were<00:03:49.566> derived<00:03:50.048> at<00:03:50.128> that<00:03:50.369> time<00:03:50.673> called<00:03:51.155> ICARE,<00:03:51.717> which<00:03:51.957> fits,<00:03:52.455> of<00:03:52.535> course,<00:03:52.856> very<00:03:53.097> well<00:03:53.482> in<00:03:53.659> a<00:03:53.739> healthcare<00:03:54.156> setting.

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It's<00:03:54.782> a<00:03:54.878> mnemonic,<00:03:56.291> but<00:03:56.451> also<00:03:56.772> has<00:03:56.965> its<00:03:57.253> own<00:03:57.430> layer<00:03:57.976> of<00:03:58.939> messaging.

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Those<00:04:00.559> are<00:04:00.945> integrity,<00:04:01.827> compassion,<00:04:02.405> accountability,<00:04:03.111> respect,<00:04:03.544> and<00:04:03.769> excellence.

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And<00:04:05.213> literally<00:04:05.678> for<00:04:06.030> now<00:04:06.399> almost<00:04:06.672> a<00:04:06.800> quarter<00:04:07.056> of<00:04:07.152> a<00:04:07.217> century,<00:04:07.778> we<00:04:07.922> have<00:04:08.242> very<00:04:09.381> purposefully,<00:04:10.022> intentionally<00:04:10.984> built<00:04:11.448> and<00:04:11.625> built<00:04:12.026> and<00:04:12.186> built<00:04:12.811> on<00:04:13.548> that<00:04:13.789> culture.

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What<00:04:14.975> that<00:04:15.216> culture<00:04:15.616> ultimately<00:04:15.953> says<00:04:16.354> is<00:04:16.578> we<00:04:16.738> demand<00:04:17.476> the<00:04:17.700> absolute<00:04:18.261> best<00:04:18.534> of<00:04:18.614> ourselves.

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We<00:04:19.640> call<00:04:19.880> that<00:04:20.105> unparalleled.

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And<00:04:21.163> our<00:04:21.323> vision<00:04:22.109> for<00:04:22.221> the<00:04:22.301> second<00:04:22.605> century,<00:04:23.263> now<00:04:23.471> having<00:04:23.712> entered<00:04:23.952> our<00:04:24.048> second<00:04:24.385> century,<00:04:25.491> is<00:04:25.587> 6<00:04:25.892> simple<00:04:26.212> words:<00:04:26.677> unparalleled,<00:04:27.495> meaning<00:04:28.040> nobody's<00:04:28.553> going<00:04:28.681> to<00:04:28.777> be<00:04:28.873> any<00:04:29.082> better<00:04:29.963> and<00:04:30.284> we're<00:04:30.396> never<00:04:30.685> going<00:04:30.765> to<00:04:30.845> be<00:04:30.941> satisfied<00:04:31.663> tomorrow<00:04:32.224> with<00:04:32.384> what<00:04:32.528> we<00:04:32.624> were<00:04:32.769> doing<00:04:33.025> yesterday.

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So<00:04:33.730> we're<00:04:33.891> on<00:04:33.987> a<00:04:34.067> constant<00:04:34.692> improvement<00:04:35.189> trajectory.

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So<00:04:36.568> it's<00:04:36.776> unparalleled<00:04:37.354> safety,<00:04:38.139> quality,<00:04:38.733> service,<00:04:39.583> and<00:04:39.984> innovation.

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And<00:04:41.363> that<00:04:41.603> combination<00:04:42.806> of<00:04:42.966> focus<00:04:43.448> and<00:04:43.592> intentionality<00:04:44.554> really,<00:04:45.035> I<00:04:45.131> believe,<00:04:45.452> is<00:04:45.612> the<00:04:45.693> secret<00:04:46.013> sauce<00:04:46.334> of<00:04:46.414> how<00:04:46.575> we<00:04:46.671> get<00:04:46.879> the<00:04:46.960> very<00:04:47.152> best<00:04:47.377> people<00:04:47.681> working<00:04:48.002> here<00:04:48.659> and<00:04:48.740> then<00:04:48.964> can<00:04:49.125> provide<00:04:49.525> the<00:04:49.622> best<00:04:50.007> outcomes<00:04:50.504> for<00:04:50.648> the<00:04:50.744> people<00:04:51.129> we<00:04:51.225> are<00:04:51.706> privileged<00:04:52.107> to<00:04:52.252> serve.

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Tell<00:04:53.775> us<00:04:53.936> more<00:04:54.032> about<00:04:54.272> the<00:04:54.352> history<00:04:54.834> of<00:04:54.914> the<00:04:55.058> institution.

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It<00:04:55.940> actually<00:04:56.181> sounds<00:04:56.517> quite<00:04:56.758> fascinating.

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I<00:04:57.255> mean,<00:04:57.544> it<00:04:57.640> seems<00:04:57.881> like<00:04:58.121> it's,<00:04:58.362> it's<00:04:58.522> been<00:04:58.666> around<00:04:58.923> for<00:04:58.987> a<00:04:59.067> very<00:04:59.308> long<00:04:59.548> time.

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How<00:05:00.703> much<00:05:00.928> do<00:05:01.008> you<00:05:01.168> think<00:05:01.409> about<00:05:01.633> the<00:05:01.713> history<00:05:02.050> of<00:05:02.760> the<00:05:02.792> institution,<00:05:03.443> the<00:05:03.605> legacy<00:05:04.158> that<00:05:04.256> it<00:05:04.418> has,<00:05:05.394> and<00:05:05.540> how<00:05:05.703> you<00:05:05.882> extend<00:05:06.370> that<00:05:06.597> legacy<00:05:08.711> in<00:05:08.809> your<00:05:09.037> role?

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Well,<00:05:10.621> I<00:05:10.654> think<00:05:10.881> a<00:05:10.947> lot<00:05:11.142> about<00:05:11.532> it,<00:05:11.760> and<00:05:12.167> I'm<00:05:12.590> very<00:05:12.834> privileged<00:05:13.322> to<00:05:13.468> hold<00:05:14.542> an<00:05:14.688> academic<00:05:15.176> chair.

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That's<00:05:15.664> one<00:05:15.762> of<00:05:15.794> the<00:05:15.827> things<00:05:16.006> we<00:05:16.087> do<00:05:16.234> in<00:05:16.315> academic<00:05:16.543> institutions,<00:05:18.433> named<00:05:18.818> in<00:05:19.059> honor<00:05:19.300> of<00:05:19.461> two<00:05:19.782> of<00:05:19.943> the<00:05:20.104> really<00:05:20.361> founding<00:05:21.068> figures<00:05:21.582> of<00:05:21.711> Houston<00:05:22.048> Methodist.

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So<00:05:22.675> I've<00:05:23.028> been<00:05:23.173> a<00:05:23.189> student<00:05:23.639> of<00:05:23.816> the<00:05:23.960> history<00:05:24.314> of<00:05:24.378> the<00:05:24.458> organization,<00:05:25.021> and<00:05:25.085> with<00:05:25.278> the<00:05:25.840> centennial<00:05:26.403> that<00:05:26.547> we<00:05:26.628> celebrated<00:05:27.270> at<00:05:27.351> the<00:05:27.495> end<00:05:27.576> of<00:05:27.658> 2019,<00:05:28.805> had<00:05:28.920> a<00:05:28.985> chance<00:05:29.559> to<00:05:29.723> really<00:05:30.526> spend<00:05:31.034> extra<00:05:31.427> time<00:05:31.607> in<00:05:31.640> telling<00:05:31.771> the<00:05:31.804> stories.

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We<00:05:32.181> did<00:05:32.230> a<00:05:32.246> book,<00:05:32.344> we<00:05:32.377> did<00:05:32.492> a<00:05:32.508> movie,<00:05:34.560> be,<00:05:34.817> uh,<00:05:35.138> really<00:05:35.379> all<00:05:35.540> about<00:05:35.861> that<00:05:36.021> history.

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And<00:05:36.584> it<00:05:36.664> was,<00:05:36.937> it<00:05:37.001> was<00:05:37.162> a<00:05:37.242> lot<00:05:37.419> of<00:05:37.467> fun<00:05:37.724> to<00:05:37.869> do<00:05:37.981> so.

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So<00:05:39.652> we<00:05:39.813> go<00:05:39.974> back<00:05:40.199> to<00:05:40.295> the<00:05:40.456> last<00:05:40.777> day<00:05:40.938> of<00:05:41.034> 1919,<00:05:42.544> December<00:05:42.930> 31st<00:05:43.428> to<00:05:43.572> be<00:05:43.669> exact.

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Uh,<00:05:45.018> a<00:05:45.034> physician<00:05:45.597> named<00:05:45.757> Dr.<00:05:46.223> Oscar<00:05:46.577> Norsworthy,<00:05:47.589> in<00:05:48.472> 1905,<00:05:49.870> 14<00:05:50.320> years<00:05:50.497> before,<00:05:50.979> had<00:05:51.284> graduated<00:05:51.846> from<00:05:52.023> Tulane<00:05:52.810> Medical<00:05:53.067> School,<00:05:53.388> moved<00:05:53.774> to<00:05:53.854> Houston.

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Now<00:05:54.818> keep<00:05:54.995> in<00:05:55.075> mind,<00:05:55.316> Houston,<00:05:55.718> which<00:05:55.879> is<00:05:56.023> now<00:05:56.120> the<00:05:56.264> greater<00:05:56.409> Houston<00:05:56.666> area,<00:05:56.746> is<00:05:56.778> about<00:05:57.003> 7.2,<00:05:57.823> 7.3<00:05:58.690> million<00:05:58.995> people,<00:05:59.333> growing<00:05:59.622> 100,000<00:06:00.377> people<00:06:00.698> plus<00:06:01.020> a<00:06:01.164> year.

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Back<00:06:02.030> then<00:06:02.310> it<00:06:02.350> was<00:06:02.510> probably<00:06:02.790> 50,000<00:06:03.270> or<00:06:03.271> 60,000<00:06:03.990> people.

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Totally<00:06:05.350> different<00:06:05.710> place.

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He<00:06:06.610> comes<00:06:06.930> and<00:06:07.190> realizes<00:06:07.630> that<00:06:07.910> to<00:06:08.070> care<00:06:08.230> for<00:06:08.410> his<00:06:08.650> patients,<00:06:09.070> he<00:06:09.270> needs<00:06:09.530> some<00:06:09.870> beds.

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And<00:06:10.411> so<00:06:10.610> in<00:06:10.710> 1908,<00:06:11.370> he<00:06:11.490> builds<00:06:11.830> a<00:06:12.010> little<00:06:12.190> wing<00:06:12.450> next<00:06:12.690> to<00:06:12.850> his<00:06:13.070> house,<00:06:13.290> literally<00:06:13.590> could<00:06:14.190> say<00:06:14.430> bye<00:06:14.510> to<00:06:14.630> his<00:06:14.830> wife,<00:06:15.170> you<00:06:15.210> know,<00:06:15.370> after<00:06:15.510> he<00:06:15.570> eats<00:06:15.710> his<00:06:15.950> toast<00:06:16.110> and<00:06:16.770> jam<00:06:17.150> and<00:06:17.250> goes<00:06:17.490> out<00:06:17.670> the<00:06:17.790> door<00:06:18.010> and<00:06:18.110> goes<00:06:18.270> sees<00:06:18.450> the<00:06:18.590> patients.

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Of<00:06:19.110> course,<00:06:19.210> it<00:06:19.570> wasn't<00:06:19.810> really<00:06:20.090> that<00:06:20.310> way<00:06:20.490> because<00:06:20.730> you<00:06:21.170> can<00:06:21.290> imagine<00:06:21.550> he<00:06:21.750> was<00:06:22.040> constantly<00:06:22.590> in<00:06:22.810> and<00:06:22.970> out<00:06:23.070> and<00:06:23.190> caring<00:06:23.470> for<00:06:23.610> these<00:06:23.850> individuals.

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But<00:06:24.530> that's<00:06:24.890> 1908.

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Medicine's<00:06:26.190> very<00:06:26.370> different.

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1919,<00:06:27.870> he<00:06:28.270> decides<00:06:28.590> to<00:06:28.850> kind<00:06:29.030> of<00:06:29.070> move<00:06:29.230> on,<00:06:29.450> do<00:06:29.590> something<00:06:29.870> else,<00:06:30.130> and<00:06:30.270> he<00:06:30.390> went<00:06:30.550> to<00:06:30.750> the<00:06:31.310> people<00:06:31.450> he<00:06:31.470> knew<00:06:31.490> and<00:06:31.510> trusted<00:06:31.530> with<00:06:31.550> the<00:06:31.570> Methodist<00:06:33.370> Episcopal<00:06:33.787> Church,<00:06:34.910> and<00:06:35.006> they<00:06:35.327> literally<00:06:35.808> passed<00:06:36.210> the<00:06:36.290> hat<00:06:36.916> at<00:06:37.413> churches<00:06:37.959> and<00:06:38.055> did<00:06:38.279> bake<00:06:38.456> sales<00:06:38.777> and<00:06:38.857> things<00:06:39.098> like<00:06:39.322> that<00:06:39.563> to<00:06:39.724> acquire<00:06:40.686> this<00:06:40.863> small<00:06:41.104> little<00:06:41.408> facility.

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Through<00:06:43.109> the<00:06:43.189> next<00:06:43.398> 100<00:06:43.895> years,<00:06:44.232> probably<00:06:44.569> the<00:06:44.650> most<00:06:45.115> pivotal<00:06:45.500> moments<00:06:45.997> were,<00:06:46.639> were<00:06:47.281> a<00:06:47.361> couple-fold.

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One<00:06:48.645> was<00:06:49.367> in<00:06:49.511> 1951,<00:06:50.715> moving<00:06:51.036> into<00:06:51.453> an<00:06:51.613> area<00:06:51.934> that<00:06:52.095> was<00:06:52.817> envisioned<00:06:53.379> in<00:06:53.523> Houston<00:06:53.924> called<00:06:54.101> the<00:06:54.261> Texas<00:06:54.646> Medical<00:06:54.967> Center,<00:06:55.224> which,<00:06:56.026> if<00:06:56.170> I<00:06:56.331> look<00:06:56.491> out<00:06:56.652> my<00:06:56.748> side<00:06:56.989> my<00:06:57.069> window,<00:06:57.374> I<00:06:57.470> can<00:06:57.615> see<00:06:57.952> every<00:06:58.208> major<00:06:59.540> medical<00:07:00.021> academic<00:07:00.455> institution<00:07:01.962> and<00:07:02.043> not-for-profit<00:07:02.748> health<00:07:02.908> system<00:07:03.806> in<00:07:03.886> the<00:07:03.982> city.

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I<00:07:04.367> can<00:07:04.688> literally<00:07:05.168> look<00:07:05.393> out<00:07:05.649> as,<00:07:05.890> as<00:07:06.050> we're,<00:07:06.355> we're<00:07:06.467> speaking<00:07:06.932> here<00:07:07.172> today.

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And<00:07:08.278> so<00:07:08.455> we<00:07:08.599> were<00:07:08.695> one<00:07:08.871> of<00:07:08.936> those<00:07:09.176> founding<00:07:09.561> institutions.

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Pivotal,<00:07:10.843> pivotal<00:07:11.180> moment.

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Another<00:07:12.222> pivotal<00:07:12.606> moment<00:07:12.943> was<00:07:13.119> Dr.<00:07:13.424> Michael<00:07:13.809> DeBakey,<00:07:14.370> who<00:07:14.466> came<00:07:14.771> here.

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And<00:07:14.947> Dr.<00:07:15.348> DeBakey,<00:07:15.732> you'll<00:07:15.909> be<00:07:15.989> familiar<00:07:16.390> with<00:07:16.470> the<00:07:16.566> name,<00:07:16.774> one<00:07:16.871> of<00:07:16.903> the<00:07:16.967> top<00:07:17.576> physicians<00:07:18.153> of<00:07:18.377> really<00:07:18.634> the<00:07:18.778> last<00:07:19.035> century.

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He<00:07:19.676> died<00:07:20.157> in<00:07:20.301> 2008,<00:07:21.760> just<00:07:22.000> shy<00:07:22.225> of<00:07:22.305> his<00:07:22.401> 100th<00:07:22.802> birthday,<00:07:23.908> uh,<00:07:24.244> but<00:07:24.389> he<00:07:24.485> was<00:07:24.645> here<00:07:24.789> for<00:07:24.918> 60<00:07:25.751> years.

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And<00:07:26.473> he<00:07:26.649> was<00:07:26.969> somebody<00:07:27.450> who<00:07:28.076> pioneered<00:07:28.476> transplant<00:07:29.037> surgery,<00:07:29.518> pioneered<00:07:29.999> heart<00:07:30.176> surgery,<00:07:30.897> pioneered<00:07:31.362> particularly<00:07:31.763> vascular<00:07:32.275> surgery,<00:07:32.740> some<00:07:32.917> of<00:07:32.981> the<00:07:33.350> procedures<00:07:33.687> done<00:07:33.863> on<00:07:33.928> the<00:07:34.024> carotid,<00:07:35.132> uh,<00:07:35.164> some<00:07:35.469> of<00:07:35.533> the<00:07:35.790> procedures<00:07:36.336> done<00:07:36.513> with<00:07:36.673> the<00:07:36.898> aorta,<00:07:38.102> uh,<00:07:38.343> and<00:07:38.519> a<00:07:38.600> remarkable<00:07:39.387> individual.

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And<00:07:40.430> then<00:07:40.607> really<00:07:40.912> about,<00:07:41.715> uh,<00:07:42.116> almost<00:07:42.453> 20<00:07:42.774> years<00:07:43.031> ago,<00:07:43.336> pivoting,<00:07:43.818> becoming<00:07:44.300> what<00:07:44.460> we<00:07:44.605> call<00:07:44.781> an<00:07:44.942> independent<00:07:45.568> academic<00:07:45.985> medical<00:07:46.307> center<00:07:47.190> and<00:07:47.350> driving<00:07:47.832> and<00:07:48.057> owning,<00:07:48.699> uh,<00:07:48.876> the<00:07:49.020> research<00:07:49.421> mission,<00:07:49.759> the<00:07:49.919> educational<00:07:50.465> mission,<00:07:50.722> all<00:07:50.818> the<00:07:50.899> other<00:07:51.107> things<00:07:51.348> that<00:07:51.444> we<00:07:51.605> do<00:07:51.942> as<00:07:52.006> an<00:07:52.167> institution.

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As<00:07:54.078> you<00:07:54.238> think<00:07:54.415> about<00:07:54.640> the<00:07:54.720> future<00:07:55.378> of<00:07:55.474> medicine<00:07:55.940> and<00:07:56.085> even<00:07:56.261> the<00:07:56.406> future<00:07:56.663> of<00:07:56.759> the<00:07:56.887> institution,<00:07:57.867> what<00:07:57.963> does<00:07:58.172> it<00:07:58.332> look<00:07:58.573> like?

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I<00:07:58.878> mean,<00:07:59.055> it<00:07:59.087> must<00:07:59.312> be<00:07:59.472> interesting<00:07:59.954> for<00:08:00.179> you<00:08:00.355> to<00:08:00.661> look<00:08:00.901> out<00:08:01.158> and<00:08:01.303> see<00:08:02.202> artificial<00:08:02.747> intelligence<00:08:03.404> disrupting,<00:08:04.350> um,<00:08:04.783> so<00:08:04.991> many<00:08:05.167> different<00:08:05.488> industries.

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I'm,<00:08:07.075> I,<00:08:07.235> I<00:08:07.267> mean,<00:08:07.652> there,<00:08:07.892> there,<00:08:08.053> you're<00:08:08.213> probably<00:08:08.694> already<00:08:08.934> using<00:08:09.319> some<00:08:09.816> versions<00:08:10.281> of<00:08:10.441> AI<00:08:11.163> in,<00:08:11.403> in<00:08:11.499> your<00:08:11.579> practices<00:08:12.205> already,<00:08:12.541> but<00:08:13.022> how<00:08:13.182> do<00:08:13.246> you<00:08:13.423> think<00:08:13.743> about<00:08:14.769> AI<00:08:15.330> and<00:08:15.411> other,<00:08:15.747> just<00:08:15.988> the<00:08:16.132> future<00:08:16.469> of<00:08:16.533> medicine<00:08:16.949> overall<00:08:18.232> given<00:08:18.536> the<00:08:18.617> seat<00:08:18.873> you're<00:08:19.033> in?

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Well,<00:08:20.396> I<00:08:20.556> think<00:08:20.861> we're<00:08:21.101> at<00:08:21.518> a<00:08:22.239> particularly<00:08:23.907> remarkable,<00:08:24.708> potentially<00:08:25.269> watershed<00:08:25.766> moment<00:08:26.311> in<00:08:26.632> healthcare,<00:08:27.353> um,<00:08:27.754> a,<00:08:28.074> as<00:08:28.187> a<00:08:28.251> result<00:08:28.507> of<00:08:28.555> many<00:08:28.812> technologies,<00:08:29.597> AI<00:08:29.950> certainly<00:08:30.479> being,<00:08:31.361> uh,<00:08:31.521> at<00:08:31.681> the<00:08:31.777> forefront<00:08:32.419> of<00:08:32.563> that,<00:08:32.964> but,<00:08:33.284> uh,<00:08:33.733> much<00:08:34.102> of<00:08:34.247> the<00:08:34.344> work<00:08:34.602> in<00:08:34.747> genetics,<00:08:35.294> particularly<00:08:35.794> now<00:08:36.100> with<00:08:36.277> CRISPR<00:08:36.679> and<00:08:36.760> the<00:08:36.857> ability<00:08:37.243> to<00:08:37.469> actually<00:08:38.467> start<00:08:38.918> modifying<00:08:39.418> genetic<00:08:40.142> code<00:08:40.465> and<00:08:41.109> hopefully<00:08:41.512> doing<00:08:41.737> a<00:08:41.753> lot<00:08:41.930> of<00:08:42.059> good<00:08:42.236> with<00:08:42.478> that,<00:08:42.720> along<00:08:43.010> with<00:08:43.350> AI.

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A<00:08:45.410> number<00:08:45.718> of<00:08:45.880> years<00:08:46.188> back<00:08:46.513> now,<00:08:46.675> almost<00:08:46.950> a<00:08:47.080> decade<00:08:47.405> ago,<00:08:47.664> we<00:08:47.891> created<00:08:48.475> something<00:08:49.026> we<00:08:49.124> call<00:08:49.367> the<00:08:49.448> Center<00:08:49.691> for<00:08:49.837> Innovation.

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Actually,<00:08:50.746> it<00:08:50.843> started<00:08:51.297> with<00:08:51.459> a<00:08:51.621> group<00:08:51.946> kind<00:08:52.123> of<00:08:52.204> informally<00:08:53.479> that<00:08:53.641> would<00:08:53.818> meet<00:08:54.529> around<00:08:56.079> digital<00:08:56.401> technology<00:08:57.047> and<00:08:57.192> healthcare.

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And<00:08:59.307> that<00:08:59.533> group<00:08:59.808> decided<00:09:00.195> to<00:09:00.276> call<00:09:00.454> themselves<00:09:00.923> DIOP,<00:09:01.422> D-I-O-P,<00:09:02.404> which<00:09:02.588> was<00:09:02.704> digitally—<00:09:02.937> digital<00:09:03.320> innovation<00:09:03.503> obsessed<00:09:03.686> people.

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And<00:09:06.547> I<00:09:06.627> wouldn't<00:09:06.787> let<00:09:06.883> them<00:09:07.044> change<00:09:07.300> the<00:09:07.380> name<00:09:07.541> because<00:09:07.781> it's<00:09:07.989> actually<00:09:08.262> a<00:09:08.326> really<00:09:08.631> cool<00:09:08.887> name<00:09:09.432> to<00:09:09.528> describe<00:09:09.929> what<00:09:10.073> they<00:09:10.234> do.

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And<00:09:11.131> they<00:09:11.372> are<00:09:11.692> there<00:09:12.334> embedded<00:09:12.895> into<00:09:13.119> operations<00:09:13.856> in<00:09:13.921> our,<00:09:14.241> our<00:09:14.337> system,<00:09:15.043> really<00:09:15.443> looking<00:09:16.165> constantly<00:09:16.886> at<00:09:17.127> what's<00:09:17.463> the<00:09:17.559> next<00:09:18.008> big<00:09:18.185> thing,<00:09:18.489> what's<00:09:18.746> coming<00:09:19.130> out<00:09:19.371> next,<00:09:19.772> what's<00:09:20.028> the<00:09:20.124> next<00:09:20.429> technology.

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Not<00:09:21.872> in<00:09:21.952> the<00:09:22.032> traditional<00:09:22.577> sense<00:09:22.833> you<00:09:22.914> would<00:09:23.074> think<00:09:23.314> of<00:09:23.410> in<00:09:23.539> a<00:09:23.555> hospital<00:09:24.020> system<00:09:24.661> and<00:09:24.757> an<00:09:24.901> academic<00:09:25.462> enterprise<00:09:25.863> like<00:09:26.039> ours<00:09:26.200> where<00:09:26.280> there's<00:09:26.520> a<00:09:26.584> lot<00:09:26.697> of<00:09:26.761> research<00:09:27.226> being<00:09:27.402> done<00:09:28.187> of,<00:09:28.444> okay,<00:09:28.684> what's<00:09:28.925> the<00:09:29.005> next<00:09:29.245> device,<00:09:29.630> what's<00:09:29.790> the<00:09:29.823> next<00:09:30.127> drug.

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That's<00:09:31.249> being<00:09:31.570> done.

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That's<00:09:32.051> not<00:09:32.195> what<00:09:32.291> I'm<00:09:32.387> talking<00:09:32.628> about<00:09:32.772> here.

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What<00:09:33.013> I'm<00:09:33.157> talking<00:09:33.413> about<00:09:33.638> here<00:09:33.894> is,<00:09:34.199> is<00:09:34.359> really<00:09:34.680> digital<00:09:34.952> innovation,<00:09:35.497> and<00:09:35.802> AI<00:09:36.443> fits<00:09:37.421> very<00:09:37.790> well,<00:09:38.142> obviously,<00:09:38.687> as<00:09:38.863> we<00:09:39.023> look<00:09:39.200> at<00:09:39.344> that.

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I<00:09:40.306> personally<00:09:40.786> believe<00:09:41.091> we're<00:09:41.203> going<00:09:41.299> to<00:09:41.411> see<00:09:41.748> a<00:09:41.828> huge<00:09:42.469> transformation<00:09:43.495> as<00:09:43.687> a<00:09:43.751> result<00:09:44.216> of<00:09:44.312> that.

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We're<00:09:45.418> using<00:09:45.818> AI<00:09:45.979> in<00:09:46.075> a<00:09:46.091> number<00:09:46.395> of<00:09:46.556> very<00:09:46.876> interesting<00:09:47.517> areas<00:09:47.838> right<00:09:48.062> now,<00:09:48.238> but<00:09:48.382> I<00:09:48.399> think<00:09:48.623> we're<00:09:48.703> only<00:09:48.943> just<00:09:49.152> scratching<00:09:49.520> the<00:09:49.616> surface.

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If<00:09:51.347> you<00:09:51.508> look<00:09:51.748> at<00:09:52.709> healthcare,<00:09:53.126> it's<00:09:53.222> a<00:09:53.286> little<00:09:53.671> odd<00:09:54.008> because<00:09:54.408> when<00:09:54.633> technology,<00:09:55.193> digital<00:09:55.546> technology<00:09:56.155> has<00:09:56.315> come<00:09:56.556> out,<00:09:57.533> medical<00:09:57.854> records<00:09:58.254> would<00:09:58.399> be<00:09:58.495> one<00:09:58.655> of<00:09:58.687> the<00:09:58.751> things<00:09:59.056> that,<00:09:59.216> you<00:09:59.296> know,<00:09:59.617> early<00:09:59.841> in<00:09:59.921> my<00:10:00.081> career,<00:10:00.418> everything<00:10:00.658> was<00:10:00.818> on<00:10:00.899> paper.

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And<00:10:02.117> of<00:10:02.245> course,<00:10:02.645> that<00:10:02.806> transition<00:10:03.302> got<00:10:03.527> made.

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Well,<00:10:03.911> if<00:10:04.008> you<00:10:04.088> look<00:10:04.248> at<00:10:04.424> banking,<00:10:04.889> you<00:10:04.969> look<00:10:05.129> at<00:10:05.226> the<00:10:05.370> airline<00:10:05.642> industry,<00:10:05.931> you<00:10:06.011> look<00:10:06.123> at<00:10:06.251> just<00:10:06.443> about<00:10:06.748> any<00:10:06.908> industry,<00:10:07.533> all<00:10:07.645> of<00:10:07.693> that<00:10:07.934> digital<00:10:08.334> work<00:10:09.697> facilitated<00:10:10.514> things,<00:10:10.755> streamlined<00:10:11.396> things,<00:10:12.278> decreased<00:10:12.823> costs,<00:10:13.079> et<00:10:13.175> cetera.

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In<00:10:13.640> healthcare,<00:10:14.137> most<00:10:14.746> physicians,<00:10:15.323> nurses,<00:10:15.949> other<00:10:16.269> people<00:10:16.590> who<00:10:16.766> provide<00:10:17.167> care<00:10:17.391> would<00:10:17.552> tell<00:10:17.792> you<00:10:18.914> it<00:10:19.010> gets<00:10:19.187> in<00:10:19.267> the<00:10:19.395> way.

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I'm<00:10:19.972> sitting<00:10:20.277> here<00:10:20.453> typing<00:10:20.918> right<00:10:21.158> now,<00:10:21.960> looking<00:10:22.232> at<00:10:22.313> a<00:10:22.377> patient<00:10:22.842> across<00:10:23.242> the<00:10:23.403> room<00:10:23.675> instead<00:10:24.044> of<00:10:24.124> having<00:10:24.381> that<00:10:24.605> interaction.

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But<00:10:25.727> one<00:10:25.887> place<00:10:26.288> AI,<00:10:26.625> for<00:10:26.865> example,<00:10:27.410> we're<00:10:27.971> already<00:10:28.228> piloting<00:10:28.933> holds<00:10:29.670> incredible<00:10:30.392> promise<00:10:31.690> is<00:10:31.835> essentially<00:10:32.412> summarizing<00:10:33.518> the<00:10:33.742> care<00:10:34.159> and<00:10:34.239> the<00:10:34.399> provision<00:10:34.880> of<00:10:35.025> care<00:10:35.265> that<00:10:35.425> happens.

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So<00:10:35.906> if<00:10:36.066> I'm<00:10:36.179> sitting,<00:10:37.205> let's<00:10:37.333> say,<00:10:37.846> in<00:10:37.926> a<00:10:38.006> primary<00:10:38.311> care<00:10:38.551> visit,<00:10:38.840> so<00:10:38.952> I'm<00:10:39.128> the<00:10:39.353> doctor<00:10:39.769> visiting<00:10:40.170> with<00:10:40.331> you<00:10:40.507> about,<00:10:40.988> the<00:10:41.068> knee<00:10:41.292> pain<00:10:41.517> you're<00:10:41.677> having<00:10:42.014> or<00:10:43.040> your<00:10:43.136> hypertension<00:10:43.777> or<00:10:43.857> your<00:10:44.001> high<00:10:44.178> cholesterol.

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It<00:10:45.604> will<00:10:45.765> literally<00:10:46.326> listen<00:10:46.823> in<00:10:46.919> the<00:10:47.047> background<00:10:47.608> to<00:10:47.720> that<00:10:47.929> entire<00:10:48.570> interaction,<00:10:49.868> weed<00:10:50.173> out<00:10:50.494> all<00:10:50.734> the<00:10:50.830> stuff<00:10:51.151> we<00:10:51.231> should<00:10:51.455> be<00:10:51.552> doing,<00:10:51.856> which<00:10:52.033> is<00:10:52.433> some<00:10:52.594> of<00:10:52.626> the<00:10:52.690> social<00:10:53.139> aspects<00:10:54.036> and<00:10:55.800> people<00:10:56.120> connection<00:10:56.601> aspects.

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And<00:10:57.082> when<00:10:57.226> I<00:10:57.258> say<00:10:57.467> weed<00:10:57.707> out,<00:10:57.867> I<00:10:57.900> mean<00:10:58.589> all<00:10:58.621> that<00:10:58.749> doesn't<00:10:59.022> need<00:10:59.230> documentation,<00:11:00.064> right?

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But<00:11:01.250> we'll<00:11:01.410> figure<00:11:01.795> out<00:11:01.955> how<00:11:02.067> to<00:11:02.212> summarize<00:11:02.853> then<00:11:03.013> that<00:11:03.254> visit<00:11:03.558> and<00:11:03.654> say,<00:11:03.895> you<00:11:03.975> know,<00:11:04.376> Mrs.<00:11:04.696> Smith<00:11:05.001> was<00:11:05.113> talking<00:11:05.370> to<00:11:05.418> Dr.<00:11:05.722> Boom<00:11:06.203> and<00:11:06.299> she<00:11:06.524> was<00:11:06.620> complaining<00:11:07.085> of<00:11:07.165> right<00:11:07.421> knee<00:11:07.582> pain<00:11:07.822> and<00:11:07.886> it's<00:11:08.063> been<00:11:08.159> going<00:11:08.367> on<00:11:08.528> for<00:11:08.624> 3<00:11:08.864> months<00:11:09.345> and<00:11:10.227> it's<00:11:10.371> worse<00:11:10.611> when<00:11:10.708> she<00:11:10.868> goes<00:11:11.092> upstairs,<00:11:11.605> not<00:11:11.830> so<00:11:11.990> bad<00:11:12.214> when<00:11:12.311> she<00:11:12.455> goes<00:11:12.503> downstairs.

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You<00:11:12.952> know,<00:11:13.032> etc.,<00:11:13.449> whatever,<00:11:13.914> whatever<00:11:14.250> that<00:11:14.475> course<00:11:14.875> is,<00:11:15.517> and<00:11:15.613> it<00:11:15.677> has<00:11:15.998> the<00:11:16.078> ability<00:11:16.559> to<00:11:16.719> transform<00:11:17.745> the<00:11:17.905> physician-patient,<00:11:19.765> the<00:11:19.909> nurse-patient<00:11:20.807> relationship,<00:11:21.512> bring<00:11:21.833> those<00:11:22.089> people<00:11:22.490> back<00:11:22.826> to<00:11:23.115> the<00:11:23.371> personal<00:11:23.997> touch<00:11:24.413> that<00:11:24.574> they<00:11:24.718> can<00:11:24.878> have<00:11:25.215> with<00:11:25.455> individuals,<00:11:26.433> I<00:11:26.577> think<00:11:26.882> that's<00:11:27.123> going<00:11:27.235> to<00:11:27.459> enrich<00:11:27.940> healthcare<00:11:28.565> tremendously.

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It<00:11:29.607> also<00:11:29.928> has<00:11:30.104> that<00:11:30.264> potential<00:11:30.825> then<00:11:31.611> to<00:11:32.829> handle<00:11:33.390> what<00:11:33.535> is<00:11:33.711> a<00:11:33.935> problematic<00:11:34.673> situation<00:11:35.298> that<00:11:35.394> we<00:11:35.490> see<00:11:35.795> already,<00:11:36.260> but<00:11:37.222> all<00:11:37.334> the<00:11:37.462> projections<00:11:38.039> of<00:11:38.183> significant<00:11:38.985> workforce<00:11:39.402> shortages,<00:11:40.027> whether<00:11:40.267> you're<00:11:40.363> talking<00:11:41.165> physicians<00:11:41.726> in<00:11:41.806> essentially<00:11:42.527> every<00:11:42.768> specialty,<00:11:43.265> whether<00:11:43.409> you're<00:11:43.553> talking<00:11:43.874> nurses<00:11:44.211> or<00:11:44.371> other<00:11:44.660> people<00:11:45.334> because<00:11:45.639> there's<00:11:45.816> great<00:11:46.217> promise.

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And<00:11:46.699> that's<00:11:46.875> just<00:11:47.180> one<00:11:47.582> example<00:11:48.224> of<00:11:48.320> a<00:11:48.449> way<00:11:48.625> that<00:11:48.770> we're<00:11:48.931> using<00:11:49.268> AI<00:11:49.509> right<00:11:49.733> now.

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How<00:11:50.809> would<00:11:51.034> you<00:11:51.178> improve<00:11:51.596> the<00:11:51.740> healthcare<00:11:52.142> system?

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I<00:11:52.575> know<00:11:52.720> that's<00:11:52.945> a<00:11:53.025> loaded<00:11:53.362> question<00:11:54.069> and<00:11:54.229> that's<00:11:54.390> something<00:11:54.807> that<00:11:54.952> many<00:11:55.209> presidents<00:11:55.931> and<00:11:57.055> politicians<00:11:57.778> have<00:11:58.243> tried<00:11:58.500> to<00:11:58.581> tackle.

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But<00:12:00.668> I<00:12:00.684> mean,<00:12:00.909> say<00:12:01.134> you<00:12:01.230> could<00:12:01.455> wave<00:12:01.696> a<00:12:01.872> magic<00:12:02.274> wand.

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I<00:12:02.755> don't<00:12:02.980> feel<00:12:03.060> like<00:12:03.221> we<00:12:03.382> hear<00:12:04.120> people<00:12:04.425> who<00:12:04.505> sit<00:12:04.698> in<00:12:04.762> your<00:12:04.923> chair,<00:12:05.244> their<00:12:05.549> perspective<00:12:06.127> on<00:12:06.352> this<00:12:07.717> nearly<00:12:08.134> enough.

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So<00:12:08.760> how<00:12:08.937> would<00:12:09.098> you<00:12:09.274> improve<00:12:09.595> it?

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Well,<00:12:10.904> there<00:12:11.145> is<00:12:11.290> a<00:12:11.322> load<00:12:11.611> question.

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That's<00:12:12.157> a,<00:12:12.190> that's<00:12:12.431> a<00:12:12.575> complicated<00:12:13.395> question,<00:12:13.812> as<00:12:13.941> you<00:12:14.101> can<00:12:14.262> imagine.

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Um,<00:12:15.804> you<00:12:15.885> know,<00:12:16.431> here's<00:12:16.688> the,<00:12:16.913> here's<00:12:17.170> the<00:12:17.315> fundamental<00:12:17.877> issue,<00:12:18.230> or<00:12:18.295> a<00:12:18.359> couple<00:12:18.616> fundamental<00:12:19.098> issues<00:12:19.564> with<00:12:19.741> our<00:12:19.950> healthcare<00:12:20.223> system<00:12:20.610> in<00:12:20.690> the<00:12:20.771> U.S.<00:12:21.495> First<00:12:21.834> is,<00:12:22.542> if<00:12:23.347> you<00:12:23.428> have<00:12:23.750> access,<00:12:24.249> and<00:12:24.394> by<00:12:24.635> access<00:12:25.054> I<00:12:25.070> mean<00:12:25.940> you<00:12:26.020> have<00:12:26.745> the<00:12:26.906> insurance<00:12:27.550> coverage<00:12:28.033> or<00:12:28.130> somebody<00:12:28.597> who<00:12:28.758> can,<00:12:29.160> you<00:12:29.192> know,<00:12:29.370> cover<00:12:29.741> those<00:12:30.031> difficult<00:12:30.450> situations<00:12:31.096> where<00:12:31.176> you're<00:12:31.338> particularly<00:12:32.048> ill,<00:12:33.677> and<00:12:34.145> if<00:12:34.322> you<00:12:34.468> have<00:12:34.629> access<00:12:35.048> physically,<00:12:35.613> right,<00:12:35.920> you're,<00:12:36.178> you're<00:12:36.339> in<00:12:36.436> a<00:12:36.565> rural<00:12:36.742> area<00:12:37.065> where<00:12:37.291> hopefully<00:12:37.791> there's<00:12:37.969> a<00:12:38.033> hospital<00:12:38.356> nearby,<00:12:38.759> or<00:12:38.856> you're<00:12:39.084> in<00:12:39.170> a,<00:12:39.274> in<00:12:39.360> a<00:12:39.377> city<00:12:39.549> someplace<00:12:39.825> where,<00:12:39.911> uh,<00:12:39.946> there<00:12:40.101> is<00:12:42.186> healthcare<00:12:42.683> nearby.

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We<00:12:43.805> actually<00:12:44.109> have<00:12:44.622> a<00:12:44.686> system<00:12:45.312> that<00:12:45.552> is<00:12:45.712> the<00:12:45.889> envy<00:12:46.145> of<00:12:46.273> the<00:12:46.354> world.

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People<00:12:46.995> come<00:12:47.235> from<00:12:47.412> all<00:12:47.572> over<00:12:47.812> the<00:12:47.892> world<00:12:48.133> to<00:12:48.229> Houston<00:12:48.534> Methodist,<00:12:48.934> for<00:12:49.031> example,<00:12:49.880> to<00:12:50.056> receive<00:12:50.602> care<00:12:51.339> because<00:12:51.980> they<00:12:52.237> know<00:12:52.541> that<00:12:52.685> what<00:12:52.798> they<00:12:52.942> can<00:12:53.102> get<00:12:53.263> here<00:12:54.144> and<00:12:54.224> in<00:12:54.304> the<00:12:54.369> United<00:12:54.641> States<00:12:55.042> is<00:12:55.186> better<00:12:55.491> than<00:12:55.651> what<00:12:55.811> they<00:12:55.907> can<00:12:56.068> get<00:12:56.228> at<00:12:56.308> home.

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But<00:12:57.671> there<00:12:57.767> was<00:12:57.895> a<00:12:57.927> massive<00:12:58.456> if<00:12:58.633> in<00:12:58.713> that,<00:12:58.953> and<00:12:59.097> that<00:12:59.338> if<00:12:59.514> was<00:13:00.300> coverage<00:13:01.101> getting<00:13:01.358> to<00:13:01.502> someplace,<00:13:02.079> etc.

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And<00:13:03.105> the<00:13:03.185> reality<00:13:03.762> is<00:13:04.003> we<00:13:04.147> have<00:13:04.259> a<00:13:04.323> situation<00:13:04.804> in<00:13:04.884> the<00:13:04.932> United<00:13:05.205> States<00:13:05.590> where<00:13:05.830> we<00:13:05.926> still<00:13:06.471> don't<00:13:06.792> have<00:13:07.032> coverage<00:13:07.513> for<00:13:07.674> everybody.

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It<00:13:08.651> varies<00:13:09.052> tremendously<00:13:09.693> by<00:13:09.854> state.

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I'm<00:13:10.415> in<00:13:10.511> a<00:13:10.559> state<00:13:10.976> with<00:13:11.136> Texas—<00:13:11.537> in<00:13:11.681> Texas<00:13:12.098> where<00:13:12.242> we<00:13:12.338> did<00:13:12.499> not<00:13:12.739> expand<00:13:13.284> Medicaid<00:13:13.845> after<00:13:14.022> the<00:13:14.118> Affordable<00:13:14.583> Care<00:13:14.888> Act<00:13:15.080> came<00:13:15.305> out.

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And<00:13:16.043> so<00:13:16.412> we<00:13:16.572> have<00:13:17.214> some<00:13:17.342> of<00:13:17.390> the<00:13:17.471> highest<00:13:17.936> uninsured<00:13:18.497> rates<00:13:18.834> in<00:13:18.979> the<00:13:19.059> country.

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And<00:13:19.733> of<00:13:19.877> course,<00:13:20.904> we<00:13:21.064> have<00:13:21.305> some<00:13:21.481> safety<00:13:21.882> nets<00:13:22.187> in<00:13:22.283> place.

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We<00:13:23.085> do<00:13:23.326> tons<00:13:23.663> of<00:13:23.791> charity<00:13:24.128> care<00:13:24.369> at<00:13:24.449> Houston<00:13:24.786> Methodist.

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We<00:13:25.396> do<00:13:25.732> about<00:13:26.278> $400+<00:13:27.337> million<00:13:28.925> of<00:13:29.406> direct,<00:13:30.128> at-cost<00:13:30.690> charity<00:13:31.026> care<00:13:31.508> every<00:13:32.005> single<00:13:32.534> year,<00:13:33.353> which<00:13:33.513> is<00:13:34.058> a<00:13:34.235> very<00:13:34.540> high<00:13:34.636> number,<00:13:35.037> but<00:13:35.181> also<00:13:35.406> a<00:13:35.438> very<00:13:35.663> high<00:13:35.823> percentage<00:13:36.336> as<00:13:36.481> you<00:13:36.625> look<00:13:36.737> at<00:13:36.882> that.

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But<00:13:38.101> think<00:13:38.390> about<00:13:39.128> the<00:13:39.288> individuals<00:13:40.074> who<00:13:40.235> have<00:13:41.053> lack<00:13:41.374> of<00:13:41.535> healthcare<00:13:42.017> insurance.

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They<00:13:43.638> aren't<00:13:43.783> getting<00:13:44.024> the<00:13:44.104> preventative<00:13:44.586> care.

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They're<00:13:44.939> not<00:13:45.132> getting<00:13:45.308> the<00:13:45.453> wellness<00:13:45.790> care.

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They're<00:13:46.191> not—<00:13:47.155> they're<00:13:47.942> often<00:13:48.199> dealing<00:13:48.504> with<00:13:48.600> the<00:13:48.760> problems,<00:13:49.322> the<00:13:49.965> dollars<00:13:50.527> I<00:13:50.607> mentioned,<00:13:51.008> but<00:13:51.169> that's<00:13:51.410> a<00:13:51.490> human<00:13:52.052> being<00:13:52.437> coming<00:13:52.694> to<00:13:52.855> our<00:13:53.080> hospital<00:13:54.139> in<00:13:54.300> need,<00:13:54.926> right?

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Whether<00:13:55.344> that's<00:13:55.601> a<00:13:55.665> cancer<00:13:56.066> diagnosis<00:13:56.725> or<00:13:56.805> whether<00:13:56.933> they've<00:13:57.174> had<00:13:57.270> a<00:13:57.351> heart<00:13:57.592> attack<00:13:57.913> or<00:13:57.993> a<00:13:58.009> stroke<00:13:58.555> or<00:13:58.940> they<00:13:59.342> fell<00:13:59.518> and<00:13:59.663> broke,<00:13:59.984> you<00:14:00.016> know,<00:14:00.241> broke<00:14:00.546> their<00:14:00.707> leg,<00:14:00.883> whatever<00:14:01.285> that<00:14:01.509> is.

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Those<00:14:03.051> are<00:14:03.372> human<00:14:03.693> beings<00:14:04.095> in<00:14:04.239> need<00:14:04.496> who<00:14:04.897> don't<00:14:05.106> have<00:14:05.283> that<00:14:05.443> coverage.

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And<00:14:06.728> for<00:14:06.889> whom,<00:14:07.130> if<00:14:07.226> we<00:14:07.451> weren't<00:14:07.692> providing<00:14:08.093> charity<00:14:08.495> care,<00:14:09.137> those<00:14:09.314> can<00:14:09.475> be<00:14:09.619> financially<00:14:10.583> ruinous<00:14:11.001> events<00:14:11.547> in<00:14:11.627> addition.

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So<00:14:12.832> first<00:14:13.249> and<00:14:13.394> foremost,<00:14:14.197> we<00:14:14.534> as<00:14:14.631> a<00:14:14.695> society<00:14:15.321> have<00:14:15.739> to<00:14:15.900> tackle<00:14:16.462> that<00:14:16.847> issue.

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Every<00:14:18.775> other<00:14:19.417> major<00:14:20.397> developed<00:14:20.895> society<00:14:21.441> in<00:14:21.521> the<00:14:21.762> world<00:14:22.180> does<00:14:22.340> a<00:14:22.485> better<00:14:22.870> job<00:14:23.352> at<00:14:23.529> that<00:14:23.850> than<00:14:24.155> us,<00:14:24.493> and<00:14:24.573> there's<00:14:24.830> no<00:14:25.039> reason<00:14:25.376> we<00:14:25.537> can't<00:14:25.858> do<00:14:26.019> that<00:14:26.244> now.

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Um,<00:14:27.850> uh,<00:14:28.283> so<00:14:28.428> that's,<00:14:28.733> that's<00:14:28.990> first<00:14:29.295> and<00:14:29.392> foremost.

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When<00:14:30.677> we<00:14:30.918> do<00:14:31.159> that,<00:14:31.383> we<00:14:31.624> actually<00:14:32.524> start<00:14:32.990> to<00:14:33.167> eliminate<00:14:33.745> a<00:14:33.809> lot<00:14:34.050> of<00:14:34.115> the<00:14:34.597> kind<00:14:34.757> of<00:14:35.320> perturbations<00:14:36.525> in<00:14:36.621> the<00:14:36.701> whole<00:14:36.942> system,<00:14:37.826> because<00:14:38.131> the<00:14:38.228> whole<00:14:38.404> system<00:14:38.870> now<00:14:39.192> is<00:14:39.352> a<00:14:39.577> crazy<00:14:40.300> shell<00:14:40.573> game<00:14:41.039> of<00:14:41.280> sort<00:14:41.505> of<00:14:41.602> cross-subsidization,<00:14:42.791> right?

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We,<00:14:43.449> we<00:14:43.610> can't<00:14:43.851> just<00:14:44.092> find<00:14:44.478> $500<00:14:44.895> million<00:14:45.281> or<00:14:45.699> $400<00:14:46.020> or<00:14:46.117> $500<00:14:46.502> million<00:14:46.807> of<00:14:47.145> charity<00:14:47.450> care.

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And<00:14:47.627> there's<00:14:47.788> another<00:14:48.173> billion<00:14:48.511> in<00:14:48.655> other<00:14:48.832> community<00:14:49.217> benefits<00:14:49.635> like<00:14:49.796> education<00:14:50.599> and<00:14:51.145> training<00:14:51.547> of<00:14:51.644> the<00:14:51.724> next<00:14:51.965> generation<00:14:52.591> and<00:14:53.009> underpayment<00:14:53.572> on<00:14:53.652> Medicare<00:14:54.021> and<00:14:54.070> a<00:14:54.134> bunch<00:14:54.375> of<00:14:54.455> other<00:14:54.680> things<00:14:55.259> that<00:14:55.725> you<00:14:55.821> can<00:14:56.046> count<00:14:56.383> in<00:14:56.464> the<00:14:56.624> benefit<00:14:57.026> we<00:14:57.171> provide<00:14:57.572> as<00:14:57.733> well.

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But<00:14:59.113> you<00:14:59.258> can't<00:14:59.434> do<00:14:59.595> that<00:14:59.755> just<00:15:00.140> waving<00:15:00.380> a<00:15:00.396> wand<00:15:00.637> out<00:15:00.701> of<00:15:00.781> the<00:15:00.878> blue.

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You<00:15:01.263> have<00:15:01.439> to<00:15:01.535> have<00:15:01.696> a<00:15:01.824> top<00:15:02.097> line<00:15:02.321> revenue.

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And<00:15:02.883> so<00:15:03.203> what's<00:15:03.444> happening<00:15:04.150> is<00:15:04.791> there's<00:15:04.968> a<00:15:05.032> hidden<00:15:05.369> tax<00:15:05.754> that<00:15:05.850> goes<00:15:06.155> to<00:15:06.251> most<00:15:06.956> of<00:15:07.293> the<00:15:07.454> employers<00:15:08.079> out<00:15:08.336> there<00:15:08.512> to<00:15:08.657> cover<00:15:09.202> the<00:15:09.298> lack<00:15:09.844> of<00:15:09.940> governmental<00:15:10.421> programs<00:15:11.046> and<00:15:11.784> societal<00:15:12.410> programs<00:15:13.051> where<00:15:13.292> we've<00:15:13.484> had<00:15:13.709> that<00:15:13.950> tough<00:15:14.190> conversation<00:15:14.912> that<00:15:15.056> says<00:15:15.954> we<00:15:16.099> got<00:15:16.227> to<00:15:16.275> cover<00:15:16.516> everybody.

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How<00:15:17.302> are<00:15:17.398> we<00:15:17.462> going<00:15:17.542> to<00:15:17.639> do<00:15:17.799> this?

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How<00:15:18.264> are<00:15:18.360> we<00:15:18.440> going<00:15:18.537> to<00:15:18.601> pay<00:15:18.761> for<00:15:19.082> it?

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What's<00:15:19.788> included?

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What's<00:15:20.686> not<00:15:21.007> included?

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If<00:15:21.648> other<00:15:21.873> countries<00:15:22.290> can<00:15:22.450> do<00:15:22.611> this,<00:15:22.851> certainly<00:15:23.477> the<00:15:23.557> United<00:15:23.878> States<00:15:24.215> can<00:15:24.375> do<00:15:24.616> this<00:15:24.856> and<00:15:24.936> lead<00:15:25.161> the<00:15:25.241> way.

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So<00:15:25.995> that's<00:15:26.284> step<00:15:26.540> number<00:15:26.925> one.

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Step<00:15:28.047> number<00:15:28.288> 2,<00:15:28.464> if<00:15:28.608> you<00:15:28.705> have<00:15:29.089> that<00:15:29.250> in<00:15:29.410> place,<00:15:30.372> we<00:15:30.532> have<00:15:30.949> to<00:15:31.414> appropriately<00:15:32.311> target<00:15:32.856> governmental<00:15:33.738> reimbursement.

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Right<00:15:34.716> now,<00:15:35.517> whether<00:15:35.662> you're<00:15:35.822> a<00:15:35.838> physician,<00:15:36.463> whether<00:15:36.623> you're<00:15:36.784> a<00:15:36.800> hospital,<00:15:38.307> every<00:15:38.563> single<00:15:39.749> provider<00:15:40.246> of<00:15:40.391> care<00:15:40.968> is<00:15:41.368> grossly<00:15:41.929> underpaid<00:15:42.635> compared<00:15:43.132> to<00:15:43.212> the<00:15:43.436> actual<00:15:43.757> cost<00:15:44.110> of<00:15:44.174> providing<00:15:44.655> care.

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So<00:15:45.135> a<00:15:45.200> whole<00:15:45.392> nother<00:15:45.681> cross-subsidy<00:15:46.963> is<00:15:47.203> all<00:15:47.235> the<00:15:47.364> private<00:15:47.700> employers<00:15:48.261> basically<00:15:48.822> paying<00:15:49.143> for<00:15:49.287> the<00:15:49.383> fact<00:15:49.688> that<00:15:49.784> the<00:15:49.864> government<00:15:50.329> doesn't<00:15:50.666> pay<00:15:50.906> for<00:15:51.083> the<00:15:51.227> cost<00:15:51.644> of<00:15:51.788> healthcare<00:15:52.333> as<00:15:52.509> it<00:15:52.846> sits.

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And<00:15:54.353> I<00:15:54.433> sort<00:15:54.657> of<00:15:54.738> laugh<00:15:55.058> because<00:15:55.299> we<00:15:55.379> get<00:15:55.539> in<00:15:55.619> all<00:15:55.715> these<00:15:55.876> discussions<00:15:56.517> and<00:15:56.918> now<00:15:57.078> we've<00:15:57.254> had<00:15:57.463> one<00:15:57.703> bill<00:15:57.960> that's<00:15:58.200> gone<00:15:58.376> in<00:15:58.441> the<00:15:58.585> right<00:15:58.761> direction.

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Action,<00:15:59.162> which<00:15:59.386> is,<00:15:59.627> okay,<00:15:59.803> should<00:16:00.027> the<00:16:00.124> government<00:16:00.589> negotiate<00:16:01.887> with<00:16:02.432> pharmaceutical<00:16:03.169> companies?

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And<00:16:03.730> there's<00:16:03.891> a<00:16:03.955> short<00:16:04.356> list<00:16:04.548> of<00:16:04.676> drugs<00:16:05.013> now<00:16:05.173> where<00:16:05.333> they're<00:16:05.494> allowed<00:16:05.814> to<00:16:05.975> do<00:16:06.135> that.

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And<00:16:06.920> I<00:16:06.936> laugh<00:16:07.241> because<00:16:07.482> they<00:16:07.578> don't<00:16:08.363> negotiate<00:16:08.796> with<00:16:08.940> doctors,<00:16:09.341> they<00:16:09.437> don't<00:16:09.886> negotiate<00:16:10.447> with<00:16:10.607> health<00:16:10.784> systems.

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They<00:16:11.345> just<00:16:11.585> tell<00:16:11.762> us<00:16:11.906> what<00:16:12.082> they're<00:16:12.178> going<00:16:12.258> to<00:16:12.387> pay<00:16:12.611> us<00:16:12.787> and<00:16:12.932> they<00:16:13.028> say,<00:16:13.252> hey,<00:16:13.365> if<00:16:13.445> it<00:16:13.573> costs<00:16:13.894> you<00:16:13.974> $100,<00:16:14.759> we'll<00:16:15.112> pay<00:16:15.336> you<00:16:15.432> $81<00:16:15.769> or<00:16:15.849> $82.

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I<00:16:16.506> mean,<00:16:16.619> that's<00:16:16.859> basically<00:16:17.212> the<00:16:17.340> way<00:16:17.452> that<00:16:17.677> works.

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So<00:16:17.981> we<00:16:18.061> have<00:16:18.302> to<00:16:18.414> normalize<00:16:19.023> that,<00:16:19.664> right-size<00:16:20.258> that,<00:16:20.434> stop<00:16:20.883> moving<00:16:21.588> the<00:16:21.668> shell<00:16:21.925> game<00:16:22.101> around.

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And<00:16:23.207> then<00:16:23.432> really<00:16:23.688> at<00:16:23.784> the<00:16:24.009> end<00:16:24.169> of<00:16:24.233> the<00:16:24.409> day,<00:16:25.211> we<00:16:25.307> need<00:16:25.451> to<00:16:25.515> all<00:16:25.756> be<00:16:25.852> in<00:16:25.996> the<00:16:26.076> wellness<00:16:26.557> business<00:16:26.974> and<00:16:27.118> the<00:16:27.215> life,<00:16:28.321> you<00:16:28.353> know,<00:16:28.497> sort<00:16:28.737> of<00:16:28.802> the<00:16:28.978> life<00:16:29.795> enhancement<00:16:30.373> business.

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Insurance<00:16:31.206> business,<00:16:32.104> not<00:16:32.665> just<00:16:33.066> the<00:16:33.146> sick<00:16:33.531> people<00:16:33.851> business.

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We<00:16:34.428> need<00:16:34.829> to<00:16:34.909> be<00:16:35.150> looking<00:16:35.631> at<00:16:35.855> people<00:16:36.176> holistically,<00:16:36.913> looking<00:16:37.154> at<00:16:37.234> communities<00:16:37.795> holistically,<00:16:39.142> and<00:16:39.238> putting<00:16:39.558> in<00:16:39.639> place<00:16:40.039> the<00:16:40.280> infrastructure<00:16:41.081> to<00:16:41.322> do<00:16:41.546> that.

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Um,<00:16:43.149> that's<00:16:43.390> a<00:16:43.550> longer-term<00:16:44.127> goal.

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There<00:16:44.528> needs<00:16:44.801> to<00:16:44.849> be<00:16:44.993> a<00:16:45.089> pathway<00:16:45.570> to<00:16:45.714> that.

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There<00:16:46.131> are<00:16:46.292> places<00:16:46.692> in<00:16:46.773> the<00:16:46.853> country<00:16:47.173> that<00:16:47.221> are<00:16:47.398> doing<00:16:47.654> some<00:16:47.895> more<00:16:48.055> of<00:16:48.151> that<00:16:48.440> than<00:16:48.616> others,<00:16:49.241> but<00:16:49.402> over<00:16:49.594> the<00:16:49.674> long<00:16:49.979> term,<00:16:50.219> we<00:16:50.364> have<00:16:50.524> to<00:16:50.684> figure<00:16:50.941> out<00:16:51.085> how<00:16:51.181> we<00:16:51.341> do<00:16:51.566> those<00:16:51.806> kinds<00:16:52.063> of<00:16:52.143> things.

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Yeah,<00:16:53.249> I<00:16:53.329> wanted<00:16:53.586> to<00:16:53.650> ask<00:16:53.890> you<00:16:54.131> a<00:16:54.307> short<00:16:54.532> answer<00:16:54.772> on<00:16:54.868> something,<00:16:56.087> and<00:16:56.231> 3<00:16:56.536> hours<00:16:56.792> on<00:16:57.016> with<00:16:57.129> you.

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That<00:16:57.497> was<00:16:57.658> a<00:16:57.738> wonderful<00:16:58.155> answer,<00:16:58.539> actually.

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That<00:16:59.004> was<00:16:59.068> super<00:16:59.357> informative.

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I'm<00:17:00.479> wondering,<00:17:01.345> um,<00:17:02.162> I<00:17:02.242> wanted<00:17:02.419> to<00:17:02.547> ask<00:17:02.723> you<00:17:02.787> about<00:17:03.028> the<00:17:03.124> wellness<00:17:03.588> piece<00:17:04.710> and<00:17:04.870> how,<00:17:05.912> yeah,<00:17:06.232> like<00:17:06.809> preventative<00:17:07.450> care<00:17:07.995> is<00:17:08.171> like,<00:17:08.411> hey,<00:17:08.876> how<00:17:09.229> do<00:17:09.357> we<00:17:09.453> make<00:17:09.677> sure<00:17:09.838> you<00:17:09.934> never<00:17:10.174> show<00:17:10.398> up<00:17:10.494> at<00:17:10.591> a<00:17:10.655> doctor's<00:17:11.055> office?

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Right.

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Which<00:17:12.177> is<00:17:12.257> kind<00:17:12.481> of<00:17:12.513> maybe<00:17:12.818> counterintuitive<00:17:13.619> to<00:17:13.779> the<00:17:13.940> business.

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Like,<00:17:14.564> I<00:17:14.580> don't<00:17:14.741> know,<00:17:15.205> like,<00:17:15.926> like,<00:17:16.167> is<00:17:16.327> that<00:17:16.728> a<00:17:16.824> change<00:17:17.385> in<00:17:17.465> the<00:17:17.625> culture<00:17:18.250> of<00:17:18.410> medicine<00:17:19.372> where<00:17:19.532> we're<00:17:19.692> trying<00:17:19.932> to<00:17:19.964> like<00:17:20.173> make<00:17:20.349> sure<00:17:20.573> you<00:17:20.750> never<00:17:21.310> come<00:17:21.535> into<00:17:21.727> the<00:17:21.855> hospital?

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Obviously,<00:17:22.913> never<00:17:23.474> is,<00:17:24.034> you<00:17:24.131> know,<00:17:24.355> is<00:17:24.675> a<00:17:24.755> hope<00:17:25.092> and<00:17:25.156> a<00:17:25.236> dream.

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At<00:17:26.117> some<00:17:26.278> point,<00:17:26.502> you're<00:17:26.598> probably<00:17:26.838> going<00:17:26.951> to<00:17:27.079> end<00:17:27.303> up<00:17:27.720> in<00:17:27.816> a<00:17:27.880> doctor's<00:17:28.345> office.

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But<00:17:30.287> what<00:17:30.448> is<00:17:30.592> that<00:17:30.769> shift<00:17:31.171> that<00:17:31.331> needs<00:17:31.556> to<00:17:31.653> happen<00:17:32.054> to<00:17:32.134> where<00:17:32.295> we<00:17:32.440> focus<00:17:32.841> on<00:17:33.002> wellness<00:17:33.725> as<00:17:33.837> a<00:17:33.901> society?

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Because<00:17:34.608> obviously,<00:17:35.411> you<00:17:35.444> know,<00:17:35.588> we're<00:17:35.668> getting<00:17:35.974> more<00:17:36.118> and<00:17:36.183> more<00:17:36.456> obese.

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There's<00:17:37.275> more—<00:17:37.660> all<00:17:37.821> these<00:17:37.934> different<00:17:38.158> things.

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And<00:17:38.705> obviously<00:17:38.962> there's<00:17:39.186> like<00:17:39.299> these<00:17:39.508> miracle<00:17:39.925> drugs<00:17:40.327> now<00:17:41.130> where<00:17:41.307> maybe<00:17:41.676> that<00:17:41.837> would<00:17:41.998> help<00:17:42.255> with<00:17:42.576> weight.

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Then<00:17:43.122> I,<00:17:43.283> I<00:17:43.299> don't<00:17:43.540> know,<00:17:43.781> maybe<00:17:44.166> you<00:17:44.263> can<00:17:44.343> give<00:17:44.423> me<00:17:44.488> your<00:17:44.664> thoughts<00:17:44.905> on<00:17:44.986> that<00:17:45.162> as<00:17:45.291> well.

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But<00:17:46.174> what<00:17:46.271> do<00:17:46.319> you<00:17:46.431> think<00:17:46.656> on<00:17:46.753> the<00:17:46.897> wellness<00:17:47.395> side<00:17:47.781> of<00:17:47.877> things<00:17:48.279> and<00:17:48.423> how<00:17:48.584> does<00:17:48.761> that<00:17:49.082> affect<00:17:49.644> business?

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Well,<00:17:51.267> so<00:17:51.395> I'm,<00:17:51.636> I'm<00:17:51.732> a<00:17:51.813> primary<00:17:52.134> care<00:17:52.359> physician.

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In<00:17:52.857> fact,<00:17:53.082> I,<00:17:53.259> I<00:17:53.339> still<00:17:53.821> have<00:17:53.997> about<00:17:54.271> 120<00:17:54.945> or<00:17:55.106> so<00:17:55.347> patients<00:17:55.829> that<00:17:55.973> I<00:17:56.070> see<00:17:56.407> in<00:17:56.487> a<00:17:56.520> in<00:17:56.837> a<00:17:56.857> primary<00:17:57.114> care<00:17:57.274> practice<00:17:57.756> as,<00:17:58.061> you<00:17:58.093> know,<00:17:58.318> 1<00:17:58.623> tiny<00:17:59.104> percent<00:17:59.441> of<00:17:59.602> what<00:17:59.763> I<00:17:59.923> do,<00:18:00.710> uh,<00:18:00.967> as<00:18:01.047> CEO<00:18:01.512> here<00:18:01.689> with<00:18:01.866> a<00:18:01.994> very<00:18:02.171> large<00:18:02.428> organization.

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But<00:18:03.921> I<00:18:03.953> saw<00:18:04.177> 2<00:18:04.338> people<00:18:04.723> in<00:18:04.884> clinic,<00:18:05.366> uh,<00:18:05.622> or<00:18:05.847> 1<00:18:05.960> person<00:18:06.265> yesterday,<00:18:06.586> I<00:18:06.666> guess.

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I've<00:18:06.987> got<00:18:07.132> a<00:18:07.164> few<00:18:07.372> coming<00:18:07.613> up<00:18:07.870> in<00:18:07.934> a<00:18:07.950> couple<00:18:08.271> days,<00:18:09.138> uh,<00:18:09.620> and,<00:18:10.182> uh,<00:18:10.664> that's<00:18:10.840> very<00:18:11.081> meaningful<00:18:11.643> to<00:18:11.707> me.

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But<00:18:12.108> it's<00:18:12.269> also<00:18:12.911> really—<00:18:13.473> you're<00:18:13.794> asking<00:18:14.051> a<00:18:14.115> question<00:18:14.533> that's<00:18:14.757> right<00:18:14.918> up<00:18:15.014> my<00:18:15.239> alley<00:18:15.496> because<00:18:15.881> as<00:18:16.122> a<00:18:16.764> healthcare<00:18:17.182> professional,<00:18:17.727> as<00:18:17.824> a<00:18:17.904> physician,<00:18:18.691> you<00:18:18.723> know,<00:18:19.092> I'm<00:18:19.413> all<00:18:19.590> about<00:18:20.071> long-term<00:18:20.649> relationships<00:18:21.340> with<00:18:21.516> my<00:18:21.677> patients<00:18:22.223> and<00:18:22.319> how<00:18:22.480> do<00:18:22.624> we<00:18:22.785> keep<00:18:23.025> them<00:18:23.186> as<00:18:23.282> healthy<00:18:23.587> as<00:18:23.684> possible.

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You<00:18:24.663> know<00:18:24.791> what,<00:18:25.113> I<00:18:25.980> Look,<00:18:26.719> I<00:18:26.799> can<00:18:26.911> tell<00:18:27.072> you<00:18:27.200> 100%<00:18:28.100> certainty,<00:18:29.771> every<00:18:30.028> person<00:18:30.735> who's<00:18:30.976> one<00:18:31.088> of<00:18:31.137> my<00:18:31.297> patients,<00:18:31.940> or<00:18:32.422> you<00:18:32.775> or<00:18:32.920> me<00:18:33.257> or<00:18:33.466> anyone<00:18:33.723> else<00:18:33.868> we<00:18:33.948> talk<00:18:34.028> about,<00:18:34.350> we<00:18:34.591> will<00:18:34.832> all<00:18:34.992> die<00:18:35.185> someday,<00:18:35.635> right?

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I<00:18:35.860> mean,<00:18:35.972> we<00:18:36.197> all<00:18:36.294> know<00:18:36.519> that<00:18:36.631> nobody's<00:18:37.724> cured<00:18:38.061> that.

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And<00:18:39.651> while<00:18:40.214> we're<00:18:40.326> seeing<00:18:40.696> life<00:18:40.888> expectancy<00:18:41.595> increase,<00:18:41.997> and<00:18:42.077> I<00:18:42.093> think<00:18:42.254> we're<00:18:42.334> going<00:18:42.415> to<00:18:42.495> see<00:18:42.720> some<00:18:43.604> mind-boggling<00:18:44.407> increases<00:18:45.114> in<00:18:46.254> life<00:18:46.479> expectancy<00:18:47.620> in<00:18:47.700> my<00:18:47.861> children's<00:18:48.423> and<00:18:48.568> particularly<00:18:49.002> in<00:18:49.130> my<00:18:49.291> grandchildren—<00:18:50.287> I<00:18:50.303> don't<00:18:50.496> have<00:18:50.576> any<00:18:50.737> yet,<00:18:50.978> but<00:18:51.154> someday—<00:18:52.263> generation.

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I<00:18:54.109> think<00:18:54.269> we're<00:18:54.333> going<00:18:54.445> to<00:18:54.510> see<00:18:55.392> tremendous<00:18:56.130> advances<00:18:57.397> and<00:18:58.199> hit<00:18:58.696> probably<00:18:59.081> even<00:18:59.257> some<00:18:59.418> inflection<00:18:59.979> point<00:19:00.220> where<00:19:00.364> we<00:19:00.460> see<00:19:00.621> that.

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And<00:19:00.845> that's<00:19:01.022> going<00:19:01.118> to<00:19:01.182> raise<00:19:01.487> all<00:19:01.583> sorts<00:19:01.904> of<00:19:02.465> societal<00:19:02.946> issues.

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But<00:19:03.748> the<00:19:03.893> dream<00:19:04.133> needs<00:19:04.390> to<00:19:04.470> be,<00:19:04.695> right,<00:19:04.951> you're<00:19:05.112> healthy,<00:19:06.074> you're<00:19:06.219> happy,<00:19:07.983> you<00:19:08.015> know,<00:19:08.159> you<00:19:08.240> don't<00:19:08.416> suffer<00:19:08.721> from<00:19:08.865> mental<00:19:09.346> illness,<00:19:09.587> you<00:19:09.619> don't<00:19:09.795> suffer<00:19:10.148> from<00:19:10.325> physical<00:19:10.870> illness,<00:19:11.929> you<00:19:12.073> don't<00:19:12.314> suffer<00:19:12.715> from<00:19:13.276> aches<00:19:13.452> and<00:19:13.757> pains<00:19:14.190> and<00:19:14.319> everything<00:19:14.639> else,<00:19:14.800> right?

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But<00:19:15.137> as<00:19:15.297> we<00:19:15.441> all<00:19:15.538> get<00:19:15.698> older,<00:19:16.003> we<00:19:16.099> get<00:19:16.259> the<00:19:16.420> aches<00:19:16.580> and<00:19:16.660> the<00:19:16.741> pains<00:19:17.142> and<00:19:17.783> the<00:19:17.863> medical<00:19:18.248> issues<00:19:18.441> start<00:19:18.730> to<00:19:18.826> catch<00:19:19.131> up<00:19:19.243> with<00:19:19.451> us.

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And<00:19:20.093> what<00:19:20.189> we<00:19:20.285> need<00:19:20.574> to<00:19:20.606> do<00:19:20.751> is<00:19:20.831> try<00:19:21.039> and<00:19:21.473> prevent<00:19:21.778> as<00:19:21.875> much<00:19:22.116> of<00:19:22.180> that<00:19:22.357> as<00:19:22.437> we<00:19:22.598> can.

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And<00:19:23.064> then,<00:19:23.385> you<00:19:23.417> know,<00:19:23.948> my<00:19:24.108> wish<00:19:24.285> for<00:19:24.365> every<00:19:24.590> one<00:19:24.671> of<00:19:24.703> my<00:19:24.847> patients,<00:19:25.233> for<00:19:25.651> myself,<00:19:26.213> my<00:19:26.358> loved<00:19:26.551> ones,<00:19:27.097> and<00:19:27.242> then<00:19:27.354> you<00:19:27.483> happily<00:19:28.061> pass<00:19:28.318> away<00:19:28.543> someday,<00:19:29.732> hopefully<00:19:30.134> very,<00:19:30.455> very<00:19:30.632> far<00:19:30.889> down<00:19:31.098> the<00:19:31.195> line,<00:19:31.902> you<00:19:31.998> know,<00:19:32.094> in<00:19:32.175> your<00:19:32.319> sleep,<00:19:32.721> in<00:19:32.785> a<00:19:32.801> very<00:19:33.043> peaceful<00:19:33.509> fashion.

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That's<00:19:34.151> obviously<00:19:34.489> what<00:19:34.649> we'd<00:19:34.874> wish<00:19:35.115> for<00:19:35.228> everybody.

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It's<00:19:35.951> not,<00:19:36.658> of<00:19:36.738> course,<00:19:37.526> what<00:19:37.686> happens.

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And<00:19:38.988> so<00:19:39.856> we<00:19:40.016> have<00:19:40.177> a<00:19:40.257> lot<00:19:40.498> to<00:19:40.579> do<00:19:40.756> on<00:19:40.900> that.

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And<00:19:41.141> it's<00:19:41.302> also<00:19:41.559> a<00:19:41.575> multifaceted,<00:19:42.362> complex<00:19:43.793> answer.

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You<00:19:44.933> hit<00:19:45.158> on<00:19:45.255> one<00:19:45.415> of<00:19:45.496> the<00:19:45.640> issues,<00:19:46.042> which<00:19:46.283> is<00:19:47.103> and<00:19:47.264> we<00:19:47.425> are<00:19:47.651> worse<00:19:47.973> than<00:19:48.134> most<00:19:48.407> of<00:19:48.536> the<00:19:48.617> world,<00:19:49.035> but<00:19:49.196> there<00:19:49.438> are<00:19:49.582> other<00:19:49.760> pockets<00:19:50.049> of<00:19:50.146> the<00:19:50.226> world<00:19:50.548> in<00:19:50.726> different<00:19:51.112> aspects.

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We<00:19:52.883> have<00:19:53.205> to<00:19:53.301> get<00:19:53.462> a<00:19:53.527> hold<00:19:54.010> of<00:19:54.525> the<00:19:55.716> personal<00:19:56.264> issues<00:19:56.602> that<00:19:56.764> drive<00:19:57.006> healthcare,<00:19:57.491> right?

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Some<00:19:59.431> of<00:19:59.900> that<00:20:00.401> we<00:20:00.563> can<00:20:01.032> help<00:20:01.355> with<00:20:01.517> drugs.

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There<00:20:03.742> is<00:20:04.144> a<00:20:04.224> presentation<00:20:05.108> we<00:20:05.349> give<00:20:05.831> where<00:20:06.072> one<00:20:06.297> of<00:20:06.490> the<00:20:06.635> experts<00:20:07.358> at<00:20:07.454> Houston<00:20:07.840> Methodist<00:20:08.242> comes<00:20:08.547> and<00:20:08.627> talks<00:20:08.836> to<00:20:08.949> the<00:20:09.029> community<00:20:09.511> about<00:20:10.989> dementia<00:20:11.520> and<00:20:11.600> Alzheimer's<00:20:12.243> disease,<00:20:12.870> heart<00:20:13.265> disease,<00:20:13.936> stroke.

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You<00:20:15.058> know,<00:20:16.020> sexual<00:20:17.030> issues,<00:20:18.168> etc.,<00:20:18.729> etc.,<00:20:19.274> etc.,<00:20:19.996> you<00:20:20.028> know,<00:20:20.396> joint<00:20:20.813> and<00:20:21.054> joint<00:20:21.358> pain,<00:20:21.615> joint<00:20:21.935> aches.

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There's<00:20:22.416> not<00:20:22.641> one<00:20:22.817> of<00:20:22.881> those<00:20:23.618> where<00:20:23.763> when<00:20:23.875> you<00:20:23.955> start<00:20:24.404> asking<00:20:24.741> them<00:20:24.917> about,<00:20:26.328> well,<00:20:26.648> how<00:20:26.824> can<00:20:26.985> that<00:20:27.145> be<00:20:27.305> better?

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The<00:20:28.091> first<00:20:28.427> thing<00:20:28.588> they<00:20:28.748> tell<00:20:28.973> you<00:20:29.069> is,<00:20:29.229> well,<00:20:29.950> exercise<00:20:30.576> helps<00:20:30.976> it.

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Certain<00:20:32.018> diets<00:20:32.435> help<00:20:32.740> it.

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Watching<00:20:33.541> your<00:20:33.701> weight<00:20:33.958> helps<00:20:34.343> it,<00:20:34.743> you<00:20:34.840> know.

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And<00:20:35.000> then,<00:20:35.176> of<00:20:35.304> course,<00:20:35.417> certain<00:20:36.186> medicines<00:20:36.683> and<00:20:36.827> other<00:20:37.004> things<00:20:37.308> can<00:20:37.468> help<00:20:37.661> that<00:20:37.821> as<00:20:38.030> well.

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Sleep,<00:20:39.825> in<00:20:39.969> terms<00:20:40.290> of<00:20:40.354> having<00:20:40.787> solid,<00:20:41.332> good,<00:20:41.733> effective<00:20:42.213> sleep,<00:20:43.336> affects<00:20:43.816> that.

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Social<00:20:44.923> support<00:20:45.323> systems<00:20:45.820> affect<00:20:46.285> that.

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And<00:20:46.864> so<00:20:47.831> we<00:20:47.976> have<00:20:48.153> to<00:20:48.298> have<00:20:48.476> those<00:20:48.701> conversations<00:20:49.443> about<00:20:49.668> how<00:20:49.910> we<00:20:50.071> do<00:20:50.249> that<00:20:50.490> better<00:20:50.990> societally.

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After<00:20:52.424> that,<00:20:52.908> it's<00:20:53.150> one<00:20:53.246> of<00:20:53.311> the<00:20:53.391> reasons<00:20:53.794> when<00:20:53.955> I<00:20:54.423> gave<00:20:54.664> you<00:20:54.810> this<00:20:54.906> sort<00:20:56.310> of<00:20:56.778> wave<00:20:56.956> a<00:20:57.021> magic<00:20:57.343> wand<00:20:57.650> and<00:20:57.908> we<00:20:58.053> have<00:20:58.166> a<00:20:58.296> better<00:20:58.538> health<00:20:58.715> system<00:20:59.345> of<00:20:59.909> over<00:21:00.071> the<00:21:00.168> long<00:21:00.410> term,<00:21:00.652> you<00:21:00.813> want<00:21:01.136> a<00:21:01.281> large<00:21:01.540> sophisticated<00:21:02.201> organization<00:21:02.911> and<00:21:03.057> all<00:21:03.153> the<00:21:03.299> wonderful<00:21:03.638> people<00:21:03.847> who<00:21:03.960> work<00:21:04.090> here.

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You<00:21:04.846> want<00:21:05.088> them<00:21:05.796> thinking<00:21:06.135> about<00:21:06.521> how<00:21:06.940> are<00:21:07.165> you<00:21:07.487> as<00:21:07.664> the<00:21:07.809> patient<00:21:08.212> who's<00:21:08.389> plugged<00:21:08.695> in<00:21:08.856> here<00:21:10.160> and<00:21:10.321> you<00:21:10.483> as<00:21:10.579> a<00:21:10.708> community<00:21:11.207> that<00:21:11.368> are<00:21:11.449> plugged<00:21:11.690> in<00:21:11.787> here,<00:21:12.012> how<00:21:12.254> you're<00:21:12.463> going<00:21:12.737> to<00:21:12.979> lead<00:21:13.381> the<00:21:13.463> safest,<00:21:14.521> healthiest,<00:21:14.935> happiest<00:21:15.232> lives<00:21:15.596> you<00:21:15.927> possibly<00:21:16.308> can.

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Align<00:21:18.666> the<00:21:18.762> incentives.

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And<00:21:19.484> that's<00:21:19.805> where<00:21:20.190> I<00:21:20.206> was<00:21:20.367> talking<00:21:20.752> about<00:21:21.024> saying,<00:21:21.410> when<00:21:21.634> you<00:21:21.666> start<00:21:22.035> thinking<00:21:22.372> on<00:21:22.516> a<00:21:22.597> population<00:21:23.254> basis<00:21:24.137> as<00:21:24.281> opposed<00:21:24.698> to<00:21:24.939> on<00:21:25.244> a,<00:21:25.324> hey,<00:21:25.581> if<00:21:25.741> one<00:21:25.966> more<00:21:26.126> person<00:21:26.447> shows<00:21:26.704> up<00:21:26.848> in<00:21:26.928> the<00:21:26.960> emergency<00:21:27.426> room<00:21:27.650> who<00:21:27.746> broke<00:21:27.987> their<00:21:28.131> leg<00:21:28.308> today,<00:21:28.613> you'll<00:21:28.725> make<00:21:28.934> more<00:21:29.046> money.

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If<00:21:29.511> one<00:21:29.736> less<00:21:30.313> person<00:21:30.714> breaks<00:21:31.019> their<00:21:31.180> leg,<00:21:31.661> you<00:21:31.918> know,<00:21:32.158> or<00:21:32.238> maybe<00:21:32.463> that's<00:21:32.639> not<00:21:32.800> the<00:21:32.880> best<00:21:33.185> example,<00:21:33.522> one<00:21:33.843> person<00:21:34.083> with<00:21:34.180> a<00:21:34.244> stroke<00:21:34.645> shows<00:21:35.030> up<00:21:35.431> that<00:21:35.527> maybe<00:21:35.752> we<00:21:35.832> could<00:21:35.960> have<00:21:36.024> prevented<00:21:36.410> if<00:21:36.570> we<00:21:36.875> treated<00:21:37.228> their<00:21:37.356> hypertension<00:21:37.998> more<00:21:38.094> aggressively,<00:21:38.736> we'd<00:21:38.880> had<00:21:39.041> the<00:21:39.137> infrastructures<00:21:39.859> in<00:21:40.003> the<00:21:40.484> community.

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And<00:21:41.078> so<00:21:41.463> it's<00:21:41.623> a<00:21:41.704> multifaceted<00:21:42.602> approach.

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What<00:21:44.270> do<00:21:44.335> you<00:21:44.431> think,<00:21:44.688> like,<00:21:44.976> my<00:21:45.474> grandpa<00:21:45.795> told<00:21:45.971> me,<00:21:46.099> hey,<00:21:46.276> there's<00:21:46.500> no<00:21:46.613> shortcuts<00:21:47.238> in<00:21:47.319> life,<00:21:48.024> and<00:21:48.121> then<00:21:49.286> Ozempic<00:21:49.866> came<00:21:50.253> out<00:21:50.430> and<00:21:50.591> Wegovy<00:21:51.155> and<00:21:51.478> these<00:21:51.720> various<00:21:52.042> things.

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And<00:21:53.090> they<00:21:53.251> seem<00:21:53.799> to,<00:21:54.121> a<00:21:54.137> lot<00:21:54.363> of<00:21:54.444> people<00:21:54.685> are<00:21:54.863> on<00:21:55.105> these,<00:21:55.572> they<00:21:55.669> seem<00:21:55.991> to<00:21:56.072> be<00:21:57.683> doing<00:21:57.989> okay<00:21:58.714> on<00:21:58.891> them,<00:21:59.615> but<00:21:59.760> it's<00:21:59.873> a<00:22:00.018> fairly<00:22:00.259> new<00:22:00.501> drug.

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Something<00:22:01.451> like<00:22:01.612> that<00:22:01.773> would<00:22:01.934> really<00:22:02.175> make<00:22:02.433> me<00:22:03.158> nervous<00:22:03.705> personally.

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But<00:22:04.912> what<00:22:04.961> are<00:22:05.009> your<00:22:05.235> thoughts<00:22:05.476> on<00:22:05.557> that?

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Could<00:22:05.830> that<00:22:06.120> actually<00:22:06.442> help?

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Could<00:22:06.990> that<00:22:07.185> be<00:22:08.307> a<00:22:08.388> part<00:22:08.648> of<00:22:08.713> the<00:22:08.746> solution?

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Obviously<00:22:09.315> not<00:22:09.478> the<00:22:09.543> entire<00:22:09.868> solution,<00:22:10.356> but.

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Well,<00:22:11.722> it's<00:22:12.161> not<00:22:12.307> the<00:22:12.389> entire<00:22:12.633> solution.

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Look,<00:22:13.822> medical<00:22:14.226> advances.

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So<00:22:15.662> I<00:22:15.743> finished<00:22:16.001> medical<00:22:16.324> school,<00:22:16.792> hate<00:22:16.889> to<00:22:17.454> admit<00:22:17.615> it<00:22:17.696> now,<00:22:17.809> 30,<00:22:17.905> 31<00:22:18.067> years<00:22:18.164> ago.

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And,<00:22:21.304> you<00:22:21.384> know,<00:22:21.528> the<00:22:21.608> advancements<00:22:22.346> we've<00:22:22.587> seen<00:22:22.988> in<00:22:23.132> medicine<00:22:23.853> are<00:22:24.511> mind-boggling,<00:22:25.297> right?

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And<00:22:26.499> we<00:22:26.820> have—<00:22:27.558> if<00:22:27.638> you<00:22:28.183> go<00:22:28.279> back<00:22:28.504> to<00:22:28.584> Dr.<00:22:28.905> Bakey,<00:22:29.081> who<00:22:29.242> I<00:22:29.290> was<00:22:29.402> talking<00:22:29.707> about,<00:22:30.188> when<00:22:30.348> you<00:22:30.460> see<00:22:30.990> the<00:22:31.406> death<00:22:31.871> rates<00:22:32.208> from<00:22:32.433> heart<00:22:32.753> disease<00:22:33.235> that<00:22:33.331> have<00:22:33.475> happened,<00:22:34.533> decreases<00:22:35.095> in<00:22:35.175> death<00:22:35.415> rate<00:22:35.576> from<00:22:35.720> heart<00:22:35.961> disease<00:22:36.281> that<00:22:36.378> have<00:22:36.522> happened<00:22:36.923> societally<00:22:38.126> over<00:22:38.382> now<00:22:38.783> decades<00:22:39.408> in<00:22:39.505> a<00:22:39.521> sustained<00:22:40.130> manner.

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And,<00:22:40.707> you<00:22:40.788> know,<00:22:40.868> of<00:22:41.012> course,<00:22:41.269> there's<00:22:41.413> a<00:22:41.493> couple<00:22:41.750> huge<00:22:42.070> inflection<00:22:42.632> points<00:22:42.872> for<00:22:43.033> that.

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Getting<00:22:44.700> far<00:22:44.957> fewer<00:22:45.197> people<00:22:45.470> to<00:22:45.582> smoke<00:22:45.983> was<00:22:46.095> a<00:22:46.224> big<00:22:46.384> one<00:22:46.560> of<00:22:46.705> those.

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Treating<00:22:47.747> cholesterol<00:22:48.405> was<00:22:48.566> a<00:22:48.790> massive<00:22:49.288> one<00:22:49.448> of<00:22:49.512> those,<00:22:49.849> and<00:22:49.913> then<00:22:50.074> many<00:22:50.330> other<00:22:50.555> drugs.

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And<00:22:50.988> of<00:22:51.116> course,<00:22:51.518> the<00:22:51.598> ability<00:22:52.015> to<00:22:52.159> go<00:22:52.560> in<00:22:52.657> a<00:22:52.721> cath<00:22:52.977> lab<00:22:53.234> or<00:22:53.362> go<00:22:53.539> in<00:22:53.619> a<00:22:53.699> bypass<00:22:54.100> surgery,<00:22:54.405> many,<00:22:54.614> many<00:22:54.887> things<00:22:55.127> that<00:22:55.207> have<00:22:55.304> happened.

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I<00:22:56.106> mean,<00:22:56.266> my,<00:22:56.731> my<00:22:57.052> wife's<00:22:57.694> two<00:22:57.951> grandfathers<00:22:58.673> died<00:22:59.635> by<00:22:59.796> about<00:23:00.132> my<00:23:01.624> age,<00:23:02.186> you<00:23:02.218> know,<00:23:02.346> from<00:23:02.507> heart<00:23:02.667> attacks.

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And<00:23:03.887> nowadays<00:23:04.528> we<00:23:04.993> don't<00:23:05.234> see<00:23:05.427> nearly<00:23:06.116> the<00:23:06.197> degree<00:23:06.437> of<00:23:06.518> that.

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We<00:23:06.710> still<00:23:07.175> see<00:23:07.416> much,<00:23:08.523> you<00:23:09.165> know,<00:23:09.341> we<00:23:09.501> now<00:23:09.903> have<00:23:10.304> cancer,<00:23:10.865> which<00:23:11.346> more<00:23:11.587> and<00:23:11.731> more<00:23:12.052> is<00:23:12.534> moving<00:23:13.095> into<00:23:13.512> chronic<00:23:13.977> disease<00:23:14.475> realm.

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It's<00:23:14.876> not<00:23:15.100> there<00:23:15.213> yet,<00:23:15.437> don't<00:23:15.598> get<00:23:15.758> me<00:23:15.903> wrong.

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And<00:23:16.320> some<00:23:16.560> cancers<00:23:16.929> are<00:23:17.010> are<00:23:17.346> better<00:23:17.763> progress<00:23:18.324> than<00:23:18.548> others.

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But<00:23:19.911> clearly<00:23:20.488> we've<00:23:20.728> made<00:23:21.049> tremendous<00:23:21.610> progress<00:23:22.091> in<00:23:22.251> medicine.

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Infectious<00:23:23.165> disease<00:23:23.518> was<00:23:23.694> the<00:23:23.774> first<00:23:24.159> one<00:23:24.271> of<00:23:24.351> those<00:23:24.640> that<00:23:24.800> happened<00:23:25.153> in<00:23:25.297> terms<00:23:25.554> of<00:23:25.682> the<00:23:25.778> things<00:23:26.163> we've<00:23:26.339> conquered.

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You<00:23:27.237> know,<00:23:27.333> now<00:23:27.702> we're<00:23:27.862> conquering<00:23:29.369> much<00:23:29.625> more<00:23:29.786> degenerative<00:23:30.827> disease,<00:23:31.405> neurological<00:23:32.895> diseases,<00:23:33.312> other<00:23:33.472> things.

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So<00:23:34.258> I<00:23:34.579> lay<00:23:34.739> that<00:23:34.915> as<00:23:35.059> context<00:23:35.476> to<00:23:35.621> say,<00:23:35.877> I<00:23:36.021> think<00:23:36.342> when<00:23:36.502> you<00:23:36.598> talk<00:23:36.919> about<00:23:37.095> Ozempic<00:23:37.640> and<00:23:37.704> Wegovy<00:23:38.057> and<00:23:38.185> all<00:23:38.282> these<00:23:38.426> things,<00:23:39.724> they're<00:23:40.670> another<00:23:41.231> one<00:23:41.488> in<00:23:41.568> a<00:23:41.712> line<00:23:42.145> of<00:23:42.369> great<00:23:42.850> advances.

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And<00:23:43.796> all<00:23:43.956> the<00:23:44.052> data<00:23:44.309> looks<00:23:44.549> extremely<00:23:45.495> encouraging.

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They're<00:23:46.216> obviously<00:23:46.681> very<00:23:46.938> effective.

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You<00:23:48.364> know,<00:23:48.781> the—<00:23:49.750> developed.

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I<00:23:50.168> mean,<00:23:50.248> I<00:23:50.409> remember<00:23:50.747> talking<00:23:51.069> to<00:23:51.149> a<00:23:51.230> friend<00:23:51.551> who's<00:23:51.728> a<00:23:51.793> scientist<00:23:52.420> who<00:23:52.581> was<00:23:52.903> involved<00:23:53.707> early<00:23:54.029> in<00:23:54.125> some<00:23:54.366> of<00:23:54.431> the<00:23:54.463> studies<00:23:54.865> around<00:23:55.010> some<00:23:55.090> of<00:23:55.155> these<00:23:55.316> things.

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This<00:23:55.975> is<00:23:56.393> 10,<00:23:56.699> 12<00:23:57.005> years<00:23:57.182> ago,<00:23:57.843> saying,<00:23:58.150> Mark,<00:23:59.505> if<00:23:59.618> you<00:24:00.086> know,<00:24:00.183> we've<00:24:00.328> been<00:24:00.441> developing<00:24:00.796> these<00:24:00.973> drugs<00:24:01.280> more<00:24:01.441> for<00:24:01.538> diabetes<00:24:02.022> and<00:24:02.167> they<00:24:02.328> look<00:24:02.522> like<00:24:02.732> they<00:24:02.812> have<00:24:02.974> these<00:24:03.232> other<00:24:03.458> effects.

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And<00:24:03.958> it<00:24:04.038> was<00:24:04.135> not<00:24:04.345> just<00:24:04.506> this<00:24:04.684> class,<00:24:04.861> it<00:24:04.926> was<00:24:05.006> another<00:24:05.329> class<00:24:05.571> he<00:24:05.652> was<00:24:05.732> talking<00:24:05.958> about<00:24:06.136> as<00:24:06.281> well.

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If<00:24:06.862> they<00:24:07.103> prove<00:24:07.408> to<00:24:07.488> be<00:24:07.585> true,<00:24:07.906> they're<00:24:08.131> game<00:24:08.388> changers<00:24:08.790> and<00:24:08.838> they<00:24:09.095> are<00:24:09.255> potential<00:24:09.834> game<00:24:10.155> changers.

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But,<00:24:11.762> and<00:24:11.842> this<00:24:12.019> is<00:24:12.163> a<00:24:12.244> huge<00:24:12.806> but,<00:24:13.111> that<00:24:13.352> every<00:24:13.673> employer<00:24:14.091> is<00:24:14.236> dealing<00:24:14.573> with,<00:24:14.798> we're<00:24:14.975> dealing<00:24:15.537> with<00:24:15.682> the<00:24:15.778> health<00:24:16.019> institution.

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It<00:24:16.630> kind<00:24:16.765> of<00:24:16.832> goes<00:24:17.086> back<00:24:17.340> to<00:24:17.424> my<00:24:18.168> pharmaceutical<00:24:19.433> discussion<00:24:20.074> earlier<00:24:20.395> about<00:24:20.715> pricing.

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The<00:24:22.478> companies<00:24:22.879> that<00:24:23.184> made<00:24:23.440> these<00:24:24.065> deserve<00:24:24.482> to<00:24:24.578> make<00:24:24.803> a<00:24:24.883> ton<00:24:25.107> of<00:24:25.139> money.

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These<00:24:25.685> are<00:24:25.765> transformative<00:24:26.566> drugs.

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I'll<00:24:27.544> start<00:24:27.929> with<00:24:28.089> that.

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However,<00:24:30.077> the<00:24:30.173> way<00:24:30.413> they're<00:24:30.574> being<00:24:30.894> priced,<00:24:31.311> no,<00:24:31.840> no<00:24:32.000> mortal<00:24:32.577> can<00:24:32.818> afford<00:24:33.283> them<00:24:33.539> individually,<00:24:34.485> and<00:24:34.581> no<00:24:34.758> society<00:24:35.367> is<00:24:35.463> going<00:24:35.527> to<00:24:35.623> be<00:24:35.719> able<00:24:35.864> to<00:24:35.960> afford<00:24:36.345> them,<00:24:37.226> and<00:24:37.787> frankly,<00:24:38.204> no<00:24:38.364> institution<00:24:39.038> is<00:24:39.118> going<00:24:39.214> to<00:24:39.246> be<00:24:39.390> able<00:24:39.503> to<00:24:39.551> afford<00:24:39.951> them.

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So<00:24:40.272> what<00:24:40.416> you're<00:24:40.512> seeing<00:24:40.977> most<00:24:41.410> employers<00:24:42.019> do<00:24:42.131> now<00:24:42.997> is<00:24:43.157> crack<00:24:43.462> down<00:24:43.702> on<00:24:43.783> the<00:24:43.863> use<00:24:44.199> and<00:24:44.279> making<00:24:44.664> sure<00:24:45.145> they're<00:24:45.386> used<00:24:45.786> in<00:24:45.963> people<00:24:46.363> very<00:24:46.684> appropriately<00:24:47.486> for<00:24:47.966> the<00:24:48.047> intended<00:24:48.752> reasons.

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So<00:24:50.050> it's<00:24:50.211> somebody,<00:24:50.563> let's<00:24:50.692> say<00:24:50.852> with<00:24:51.012> diabetes<00:24:51.734> and<00:24:51.878> who—<00:24:52.150> or<00:24:52.295> has<00:24:52.535> a<00:24:52.840> very,<00:24:53.112> very<00:24:53.417> high<00:24:53.737> body<00:24:53.994> mass<00:24:54.298> index<00:24:54.699> and<00:24:55.340> most<00:24:55.982> definitely<00:24:56.462> in<00:24:56.559> every<00:24:56.719> single<00:24:57.007> study<00:24:57.344> will<00:24:57.568> benefit<00:24:58.065> from<00:24:58.530> losing<00:24:58.851> weight<00:24:59.733> as<00:24:59.909> opposed<00:25:00.390> to,<00:25:00.775> hey,<00:25:01.015> let's<00:25:01.191> put<00:25:01.368> somebody<00:25:01.897> on<00:25:01.993> it<00:25:02.233> because<00:25:02.634> they<00:25:02.794> just<00:25:03.019> like<00:25:03.211> to<00:25:03.291> be<00:25:03.419> a<00:25:03.436> little<00:25:03.596> bit<00:25:03.820> thinner.

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It's<00:25:04.317> not<00:25:04.622> totally<00:25:05.103> clear<00:25:05.279> whether<00:25:05.439> they're<00:25:05.600> going<00:25:05.696> to<00:25:05.840> lose<00:25:06.081> weight.

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And<00:25:06.882> then<00:25:07.267> you<00:25:07.363> get<00:25:07.507> into<00:25:07.684> those<00:25:07.860> societal<00:25:08.469> questions<00:25:08.886> of<00:25:08.966> who<00:25:09.110> should<00:25:09.287> pay<00:25:09.431> for<00:25:09.607> those<00:25:09.832> kinds<00:25:10.088> of<00:25:10.168> things.

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And<00:25:10.986> so<00:25:11.595> I<00:25:11.851> don't<00:25:12.156> think<00:25:12.589> the<00:25:12.717> way<00:25:12.973> they're<00:25:13.134> pricing<00:25:13.599> them,<00:25:13.775> we're<00:25:13.887> going<00:25:13.999> to<00:25:14.080> see<00:25:14.256> as<00:25:14.336> many<00:25:14.576> people<00:25:14.897> benefit<00:25:15.362> from<00:25:15.554> them<00:25:16.003> as<00:25:16.163> they<00:25:16.260> could.

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And<00:25:16.660> I<00:25:16.741> think<00:25:16.981> this<00:25:17.157> is<00:25:17.302> one<00:25:17.526> of<00:25:17.558> the<00:25:17.686> fundamental<00:25:18.183> challenges<00:25:18.728> we<00:25:18.824> often<00:25:19.129> have<00:25:19.386> when<00:25:19.482> you<00:25:19.610> get<00:25:19.706> back<00:25:19.947> to<00:25:20.027> the<00:25:20.107> cost<00:25:20.363> of<00:25:20.427> healthcare<00:25:21.453> is<00:25:22.431> we<00:25:22.560> We<00:25:22.592> can't<00:25:22.993> have<00:25:23.331> sort<00:25:23.572> of<00:25:23.797> rampant<00:25:24.359> capitalism.

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We<00:25:25.243> need<00:25:25.484> appropriate<00:25:25.982> capitalism.

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There<00:25:26.849> needs<00:25:27.155> to<00:25:27.251> be<00:25:27.492> a<00:25:27.717> great<00:25:28.456> profit<00:25:28.874> motive,<00:25:29.806> but<00:25:30.288> we<00:25:30.384> shouldn't<00:25:30.866> be<00:25:30.962> spending,<00:25:31.814> you<00:25:31.846> know,<00:25:32.071> multifold<00:25:32.794> times<00:25:33.356> in<00:25:33.517> cost<00:25:34.304> for<00:25:34.883> a<00:25:34.963> drug<00:25:35.429> in<00:25:35.509> our<00:25:35.606> country<00:25:35.991> what<00:25:36.104> somebody<00:25:36.409> does<00:25:36.650> in<00:25:37.052> another<00:25:37.373> country<00:25:37.678> and<00:25:37.759> effectively<00:25:38.321> subsidizing<00:25:39.044> the<00:25:39.141> other<00:25:39.301> countries.

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We<00:25:40.185> should<00:25:40.410> allow<00:25:40.731> a<00:25:40.972> good<00:25:41.149> profit,<00:25:41.631> but<00:25:41.792> we<00:25:41.952> have<00:25:42.338> to<00:25:42.434> find<00:25:42.980> ways<00:25:43.880> that<00:25:44.266> technology<00:25:45.005> helps<00:25:45.487> decrease<00:25:46.049> the<00:25:46.130> cost<00:25:46.467> of<00:25:46.547> healthcare,<00:25:47.495> not<00:25:47.897> where,<00:25:48.684> you<00:25:48.716> know,<00:25:48.990> end<00:25:49.086> up<00:25:49.342> pricing<00:25:49.823> things.

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Another<00:25:51.008> example<00:25:51.505> of<00:25:51.985> an<00:25:52.065> amazing<00:25:52.642> advance<00:25:53.972> was<00:25:54.132> hepatitis<00:25:54.709> C<00:25:54.869> drugs.

00:25:56.055 --> 00:26:00.108
These<00:25:56.231> are<00:25:56.375> drugs<00:25:56.711> to,<00:25:57.032> to<00:25:57.512> cure<00:25:57.897> hepatitis<00:25:58.394> C.<00:25:59.659> Phenomenal.

00:26:00.156 --> 00:26:13.677
I<00:26:00.172> mean,<00:26:00.380> when<00:26:00.540> I<00:26:00.556> was<00:26:00.941> in,<00:26:01.197> in<00:26:01.742> medical<00:26:02.094> school,<00:26:02.703> wasn't<00:26:02.959> even<00:26:03.120> a<00:26:03.200> dream<00:26:03.600> that<00:26:03.744> we'd<00:26:03.840> have<00:26:04.017> a<00:26:04.145> drug<00:26:04.401> that<00:26:04.545> could<00:26:04.786> cure<00:26:04.962> hepatitis<00:26:05.443> C.<00:26:06.003> Hepatitis<00:26:06.484> C,<00:26:06.724> in<00:26:06.884> some<00:26:07.285> percentage<00:26:07.701> of<00:26:07.846> people,<00:26:08.150> will<00:26:08.326> lead<00:26:08.502> to<00:26:08.631> chronic<00:26:08.967> liver<00:26:09.271> failure,<00:26:09.768> can<00:26:09.928> lead<00:26:10.169> to<00:26:10.313> liver<00:26:10.569> cancer,<00:26:11.755> you<00:26:11.835> know,<00:26:11.931> can<00:26:12.091> ultimately<00:26:12.492> require<00:26:12.956> a<00:26:13.036> transplant.

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Many<00:26:13.933> people<00:26:14.254> pass<00:26:14.494> away.

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Many<00:26:15.039> people<00:26:15.359> live<00:26:15.535> with<00:26:15.760> it<00:26:15.856> and<00:26:16.080> don't<00:26:16.320> have<00:26:16.737> dramatic<00:26:17.282> issues.

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And<00:26:18.259> so<00:26:18.435> now<00:26:18.643> you<00:26:18.739> can<00:26:18.900> cure<00:26:19.140> it.

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You<00:26:19.444> can<00:26:19.541> prevent<00:26:19.861> all<00:26:20.021> of<00:26:20.085> that.

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Well,<00:26:21.270> those<00:26:21.650> drugs<00:26:21.990> got<00:26:22.230> priced,<00:26:22.670> I<00:26:22.690> don't<00:26:22.830> know,<00:26:23.030> somewhere<00:26:23.150> in<00:26:23.310> the<00:26:23.370> $90,000<00:26:23.710> to<00:26:23.711> $100,000<00:26:24.510> range<00:26:25.050> for<00:26:25.250> a<00:26:25.490> course<00:26:25.670> of<00:26:25.850> therapy.

00:26:27.610 --> 00:26:29.310
Game<00:26:27.910> changing.

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Absolutely.

00:26:29.790 --> 00:26:30.610
They<00:26:29.910> should<00:26:30.050> be<00:26:30.210> expensive.

00:26:30.810 --> 00:26:32.390
The<00:26:30.970> company<00:26:31.310> should<00:26:31.530> make<00:26:31.670> a<00:26:31.850> lot<00:26:31.930> of<00:26:32.090> profit.

00:26:32.390 --> 00:26:33.770
But<00:26:32.590> how<00:26:32.930> did<00:26:33.070> they<00:26:33.190> price<00:26:33.470> that?

00:26:33.770 --> 00:26:42.990
They<00:26:33.810> said,<00:26:34.170> okay,<00:26:34.230> let's<00:26:34.430> look<00:26:34.590> at<00:26:34.710> all<00:26:34.810> the<00:26:34.930> people<00:26:35.210> with<00:26:35.650> liver<00:26:36.170> disease<00:26:37.070> that<00:26:37.470> have<00:26:37.850> from<00:26:38.190> hepatitis<00:26:38.610> C,<00:26:38.830> or<00:26:38.910> let's<00:26:39.050> look<00:26:39.190> at<00:26:39.310> the<00:26:39.390> population<00:26:39.810> of<00:26:39.970> people<00:26:40.030> with<00:26:40.170> hepatitis<00:26:40.470> C.<00:26:40.990> What<00:26:41.170> do<00:26:41.310> they<00:26:41.370> cost<00:26:41.670> on<00:26:41.870> average<00:26:42.210> to<00:26:42.470> society?

00:26:42.990 --> 00:26:46.350
Okay,<00:26:43.190> it<00:26:43.390> costs<00:26:43.470> about<00:26:43.670> 100<00:26:44.030> grand,<00:26:44.350> so<00:26:44.730> we'll<00:26:45.270> price<00:26:45.470> it<00:26:45.610> at<00:26:45.810> 95.

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We'll<00:26:46.510> save<00:26:46.730> society<00:26:47.150> a<00:26:47.330> little<00:26:47.450> bit.

00:26:47.650 --> 00:27:03.940
Well,<00:26:47.810> that<00:26:47.930> was<00:26:48.110> a<00:26:48.210> missed<00:26:48.690> opportunity<00:26:49.270> among<00:26:49.530> many<00:26:49.950> where<00:26:50.290> we<00:26:50.310> should<00:26:50.330> have<00:26:50.350> said,<00:26:50.370> okay,<00:26:50.390> no,<00:26:51.752> It's<00:26:52.383> $20,000,<00:26:52.965> $30,000,<00:26:53.514> something<00:26:53.919> very<00:26:54.161> healthy<00:26:54.501> from<00:26:54.663> a<00:26:54.743> profit<00:26:55.132> standpoint,<00:26:55.875> but<00:26:56.021> where<00:26:56.134> society<00:26:56.862> not<00:26:57.153> only<00:26:57.573> has<00:26:58.139> obviously<00:26:58.544> healthier,<00:26:59.110> longer-living<00:26:59.756> people,<00:27:00.872> but<00:27:01.358> also<00:27:01.780> then<00:27:02.024> has<00:27:02.446> a<00:27:02.511> savings<00:27:03.014> to<00:27:03.144> the<00:27:03.225> healthcare<00:27:03.582> system.

00:27:03.988 --> 00:27:07.657
So<00:27:04.443> another<00:27:04.865> piece<00:27:05.255> of<00:27:05.352> that<00:27:05.660> complex<00:27:06.407> interweb<00:27:06.976> we<00:27:07.057> were<00:27:07.138> talking<00:27:07.528> about.

00:27:08.520 --> 00:27:08.648
Yeah.

00:27:08.697 --> 00:27:14.480
How<00:27:08.793> do<00:27:08.858> you<00:27:08.954> think<00:27:09.132> about<00:27:09.357> trust<00:27:10.066> in<00:27:10.727> the<00:27:10.807> medical—<00:27:12.901> I<00:27:12.982> don't<00:27:13.143> know,<00:27:13.385> industry,<00:27:14.190> right?

00:27:14.577 --> 00:27:23.665
Like<00:27:15.302> it<00:27:15.382> was<00:27:15.543> never<00:27:16.929> the<00:27:17.058> medical<00:27:17.333> industry<00:27:18.251> and,<00:27:18.931> you<00:27:19.016> know,<00:27:19.118> that<00:27:20.332> is<00:27:20.428> a<00:27:20.509> lot<00:27:20.686> of<00:27:20.750> people<00:27:21.378> when<00:27:21.475> I<00:27:21.555> say<00:27:21.716> that,<00:27:21.797> and<00:27:22.022> that,<00:27:22.183> that's<00:27:22.377> a<00:27:22.602> very<00:27:22.924> broad<00:27:23.246> industry.

00:27:24.293 --> 00:27:34.598
But<00:27:24.760> healthcare<00:27:25.484> experts<00:27:26.370> and<00:27:26.547> doctors<00:27:27.094> and<00:27:27.191> things<00:27:27.352> like<00:27:27.497> that<00:27:27.996> have—<00:27:28.463> were<00:27:28.560> never<00:27:28.882> questioned<00:27:29.349> in<00:27:29.445> my<00:27:29.671> lifetime<00:27:30.089> like<00:27:30.250> they've<00:27:30.411> been<00:27:30.556> questioned<00:27:30.878> over<00:27:30.991> the<00:27:31.120> past<00:27:31.538> few<00:27:31.844> years,<00:27:32.988> COVID-19<00:27:33.712> being<00:27:33.873> the<00:27:33.954> big<00:27:34.195> one,<00:27:34.437> right?

00:27:34.920 --> 00:27:39.796
And<00:27:35.065> it's<00:27:35.161> kind<00:27:35.322> of<00:27:35.403> become<00:27:35.805> like<00:27:37.174> political<00:27:37.899> in<00:27:37.995> a<00:27:38.060> way,<00:27:38.221> which<00:27:38.626> must<00:27:38.788> be<00:27:38.935> fascinating<00:27:39.503> for<00:27:39.682> you.

00:27:41.372 --> 00:27:45.360
I<00:27:41.535> wonder,<00:27:41.941> like,<00:27:42.753> how<00:27:42.932> do,<00:27:43.078> like,<00:27:43.338> pharma—<00:27:43.907> and<00:27:43.988> in<00:27:44.070> particular,<00:27:44.541> it's<00:27:44.606> pharmaceutical<00:27:44.880> pharmaceutical<00:27:45.232> company.

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Let's<00:27:45.617> just<00:27:45.713> be<00:27:45.873> honest,<00:27:46.354> right?

00:27:46.595 --> 00:27:53.953
It's<00:27:46.755> pharmaceutical<00:27:47.380> companies<00:27:48.422> that,<00:27:48.903> um,<00:27:49.865> we,<00:27:50.025> we<00:27:50.105> kind<00:27:50.282> of<00:27:50.362> distrust<00:27:51.163> as<00:27:51.308> a<00:27:51.388> country,<00:27:51.788> even<00:27:52.029> more<00:27:52.189> so<00:27:52.366> now<00:27:52.670> as<00:27:52.766> we've<00:27:52.927> come<00:27:53.151> out<00:27:53.263> of<00:27:53.327> this<00:27:53.488> pandemic.

00:27:54.514 --> 00:27:56.069
How<00:27:54.626> do<00:27:54.834> they<00:27:55.171> rebuild<00:27:55.716> trust?

00:27:56.133 --> 00:28:02.208
How<00:27:56.229> do<00:27:56.437> you<00:27:56.614> build<00:27:56.918> trust,<00:27:57.639> um,<00:27:57.880> within<00:27:58.136> your<00:27:58.377> institution<00:27:59.579> and<00:27:59.723> with<00:27:59.884> your<00:28:00.060> patients<00:28:00.701> and<00:28:00.846> with<00:28:01.102> your<00:28:01.519> students?

00:28:02.769 --> 00:28:19.485
I<00:28:02.801> mean,<00:28:03.026> I,<00:28:03.186> I<00:28:03.266> feel<00:28:03.410> like<00:28:03.571> trust<00:28:04.212> is<00:28:04.308> something<00:28:04.869> that<00:28:05.029> is<00:28:05.110> so<00:28:05.334> missing<00:28:05.911> in<00:28:06.071> leadership,<00:28:07.338> um,<00:28:08.075> today,<00:28:08.540> not<00:28:08.957> in<00:28:09.101> every<00:28:09.357> industry,<00:28:09.822> but<00:28:09.999> in<00:28:10.079> particular,<00:28:10.560> like,<00:28:10.720> I<00:28:10.800> just<00:28:11.041> wonder<00:28:12.442> they<00:28:12.700> rebuild<00:28:13.266> trust<00:28:14.073> given,<00:28:14.865> um,<00:28:16.173> the<00:28:16.335> way<00:28:17.046> the<00:28:17.143> pandemic<00:28:17.611> shook<00:28:17.805> out?

00:28:20.196 --> 00:28:26.230
Boy,<00:28:20.454> talk<00:28:20.858> about<00:28:21.181> a<00:28:21.230> great<00:28:21.505> question,<00:28:21.990> and<00:28:22.071> something<00:28:23.107> keeps<00:28:23.366> me<00:28:23.511> up<00:28:23.624> at<00:28:23.754> night,<00:28:23.997> frankly,<00:28:24.482> and,<00:28:24.660> and<00:28:24.806> I<00:28:24.838> spend<00:28:25.210> a<00:28:25.291> lot<00:28:25.469> of<00:28:25.582> time<00:28:25.712> thinking<00:28:26.052> about.

00:28:26.294 --> 00:28:40.268
And<00:28:26.845> having<00:28:27.168> been<00:28:27.330> somebody<00:28:27.718> who<00:28:27.896> lived<00:28:28.139> through,<00:28:28.851> obviously,<00:28:29.579> leadership<00:28:30.081> of<00:28:30.324> a<00:28:30.485> big<00:28:30.712> institution<00:28:31.456> that<00:28:31.618> cared<00:28:31.942> for<00:28:32.427> tens<00:28:32.750> of<00:28:32.896> thousands<00:28:33.333> of<00:28:33.462> people<00:28:33.867> with<00:28:34.109> COVID<00:28:35.161> um,<00:28:35.501> you<00:28:35.566> know,<00:28:35.663> we<00:28:35.743> vaccinated<00:28:36.472> 1.1,<00:28:37.038> 1.2<00:28:37.378> million<00:28:37.766> people<00:28:38.575> with,<00:28:38.979> with<00:28:39.322> COVID<00:28:39.883> vaccine.

00:28:41.310 --> 00:28:50.066
I've<00:28:42.048> experienced<00:28:42.914> firsthand<00:28:43.636> that<00:28:43.876> lack<00:28:44.117> of<00:28:44.277> trust,<00:28:45.255> the<00:28:45.400> misinformation,<00:28:46.859> the<00:28:47.099> divisiveness<00:28:48.046> that<00:28:48.286> is<00:28:48.527> out<00:28:49.344> in<00:28:49.489> society.

00:28:51.493 --> 00:28:55.053
Let<00:28:51.574> me<00:28:51.670> be<00:28:51.830> really<00:28:52.135> clear,<00:28:53.354> because<00:28:53.594> I<00:28:53.610> know<00:28:53.835> I<00:28:53.915> was<00:28:54.075> beating<00:28:54.380> on<00:28:54.460> him<00:28:54.556> a<00:28:54.636> little<00:28:54.877> bit.

00:28:55.342 --> 00:29:11.039
We<00:28:55.663> are<00:28:55.839> so<00:28:56.705> fortunate<00:28:57.363> to<00:28:57.507> have<00:28:58.068> an<00:28:58.148> amazing,<00:28:59.111> robust<00:29:00.490> scientific<00:29:01.757> and<00:29:01.853> sort<00:29:02.174> of<00:29:02.318> a<00:29:02.350> medical<00:29:03.232> scientific,<00:29:04.322> even<00:29:04.579> industrial<00:29:05.365> connection<00:29:06.521> to<00:29:06.861> advance<00:29:07.589> science,<00:29:08.464> and<00:29:08.561> the<00:29:08.642> pharmaceutical<00:29:09.533> companies<00:29:10.035> are<00:29:10.164> heroes<00:29:10.666> in<00:29:10.812> that.

00:29:11.411 --> 00:29:15.152
So<00:29:11.541> I<00:29:11.638> want<00:29:11.768> to<00:29:11.800> be<00:29:11.946> real<00:29:12.189> clear,<00:29:12.513> I<00:29:12.707> don't<00:29:12.917> agree<00:29:13.096> with<00:29:13.241> how<00:29:13.339> they<00:29:13.500> price<00:29:13.824> things,<00:29:14.083> and<00:29:14.148> I<00:29:14.229> think<00:29:14.391> there's<00:29:14.602> some<00:29:14.715> issues<00:29:15.023> there.

00:29:15.630 --> 00:29:19.844
But<00:29:15.743> in<00:29:15.889> terms<00:29:16.229> of<00:29:16.294> the<00:29:16.408> advances<00:29:17.040> we<00:29:17.186> get<00:29:17.364> from<00:29:17.607> them,<00:29:18.175> they're<00:29:18.337> nothing<00:29:18.661> short<00:29:19.309> of<00:29:19.407> amazing.

00:29:21.670 --> 00:29:25.470
This<00:29:21.799> is<00:29:21.944> not<00:29:22.349> just<00:29:22.688> a<00:29:22.898> pro—<00:29:23.238> this,<00:29:23.869> your<00:29:24.047> question<00:29:24.435> really<00:29:24.613> doesn't<00:29:24.855> just<00:29:25.033> apply<00:29:25.259> to<00:29:25.405> them.

00:29:25.518 --> 00:29:27.491
It<00:29:25.599> applies<00:29:26.052> to<00:29:26.488> me<00:29:26.715> as<00:29:26.860> a<00:29:26.957> physician.

00:29:27.588 --> 00:29:30.289
It<00:29:27.669> applies<00:29:28.073> to<00:29:28.801> me<00:29:28.963> as<00:29:29.124> a<00:29:29.140> hospital<00:29:29.803> executive.

00:29:30.353 --> 00:29:31.840
It<00:29:30.418> applies<00:29:30.709> to<00:29:30.822> the<00:29:31.000> people<00:29:31.130> who<00:29:31.251> work<00:29:31.667> here.

00:29:33.103 --> 00:29:43.561
Trust<00:29:33.585> has<00:29:33.826> been<00:29:34.067> shaken<00:29:35.658> and<00:29:36.316> there's<00:29:36.557> a<00:29:36.782> lot<00:29:37.039> of<00:29:37.280> very<00:29:38.164> pervasive,<00:29:39.063> insidious<00:29:40.830> factors<00:29:41.376> at<00:29:41.457> play<00:29:42.887> when<00:29:43.047> you<00:29:43.208> look<00:29:43.320> at<00:29:43.465> that.

00:29:43.642 --> 00:29:47.642
So<00:29:44.750> let<00:29:44.895> me,<00:29:45.055> let<00:29:45.136> me<00:29:45.232> say<00:29:45.457> what<00:29:45.891> I<00:29:45.939> mean<00:29:46.196> by<00:29:46.356> that.

00:29:48.589 --> 00:29:51.818
This<00:29:48.766> isn't<00:29:49.087> just<00:29:49.489> mistrust<00:29:49.971> of<00:29:50.051> medicine,<00:29:50.469> it's<00:29:50.614> mistrust<00:29:51.112> of<00:29:51.240> science.

00:29:51.995 --> 00:30:13.118
Somehow<00:29:53.505> in<00:29:53.650> a<00:29:53.666> century<00:29:54.469> where<00:29:54.694> we<00:29:54.855> are<00:29:55.015> all<00:29:55.272> here<00:29:55.818> living<00:29:56.477> decades<00:29:57.039> longer<00:29:57.361> than<00:29:57.505> we<00:29:57.602> would<00:29:57.746> have<00:29:57.923> lived<00:29:58.244> in<00:29:58.405> most<00:29:58.790> of<00:29:58.903> human<00:29:59.369> history,<00:30:00.477> deal,<00:30:00.814> you<00:30:00.895> know,<00:30:01.537> enjoying<00:30:02.244> the<00:30:02.340> fruits<00:30:02.886> of<00:30:02.983> science<00:30:03.529> and<00:30:03.625> technology,<00:30:04.428> whether<00:30:04.605> you're<00:30:04.750> talking<00:30:05.055> about<00:30:05.296> the<00:30:05.328> ability<00:30:05.665> to<00:30:05.778> hop<00:30:06.019> on<00:30:06.115> a<00:30:06.195> plane<00:30:06.516> and<00:30:06.613> go<00:30:06.773> someplace,<00:30:07.464> whether<00:30:07.625> you're<00:30:07.785> talking<00:30:08.139> about<00:30:08.910> obviously<00:30:09.327> everything<00:30:09.649> we<00:30:09.809> enjoy<00:30:10.114> in<00:30:10.291> terms<00:30:10.548> of<00:30:10.596> the<00:30:10.757> internet<00:30:11.078> and<00:30:11.191> streaming,<00:30:11.962> you<00:30:11.994> know,<00:30:12.138> all<00:30:12.299> the<00:30:12.379> different<00:30:12.700> things<00:30:12.861> that<00:30:12.941> happen.

00:30:13.166 --> 00:30:19.687
Of<00:30:13.263> course,<00:30:14.066> medical<00:30:14.531> technology—<00:30:16.234> there<00:30:16.459> is<00:30:16.555> an<00:30:16.796> undercurrent<00:30:17.374> of<00:30:17.519> just,<00:30:18.065> uh,<00:30:18.708> lack<00:30:18.965> of<00:30:19.125> trust<00:30:19.511> in<00:30:19.591> that.

00:30:19.768 --> 00:30:27.058
I<00:30:19.848> think<00:30:20.234> it<00:30:20.410> comes<00:30:21.278> down<00:30:21.936> to<00:30:23.141> a<00:30:23.221> lot<00:30:23.703> of,<00:30:24.088> uh,<00:30:24.281> stress<00:30:24.827> and<00:30:24.972> strife<00:30:25.373> in<00:30:25.454> our,<00:30:25.791> in<00:30:25.920> our<00:30:26.593> society.

00:30:27.955 --> 00:30:34.367
What<00:30:28.100> I<00:30:28.180> worry<00:30:28.420> a<00:30:28.436> lot<00:30:28.613> about—<00:30:28.917> so<00:30:29.638> this<00:30:29.943> year<00:30:30.504> I've<00:30:30.745> had<00:30:30.905> the<00:30:31.001> privilege<00:30:31.386> of<00:30:31.546> being,<00:30:32.043> uh,<00:30:32.348> the<00:30:32.909> chairman<00:30:33.181> of<00:30:33.245> the<00:30:33.325> Greater<00:30:33.566> Houston<00:30:33.951> Partnership.

00:30:34.448 --> 00:30:42.847
The,<00:30:34.768> the<00:30:34.912> Greater<00:30:35.073> Houston<00:30:35.329> Partnership<00:30:35.730> is<00:30:36.307> essentially<00:30:36.772> the<00:30:37.157> Chamber<00:30:37.477> of<00:30:37.573> Commerce<00:30:38.215> economic<00:30:38.679> development<00:30:39.737> unified<00:30:40.283> organization<00:30:40.860> across<00:30:41.324> all<00:30:41.485> of,<00:30:41.805> all<00:30:41.966> of,<00:30:42.206> uh,<00:30:42.527> Houston.

00:30:42.927 --> 00:30:52.546
There's<00:30:43.040> some<00:30:43.601> small,<00:30:43.985> very<00:30:44.306> good<00:30:44.627> niche<00:30:45.027> ones<00:30:45.348> that<00:30:45.572> focus<00:30:45.973> on<00:30:46.294> certain<00:30:46.550> communities,<00:30:47.031> certain<00:30:47.496> aspects,<00:30:47.977> certain,<00:30:48.378> uh,<00:30:48.778> industries,<00:30:50.157> but<00:30:50.301> this<00:30:50.878> knits<00:30:51.183> together<00:30:51.600> the,<00:30:51.824> the<00:30:51.920> business<00:30:52.241> community.

00:30:52.642 --> 00:30:57.948
I've<00:30:52.786> had<00:30:52.882> that<00:30:53.043> privilege,<00:30:53.443> and<00:30:53.523> one<00:30:53.668> of<00:30:53.700> the<00:30:54.084> privileges<00:30:54.549> you<00:30:54.646> get<00:30:54.822> is<00:30:54.950> to<00:30:55.062> speak,<00:30:55.671> um,<00:30:55.912> you<00:30:55.944> know,<00:30:56.088> at<00:30:56.233> the<00:30:56.313> annual<00:30:56.569> meeting<00:30:56.810> with<00:30:56.986> a<00:30:57.034> couple<00:30:57.274> thousand<00:30:57.611> people<00:30:57.820> there.

00:30:58.012 --> 00:31:17.913
And<00:30:58.637> I<00:30:59.279> framed<00:30:59.856> my<00:31:00.097> entire<00:31:00.658> talk<00:31:01.283> on<00:31:01.540> the<00:31:01.700> beauty<00:31:02.021> of<00:31:02.165> the<00:31:02.663> word<00:31:03.128> "and"<00:31:05.533> as<00:31:05.629> opposed<00:31:05.950> to<00:31:06.030> the<00:31:06.431> problem<00:31:07.458> of<00:31:07.554> the<00:31:07.698> word<00:31:08.179> "or,"<00:31:08.596> and<00:31:08.821> really<00:31:09.222> reflecting<00:31:09.943> on<00:31:10.023> the<00:31:10.104> fact<00:31:10.601> that<00:31:11.467> I<00:31:11.643> believe<00:31:12.188> that<00:31:12.365> when<00:31:13.247> people<00:31:13.632> succeed,<00:31:14.610> businesses<00:31:15.091> succeed,<00:31:15.668> and<00:31:15.797> when<00:31:15.957> businesses<00:31:16.230> succeed,<00:31:17.176> people<00:31:17.497> succeed.

00:31:17.962 --> 00:31:28.487
And<00:31:18.042> you<00:31:18.138> can<00:31:18.282> put<00:31:18.459> that<00:31:18.603> in<00:31:18.683> healthcare<00:31:19.100> and<00:31:19.196> everything<00:31:19.565> else<00:31:19.742> as<00:31:19.902> well,<00:31:20.928> but<00:31:21.105> that<00:31:21.409> we<00:31:21.650> have<00:31:23.109> really<00:31:23.975> a<00:31:25.257> almost<00:31:27.603> inescapable.

00:31:28.632 --> 00:31:30.833
I<00:31:28.728> used<00:31:28.985> an<00:31:29.114> analogy<00:31:29.917> of<00:31:30.014> the<00:31:30.094> siren<00:31:30.657> call.

00:31:30.898 --> 00:32:00.868
If<00:31:31.058> you<00:31:31.155> think<00:31:31.396> of<00:31:31.476> Odysseus<00:31:32.891> and<00:31:32.971> the<00:31:33.132> Odyssey<00:31:33.549> and<00:31:33.694> the<00:31:34.000> sirens<00:31:34.434> and<00:31:34.595> him<00:31:34.755> strapping<00:31:35.222> himself<00:31:35.624> to<00:31:35.720> the<00:31:35.865> mast<00:31:36.283> to<00:31:36.460> not<00:31:36.766> get<00:31:37.023> seduced<00:31:37.714> over<00:31:37.972> to<00:31:38.116> the<00:31:38.213> sirens<00:31:38.695> who<00:31:38.840> would<00:31:38.920> have<00:31:39.081> led<00:31:39.323> him<00:31:39.499> and<00:31:39.580> his<00:31:39.676> sailors<00:31:40.625> on<00:31:40.706> the<00:31:40.850> rocks<00:31:41.188> and<00:31:41.349> die,<00:31:43.120> that<00:31:43.962> the<00:31:44.026> siren<00:31:44.367> song<00:31:44.690> right<00:31:44.933> now<00:31:45.354> for<00:31:46.213> politicians<00:31:47.039> in<00:31:47.184> particular,<00:31:47.848> but<00:31:48.010> for<00:31:48.108> many<00:31:48.415> people<00:31:48.966> in<00:31:49.063> society,<00:31:50.396> is<00:31:50.877> this<00:31:51.311> idea<00:31:51.777> of<00:31:52.082> or,<00:31:52.403> this<00:31:52.580> idea<00:31:53.142> of<00:31:53.367> retreating<00:31:53.849> into<00:31:54.652> one<00:31:54.909> way<00:31:55.086> of<00:31:55.230> doing<00:31:55.552> things<00:31:56.018> or<00:31:56.114> another<00:31:56.499> way<00:31:56.676> of<00:31:56.756> doing<00:31:57.142> things<00:31:57.865> when<00:31:57.961> the<00:31:58.122> right<00:31:58.363> answer<00:31:58.604> is<00:31:58.909> almost<00:31:59.471> always<00:31:59.664> somewhere<00:32:00.274> in<00:32:00.370> between.

00:32:00.917 --> 00:32:04.354
And<00:32:01.013> so<00:32:01.174> we<00:32:01.270> saw<00:32:01.656> that,<00:32:02.218> I<00:32:02.298> mean,<00:32:02.523> on<00:32:02.700> steroids<00:32:03.904> in<00:32:04.049> COVID.

00:32:05.334 --> 00:32:08.675
Very<00:32:05.735> early<00:32:05.896> on,<00:32:06.073> we<00:32:06.217> recognized<00:32:07.037> that<00:32:07.342> we<00:32:07.518> would<00:32:07.663> stay<00:32:08.000> data-driven.

00:32:08.787 --> 00:32:10.394
We<00:32:08.948> would<00:32:09.125> focus<00:32:09.751> on<00:32:09.831> the<00:32:09.928> facts.

00:32:10.811 --> 00:32:11.952
We<00:32:10.956> would<00:32:11.052> present<00:32:11.454> the<00:32:11.534> facts.

00:32:12.080 --> 00:32:20.614
We<00:32:12.241> would<00:32:12.353> acknowledge<00:32:12.883> the<00:32:12.980> fact<00:32:13.237> that<00:32:13.381> sometimes<00:32:14.088> with<00:32:14.265> the<00:32:14.506> data<00:32:14.891> we<00:32:15.052> knew<00:32:15.309> today,<00:32:15.935> we<00:32:16.000> might<00:32:17.233> 3<00:32:17.393> months<00:32:17.698> later<00:32:18.595> have<00:32:18.755> to<00:32:18.835> say<00:32:18.995> something<00:32:19.380> different<00:32:19.668> because<00:32:19.861> the<00:32:19.957> data<00:32:20.181> evolved.

00:32:21.062 --> 00:32:22.857
I've<00:32:21.222> learned<00:32:21.463> this<00:32:21.639> in<00:32:21.719> every<00:32:21.943> disaster<00:32:22.440> we've<00:32:22.600> dealt<00:32:22.760> with.

00:32:22.937 --> 00:32:29.121
You<00:32:23.017> know,<00:32:23.081> of<00:32:23.225> course,<00:32:23.401> running<00:32:23.578> a<00:32:23.626> hospital<00:32:23.962> system,<00:32:24.347> you<00:32:24.379> get<00:32:24.523> a<00:32:24.587> hurricane<00:32:24.939> in<00:32:25.068> Houston<00:32:26.029> and<00:32:26.509> all<00:32:26.606> hands<00:32:26.910> on<00:32:27.006> deck,<00:32:27.311> I'm<00:32:27.407> at<00:32:27.551> the<00:32:27.631> hospital,<00:32:28.288> you<00:32:28.368> know,<00:32:28.432> etc.,<00:32:28.865> etc.

00:32:29.169 --> 00:32:36.010
And<00:32:29.393> I<00:32:29.425> know<00:32:29.730> that<00:32:29.874> we'll<00:32:29.970> make<00:32:30.130> a<00:32:30.194> decision<00:32:30.611> at<00:32:30.755> 8<00:32:30.867> in<00:32:30.931> the<00:32:31.011> morning<00:32:31.796> watching<00:32:32.053> the<00:32:32.133> thing<00:32:32.373> barreling<00:32:32.774> down<00:32:33.078> at<00:32:33.238> us,<00:32:33.399> and<00:32:33.895> 5<00:32:34.152> hours<00:32:34.456> later<00:32:34.600> you're<00:32:34.712> like,<00:32:34.857> well,<00:32:34.937> that<00:32:35.081> was<00:32:35.177> a<00:32:35.241> stupid<00:32:35.578> decision.

00:32:36.058 --> 00:32:38.766
You<00:32:36.138> make<00:32:36.314> a<00:32:36.379> different<00:32:36.619> decision<00:32:37.100> based<00:32:37.420> on<00:32:37.500> the<00:32:37.580> facts<00:32:38.045> on<00:32:38.125> the<00:32:38.205> ground,<00:32:38.525> right?

00:32:38.878 --> 00:32:43.540
It's—<00:32:39.102> you'd<00:32:39.246> hear<00:32:39.423> the<00:32:39.503> same<00:32:39.807> from<00:32:39.903> anybody<00:32:40.624> who's<00:32:40.865> in<00:32:41.009> a,<00:32:41.169> in<00:32:41.249> a,<00:32:41.730> you<00:32:41.762> know,<00:32:41.906> armed<00:32:42.146> conflict<00:32:42.707> or<00:32:42.771> anything<00:32:42.947> else<00:32:43.188> like<00:32:43.348> that.

00:32:43.909 --> 00:32:57.721
It<00:32:43.989> was<00:32:44.133> the<00:32:44.229> same<00:32:44.549> with<00:32:44.774> this,<00:32:45.334> um,<00:32:45.815> and<00:32:46.676> And<00:32:46.696> unfortunately,<00:32:47.834> we<00:32:47.994> saw<00:32:48.715> people<00:32:49.501> and<00:32:50.142> our<00:32:50.718> political<00:32:51.167> leaders<00:32:51.520> decide,<00:32:52.000> oh,<00:32:52.225> I'm<00:32:52.273> going<00:32:52.385> to<00:32:52.481> take<00:32:52.802> this<00:32:53.346> viewpoint,<00:32:53.779> I'm<00:32:53.875> going<00:32:54.019> to<00:32:54.067> take<00:32:54.308> that<00:32:54.548> viewpoint,<00:32:55.365> there'll<00:32:55.510> be<00:32:55.606> nothing<00:32:55.990> in<00:32:56.087> between,<00:32:56.647> and<00:32:56.727> I'm<00:32:56.808> going<00:32:56.952> to<00:32:56.984> throw<00:32:57.112> rocks<00:32:57.352> at<00:32:57.465> the<00:32:57.593> others.

00:32:57.769 --> 00:33:02.240
And<00:32:57.865> so<00:32:58.875> if<00:32:58.955> you<00:32:59.195> ask<00:32:59.355> about<00:32:59.532> this<00:32:59.756> trust<00:33:00.157> question,<00:33:00.653> it<00:33:00.894> goes<00:33:01.294> back<00:33:01.679> to<00:33:01.935> that.

00:33:02.737 --> 00:33:08.249
We<00:33:02.897> need<00:33:03.121> to<00:33:03.281> bring<00:33:03.938> people's<00:33:04.643> voices<00:33:05.300> back<00:33:06.406> to<00:33:06.582> where<00:33:06.823> the<00:33:06.903> middle<00:33:07.303> has<00:33:07.544> a<00:33:07.624> better<00:33:07.944> voice.

00:33:08.906 --> 00:33:17.963
And<00:33:08.986> I'll<00:33:09.066> be<00:33:09.226> really<00:33:09.531> clear,<00:33:09.787> I'm<00:33:09.947> not<00:33:10.188> saying<00:33:11.229> we<00:33:11.374> shouldn't<00:33:11.790> listen<00:33:12.111> to<00:33:12.255> people<00:33:12.575> where<00:33:13.457> views<00:33:13.778> that<00:33:13.938> are,<00:33:14.195> you<00:33:14.275> know,<00:33:14.500> very,<00:33:14.756> very<00:33:14.981> conservative,<00:33:15.702> or<00:33:15.943> views<00:33:16.199> that<00:33:16.344> are<00:33:16.504> very,<00:33:16.760> very<00:33:17.081> liberal<00:33:17.306> or<00:33:17.466> progressive.

00:33:19.390 --> 00:33:20.497
They<00:33:19.567> deserve<00:33:19.967> voices.

00:33:20.946 --> 00:33:23.511
So<00:33:21.170> does<00:33:21.394> everybody<00:33:21.795> in<00:33:21.892> between,<00:33:22.292> the<00:33:22.389> bell-shaped<00:33:22.838> curve<00:33:23.094> in<00:33:23.174> between.

00:33:23.575 --> 00:33:29.877
And<00:33:23.639> the<00:33:23.816> fact<00:33:23.992> of<00:33:24.056> the<00:33:24.201> matter<00:33:24.457> is,<00:33:24.617> most<00:33:24.954> of<00:33:25.018> our<00:33:25.115> society<00:33:25.660> is<00:33:25.740> somewhere<00:33:26.285> in<00:33:26.381> the<00:33:26.622> bulk<00:33:26.926> of<00:33:27.023> the<00:33:27.183> bell-shaped<00:33:27.744> curve,<00:33:28.450> not<00:33:28.626> the<00:33:28.706> tails<00:33:29.091> of<00:33:29.123> the<00:33:29.252> bell-shaped<00:33:29.668> curve.

00:33:30.053 --> 00:33:35.216
But<00:33:30.230> the<00:33:30.310> voices<00:33:31.352> and<00:33:31.512> the<00:33:31.657> voting<00:33:32.298> in<00:33:32.458> the<00:33:32.635> primary<00:33:33.036> systems<00:33:33.517> are<00:33:33.741> all<00:33:33.902> going<00:33:34.158> to<00:33:34.302> the<00:33:34.399> tails<00:33:34.784> of<00:33:34.864> the<00:33:34.960> curve.

00:33:35.265 --> 00:33:37.654
So<00:33:35.425> we<00:33:35.521> want<00:33:35.665> to<00:33:35.746> fix<00:33:36.628> trust<00:33:37.044> in<00:33:37.189> science.

00:33:37.750 --> 00:33:38.840
We<00:33:37.846> have<00:33:38.071> to<00:33:38.167> fix<00:33:38.488> some<00:33:38.648> of<00:33:38.712> that.

00:33:38.888 --> 00:33:56.602
We<00:33:39.113> have<00:33:39.369> to<00:33:39.466> think<00:33:39.786> about<00:33:40.957> I<00:33:41.678> mean,<00:33:42.095> and<00:33:42.159> I<00:33:42.255> don't<00:33:42.383> know<00:33:42.415> how<00:33:42.576> to<00:33:42.608> do<00:33:42.672> this,<00:33:43.121> but<00:33:43.698> decorum<00:33:45.044> and<00:33:45.686> how<00:33:45.878> we<00:33:46.022> interact<00:33:46.487> with<00:33:46.663> people<00:33:47.289> in<00:33:47.465> times<00:33:48.026> when<00:33:48.186> we<00:33:48.347> are,<00:33:48.972> let's<00:33:49.164> say,<00:33:49.389> a<00:33:49.469> little<00:33:49.693> more<00:33:49.869> anonymous<00:33:50.511> than<00:33:50.815> when<00:33:50.976> you<00:33:51.136> and<00:33:51.184> I<00:33:51.216> are<00:33:51.392> sitting<00:33:51.633> here<00:33:52.338> on<00:33:53.540> a<00:33:53.572> Zoom<00:33:54.743> or<00:33:54.823> on<00:33:54.919> a<00:33:54.999> podcast,<00:33:55.961> right?

00:33:57.147 --> 00:34:06.813
You<00:33:57.243> go<00:33:57.388> out<00:33:57.484> to<00:33:57.580> the<00:33:57.724> internet,<00:33:58.430> you're<00:33:58.590> interested<00:33:59.231> in<00:33:59.327> a<00:33:59.407> hobby,<00:34:00.369> and<00:34:00.514> you<00:34:00.610> go<00:34:00.706> to<00:34:00.834> a<00:34:00.914> hobby<00:34:01.171> site<00:34:01.491> where<00:34:01.572> people<00:34:01.828> are<00:34:01.956> chatting<00:34:02.293> about<00:34:02.469> your<00:34:02.597> hobby<00:34:03.335> and<00:34:03.415> people<00:34:03.736> start<00:34:04.617> yelling<00:34:05.002> at<00:34:05.098> each<00:34:05.323> other<00:34:05.579> and<00:34:05.739> getting<00:34:05.980> nasty<00:34:06.381> with<00:34:06.541> each<00:34:06.701> other.

00:34:06.861 --> 00:34:08.336
Like,<00:34:07.022> what<00:34:07.342> are<00:34:07.487> you<00:34:07.807> doing<00:34:08.208> here?

00:34:08.448 --> 00:34:10.244
You're<00:34:08.545> talking<00:34:08.945> about<00:34:09.250> a<00:34:09.266> hobby,<00:34:09.667> for<00:34:09.827> instance.

00:34:10.292 --> 00:34:12.055
You<00:34:10.372> know,<00:34:10.548> we're<00:34:10.869> not<00:34:11.013> even<00:34:11.174> talking<00:34:11.494> the<00:34:11.654> political.

00:34:12.199 --> 00:34:14.768
We've<00:34:12.712> kind<00:34:12.937> of<00:34:13.756> got<00:34:13.933> to<00:34:14.158> back<00:34:14.623> up.

00:34:14.816 --> 00:34:16.919
And<00:34:14.944> it's<00:34:15.057> been<00:34:15.266> one<00:34:15.426> of<00:34:15.458> the<00:34:15.603> downsides<00:34:16.181> of<00:34:16.309> social<00:34:16.711> media.

00:34:16.968 --> 00:34:19.906
And<00:34:17.032> when<00:34:17.112> you<00:34:17.273> ask<00:34:17.385> about<00:34:17.674> AI,<00:34:18.413> there's<00:34:18.718> so<00:34:18.959> many<00:34:19.296> positives.

00:34:20.003 --> 00:34:25.205
But<00:34:20.661> where<00:34:20.805> I<00:34:20.902> lose<00:34:21.062> a<00:34:21.127> little<00:34:21.368> sleep<00:34:21.721> and<00:34:21.785> I<00:34:21.865> worry<00:34:22.026> a<00:34:22.090> little<00:34:22.267> bit<00:34:22.411> about<00:34:22.604> is<00:34:23.070> what<00:34:23.246> are<00:34:23.327> the<00:34:23.455> negatives<00:34:23.873> going<00:34:23.969> to<00:34:24.113> be<00:34:24.210> that<00:34:24.354> we<00:34:24.499> haven't<00:34:24.740> anticipated?

00:34:25.253 --> 00:34:39.898
Because<00:34:25.462> I<00:34:25.478> think<00:34:25.719> we<00:34:25.944> let<00:34:26.185> social<00:34:26.586> media<00:34:27.389> just<00:34:27.887> run<00:34:28.449> and<00:34:28.594> get<00:34:28.754> out<00:34:28.867> of<00:34:28.931> control<00:34:29.557> to<00:34:29.718> a<00:34:29.734> point<00:34:30.039> now<00:34:30.280> where<00:34:30.456> we're<00:34:30.601> trying<00:34:30.777> to<00:34:30.858> figure<00:34:31.163> out<00:34:31.564> how<00:34:31.596> do<00:34:31.661> we<00:34:31.805> put<00:34:31.966> some<00:34:32.078> structure<00:34:32.463> around<00:34:32.849> this<00:34:33.652> that<00:34:33.909> it<00:34:34.214> doesn't<00:34:35.113> really<00:34:35.498> lead<00:34:35.755> to<00:34:35.900> some<00:34:36.173> of<00:34:37.746> these<00:34:38.581> stressors<00:34:39.208> in<00:34:39.272> our<00:34:39.384> society.

00:34:40.476 --> 00:34:49.917
When<00:34:40.797> I<00:34:40.877> talk<00:34:41.053> to<00:34:41.134> my<00:34:41.294> board,<00:34:42.352> I<00:34:42.480> tell<00:34:42.656> them<00:34:42.881> the<00:34:43.073> most<00:34:43.442> important<00:34:43.922> job<00:34:44.483> I<00:34:44.644> have<00:34:45.060> and<00:34:45.205> they<00:34:45.445> have<00:34:46.407> is<00:34:46.503> the<00:34:46.647> culture<00:34:46.968> of<00:34:47.064> our<00:34:47.128> organization,<00:34:47.865> circling<00:34:48.266> back<00:34:48.490> to<00:34:48.571> some<00:34:48.747> of<00:34:48.843> our<00:34:49.067> early<00:34:49.372> discussion.

00:34:50.013 --> 00:35:04.182
Well,<00:34:50.975> when<00:34:51.151> you<00:34:51.295> have<00:34:51.472> a<00:34:51.552> great<00:34:51.872> culture<00:34:52.273> and<00:34:52.353> you<00:34:52.433> have<00:34:52.738> 32,000<00:34:53.716> people<00:34:54.261> who<00:34:54.517> share<00:34:55.078> a<00:34:55.158> common<00:34:55.559> culture<00:34:56.040> yet<00:34:56.905> are<00:34:57.707> all<00:34:57.963> over<00:34:58.219> that<00:34:58.668> spectrum<00:34:59.165> of<00:34:59.325> political<00:34:59.790> thought<00:35:00.511> and<00:35:00.928> opinion<00:35:01.489> thought<00:35:01.810> and<00:35:01.954> other<00:35:02.130> things<00:35:02.403> like<00:35:02.595> that,<00:35:02.836> that's<00:35:03.012> a<00:35:03.252> wonderful<00:35:03.813> thing.

00:35:04.695 --> 00:35:05.801
We<00:35:04.839> can<00:35:04.999> share<00:35:05.272> that<00:35:05.496> culture.

00:35:05.881 --> 00:35:07.772
Why<00:35:06.041> can't<00:35:06.282> we<00:35:06.442> do<00:35:06.602> that<00:35:06.859> better<00:35:07.115> societally?

00:35:07.884 --> 00:35:10.706
I<00:35:07.916> think<00:35:08.205> it<00:35:08.381> takes<00:35:08.510> takes<00:35:09.253> real<00:35:09.689> significant<00:35:10.400> leadership.

00:35:10.787 --> 00:35:12.855
I<00:35:10.820> think<00:35:11.046> businesses<00:35:11.611> are<00:35:11.692> a<00:35:11.773> big<00:35:11.934> part<00:35:12.176> of<00:35:12.241> the<00:35:12.338> answer<00:35:12.532> to<00:35:12.661> that.

00:35:13.695 --> 00:35:17.750
Do<00:35:13.760> you<00:35:13.856> think<00:35:14.099> in<00:35:14.196> 20<00:35:14.583> years<00:35:14.923> we'll<00:35:15.149> look<00:35:15.262> at<00:35:15.343> social<00:35:15.746> media<00:35:15.989> the<00:35:16.070> same<00:35:16.376> way<00:35:16.619> we<00:35:16.699> look<00:35:16.877> at<00:35:16.958> cigarettes<00:35:17.507> today?

00:35:20.550 --> 00:35:22.647
I<00:35:20.566> don't<00:35:20.646> think<00:35:20.808> that's<00:35:21.469> a<00:35:21.550> fair<00:35:22.098> analogy.

00:35:22.744 --> 00:35:27.164
I,<00:35:22.921> I—<00:35:23.163> there's,<00:35:23.954> there's<00:35:24.147> no<00:35:24.889> safe<00:35:25.648> use<00:35:26.148> of<00:35:26.245> cigarettes,<00:35:26.793> period.

00:35:27.277 --> 00:35:30.572
I<00:35:27.293> mean,<00:35:27.503> they,<00:35:27.745> they<00:35:27.906> were<00:35:28.003> one<00:35:28.181> of<00:35:28.229> the<00:35:28.326> worst<00:35:28.648> things<00:35:28.890> we<00:35:29.052> ever<00:35:29.213> invented,<00:35:29.858> the<00:35:29.923> dumbest<00:35:30.230> things<00:35:30.344> we<00:35:30.425> ever—.

00:35:30.572 --> 00:35:33.082
Yeah,<00:35:30.670> there's<00:35:31.159> no<00:35:31.387> like,<00:35:31.729> uh,<00:35:32.300> mind-boggling—.

00:35:33.425 --> 00:35:35.479
There's<00:35:33.669> lots<00:35:33.865> of<00:35:34.012> good<00:35:34.240> uses<00:35:34.664> for<00:35:34.745> social<00:35:35.104> media,<00:35:35.414> okay?

00:35:35.630 --> 00:35:38.069
Let's<00:35:35.742> be<00:35:35.967> clear,<00:35:36.304> lots<00:35:36.528> of<00:35:36.705> wonderful<00:35:37.170> uses<00:35:37.491> for<00:35:37.588> social<00:35:37.860> media.

00:35:38.165 --> 00:35:47.811
So<00:35:38.856> I<00:35:38.952> think<00:35:39.209> it's<00:35:39.369> a<00:35:39.498> matter<00:35:39.835> of<00:35:40.075> understanding<00:35:40.782> where<00:35:40.878> the<00:35:41.022> boundaries<00:35:41.504> are<00:35:41.921> and<00:35:42.082> trying<00:35:42.403> to<00:35:42.547> understand,<00:35:44.152> you<00:35:44.184> know,<00:35:44.393> how<00:35:44.714> we<00:35:44.810> should<00:35:45.115> be<00:35:45.356> acting,<00:35:45.773> how<00:35:46.030> we<00:35:46.158> should<00:35:46.399> acknowledge<00:35:46.977> the<00:35:47.121> fact<00:35:47.378> that<00:35:47.474> it's<00:35:47.699> there.

00:35:48.421 --> 00:35:52.562
It's<00:35:48.919> a<00:35:49.144> broad<00:35:49.705> cultural<00:35:50.203> societal<00:35:51.310> discussion<00:35:51.792> that<00:35:51.936> we<00:35:52.033> need<00:35:52.145> to<00:35:52.257> have.

00:35:52.739 --> 00:36:01.520
And<00:35:52.819> I<00:35:52.980> think<00:35:53.156> there's<00:35:53.317> a<00:35:53.397> lesson<00:35:53.798> there<00:35:54.023> for<00:35:55.467> as<00:35:55.708> we<00:35:55.820> are<00:35:56.029> rolling<00:35:56.430> out<00:35:56.591> AI,<00:35:56.848> which,<00:35:57.072> you<00:35:57.120> know,<00:35:57.313> rolling<00:35:57.650> out<00:35:57.746> is<00:35:57.811> probably<00:35:58.148> not<00:35:59.560> the<00:35:59.640> right<00:35:59.817> word<00:35:59.993> because<00:36:00.282> it's<00:36:00.603> rolling<00:36:01.101> on<00:36:01.197> its<00:36:01.407> own.

00:36:01.972 --> 00:36:21.175
But<00:36:02.134> as<00:36:02.312> we<00:36:02.474> do,<00:36:02.716> we<00:36:02.942> have<00:36:03.347> to<00:36:03.508> have,<00:36:04.721> um,<00:36:05.060> you<00:36:05.141> know,<00:36:05.319> the<00:36:05.610> right<00:36:06.515> people,<00:36:07.712> um,<00:36:08.132> you<00:36:08.229> know,<00:36:08.536> the<00:36:08.682> philosophers,<00:36:09.652> the<00:36:09.829> educational<00:36:10.622> leaders,<00:36:11.010> the<00:36:11.122> experts<00:36:11.607> in<00:36:11.687> the<00:36:11.833> content,<00:36:12.656> our<00:36:12.817> political<00:36:13.285> leaders,<00:36:13.785> and<00:36:13.931> many<00:36:14.334> others<00:36:15.625> having<00:36:16.045> the<00:36:16.206> tough<00:36:16.529> decisions,<00:36:17.481> um,<00:36:17.723> and<00:36:17.885> tough<00:36:18.143> discussions<00:36:18.950> and<00:36:19.095> putting<00:36:19.353> some<00:36:19.531> of<00:36:19.595> the<00:36:19.660> structure<00:36:20.160> and<00:36:20.290> expectations<00:36:20.896> in<00:36:20.978> place.

00:36:23.701 --> 00:36:29.095
In<00:36:24.106> medicine—<00:36:24.575> excuse<00:36:25.483> me—<00:36:26.714> CRISPR<00:36:27.119> is<00:36:27.265> a<00:36:27.346> great<00:36:27.605> example<00:36:28.026> of<00:36:28.091> that,<00:36:28.253> some<00:36:28.399> of<00:36:28.431> the<00:36:28.561> gene<00:36:28.804> editing.

00:36:29.144 --> 00:36:35.058
There's<00:36:29.533> actually<00:36:29.792> been<00:36:30.019> a<00:36:30.197> lot<00:36:30.456> of<00:36:30.666> effort<00:36:31.323> through<00:36:31.643> the<00:36:31.788> field<00:36:32.205> to<00:36:32.285> say,<00:36:32.525> hey,<00:36:33.247> this<00:36:33.487> is<00:36:34.208> game-changing.

00:36:35.315 --> 00:36:50.416
The,<00:36:35.796> you<00:36:35.828> know,<00:36:35.972> the<00:36:36.212> people<00:36:36.613> that<00:36:36.757> are<00:36:36.838> going<00:36:36.918> to<00:36:37.014> be<00:36:37.238> helped<00:36:37.799> medically,<00:36:39.002> you<00:36:39.322> know,<00:36:39.435> there<00:36:39.659> are<00:36:39.803> trials<00:36:40.284> out<00:36:40.541> there<00:36:40.781> now,<00:36:41.326> you<00:36:41.406> know,<00:36:41.647> kind<00:36:41.807> of<00:36:41.984> starting<00:36:42.465> to<00:36:42.609> dribble<00:36:43.010> out<00:36:43.186> where<00:36:43.346> you're<00:36:43.507> taking<00:36:43.891> people<00:36:44.132> with<00:36:44.244> sickle<00:36:44.645> cell<00:36:45.591> disease<00:36:46.072> and<00:36:46.152> you're<00:36:46.376> able<00:36:46.553> to<00:36:46.697> change<00:36:47.114> enough<00:36:47.611> that<00:36:47.755> you<00:36:47.851> can<00:36:48.556> dramatically<00:36:49.438> transform<00:36:49.999> their<00:36:50.160> lives.

00:36:50.544 --> 00:36:55.562
That<00:36:50.945> is<00:36:51.538> society-changing,<00:36:53.189> you<00:36:53.270> know,<00:36:53.606> one<00:36:53.783> of<00:36:53.847> the<00:36:54.007> best<00:36:54.312> things<00:36:54.552> that<00:36:54.632> could<00:36:54.809> ever<00:36:55.033> happen,<00:36:55.434> right?

00:36:56.300 --> 00:37:06.076
But<00:36:57.118> you<00:36:57.215> can<00:36:57.375> see<00:36:57.552> some<00:36:57.841> of<00:36:57.873> that<00:36:58.033> same<00:36:58.419> technology<00:36:59.141> being<00:36:59.446> used<00:36:59.928> for<00:37:00.586> bioterrorism,<00:37:01.533> for<00:37:01.694> instance,<00:37:02.272> for<00:37:03.540> eugenics,<00:37:04.198> for,<00:37:04.904> you<00:37:04.937> know,<00:37:05.161> etc.,<00:37:05.707> etc.

00:37:06.125 --> 00:37:09.689
And<00:37:06.205> so<00:37:06.927> that<00:37:07.168> field—<00:37:07.586> I'm<00:37:07.730> not<00:37:07.874> saying<00:37:08.035> they<00:37:08.115> got<00:37:08.228> it<00:37:08.308> solved—<00:37:08.838> has<00:37:09.014> really<00:37:09.255> tackled<00:37:09.640> that.

00:37:09.737 --> 00:37:13.124
I<00:37:09.817> think<00:37:09.994> we're<00:37:10.122> at<00:37:10.218> a<00:37:10.234> moment<00:37:10.700> with<00:37:10.925> AI<00:37:11.246> where<00:37:11.342> we<00:37:11.487> have<00:37:11.583> to<00:37:11.744> tackle<00:37:12.065> many<00:37:12.305> of<00:37:12.386> those<00:37:12.546> same<00:37:12.803> issues.

00:37:14.152 --> 00:37:24.683
I<00:37:14.216> wonder,<00:37:14.473> like,<00:37:14.874> just<00:37:15.035> back<00:37:15.211> on<00:37:15.275> the<00:37:15.356> social<00:37:15.645> media<00:37:15.918> thing<00:37:16.158> real<00:37:16.319> quick,<00:37:16.624> and<00:37:16.865> I<00:37:16.961> think<00:37:17.138> it's<00:37:17.427> actually<00:37:17.684> even<00:37:17.989> a<00:37:18.005> larger<00:37:18.486> point,<00:37:18.888> like,<00:37:19.112> obviously<00:37:19.369> there's<00:37:19.594> no,<00:37:19.754> like,<00:37:20.413> you<00:37:20.445> don't<00:37:20.573> get<00:37:20.798> lung<00:37:21.039> cancer,<00:37:21.858> uh,<00:37:22.098> so,<00:37:22.403> so<00:37:22.580> the,<00:37:22.821> the<00:37:23.142> corollary<00:37:24.009> isn't<00:37:24.346> that<00:37:24.506> great.

00:37:24.731 --> 00:37:29.707
But<00:37:24.828> I'm<00:37:25.052> actually—<00:37:25.373> I<00:37:25.454> actually<00:37:25.711> live<00:37:25.807> in<00:37:26.000> state<00:37:26.754> in<00:37:26.914> Utah<00:37:27.315> where<00:37:27.540> they've<00:37:27.733> sued<00:37:28.118> these<00:37:28.310> social<00:37:28.599> media<00:37:28.984> companies,<00:37:29.482> right?

00:37:29.947 --> 00:37:34.874
And<00:37:30.124> they've<00:37:30.348> really<00:37:30.750> tried<00:37:31.006> to<00:37:31.167> limit,<00:37:32.114> uh,<00:37:32.611> the<00:37:32.707> effects<00:37:33.398> and<00:37:33.735> access<00:37:34.136> that<00:37:34.296> children<00:37:34.762> have.

00:37:34.954 --> 00:37:38.453
I<00:37:34.970> don't<00:37:35.163> think<00:37:35.259> they've<00:37:35.371> done<00:37:35.564> a<00:37:35.580> good<00:37:35.740> job<00:37:35.981> of<00:37:36.142> it<00:37:36.286> yet,<00:37:37.169> or<00:37:37.506> even<00:37:37.682> if<00:37:37.827> it<00:37:37.907> should<00:37:38.148> do<00:37:38.228> that.

00:37:38.549 --> 00:37:40.266
I<00:37:38.629> actually<00:37:38.838> have<00:37:38.950> no<00:37:39.592> real<00:37:39.752> sense<00:37:40.073> of<00:37:40.154> it.

00:37:40.796 --> 00:37:44.150
I've<00:37:40.956> interviewed<00:37:41.277> Mark<00:37:41.534> Zuckerberg<00:37:42.304> and<00:37:42.384> he<00:37:42.481> tells<00:37:42.785> me<00:37:42.818> it's<00:37:42.994> not<00:37:43.139> a<00:37:43.203> big<00:37:43.363> deal,<00:37:43.845> right?

00:37:44.246 --> 00:37:45.449
And<00:37:44.342> so<00:37:45.032> I<00:37:45.128> don't<00:37:45.321> know.

00:37:46.252 --> 00:37:53.136
But,<00:37:47.279> um,<00:37:48.338> I<00:37:48.482> wonder<00:37:48.723> like<00:37:48.980> the<00:37:49.076> mental<00:37:49.766> health<00:37:51.050> of<00:37:51.211> our<00:37:51.323> society,<00:37:52.093> how<00:37:52.334> you<00:37:52.494> think<00:37:52.751> of<00:37:52.880> that.

00:37:53.472 --> 00:38:00.107
And<00:37:53.617> that's<00:37:53.777> what<00:37:53.873> I<00:37:54.017> think,<00:37:54.177> like,<00:37:54.338> when<00:37:54.434> people<00:37:54.690> say<00:37:54.915> that—<00:37:55.219> ask<00:37:55.395> that<00:37:55.556> cigarettes<00:37:56.116> question,<00:37:56.517> they're<00:37:56.661> like,<00:37:57.398> well,<00:37:57.495> that—<00:37:57.863> will<00:37:58.103> their<00:37:58.264> mental<00:37:58.584> health<00:37:58.809> have<00:37:58.921> the<00:37:59.017> same<00:37:59.241> type<00:37:59.498> of<00:37:59.626> an<00:37:59.658> effect?

00:38:00.747 --> 00:38:17.717
Social<00:38:01.052> media,<00:38:01.324> or<00:38:01.485> just<00:38:01.645> like<00:38:01.821> society<00:38:02.286> at<00:38:02.366> large,<00:38:02.702> and<00:38:02.767> particularly<00:38:03.151> like<00:38:03.327> coming<00:38:03.648> out<00:38:03.744> of<00:38:03.888> COVID<00:38:04.930> the<00:38:05.026> state<00:38:05.346> of<00:38:05.411> mental<00:38:05.731> health<00:38:06.452> of<00:38:06.596> society<00:38:07.414> and<00:38:07.958> all<00:38:08.135> of<00:38:08.231> us<00:38:08.455> being<00:38:08.696> cooped<00:38:08.936> up<00:38:09.096> that<00:38:09.321> long,<00:38:09.913> and,<00:38:11.003> you<00:38:11.099> know,<00:38:11.340> our<00:38:11.500> only<00:38:11.804> outlet<00:38:12.205> was<00:38:12.317> like<00:38:12.541> fighting<00:38:12.862> with<00:38:13.038> each<00:38:13.182> other<00:38:13.423> on<00:38:13.567> the<00:38:13.663> internet<00:38:14.368> and,<00:38:14.769> you<00:38:14.977> know,<00:38:15.586> like<00:38:15.987> talking<00:38:16.307> to<00:38:16.371> each<00:38:16.532> other<00:38:16.708> via<00:38:17.012> Zoom<00:38:17.333> calls.

00:38:18.070 --> 00:38:23.007
I<00:38:18.214> wonder<00:38:18.390> how<00:38:18.535> you<00:38:18.631> think<00:38:18.951> about<00:38:19.160> about<00:38:20.073> societal<00:38:20.939> mental<00:38:21.259> health<00:38:21.676> and<00:38:21.772> then<00:38:21.933> individual<00:38:22.558> mental<00:38:22.862> health?

00:38:24.225 --> 00:38:27.784
Well,<00:38:24.626> yeah,<00:38:24.786> I<00:38:25.043> guess<00:38:25.427> I'll<00:38:25.620> start<00:38:26.229> as<00:38:26.341> a<00:38:26.405> physician.

00:38:27.992 --> 00:38:42.195
You<00:38:28.024> know,<00:38:28.152> one<00:38:28.265> of<00:38:28.329> the<00:38:28.409> things<00:38:28.633> that<00:38:29.836> has<00:38:30.076> trended<00:38:30.637> very<00:38:31.118> well,<00:38:31.374> I'd<00:38:31.551> say,<00:38:32.096> you<00:38:32.176> know,<00:38:32.272> in<00:38:32.416> the<00:38:32.497> 30<00:38:32.817> years<00:38:33.298> I've<00:38:33.458> been<00:38:33.603> a<00:38:33.619> physician,<00:38:34.965> is<00:38:35.446> thinking<00:38:36.023> about<00:38:36.328> mental<00:38:36.729> health<00:38:37.770> more<00:38:38.171> like<00:38:38.508> we<00:38:38.652> think<00:38:38.925> about<00:38:39.550> hypertension,<00:38:40.351> high<00:38:40.592> cholesterol,<00:38:41.313> etc.,<00:38:41.778> etc.

00:38:42.499 --> 00:38:43.926
We're<00:38:42.612> not<00:38:42.820> there<00:38:42.932> yet,<00:38:43.157> don't<00:38:43.397> get<00:38:43.557> me<00:38:43.702> wrong.

00:38:44.038 --> 00:38:55.432
But,<00:38:44.744> you<00:38:44.824> know,<00:38:44.936> there<00:38:45.144> was<00:38:45.321> a<00:38:45.545> time<00:38:45.770> time<00:38:46.843> when<00:38:47.084> nobody<00:38:47.789> would<00:38:47.949> talk<00:38:48.205> about<00:38:48.510> the<00:38:48.606> fact<00:38:49.071> that<00:38:49.471> they<00:38:49.631> had<00:38:49.728> a<00:38:49.792> mental<00:38:50.289> ill—<00:38:50.913> mental<00:38:51.234> health<00:38:51.570> issue,<00:38:52.612> and<00:38:52.772> where<00:38:52.917> it's<00:38:53.077> much<00:38:53.333> more<00:38:53.493> socially<00:38:53.958> acceptable<00:38:54.487> to<00:38:54.840> talk<00:38:55.112> about<00:38:55.352> it.

00:38:55.513 --> 00:38:59.791
Now<00:38:55.657> let<00:38:56.154> me<00:38:56.298> be<00:38:56.442> clear,<00:38:56.859> it's<00:38:57.099> not<00:38:57.644> fully<00:38:57.900> socially<00:38:58.445> acceptable<00:38:59.022> to<00:38:59.182> do<00:38:59.343> so,<00:38:59.583> right?

00:39:00.384 --> 00:39:18.035
But<00:39:00.528> if<00:39:00.609> you<00:39:00.705> think<00:39:00.961> about<00:39:01.266> it,<00:39:02.692> our,<00:39:03.172> you<00:39:03.253> know,<00:39:03.509> we,<00:39:03.733> we<00:39:03.894> have<00:39:04.134> kind<00:39:04.246> of<00:39:04.310> some,<00:39:04.551> some<00:39:05.047> sort<00:39:05.336> of<00:39:05.512> artificial<00:39:06.137> distinctions<00:39:06.778> in<00:39:07.050> medicine<00:39:07.499> that<00:39:07.611> are<00:39:07.820> there<00:39:08.076> for<00:39:08.220> a<00:39:08.236> good<00:39:08.461> reason<00:39:08.797> of<00:39:08.861> how<00:39:09.102> we<00:39:09.198> treat<00:39:09.598> people,<00:39:10.384> the<00:39:10.464> expertise<00:39:10.977> you<00:39:11.121> might<00:39:11.345> have,<00:39:12.147> But<00:39:12.644> the<00:39:12.805> lines<00:39:13.206> between<00:39:13.607> what<00:39:13.751> a<00:39:13.767> psychiatrist<00:39:14.489> does,<00:39:14.794> what<00:39:14.890> a<00:39:14.906> neurologist<00:39:15.628> and<00:39:15.757> a<00:39:15.773> neurosurgeon<00:39:16.415> does,<00:39:16.639> I<00:39:16.655> mean,<00:39:16.800> those<00:39:16.992> are<00:39:17.217> blurry<00:39:17.538> lines,<00:39:17.778> right?

00:39:18.083 --> 00:39:33.340
Because<00:39:18.340> at<00:39:18.420> the<00:39:18.564> end<00:39:18.677> of<00:39:18.757> the<00:39:18.901> day,<00:39:19.142> whatever<00:39:19.463> you're<00:39:19.623> talking<00:39:20.024> about,<00:39:20.249> whether<00:39:20.409> you're<00:39:20.570> talking<00:39:20.826> about<00:39:21.051> depression<00:39:22.030> or<00:39:22.110> bipolar<00:39:22.575> disorder,<00:39:23.072> whether<00:39:23.217> you're<00:39:23.313> talking<00:39:23.650> about<00:39:24.500> Alzheimer's<00:39:24.949> disease,<00:39:25.302> or<00:39:25.383> whether<00:39:25.463> you're<00:39:25.575> talking<00:39:25.800> about<00:39:26.040> multiple<00:39:26.441> sclerosis<00:39:27.163> or<00:39:27.244> stroke,<00:39:28.431> every<00:39:28.607> single<00:39:29.008> one<00:39:29.185> of<00:39:29.313> them<00:39:30.051> is<00:39:30.196> your<00:39:30.340> nervous<00:39:30.693> system<00:39:31.158> not<00:39:31.335> functioning<00:39:31.896> the<00:39:31.976> way<00:39:32.137> it's<00:39:32.297> supposed<00:39:32.698> to<00:39:32.778> be,<00:39:33.083> right?

00:39:33.404 --> 00:39:35.923
And<00:39:34.126> all<00:39:34.447> different<00:39:34.768> causes,<00:39:35.185> different<00:39:35.506> reasons.

00:39:36.468 --> 00:39:39.661
The<00:39:36.613> problem<00:39:37.014> is,<00:39:37.335> you<00:39:37.367> know,<00:39:38.714> through<00:39:38.939> humankind.

00:39:39.821 --> 00:39:46.991
You<00:39:39.853> know,<00:39:40.013> if<00:39:40.222> you<00:39:40.944> had<00:39:41.120> bipolar<00:39:41.585> disorder,<00:39:42.099> schizophrenia,<00:39:42.949> worse,<00:39:43.270> let's<00:39:43.446> say<00:39:43.590> 1,000<00:39:44.088> years<00:39:44.312> ago,<00:39:44.553> you<00:39:44.585> know,<00:39:44.793> you<00:39:44.874> were<00:39:45.194> possessed<00:39:45.611> by<00:39:45.772> demons<00:39:46.253> is<00:39:46.333> what<00:39:46.494> people<00:39:46.814> thought.

00:39:47.055 --> 00:39:49.525
And<00:39:47.376> it<00:39:47.616> got<00:39:47.937> treated<00:39:48.338> that<00:39:48.499> way<00:39:48.659> and<00:39:48.739> literally<00:39:49.140> demonized.

00:39:50.006 --> 00:39:56.567
If<00:39:50.087> you<00:39:50.183> had<00:39:50.279> a<00:39:50.343> stroke,<00:39:50.744> everybody<00:39:51.081> knew<00:39:51.290> something<00:39:51.610> really<00:39:51.787> bad<00:39:52.044> happened<00:39:52.428> and<00:39:52.573> dad<00:39:53.070> can't<00:39:53.375> use<00:39:53.615> the<00:39:53.696> right<00:39:53.888> side<00:39:54.193> of<00:39:54.273> his<00:39:54.498> arm,<00:39:54.674> you<00:39:54.770> know,<00:39:55.075> of<00:39:55.219> his,<00:39:55.476> of<00:39:55.556> his<00:39:55.717> body<00:39:55.973> or<00:39:56.038> whatever<00:39:56.342> that<00:39:56.503> is.

00:39:57.882 --> 00:39:59.518
We've<00:39:58.347> come<00:39:58.620> so<00:39:58.909> far<00:39:59.229> with<00:39:59.390> that.

00:39:59.566 --> 00:40:00.866
We<00:39:59.647> have<00:39:59.807> so<00:40:00.192> far<00:40:00.449> to<00:40:00.609> go.

00:40:01.956 --> 00:40:04.186
Mental<00:40:02.277> health<00:40:02.694> affects<00:40:03.496> every<00:40:03.737> family.

00:40:04.459 --> 00:40:12.765
It<00:40:04.555> affects,<00:40:05.261> you<00:40:05.341> know,<00:40:05.806> at<00:40:06.610> least<00:40:06.883> a<00:40:06.947> significant<00:40:07.896> plurality,<00:40:08.490> if<00:40:08.635> not<00:40:08.812> a<00:40:08.876> majority<00:40:09.519> of<00:40:09.664> the<00:40:09.760> population<00:40:10.885> at<00:40:10.981> some<00:40:11.367> point<00:40:12.090> in<00:40:12.171> their<00:40:12.412> lives.

00:40:12.814 --> 00:40:23.930
Of<00:40:12.958> course,<00:40:13.376> the<00:40:13.457> more<00:40:13.762> common<00:40:14.180> things<00:40:14.913> like<00:40:15.161> depression<00:40:15.723> in<00:40:15.822> particular,<00:40:16.417> anxiety,<00:40:19.153> obsessive-compulsive<00:40:20.105> disorder—<00:40:20.299> I<00:40:20.347> mean,<00:40:20.444> these<00:40:20.670> things<00:40:21.154> affect<00:40:22.445> inordinate<00:40:23.026> numbers<00:40:23.446> of<00:40:23.591> people.

00:40:24.818 --> 00:40:27.433
And<00:40:24.947> so<00:40:25.609> thankfully,<00:40:26.173> we've,<00:40:26.561> we've<00:40:26.722> normalized<00:40:27.110> a<00:40:27.223> lot.

00:40:28.421 --> 00:40:34.460
Nothing<00:40:28.826> could<00:40:28.988> have<00:40:29.069> happened<00:40:29.554> worse<00:40:30.202> for<00:40:30.364> mental<00:40:30.688> health<00:40:31.011> than<00:40:31.125> something<00:40:31.578> like<00:40:32.015> a<00:40:32.080> pandemic<00:40:32.647> and<00:40:32.809> everything<00:40:33.197> that<00:40:33.294> went<00:40:33.456> around<00:40:33.764> with<00:40:33.861> that<00:40:34.088> pandemic.

00:40:34.509 --> 00:40:37.902
So<00:40:34.735> we're<00:40:34.849> still<00:40:34.929> societally<00:40:35.253> recovering<00:40:35.464> from<00:40:37.530> from<00:40:37.643> that.

00:40:38.048 --> 00:40:41.614
And<00:40:38.145> I<00:40:38.210> think<00:40:38.599> that's<00:40:38.924> going<00:40:39.037> to<00:40:39.167> continue<00:40:40.236> to<00:40:40.399> be<00:40:40.561> a<00:40:40.642> pretty<00:40:41.031> heavy<00:40:41.355> lift.

00:40:41.938 --> 00:40:46.818
Your<00:40:42.263> question<00:40:42.587> sort<00:40:42.749> of<00:40:42.781> started<00:40:43.219> around<00:40:44.127> the<00:40:44.886> internet<00:40:45.373> and<00:40:45.454> social<00:40:45.795> media<00:40:46.120> and<00:40:46.266> other<00:40:46.444> things.

00:40:46.997 --> 00:40:55.029
And<00:40:48.377> I<00:40:48.539> will<00:40:48.637> tell<00:40:48.945> you,<00:40:50.970> I'll<00:40:51.083> give<00:40:51.228> you<00:40:51.390> just<00:40:51.552> a<00:40:51.633> couple<00:40:52.781> disconnected<00:40:53.816> but<00:40:53.978> ultimately<00:40:54.318> connected<00:40:54.722> thoughts.

00:40:56.824 --> 00:40:59.105
We<00:40:56.970> like<00:40:57.148> to<00:40:57.229> refer<00:40:57.471> to<00:40:57.536> something<00:40:58.264> called<00:40:58.523> the<00:40:58.604> nature<00:40:58.992> pill.

00:40:59.170 --> 00:41:00.668
We<00:40:59.267> actually<00:40:59.493> do<00:40:59.574> some<00:40:59.736> study<00:41:00.059> around<00:41:00.303> this<00:41:00.535> here.

00:41:01.215 --> 00:41:04.102
This<00:41:01.464> is<00:41:01.563> around<00:41:02.127> the<00:41:02.376> benefit<00:41:02.725> of<00:41:02.791> being<00:41:02.940> in<00:41:02.973> the<00:41:03.412> outdoors.

00:41:04.278 --> 00:41:09.846
There<00:41:04.599> is<00:41:04.856> benefit<00:41:05.401> to<00:41:05.578> people<00:41:05.915> spending<00:41:06.460> time<00:41:07.487> in<00:41:07.583> the<00:41:07.728> outdoors,<00:41:08.225> particularly<00:41:08.787> the<00:41:08.899> more<00:41:09.108> nature<00:41:09.509> it<00:41:09.653> gets.

00:41:09.894 --> 00:41:14.081
In<00:41:09.974> other<00:41:10.134> words,<00:41:10.872> it's<00:41:11.193> fine<00:41:11.514> to<00:41:11.594> be<00:41:11.755> going<00:41:11.995> exercising,<00:41:12.557> walking<00:41:12.878> down<00:41:13.119> the<00:41:13.439> urban<00:41:13.680> street.

00:41:14.627 --> 00:41:21.766
It's<00:41:14.787> a<00:41:14.803> whole<00:41:14.980> nother<00:41:15.204> thing<00:41:15.445> to<00:41:15.589> be<00:41:16.087> in<00:41:16.183> a<00:41:16.327> quiet<00:41:16.728> area<00:41:17.194> with<00:41:17.755> chirping<00:41:18.092> birds<00:41:18.574> and<00:41:18.975> beautiful<00:41:19.360> trees<00:41:19.777> and<00:41:20.643> meadows<00:41:20.996> of<00:41:21.060> flowers<00:41:21.462> and<00:41:21.510> everything<00:41:21.686> else.

00:41:21.927 --> 00:41:24.398
These<00:41:22.200> are<00:41:22.408> actually<00:41:22.906> very<00:41:23.226> important<00:41:23.611> for<00:41:23.708> your<00:41:23.868> mental<00:41:24.173> health.

00:41:25.777 --> 00:41:27.189
I<00:41:25.890> mean,<00:41:26.179> let's<00:41:26.419> all<00:41:26.515> be<00:41:26.676> honest,<00:41:26.997> right?

00:41:27.382 --> 00:41:32.628
People<00:41:27.719> do<00:41:27.943> less<00:41:28.200> of<00:41:28.344> that<00:41:28.601> now<00:41:29.002> because<00:41:29.339> they're<00:41:29.548> on<00:41:29.724> their<00:41:29.885> social<00:41:30.286> media,<00:41:30.687> because<00:41:31.072> they're<00:41:31.313> on<00:41:31.425> their<00:41:31.634> devices,<00:41:32.340> et<00:41:32.420> cetera.

00:41:32.933 --> 00:41:37.443
The<00:41:33.335> second<00:41:33.800> is<00:41:34.137> our<00:41:34.298> brains<00:41:34.683> are<00:41:34.779> not<00:41:35.180> built<00:41:35.662> to<00:41:35.806> multitask,<00:41:36.689> yet<00:41:36.930> we<00:41:37.090> all<00:41:37.251> do<00:41:37.411> it.

00:41:37.491 --> 00:41:39.128
I'm<00:41:38.149> guilty<00:41:38.551> as<00:41:38.695> charged.

00:41:39.177 --> 00:41:41.969
I'll<00:41:39.273> be<00:41:39.417> the<00:41:39.498> first<00:41:39.819> to<00:41:39.915> say<00:41:40.156> it,<00:41:41.103> that<00:41:41.263> I<00:41:41.359> do<00:41:41.520> sometimes.

00:41:42.387 --> 00:41:53.172
But<00:41:42.483> if<00:41:42.515> I'm<00:41:42.724> watching<00:41:43.109> my<00:41:43.205> streaming<00:41:43.606> show<00:41:43.831> on<00:41:43.927> Netflix<00:41:44.409> and<00:41:44.505> instead<00:41:44.906> of<00:41:45.051> being<00:41:45.292> engaged<00:41:45.837> on<00:41:45.934> that<00:41:46.335> and<00:41:46.479> I'm<00:41:47.442> doing<00:41:47.699> something<00:41:48.646> where<00:41:48.887> I'm<00:41:49.127> in,<00:41:50.090> I'm<00:41:50.267> instead<00:41:50.732> distracted<00:41:51.374> doing<00:41:51.615> something<00:41:52.016> else<00:41:52.193> on<00:41:52.273> my<00:41:52.369> phone<00:41:52.610> at<00:41:52.739> the<00:41:52.771> same<00:41:53.060> time.

00:41:53.236 --> 00:41:55.018
I<00:41:53.316> see<00:41:53.461> it<00:41:53.557> in<00:41:53.702> the<00:41:53.798> younger<00:41:54.039> generation<00:41:54.664> even<00:41:54.841> more.

00:41:55.387 --> 00:41:56.623
Our<00:41:55.467> brains<00:41:55.788> aren't<00:41:55.964> designed<00:41:56.366> that<00:41:56.526> way.

00:41:56.687 --> 00:42:07.398
So<00:41:56.911> your<00:41:57.088> brain<00:41:57.393> kind<00:41:57.553> of<00:41:57.955> goes<00:41:58.195> back<00:41:58.452> and<00:41:58.532> forth,<00:41:58.934> and<00:41:59.078> so<00:41:59.239> you'll<00:41:59.479> catch<00:41:59.800> bits<00:42:00.057> of<00:42:00.202> this<00:42:00.458> and<00:42:00.603> then<00:42:00.763> go<00:42:00.860> do<00:42:01.100> bits<00:42:01.357> of<00:42:01.470> that,<00:42:02.062> you're<00:42:02.207> not<00:42:02.463> really<00:42:02.719> multi-processing<00:42:04.145> and<00:42:04.226> multitasking,<00:42:05.027> and<00:42:05.091> you're<00:42:05.267> not<00:42:05.572> giving<00:42:05.812> the<00:42:05.908> brain<00:42:06.709> the<00:42:06.853> unwinding.

00:42:08.392 --> 00:42:13.936
Being<00:42:08.696> connected<00:42:09.113> to<00:42:09.257> devices<00:42:09.818> constantly,<00:42:10.699> you<00:42:10.731> know,<00:42:11.260> always<00:42:11.580> looking<00:42:11.837> at<00:42:11.997> them,<00:42:12.622> having<00:42:12.942> that<00:42:13.103> interfere<00:42:13.439> with<00:42:13.535> sleep.

00:42:14.000 --> 00:42:19.015
And<00:42:14.144> I<00:42:14.240> think<00:42:14.417> sleep<00:42:14.961> is<00:42:15.042> a<00:42:15.202> huge,<00:42:16.324> still<00:42:16.788> very<00:42:17.125> under-recognized<00:42:18.070> aspect<00:42:18.487> of<00:42:18.567> mental<00:42:18.887> health.

00:42:19.064 --> 00:42:20.345
So<00:42:19.368> it's<00:42:19.833> all<00:42:19.993> of<00:42:20.089> the<00:42:20.153> above.

00:42:20.410 --> 00:42:25.633
And<00:42:20.490> I<00:42:20.650> mean,<00:42:20.810> I'm<00:42:20.954> no<00:42:21.131> expert<00:42:21.515> on<00:42:21.611> this,<00:42:21.852> but,<00:42:22.493> but<00:42:23.518> I<00:42:23.999> think<00:42:24.175> we<00:42:24.335> have<00:42:24.560> to<00:42:24.656> think<00:42:24.896> about<00:42:25.121> all<00:42:25.217> those<00:42:25.441> things.

00:42:25.713 --> 00:42:32.559
I<00:42:25.842> think<00:42:26.098> there<00:42:26.338> is<00:42:26.483> a<00:42:26.643> lot<00:42:26.915> of<00:42:27.204> rationale<00:42:27.877> for<00:42:28.101> people<00:42:28.405> to<00:42:28.903> question<00:42:29.287> themselves<00:42:29.624> and<00:42:29.720> say,<00:42:29.929> hey,<00:42:30.105> listen,<00:42:30.747> don't<00:42:30.891> get<00:42:30.987> me<00:42:31.068> wrong,<00:42:31.452> I<00:42:31.693> love<00:42:31.869> my<00:42:32.415> iPhone.

00:42:32.671 --> 00:42:34.692
I<00:42:32.944> love,<00:42:33.634> I<00:42:33.714> love<00:42:33.938> everything<00:42:34.275> about<00:42:34.660> it.

00:42:34.756 --> 00:42:36.007
I,<00:42:34.997> I<00:42:35.157> use<00:42:35.398> it<00:42:35.542> all<00:42:35.638> the<00:42:35.783> time.

00:42:36.536 --> 00:42:37.675
I'm<00:42:36.681> not<00:42:36.841> saying<00:42:37.066> change<00:42:37.386> all<00:42:37.483> that.

00:42:38.060 --> 00:42:40.449
I'm<00:42:38.220> saying<00:42:38.525> figure<00:42:38.910> out<00:42:39.070> how<00:42:39.166> to<00:42:39.247> be<00:42:39.471> present<00:42:39.808> in<00:42:39.888> the<00:42:39.968> moment.

00:42:40.594 --> 00:42:43.865
Um,<00:42:40.834> you<00:42:40.866> know,<00:42:41.011> we,<00:42:41.636> we,<00:42:42.294> and<00:42:42.438> we,<00:42:42.614> we<00:42:42.759> kind<00:42:43.015> of<00:42:43.176> always<00:42:43.336> have<00:42:43.497> to<00:42:43.577> push<00:42:43.801> on<00:42:43.833> it.

00:42:43.913 --> 00:42:45.501
We<00:42:44.042> have<00:42:44.298> a<00:42:44.379> saying<00:42:44.699> here,<00:42:44.860> which<00:42:45.036> is<00:42:45.164> eyes<00:42:45.405> up.

00:42:45.646 --> 00:42:47.362
I<00:42:45.758> mean,<00:42:46.143> yeah,<00:42:46.367> eyes<00:42:46.528> up,<00:42:46.624> phone<00:42:46.864> down,<00:42:47.169> right?

00:42:47.426 --> 00:42:51.611
So<00:42:47.746> if<00:42:47.891> you're<00:42:47.987> walking<00:42:48.372> through<00:42:48.548> the<00:42:48.628> hallway,<00:42:49.735> you<00:42:49.767> know,<00:42:49.976> and<00:42:50.697> what<00:42:50.794> do<00:42:50.874> our<00:42:51.018> patients<00:42:51.419> see?

00:42:51.692 --> 00:42:57.783
They<00:42:51.836> see<00:42:52.317> an<00:42:52.397> employee<00:42:52.782> who's<00:42:52.943> not<00:42:53.119> really<00:42:53.279> engaged,<00:42:53.680> who's<00:42:53.760> not<00:42:54.001> really<00:42:54.306> like<00:42:54.706> there<00:42:54.883> for<00:42:55.043> them,<00:42:55.347> who's<00:42:55.924> not<00:42:56.085> going<00:42:56.197> to<00:42:56.245> smile<00:42:56.549> and<00:42:56.645> make<00:42:56.870> eye<00:42:57.030> contact<00:42:57.527> with<00:42:57.687> them.

00:42:57.831 --> 00:43:01.389
It's<00:42:58.008> not<00:42:58.168> good<00:42:58.392> service,<00:42:59.226> not<00:42:59.514> to<00:42:59.546> mention<00:42:59.835> you're<00:43:00.011> crashing<00:43:00.412> into<00:43:00.508> a<00:43:00.572> wall<00:43:00.812> or<00:43:00.892> something<00:43:01.277> else.

00:43:01.453 --> 00:43:05.396
So<00:43:02.719> I<00:43:02.976> know<00:43:03.136> that<00:43:03.296> I<00:43:03.376> have<00:43:03.537> to<00:43:03.617> lead<00:43:03.777> by<00:43:03.921> example<00:43:04.722> as<00:43:04.979> CEO.

00:43:05.460 --> 00:43:16.902
So<00:43:05.780> barring<00:43:06.165> I<00:43:06.245> have<00:43:06.357> to<00:43:06.582> take<00:43:06.758> an<00:43:06.838> urgent<00:43:07.207> call<00:43:07.399> that<00:43:07.607> rings<00:43:07.799> or<00:43:07.880> something,<00:43:08.424> which<00:43:08.601> is<00:43:09.226> going<00:43:09.338> to<00:43:09.386> be<00:43:09.546> rare,<00:43:09.947> if<00:43:10.091> I'm<00:43:10.251> walking<00:43:10.652> from<00:43:10.828> point<00:43:11.133> A<00:43:11.229> to<00:43:11.309> point<00:43:11.550> B<00:43:11.726> in<00:43:11.854> one<00:43:11.950> of<00:43:12.014> our<00:43:12.110> hospitals,<00:43:13.553> that<00:43:13.697> phone's<00:43:14.018> staying<00:43:14.258> in<00:43:14.290> my<00:43:14.434> pocket<00:43:15.476> and<00:43:15.700> I'm<00:43:15.780> going<00:43:15.861> to<00:43:15.957> lead<00:43:16.117> by<00:43:16.341> example.

00:43:17.062 --> 00:43:21.710
And<00:43:17.639> because<00:43:17.864> I<00:43:17.960> know<00:43:18.136> if<00:43:18.345> I'm<00:43:18.505> not<00:43:18.665> engaged,<00:43:19.482> I'm<00:43:19.643> sending<00:43:19.963> the<00:43:20.027> message<00:43:20.428> to<00:43:20.588> others<00:43:20.845> they<00:43:20.925> don't<00:43:21.069> have<00:43:21.181> to<00:43:21.309> be<00:43:21.341> engaged.

00:43:21.790 --> 00:43:23.569
Our<00:43:21.966> pay—<00:43:22.143> our<00:43:22.271> employees<00:43:22.752> see<00:43:22.848> that,<00:43:23.088> etc.

00:43:23.649 --> 00:43:26.440
I<00:43:23.665> mean,<00:43:23.809> and<00:43:23.970> then<00:43:24.034> our<00:43:24.130> patients<00:43:24.514> see<00:43:24.691> that<00:43:24.915> most<00:43:25.573> most<00:43:25.749> significantly.

00:43:27.579 --> 00:43:31.127
Dr.<00:43:27.820> Boom,<00:43:28.045> I<00:43:28.125> could<00:43:28.221> talk<00:43:28.446> to<00:43:28.478> you<00:43:28.542> for<00:43:28.863> 3<00:43:29.072> more<00:43:29.329> hours,<00:43:29.746> but<00:43:29.811> I<00:43:29.891> want<00:43:30.019> to<00:43:30.067> be<00:43:30.212> respectful<00:43:30.629> of<00:43:30.774> your<00:43:30.870> time.

00:43:31.191 --> 00:43:38.510
We<00:43:31.416> end<00:43:31.656> every<00:43:31.913> interview<00:43:32.234> at<00:43:32.315> CEO.com<00:43:32.957> the<00:43:33.021> exact<00:43:33.358> same<00:43:33.599> way,<00:43:34.401> and<00:43:34.482> that<00:43:34.706> is<00:43:34.883> we<00:43:35.043> believe<00:43:35.348> the<00:43:35.445> chances<00:43:35.910> one<00:43:36.087> gives<00:43:36.552> is<00:43:36.648> just<00:43:36.825> as<00:43:36.953> important<00:43:37.291> as<00:43:37.371> the<00:43:37.515> chances<00:43:37.917> one<00:43:38.093> takes.

00:43:39.136 --> 00:43:44.177
And<00:43:39.281> I<00:43:39.361> wonder,<00:43:39.602> when<00:43:39.762> you<00:43:39.923> hear<00:43:40.340> that,<00:43:41.063> who<00:43:41.223> comes<00:43:41.464> to<00:43:41.544> mind<00:43:41.785> that<00:43:41.865> gave<00:43:42.170> you<00:43:42.347> a<00:43:42.427> chance<00:43:42.893> to<00:43:42.989> get<00:43:43.214> you<00:43:43.310> to<00:43:43.390> where<00:43:43.615> you<00:43:43.727> are<00:43:43.872> today?

00:43:45.316 --> 00:43:50.180
Well,<00:43:45.621> you<00:43:45.653> know,<00:43:45.782> there's<00:43:45.942> obviously<00:43:46.504> lots,<00:43:46.986> lots<00:43:47.259> of<00:43:47.323> people,<00:43:48.591> um,<00:43:48.687> but<00:43:48.751> I'll,<00:43:49.265> I'll<00:43:49.490> reflect<00:43:49.891> on<00:43:50.035> one.

00:43:50.276 --> 00:43:56.633
I've<00:43:50.373> talked<00:43:50.613> about<00:43:50.838> him<00:43:50.934> before,<00:43:51.962> uh,<00:43:52.523> but<00:43:52.604> when<00:43:52.684> I<00:43:52.748> was<00:43:52.861> in<00:43:52.941> medical<00:43:53.278> school,<00:43:54.048> uh,<00:43:54.626> I<00:43:54.771> kind<00:43:54.931> of<00:43:54.963> saw<00:43:55.268> that<00:43:55.429> I<00:43:55.509> wanted<00:43:55.750> to<00:43:55.830> get<00:43:55.991> into<00:43:56.392> leadership.

00:43:57.356 --> 00:43:58.255
Wasn't<00:43:57.516> sure<00:43:57.677> what<00:43:57.838> that<00:43:57.998> meant.

00:43:58.464 --> 00:44:00.360
Thought<00:43:58.577> it<00:43:58.641> would<00:43:58.802> be<00:43:59.283> what's<00:43:59.508> called<00:43:59.605> an<00:43:59.749> academic<00:44:00.151> chair.

00:44:01.115 --> 00:44:03.878
But<00:44:01.275> at<00:44:01.356> the<00:44:01.436> end<00:44:01.516> of<00:44:01.548> the<00:44:01.597> day,<00:44:02.095> decided<00:44:02.352> it<00:44:02.400> was<00:44:02.496> more<00:44:02.721> the<00:44:03.042> business<00:44:03.444> leadership.

00:44:04.649 --> 00:44:11.637
But<00:44:04.970> in<00:44:05.083> medical<00:44:05.452> school,<00:44:05.709> was<00:44:05.870> given<00:44:06.095> a<00:44:06.111> chance<00:44:06.512> to<00:44:06.657> follow<00:44:07.637> the<00:44:07.717> then<00:44:07.958> physician-in-chief<00:44:08.906> at,<00:44:09.243> at<00:44:09.323> a<00:44:09.339> neighboring<00:44:09.725> hospital<00:44:10.111> here<00:44:10.287> called<00:44:10.512> Texas<00:44:10.850> Children's<00:44:11.235> Hospital.

00:44:11.797 --> 00:44:13.050
His<00:44:12.167> name<00:44:12.295> was<00:44:12.440> Ralph<00:44:12.697> Feigen.

00:44:14.046 --> 00:44:19.524
And<00:44:14.239> a<00:44:14.303> few<00:44:14.608> years<00:44:14.865> later,<00:44:15.267> when<00:44:15.428> I<00:44:15.572> was<00:44:16.456> done<00:44:16.616> my<00:44:16.777> residency,<00:44:17.355> now<00:44:17.532> I'd<00:44:17.661> gone<00:44:17.773> to<00:44:17.918> business<00:44:18.159> school,<00:44:18.496> I<00:44:18.560> was<00:44:18.641> starting<00:44:18.898> to<00:44:18.946> look<00:44:19.042> for<00:44:19.187> a<00:44:19.203> job.

00:44:20.343 --> 00:44:31.299
Still<00:44:20.632> in<00:44:20.665> the<00:44:20.745> days<00:44:21.050> of<00:44:21.452> not<00:44:21.693> that<00:44:21.853> much<00:44:22.159> email,<00:44:22.416> so<00:44:22.560> I<00:44:22.721> wrote<00:44:22.881> him<00:44:23.203> a<00:44:23.283> physical<00:44:23.910> letter,<00:44:24.727> and<00:44:25.368> he<00:44:25.544> opened<00:44:25.801> up<00:44:25.929> that<00:44:26.105> letter<00:44:26.666> and<00:44:26.907> literally<00:44:27.372> paged<00:44:27.788> me<00:44:27.949> in<00:44:28.093> Philadelphia<00:44:28.606> where<00:44:28.734> I<00:44:28.814> was<00:44:28.990> at<00:44:29.135> the<00:44:29.295> time<00:44:29.551> and<00:44:29.632> said,<00:44:29.808> hey<00:44:29.936> Mark,<00:44:30.177> I<00:44:30.273> think<00:44:30.433> I<00:44:30.481> have<00:44:30.593> a<00:44:30.657> job<00:44:30.914> for<00:44:31.074> you.

00:44:31.459 --> 00:44:43.881
And<00:44:31.619> he<00:44:31.651> took<00:44:31.892> a<00:44:31.956> chance<00:44:32.260> on<00:44:32.437> me,<00:44:33.142> uh,<00:44:33.238> for<00:44:33.462> a<00:44:33.543> job,<00:44:33.879> if<00:44:33.975> I'm<00:44:34.120> being<00:44:34.344> honest,<00:44:34.825> uh,<00:44:34.857> it<00:44:35.145> was<00:44:35.306> a<00:44:35.386> little<00:44:35.562> over<00:44:35.803> my<00:44:35.963> head<00:44:36.267> to<00:44:36.364> be<00:44:36.604> the<00:44:36.684> first<00:44:37.005> job<00:44:37.309> coming<00:44:37.630> out<00:44:37.710> of<00:44:37.790> business<00:44:38.046> school<00:44:38.367> and<00:44:38.447> residency,<00:44:39.649> but<00:44:39.874> I<00:44:40.034> learned<00:44:40.435> like<00:44:40.675> this<00:44:41.012> and<00:44:41.236> drank<00:44:41.477> from<00:44:41.653> the<00:44:41.733> fire<00:44:42.038> hose,<00:44:42.374> and<00:44:42.518> he<00:44:42.615> trusted<00:44:43.095> in<00:44:43.176> me<00:44:43.320> and<00:44:43.416> mentored<00:44:43.801> me.

00:44:43.961 --> 00:44:47.856
And<00:44:44.137> so<00:44:44.698> that's<00:44:44.939> one<00:44:45.099> person<00:44:45.387> who<00:44:45.484> took<00:44:45.660> a<00:44:45.724> chance<00:44:46.125> on<00:44:46.221> me<00:44:46.622> and<00:44:46.766> made<00:44:46.926> a<00:44:46.958> real<00:44:47.102> difference<00:44:47.503> in<00:44:47.567> my<00:44:47.663> life.

00:44:48.625 --> 00:44:49.266
That's<00:44:48.801> incredible.

00:44:49.346 --> 00:44:52.408
Dr.<00:44:49.972> Boom,<00:44:50.388> thank<00:44:50.565> you<00:44:50.645> so<00:44:50.885> much<00:44:51.190> for,<00:44:51.655> uh,<00:44:51.975> joining<00:44:52.296> us.

00:44:52.873 --> 00:44:54.107
It's<00:44:53.033> been<00:44:53.129> an<00:44:53.258> honor<00:44:53.450> to<00:44:53.594> talk<00:44:53.835> to<00:44:53.979> you.

00:44:54.380 --> 00:45:01.770
Uh,<00:44:54.540> we<00:44:54.636> got<00:44:54.748> to<00:44:54.796> have<00:44:54.941> you<00:44:55.037> on<00:44:55.181> again<00:44:55.357> because<00:44:55.662> I<00:44:55.678> have<00:44:55.822> a<00:44:55.919> million<00:44:56.303> other<00:44:56.464> questions<00:44:57.506> for<00:44:57.682> you,<00:44:58.067> and,<00:44:58.387> uh,<00:44:58.804> your<00:44:59.109> expertise<00:44:59.830> and<00:44:59.926> what<00:45:00.151> you<00:45:00.247> do<00:45:00.487> is,<00:45:00.792> is<00:45:01.289> phenomenal.

00:45:02.170 --> 00:45:07.268
And<00:45:02.267> the<00:45:02.395> way<00:45:02.892> you've<00:45:03.293> decided<00:45:03.693> to,<00:45:04.399> uh,<00:45:04.815> dedicate<00:45:05.216> your<00:45:05.376> life<00:45:05.697> towards<00:45:06.002> this<00:45:06.418> is<00:45:06.659> really<00:45:06.899> admirable.

00:45:07.316 --> 00:45:10.891
So<00:45:07.925> thank<00:45:08.102> you<00:45:08.166> very<00:45:08.374> much<00:45:08.663> for<00:45:08.807> joining<00:45:09.144> us,<00:45:09.464> and,<00:45:09.560> uh,<00:45:09.625> we'll<00:45:10.186> talk<00:45:10.442> again<00:45:10.667> soon.

00:45:11.789 --> 00:45:12.318
Thank<00:45:11.965> you,<00:45:12.109> Clint.

00:45:12.446 --> 00:45:13.215
Appreciate<00:45:13.135> it.

00:45:14.033 --> 00:45:15.588
Thanks<00:45:14.658> so<00:45:14.770> much.

00:45:15.860 --> 00:45:16.934
Thanks.

00:45:19.085 --> 00:45:23.597
Hey!