The Healthcare Cure Podcast - With Nick Webb

Hi, this is Nick Webb and welcome to another episode of the Healthcare Cure podcast. You know, in my career, I've had the opportunity to meet some amazing people and to learn from their journey. And that's what I love about this podcast is to be able to really spend some time with some incredible people that are actually making a difference. And there's a name that kept on coming up to me over and over again when I started my work at the university. And it was Dr. Pakia. And Dr. Pakia is not a theorist. What he talks about isn't conceptual. It isn't ideas without foundation. He's a practitioner. And you know, I read so much about the impact of technology and the and the impact of emerging trends from people who really are not seeing patients and are not living this on a humanistic level, the impact on the on the patient and the way in which we have this beautiful convergence between technology and emerging resources and the human. And that's really what I'd like to talk to Dr. Pakia about today. And, but what I'd like to first say first of all, welcome to the program, and I'd love for you to introduce yourself and tell us a little bit more about your journey. 

Nick, thanks for having me on board. Pleasure to be here. It all started out about 35 - 40 years ago, off to medical school, I went after looking at different careers pathways, I was fortunate enough to be admitted to Michigan State University trained in osteopathic medicine. There did postgraduate moving back out west, I was born and raised in the greater LA area. Focused on primary care and met up with some folks in Orange County, California spent 25 years there and then private practice private group practice, practicing in a variety of different settings everything from standard ambulatory care medical office to the admitting of patients to the trauma center next door. And, and then in the outpatient or remote setting, nursing homes, rehab centers, house calls, etc. So I was fortunate to have that that type of experience prior to moving out to the desert area with a health system that was beginning the process of starting an advanced primary care model for its you know, Health System strategy started with five physicians there are about 10 years ago now with with a view toward implementing a primary care residency program as well and 10 years later, and 240 clinicians later and 90 residents in training. It's been an interesting and informative run. So that brings us up to today. Thank you for asking. 

That's terrific. You know, it's interesting, I remember you and I talking a few years back about the inevitable impact of telemedicine and, and I think, you know, we were both sort of surprised that the adoption of telemedicine was so slow and it felt like that most people when they thought about telemedicine, they saw the interaction telemedicine of having some degree of sterility between the patient and the caregiver. And it's interesting we we were lucky enough to have scripps in our in our documentary film, and you know, they were very much ramping up, they understood the inevitable benefits of being able to provide access to patients quickly. You know, if somebody has a urinary tract infection rather than sitting in the emergency room or an urgent care for hours, they could quickly see a caregiver, get diagnosed and get intervention in a way that was frictionless. And of course, that's one of the big movements as we think about these four big trends in healthcare that I talked about in my upcoming book, The Healthcare Mandate that'll be out this September, is that we see hyper consumerization patients are demanding not just efficacious, safe and beautiful care. They also want amazing experiences. They want it to be friction free, they want it to be convenient and relevant.

Hi, this is Nicholas Webb and welcome to another episode of The Healthcare Cure podcast. Today I have an amazing individual, Dr. David Redding, who really has inspired me to to continue my journey personally to to really live as long as I can, and he's going to talk about his, was it the hundred year club? What was the club that you were talking about?

It's called the Moses club because he was 120 years old.

120 years. That's our goal. I love that. And and I love his approach. He combines really a lot of different teachings and a lot of different ideas to be able to bring together a real focus on prevention, over gratuitous intervention, which I think is a big part of the problem. You know, 80% of healthcare costs are now estimated to be represent or 80% of healthcare costs are self inflicted chronic disease, in other words, preventable diseases. And it's not just the fact that we could save this money, we could improve the quality of lives for hundreds of millions of people. So I think that this is, is good work. And he was gracious enough to be on our on our documentary film, which will be out this November. And so Dr. Redding, why don't you share with us your amazing journey?

Well, let's go ahead and start within the very beginning because I was grew up basically in a very poor family, and I was drafted in the military during the Vietnam era. And it led to a series of opportunities that were just quite wonderful for me. When I got out of the military. I had the GI Bill, so I started going to school and I finally found out my niche was physical therapy. So I went ahead and went to Cal State Long Beach PT program, and was a physical therapist there for about 10 years I work at Casa Colina hospital. And a student came in one day after being there about eight years. And he said, Yeah, I'm going to be a physician. Now he was about 35 - 36. And I understood that once you're past about 30, that you're really not open to medical education is not really open to you. And then I talked to him about his journey. And he was saying basically that as an osteopathic physician, that they're much more open to age limitations. And so I said, Tell me a little bit about this osteopathic because I had no idea what he was talking about. And he talked about a philosophy that I absolutely love, which was to focus on the whole person kind of body mind spirit approach, and to see if you could encourage healthy, find out what the problem is, and see if you can address the problem, so not to focus so much on the symptoms, but really what is the underlying cause of their problem? And so I was so enticed by what he said that he went down there and checked it out. And then it started going through all the prerequisites. But I recognized that with my background. Once my mother, I'd come home from PT from working at Casa Colina, and my mother actually was in the process of making dinner. And she said, time for dinner and so I started walking over there. My dad started walking over to the table, and my mother passed out just as I got there. And she went on the floor, I laid her down gently, I said, Dad, call 911. And he just stood there, frozen late, my mother down, tilted her head back, got ready for CPR. I said, Dad call 911. And so finally he did and as I tilt her head back to give her initial breath of air, she started breathing in and when she started breathing in an ambulance came to the hospital and I found out that she had an overdose of a new medication that she was taking. And I realized over and over again, when you look at the statistics related to medication issues, there's over 100,000 people that die every year in the United States from properly prescribed medications, especially if you take in more than two medications at a time. If you take a look at just gi bleed, which kills about 100,000 people a year, that's related to people taking insets I'm sorry.

Hi, this is Nicholas Webb and welcome to another episode of The Healthcare Cure podcast. You know, I've had an interesting journey in my career as a management consultant as a owner of various medical companies throughout the years. And, you know, I realized in my later life that I had the opportunity to start hearing different voices and getting different vantage points. And that's really what I love about my opportunity to meet and work with people at the university I had a chance to evolve even at my ripe age of 62, I began to realize that we are inventing the wrong things. We're inventing more gratuitous interventions and more treatments and more drugs and more and more and more. And many of these, of course, are important. But what about using our innovative prowess to invent more health in sort of more treatment? I think that to me is the thing that Dr. Power and I were most interested in when we started this process of Fixing Healthcare documentary film. 

One of the most amazing people that I've had the honor to meet is on the screen today with us, and she is incredible. I, you know, I it's so funny, because you think you write the books and you give the lectures and you think you know everything of you. The other day, we were talking, and she said, Yeah, Nick, so what about the, you know, the food pharmacy? And I'm like, Well, you know, I am a learned expert in this and wait, what, what's the food pharmacy? And the next thing I know, my mind is blown. And Azaria taught me that there is a whole new way of looking at the prescription of interventions, and that resulted in this amazing, amazing, enlightening for me and hopefully for you the listener. But before we go into that, I'd like for Azaria to talk a little bit about her journey. She really is an amazing person. I wish that she was running for the President of the United States right now, because I would be her campaign manager, and she would be elected and in a heartbeat, she's just has a beautiful spirit. I love the fact that everything that she talks about always is about being able to impact other people. And that's beautiful. And unfortunately, we just don't have enough of that right now. And I probably should stop doting on you Azaria. But why don't we, why don't you introduce us to your awesomeness by telling us about your journey.

Awesome. Thank you so much for that amazing intro. My name is Azaria Lewis. I am a second year at the College of Osteopathic Medicine of the Pacific at Western U. My journey so, I went to UC Davis as an undergrad and kind of experienced some some challenges academically, which led to my going to Charles R. Drew University, which is in Watts, California for post baccalaureate certificate. And you know, it was there that I really saw, you know what a food desert looks like what an underserved community looks like. And the impacts of that, right across the street from our university is the Martin Luther King hospital, which was known at the time as the killer King hospital because so many deaths happen at that hospital. And I think it was that that moment that I realized, how disadvantaged some communities of color and communities that are socioeconomically lower, socioeconomically lower status were impacted by, you know, social issues but also the health care system, how they kind of neglected in general. And you know, my childhood, early on, we would be considered lower socioeconomic status, my parents worked really hard to move us up the ranks, so I wasn't really exposed until that moment, you know, attending that university for two years, so really opened my eyes and impassioned me. And my goal since then, has been to figure out solutions to the problem that impacts so many people of color and so many people who were low socioeconomic status. So that's been my mission since and I was fortunate to get a master's degree at Western U.

Hi, this is Nicholas Webb and welcome to another episode of the Healthcare Cure podcast. Today I have the great honor of being able to share this podcast with not just Dr. Power, but also my entire team for the center from innovation from WesternU, you know, they've been instrumental in supporting this incredible mission and helping us move all of this forward all the way from finding cast members to managing the logistics, to locations. You know, it's hard to believe just how much is involved when you make a commitment to doing something like this and without their contributions, certainly this couldn't have happened. I also love the fact that my CFI team is really committed to this mission, the mission of improving the quality and safety of patient care. The mission of really providing excellence in higher education in the area of Health Sciences, where we're providing opportunities to share the latest and greatest technologies with students and to really learn and collaborate from our students. So it's been an incredible journey. And this couldn't have happened without the contribution of this incredible team. So today, I'd like to start off by having everyone introduce themselves and their role specifically on the Fixing Healthcare team. Although this is not their full time job, they actually have a job at the center. But they've all taken on a unique and special role in supporting this film. So I think I'd like to start with Miary, Miary is the director for the Center for Innovation. And has done an incredible job of bringing amazing people to this story and bringing his ownmessage to the story as well. So Miary. 

Yes. Good morning, everyone. It is my pleasure to be on this podcast this morning. And it has been a really interesting journey as we embarked on creating this documentary and working with Ray and Nick. And given the fact that I've been in healthcare education for decades, this has been, I think instrumental in sending the message because the the humanist message, and the preventive care message, I believe, has not been is a story that has not been told enough. So it has been my greatest privilege to participate in this endeavor that is I think is meaningful and will be impactful.

Thank you so much, Miary. Jesse, would you like to introduce yourself?

Yes, thank you, Nick. I'm Jesse. I oversee legal compliance and budget management for the film. I also assist a little bit with distribution whether it be video on demand platforms, film festivals, theatrical releases, or any other types of promotion. So it's definitely been a for me, I've learned a lot about the film industry as a whole, and also how much it takes to make a film. So that kind of surprised me. It's not just a camera and a microphone and a couple of cast members, there's a lot more logistics that go into the back end. So it's definitely been a journey and an exciting one for me. 

Thanks, Jesse. And, Chris, you've had an incredible role. We've been driving you crazy chasing down cast members, you know, the problem is, is that when you want the voice of really, really cool people, where do you start, you know that there's so many amazing people that believe in the mission of re establishing the relationship with the caregiver and the and the patient. There are people that know that healthcare is broken, they want a voice. And I think that the thing that Ray and I are most proud of is the fact that we're giving really, really smart people a voice to talk about how we might be able to actually do this to actually fix healthcare. So Chris, share with us your journey and in chasing down cast members. 

Hi, this is Nick Webb and welcome to another episode of the Healthcare Cure podcast. You know, one thing is for sure is that if we're going to fix healthcare, we need to take a look at the core causality of cost. And when you look at that, it's pretty clear that one of the major causes of the cost of health care is self inflicted chronic disease, yet the dialogue that tends to go on is the we need more access to healthcare. But I really think there's a more interesting argument and I think that argument is, shouldn't we be asking for more access to health over healthcare? You know, 60, 70, 80%, depending on the numbers, and the studies you look at of all the costs associated with healthcare are directly associated with lifestyle disease. And this new concept of lifestyle disease is driven by primarily obesity, but also drinking, smoking and even setting. Sedentary lifestyle is a big part of how we attribute to the problems associated with lifestyle disease. 

Today, I have a tremendous guest who I've had the opportunity to learn from, and really get to know in our relationship as a board member at Western University of Health Sciences where I serve as the Chief Innovation Officer. And also I've learned from him in the work that he's doing and and the enthusiasm that he has around the area of wellness and prevention and really changing the dialogue from the automatic trigger mechanism of allopathic care. And again, we all believe in traditional health care. Chances are everybody listening to this podcast has been saved through an antibiotic or a vaccine. But we also need to realize that the opportunity to fix healthcare is rooted in our ability to make the big shift the big shift from anticipatory healthcare to one of prevention and one of wellness over the automatic intervention trigger mechanism. So I have with me today, Gene Barduson. Gene, can you tell us a little more about your background? And then I'm going to hit you with a lot of great questions. 

Well, thanks, Nick. It's great to be here. Thanks for, thanks for having me. I've been, I've been in the computer oriented business for a long, long time since actually since the 60s with IBM and the last three decades or so in the health information technology business. And after leaving that in about 2009 I started a wellness business called the La Jolla Wellness Studio. And and subsequently have been on the board as you mentioned, at Western, and also at Scripps, I've been honored to be on the board at Scripps health in a large integrated health system here in Southern California. 

Terrific, thanks for that Gene. So let me ask you about so many questions I, well, first of all, I love the fact that every time we talk, your the conversation always goes to Nick, let's talk about the way in which and the incredible opportunities to innovate around prevention and wellness we have all these great drug companies and all these great device companies and hospitals and clinics that are populated by true innovators but it feels like our focus has been sort of reactive rather than proactive. Tell me about your philosophy about the importance and your own experience with it with your own center on how this has really changed lives. 

Hi, this is Nick Webb and welcome to another episode of The Healthcare Cure. You know, today is kind of an exciting program for us. It's our first video of the podcast we wanted to add this to our V log to be able to make it available to those who want to be able to have the element of video within the podcast. So welcome to our video watchers and, and welcome back our podcast listeners. 

Today we're going to talk about something that is that I'm very, very passionate about and that's digital health generically. One of the areas that that fascinates me is the area of continuous patient monitoring. And I know that a lot of people, they hear that and they immediately start thinking how Orwellian it would be to be monitored 24 hours a day. But I think as we start to look at the incredible life saving benefits of continuous patient monitoring, we'll begin to we'll begin to realize that the benefits are far greater. And I always like to give the example of Amazon. Just a few decades ago, there were many experts, financial analysts and business analysts that ensured that Amazon was going to fail because nobody would ever risk putting their credit card on the internet. Well, it worked out okay for Amazon. And my point is, is that today, there is a general concern that your data, your health data could be made available in some way that could be injurious to a patient. But with blockchain and other encryption technologies, in combination with many new other opportunities to to really protect that data. I sense that that really will not be a problem. Also, the exciting part of this is that patients will actually be able to monetize their data by selling their data to insurance companies or drug companies and the like. So continuous monitoring is definitely going to happen. I believe that that continuous monitoring will be an in ear technology because we're moving towards the Internet of the voice, right? The idea of typing something is you know, so 2020. What we want to do is to be able to communicate using normal human language. And that's why Amazon is embedding Alexa in just about everything from cars to telephone, I mean televisions and the list goes on and on. Right? So the Internet of the voice is where we want to go. And that's why we need to have that sensor technology in the ear so we can provide bi directional patient communication. It's also a great place to be able to get blood pressure now with new sensor technology, core body temperature, and this whole new body of study around the concept of head movement AI, we're beginning to realize that head movement is the ultimate place to be able to get total body movement when compared to the wrist which provides erroneous and and incomplete data. 

So at any rate, what today what we're going to talk about is hospitals and clinics, how we can look at these hospitals and clinics in a way that allows us to get data that we can use to improve safety, improve efficacy, improve patient flow, improve everything. Now, one of the things that you have to do if you want to fix this problem, and I recently I spoke at the chime event, and I made a proclamation at that event in front of thousands of people, that hospitals are technology organizations that happen to deliver safe and efficacious care. And a lot of people send me emails saying, 'You monster, how could you say that hospitals are nothing more than technology companies?' Well, the truth of the matter is, is that of course we need good caregivers and that's the centerpiece of a hospital or clinic. But in today's with the opportunities that we have today, it would be negligent not to leverage these different disparate data sets to be able to improve the quality and safety of patient care plain and simple. And that will continue. So the process of doing this right from my perspective is that you go on a data safari, and you crawl around your enterprise to find out where data lives.

You know, it's really exciting for me to be able to share my relationships and the stories of some of the smartest people in healthcare. In the great honor that I have as serving as the Chief Innovation Officer at Western U. I've had a chance to meet some incredible people. And what I love about the the teams that I've met and the individuals I've met at Western U is that they're completely and totally dedicated to improving the quality of patient care. And I love that mission. And that's really what this entire film is about is how can we leverage technology and new clinical models and new economic models to be able to deliver predictable quality and safety to patients, while at the same time reducing cost improving access, especially access to underserved communities. And that's what this is really all about. We can do this. It's not easy, but it's possible. And as we talked about in all of our podcasts, the three elements of change is that we first have to recognize that healthcare is broken. I think we all agree on that. The second thing we have to realize, and this is hard for people is to believe that it's fixable. And in fact, Dr. Barnes just mentioned to me prior to the broadcast here, he said, 'Hey, Nick, anything that we can break, we can probably fix' and I love that. And then the last thing that we have to realize in this continuum is that we have to fix it. And that's really, in many ways what this movement is all about. Healthcare is broken, it's fixable, but we have to fix it. If we're waiting for industry and drug companies and device companies and insurance companies to fix it, well, my sense is we may not like the fix. 
So right now I'd like to introduce really and truly and this I know this sounds really patronizing, but it's true. And he knows it is that Dr. Edward Barnes is one of my favorite people on the planet. He's just a super cool innovator. And he and I have become close. Well, at least I know I like him. And in the fun thing about Dr. Barnes is that he is such an innovative thinker and I love the fact that he has plasticity in his thinking he sees that this stuff is fixable, and, and we have a very, very strong partnership. In his role as the Chief Clinical Innovation Officer at our medical school. And me in my role as the Chief Innovation Officer, we hang out a lot. We bounce around ideas, we move things forward. And it's such an honor to have him with us today. And of course, I have as always Dr. Ray Power. Dr. Power is chiming in from Dublin, Ireland today. And of course, he'll be asking questions while we have the great honor of having Ed on the phone with us today. So with that being said, Ed one of the things that we're really excited about, and we talked about is one of our four elements in the film is that if we're going to fix healthcare, we need to change the relationship with a primary care physician with all doctors and all caregivers in general. But that that sort of air traffic control a primary care is really, really important. And we believe that and I sense you can relate to this is that I, as I see our medical students walking up to pick up their diploma, I'm thinking to myself, there are four unfortunate battles that they're going to have to wage. 
Number one is that the economic system punishes them for spending time with their patient. In my consulting practice, I work with consultants that do patient throughput, optimization, yikes, that's actually a thing. It's really a fancy way of saying let's get patients through here as fast as we possibly can. And believe it or not, they're actually using models that they've learned through fast food restaurants. It's bad, right? So time is something we have to give caregivers.

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