[00:00:16] So hello everyone, welcome back to your favorite show. It's The Care OACES with Dr. Cooper. I like to call him Dr. Coop because by now I feel like we're all friends. Dr. Coop, welcome back. Thank you, Ursula. Good to be back. Thank you so much. I do have to tell you, everyone is loving the show. Everyone is really excited about what's coming next.

[00:00:40] And I am particularly very excited about this episode because we're going to talk about something that I feel is like an elephant in the room and nobody really likes to talk about. I don't know if you agree. I agree. Yes, I totally agree with that. And the elephant in the room is the intersection of equity and advocacy, how to bridge gaps in the healthcare access.

[00:01:07] We do know that it is not easy to get healthcare for everyone. I would say it's very, very hard. So on this episode, we are going to talk about healthcare equity and advocacy, which is a critical topic that is going to combine systemic challenges, personal stories, and of course, because we are with Dr. Coop,

[00:01:36] actionable advice. Because what's the point in complaining and realizing that there's something wrong if we're not going to do something about it? Right? That's correct. I agree. I agree. Okay. So do you want to go right into it? Sure. Let's do it.

[00:01:55] So Dr. Cooper, equity in healthcare, as we have just mentioned, is a significant challenge. It has always been, but it is more so today. But was there a moment in your career or in your life where you saw firsthand the inequities that patients face?

[00:02:17] Yeah. Yeah. Yeah. That, that one hits right at home. Um, I am one of seven children in my family and I'm one of only three of those children that's still alive. Um, I came from a traditional, uh, family back background and mother, father. There was no, um, you know, half this, half that, none of those things. It was just mom, dad, and, and, uh, eight children.

[00:02:44] My mom died when I was 14 years old. She was young, 46 years old. She died of pancreatic cancer. When I think back on the time leading up to her diagnosis, I remember her having back pain and complaining of various things. I'll never forget one day I went into the bathroom behind her and there was blood in the stool. So of course at 14, I'm thinking, oh, well, you know, maybe she's, this is, you know, a woman thing. This is a period or whatever at that age.

[00:03:13] And, and not really understanding all those things fully myself. But what it was is actually, she was having gastrointestinal bleeding from her pancreatic cancer that at that time, um, was metastatic. And she died about six months after the diagnosis.

[00:03:27] When you think back on, uh, those symptoms, however, she was having symptoms for quite a long time. So even if you think about the diagnosis being made late, which is very, very common, at least at that time, it was very common with pancreatic cancer. She had symptoms. She was going back and forth as a doctor. In fact, back in those days, they were recommending BC powders. If you've ever heard of those things, uh, whatever's in that subsalicylate and some other anti-inflammatory things.

[00:03:55] So, you know, not having access to, um, advanced type diagnostic imaging and, and, and, and, and having a high index of suspicion, uh, here we go. That's an inequity. Okay. Why is that? I mean, we lived in a small town. Uh, you only had access to the same family doctor that everybody saw for just about everything, for delivering babies from a toothache to pancreatic cancer. Um,

[00:04:22] and, and, and so that was, that was circumstantial, uh, but it's an indication and it, and it tells us, it gives you the indication of, of where and how inequities can be very, very subtle. Um, and so that's, that's one example. And then it, it, you know, my entire family, I mean, my youngest sister died when she was, uh, 27 years old.

[00:04:42] Uh, you think back on her history leading up to her being admitted to the hospital for DKA, diabetic ketoacidosis. She's young, sexually active. You know, she had, um, uh, what we call polydipsia and polyuria. She would go to the doctor for urinary tract infections.

[00:04:59] Well, in fact, that was probably, uh, she's having this, this polyuria because she, her blood sugar was high. She's undiagnosed diabetic and she died, uh, literally a week after being admitted to the hospital for diabetic ketoacidosis and multi-system organ failure. But, you know, again, she's been going to doctors being treated for, uh, urinary tract infections, young, sexually active female. Um, it's sort of default. I mean, you would default to that. Um, and if you were at a place where

[00:05:28] there's, you know, inadequate healthcare, uh, to deal with those things and oftentimes need to smoke to the most, to the least common denominator. So we can fast forward from there. And my, uh, next to oldest sister who was a smoker, um, and had been diagnosed at a younger age with asthma, but developed significant shortness of breath as she got older.

[00:05:52] And she was admitted to the hospital in late 1999 with a heart attack, 37 years old heart attack. She developed severe congestive heart failure. She was ultimately recommended to have open heart surgery and she died as a result of that surgery and postoperative complications.

[00:06:14] Again, her situation is one that underdiagnosed probably, uh, the shortness of breath was probably an indication that she had, uh, coronary artery disease causing blockages and perhaps even inadequate blood flow to her heart. And so again, you know, you can look back on it and think, you know, what if this or that, um, but embedded in that is, is in a very subtle way, the issue of the inequity and care access again.

[00:06:43] And so we can fast forward again, 2007, my one of set of twin brothers, um, uh, dropped dead of a massive heart attack. He, uh, had been seen about four or five years earlier, really didn't have insurance. He insurance off and on back and forth.

[00:07:03] And, um, um, interesting thing is that he had about age 40, he underwent a bypass procedure to reroute blood flow around a blockage in his leg. Well, if you have that at that young age, you have to assume that you also have blockages in your heart, but his heart was never looked into.

[00:07:25] And so five years later, after he survived the, the previous operation to reroute blood flow to his leg to keep him from losing his, his leg, he has a heart attack and dies. And then we can fast forward a little bit more. Uh, my oldest brother who, um, lived in California in 2010, 11, we got a call that he was sort of wandering the streets and, you know, really didn't know his name, didn't know who he was.

[00:07:54] He, um, was hospitalized and we got involved. And in so many ways, the doctor told me through doctor speak that, uh, he was immunocompromised. So he had, he was diagnosed with HIV and AIDS and died in February, 2012 of HIV or AIDS encephalopathy. Now that's very interesting because I haven't, I've been in healthcare now for 20 or 36 years.

[00:08:24] And honestly, I, I can't remember the last time I saw a patient with AIDS, see patients with HIV all the time, but it's a chronic illness now for all intents and purposes with, with the, uh, adequate treatment. And this was definitely the case during the period of time when he was initially diagnosed. Uh, but because he didn't really trust the system, didn't trust the medications, um, he decided he didn't want to be treated.

[00:08:48] I learned this after the fact that at his funeral, in fact, some of his friends attended that funeral and told me this, said, you know, we talked to him for a long time about take the medicine. It's okay. And he never talked to me about it.

[00:09:03] And of course it's not my responsibility to be intrusive with interrogating someone about their healthcare, uh, who's not willfully being treated by me or, um, uh, who's, who's not necessarily, uh, in any kind of, um, uh, doctor patient relationship with me. So he died.

[00:09:22] So, um, when you think about that and these stories embedded in each one of those stories is some form of inequity, lack of insurance, lack of access, lack of competent, uh, care teams, personal responsibility can create inequities. Uh, if you decide to do things that are, could be destructive to your health or not, um, uh, be responsible in terms of how you respond to your physical health.

[00:09:51] So for me, that has been really impactful for how I comport myself and for all the things, quite frankly, that I do in healthcare. It's, it's, it's embedded in those stories. And so part of my life's purpose is to do all I can to help improve conditions for everyone. And so the other thing I like to say about inequity is so many times when you bring that word up, particularly in this day and age, uh, it's, you know, it's a black, white thing, race, culture, ethnicity. No, it's not.

[00:10:20] I practiced, um, uh, for a number of years in areas that are a little closer to rural communities. And I can tell you right now, some of the, the most startling inequities to access in particular in healthcare and rural communities, rural hospitals are closing across America, uh, at alarming rates. And, uh, so what does that, that leaves a healthcare void. So how do you fill those voids?

[00:10:43] Well, if you think about standard approach to public health, general health management of chronic illnesses and disease, it requires an infrastructure. And if that infrastructure has been removed and the anchor for those in that infrastructure tends to be a hospital or hospital system, that becomes a significant, um, source of inequity in some of these communities.

[00:11:05] So a lot, a lot, a lot of things to unravel there, but, but personally, that's sort of been my personal, uh, and professional experience in dealing with and looking at, um, the, the impact of healthcare inequities, um, uh, firsthand. Well, first and foremost, uh, I am so sorry for each of those, of those losses.

[00:11:30] Um, one thing that comes, pops into my mind is if you feel, if this happens to the family of a doctor, then what is left for everybody else? Because one assumes that in, you know what, I mean, if this happens to you, then what can we expect for, for us all? So let's, let's try to, to move on. And it's, it's a very, um, this is a very touchy episode, but, um, let's try to think.

[00:12:00] I, I do see how, um, you're a very empathic person and you're a very, and you feel the pain of everybody else. Um, I guess that is what makes you a great doctor, um, other than a good one.

[00:12:16] So, um, when you see patients who are undeserved or neglected, how do you channel that frustration that I, I know you feel and take it into action? Yeah, you know, it's easy to feel frustrated when you see the same disparities and inequities play out over and over and over again.

[00:12:43] But, you know, being frustrated, being angry, it never solves anything. It doesn't change outcomes. You, you have to take action, uh, channel that energy and drive into every space that I'm in. That's what I do. I rarely ignore someone who calls me and says, Hey, I, I have a question. I get it on social media. I get it directly on my cell phone. Hey, I just need to know, should I, what doctor should I see?

[00:13:10] We get, I get those things and I've gotten those things over and over and over and over again, uh, throughout my career. So I respond to those things. And the frustration often comes is not necessarily at seeing it, but not being able to actually directly do something about it right then and there. So that's why I created my telehealth platform, uh, Primo Health Partners.

[00:13:31] Um, why we are, we are adding and layer on, layering on top of that, our, uh, artificial intelligence tool called Trend, uh, which would allow us to, to, to basically help people in a very meaningful way by aggregating their records, improving the continuity of care and being able to communicate that to, um, to their providers. And to the systems and resources of care that they're plugged into pharmacies, imaging laboratories, creating that repository.

[00:14:02] So it, it can at least to some extent impact the, uh, information gap. So that's why I'm here on the care Oasis podcast, having conversations like this, spreading the word, having people raising awareness. Those things are very, very important. I also think that mentorship is crucial.

[00:14:20] I, I spend time mentoring young physicians, especially those that are from underrepresented backgrounds and communities, uh, because we need those diverse perspectives in medicine to break down the biases, uh, that can lead to the perpetuation and propagation of unnecessary, uh, inequities. Well, since you are here, um, I do have to ask. Yes.

[00:14:46] We know the problem, but what do you see as the root that causes of healthcare inequities and why on earth do these challenges persist after so long? Yeah. Yeah. So, you know, healthcare inequities are deeply rooted in, uh, in my opinion, in systemic, um, problems, barriers, and, uh, problems with our society in general.

[00:15:16] These, these things have been around for generations and, you know, some of them, you know, we, the biggest factors, I mean, we've already talked about implicit bias and cultural competence. And, you know, studies show that minority patients are less likely to receive pain management, uh, treatment appropriately, uh, more likely to have their symptoms dismissed and less likely to be recommended for life-saving procedures.

[00:15:37] And then, uh, you think about that alone when it comes to a racial barrier, but, you know, it happens in very subtle ways within, uh, the healthcare environment. For example, I, I, I never allow my advanced practice professionals, nurses, PAs to, to lead a presentation with a patient with, oh, he's a drug addict or, oh, he smokes X or, oh, he shot up this or he snorted that.

[00:16:03] Those create biases immediately just because you've created the context of a negative scenario. So, we see these things happen all the time in, in, in healthcare. There are geographic barriers. Many rural, as I talked about, and underserved urban communities even have limited healthcare facilities. Making access to specialists or even primary care in some cases very difficult.

[00:16:24] You imagine a large metropolis like New York or, or Atlanta, for example, and, and patients have to navigate a transportation system to try to get to that care. That creates, uh, somewhat of a barrier. And then, you know, you have the socioeconomic status. If you don't have insurance or you can't afford co-pays and other, uh, costly things, you're less likely to seek preventive care. We know this.

[00:16:47] And that leads a lot of people to wait till later in the diagnosis or later in the course of their illness to seek treatment. And oftentimes that means a late stage diagnosis and, and perhaps even worse outcomes. And then there's also the issue of health literacy. Um, patients who don't understand their diagnosis or treatment options can't make informed decisions. And, and, and really they kind of get to do the throw your hands up thing where they, they, they basically just give up.

[00:17:15] And this leads to poor outcomes. Um, you know, you layer on top of that, uh, most recently, uh, in the last, you know, 10 years, you know, going through, I'm sorry, in the last five years, we went through the COVID pandemic and all of the misinformation and hype. And, uh, asymmetric information that persisted as a result of that. And, and, and so some of that, that mistrust, uh, for the system still exists.

[00:17:44] Um, you know, these things are built into the fabric of our healthcare system. They go back decades, centuries, a lot of very unnatural, nefarious things were done, um, in the name of advancing, uh, a cause or an entrance or, or some other, uh, reason. But those things, quite frankly, were very, uh, uh, hurtful, uh, overall to the healthcare system. So, you know, change requires a multifaceted approach.

[00:18:10] You, you have to policy, yes, you have to deal with policies that, um, that do not, um, passively, um, reinforce inequities in healthcare. Um, cultural shifts in medicine and technology that break down, uh, access to barriers. These are things that we can look for and use to really, to really make an impact.

[00:18:34] I was actually, um, going to ask you about that because you are a person that takes action and that doesn't stay in the complaint area. So what specific changes in policy or healthcare practices you believe could have the biggest impact on equity? Uh-huh. Yeah, I think that's a great question.

[00:18:59] So absolutely, you know, a few key policy things that I think are, you know, could make a significant impact. And I think studies have shown this, you know, we've, we've been arguing, it seems, about this expansion of Medicaid, um, and Medicare access for decades. It seems to never go away. Uh, but many patients fall into that gap where they earn too much to qualify for Medicaid but not enough to afford private insurance.

[00:19:22] They are hourly workers where the cost of accepting even the employer-based plan would basically usurp their entire paycheck. So expanding support, uh, for these programs and to provide that coverage is going to be very important. It doesn't look like that's going to happen, uh, in this current political environment, uh, for now. But we can't stop. We can't stop talking about it.

[00:19:46] We can't stop, um, uh, advocating for it and being stewards of good information and good policies that are going to make a difference. And, of course, um, you know, you know, the same, same issue here with mandating bias training in medical education. We're getting rid of DEI programs right now. And, but we need to train physicians to recognize their own, um, implicit, uh, biases and improve the cultural competence in patient care. It's very important. It makes a difference.

[00:20:17] Um, I, I, I have the, you know, I, I have a gift because I don't really, you know, and the people that I work with often, them, you just have such a way of connecting with people. Because I see them as humans first. And, and, and I see, when I, when I look at them, I see myself, I see this connectedness that transcends, you know, your, your skin color, your whatever, the tattoos on your, on your skin or whatever. You're all humans.

[00:20:47] And so am I. So I think it's very important that despite this transformation that we're going through in our, throughout our society today, as it relates to bias and, and, and diversity and those things, we should be steadfast. There's, there's people out here to understand the importance of that. Um, I, I think, you know, putting people in a, in a position to have a voice, uh, and then empowering them.

[00:21:15] Um, I will tell you that one of the things that, uh, that I'm biased, if you want to use that word is, is, is remote, uh, is remote care, virtual care, investing in telehealth. And I think, you know, we've seen some progress in these areas where, uh, we're getting more and more regulations that encourage and not restrict, uh, the use of, of, of, of virtual care.

[00:21:40] Not just for the general population, but even in underserved communities, um, communities like, um, uh, veterans, for example, uh, with the expansion of, uh, veterans, telehealth services. Uh, and then the, but giving people, um, really this, the, you know, an embedded, a place to embed their digital life journey. That's what we're doing with our trend, artificial intelligence. It's not about turning over the decision-making and, and care to, um, you know, uh, to an algorithm.

[00:22:09] It's about facilitating, uh, our ability to connect with people and create that trust, break down those barriers and give them a home.

[00:22:19] Um, um, I have a vision that one day we will have, uh, health care that is essentially eliminated completely, uh, the terminology of, of, uh, inaccessible or access because access is literally at your fingertips through a mobile phone or device of, of that nature.

[00:22:40] So these things won't happen overnight, but, uh, strategic policy changes, community engagement, uh, engagement with health care institutions, providers, nurses, and the entire health care ecosystem is really going to get us moving in the right direction or continue us in that direction. So to advocate is such a powerful tool for change. Um, what does being an advocate mean to you and how can, and I think this is very important.

[00:23:08] How can listeners start advocating for themselves or for others? Yeah. You know, uh, you know, to me, advocacy from where I sit as a provider is about using your voice and your platform to create meaningful change. As a physician, I advocate by educating my patients, challenging biases in medicine and pushing for innovation that improves access to that care, to great care. So for listeners, advocacy starts with education and engagement.

[00:23:37] You have to know your rights as a patient. You have to engage in this system, ask questions, seek second opinions, and don't be afraid to speak up about your health concerns. And, you know, the, the reality is, is that the system has not really made these things easy. Okay. Uh, we are very, very paternalistic in our healthcare system. Um, and, and so it is incumbent upon patients to understand that these resources do exist. Primal health partners exist.

[00:24:04] You know, we're layering on AI that's going to take it to the entire new level. These things are very, very important. And there's many, uh, there's a support from community health initiatives. Look around, just know what these programs are. If your city has these programs for free screenings, community clinics, spread the word, volunteer, engage, get yourself active in being proactive about what's happening in your, with, with yourself, but also with your community.

[00:24:32] And get involved in the policy discussions, um, call your legislators, vote on healthcare initiatives that, that, uh, that you have the opportunity to do so and demand equitable healthcare policies and practices. And then, you know, the other, the, I know those are tall order, uh, issues. But you know what? I think that's a very important point you touched right there. It is about you. I think that's what everyone should understand. Get involved.

[00:24:59] Do not wait until you have to go to the doctor. Right. And so it's, you know, for me, you know, again, creating these platforms, um, is just about that. It's about getting that word out there, but also having, having people understand they can, you can reach out to us. You can talk to us. We're real people. We want to help. Tell us what your problem is. Um, medicine is because of the business of medicine has become very, very much so transactional.

[00:25:29] Um, that's why the name of my company is called partners. We want to be your partner. It's not about a transaction. Well, yeah, you got to do that from the business perspective, but the reality is we want to partner with you, create a relationship that's sustainable and have you, have us be a resource for you as you try to navigate, uh, this, this very, very challenging, uh, confusing at times, uh, healthcare marketplace. Well, you were just talking about, um, IA or AI actually.

[00:25:59] Yeah. Uh-huh. So, um, what role does technology or innovation play in trying to level the field, uh, for undeserved communities? Oh, yeah. Technology to me is one of the greatest equalizers in healthcare, uh, when used correctly. Of course, everybody's concerned about the nefarious use and use for harm, and we have to be concerned about those things. But I also am a very positive person.

[00:26:27] So I like to look at all new technologies that come along. I embrace them in healthcare, uh, and then there have been waves of them from electronic health records to new medical devices to now AI in healthcare. And there's just been so many things that come along. I personally have been one to always embrace the change because the reality is oftentimes change is inevitable.

[00:26:51] And once change gets going, you can find yourself way behind the chain, a change line. And that's not a good place to be. So, you know, AI, telehealth can remove a lot of those traditional barriers to care. Diagnostics that help, you know, and, and again, you know, if it, oh, well, I don't want to be treated by a machine. Well, here's the reality. Okay. The data is out there. Okay. The so-called machine that you are poo-pooing is actually almost just as good as you are. I mean, it is what it is.

[00:27:19] Uh, but you don't, you don't have to be defensive about that. If you embrace that, you can find ways that it actually helps you do your job better. Detecting these diseases earlier, reducing disparities in, in, in late stage diagnoses. Okay. Helping you become more efficient in your, in your work, in your workplace environment. Um, you know, telehealth services for people with chronic conditions who just go in to have, um, you know, have the doctor sort of look at them and click, click, click on the computer while they're talking to them.

[00:27:47] Them through the side of their, their, their, their, their side eye. Uh, those are things that, that we can overcome by, by utilizing technology. So you think about wearable devices and remote monitoring that allow people to kind of manage some of these chronic conditions. Uh, so we, we've, we've got to, we've got to start understanding the power that we have. Think about it.

[00:28:07] Um, you, most of us have on some kind of a wet walk around all day long with these, um, devices, the Apple watches, the Fitbits, the Garmin's or whatever it is, whatever our device of choice is. Where does that data go? Do you ever think about, you know, what, what are you doing? So you look at it instantaneously. Oh, my split saturation is 98%. Oh, my heart rate is. But what does that mean?

[00:28:33] So you imagine if you could continuously monitor that information, what they call PGHD or person generated health data to affect or to, to pick up, uh, trends in their healthcare. Um, that could be, you know, could indicate, um, uh, a disease.

[00:28:51] And some of these things have gotten so advanced that the biometrics and the things that it's monitoring are, are tremendous from your temperature to your blood pressure, to your oxygen saturation, uh, to literally your blood glucose level. Um, and so these things are really, really exciting. You imagine, um, using technology to reduce medical errors. Okay.

[00:29:14] We still have a very human centric, uh, process and a lot of hospitals, uh, you know, to nurse, um, uh, documentation before medication for a dangerous med, certain medications are given timeouts in the operating room and those kinds of things. Important, but quite frankly, the reality is we still make mistakes. And so using technology to help facilitate those interactions, uh, is, is very, very, very, very, very important.

[00:29:41] Um, I think one of the challenges is going to be, uh, you know, getting access to technology, uh, and not just to those people who can afford them, but, uh, to figure out how we can have initiatives out there that, that ensure that communities that are at most need can get access to those things.

[00:29:59] And so, you know, that's part of our mission, um, at, uh, at, uh, premium health department of the Oasis, uh, care is ensuring that we use technology to serve everyone and not just to select few people. But technology is going to be very, very important in my opinion. You know, yes, every technology can create harm. I mean, it's, it's amazing how it seems like that the, the, the, the narrative around these things is just so accentuates the negative.

[00:30:26] And I try to stay positive because I see so many positive effects of having this type of, uh, these types of technologies out there. You know, while listening to you, I was thinking that many people are afraid of technology and think that technology is not going to give them like the best advice. Who are going to be good for them or the technology wouldn't know as much as a doctor, but still they trust an autopilot when they fly a plane over the Atlantic Ocean.

[00:30:55] So they trust technology on a plane. They do not trust technology for the health, the health care. Imagine that. Yeah. Yeah. So, um, what is your vision for Oasis Health? Um, I mean, to create a more equitable. Equitable health care system. How do you think the Oasis care is going to do? Yeah. Oasis stands for omnipresent.

[00:31:22] Oh, access, A to care, health care, uh, C, uh, E experts, health care experts, and, uh, S health care services. And that name is intentional. Um, it, um, is my vision that we create, uh, an ecosystem where access to quality health care is not determined by a zip code income background. Or any of those things. Okay.

[00:31:48] So, um, it is, it is truly a place, you know, you, you think about an oasis in a desert, uh, and it's that one place where everybody comes to drink. So, um, so you imagine that we're creating the place where everybody can come drink of this, this nectar of good health and good health practices. So, um, so through the combination of AI, telehealth, strategic partnerships, um, provide real-time access to medical experts no matter where you live.

[00:32:14] Um, use AI-driven tools to, uh, give you access and continuity of care across different, regardless of what it is you need. We empower patients to own and manage their own health data, uh, through one of our tools called AccessMD. So, you know, healthcare, I certainly believe that healthcare is a right, not necessarily a privilege.

[00:32:35] Uh, but in this society, it's almost become default that it is a privilege because if you don't have resources, oftentimes you don't have access. So, uh, Oasis Health is about building a patient-first, tech-driven model that makes equitable healthcare a reality for everyone.

[00:32:56] Um, actually, I was, I was going to tell you while I was listening to you and you were talking about, um, how difficult it is for a patient to access healthcare and how difficult it is to, um, actually get treatment or get something. Um, a few days ago, I, I, I, I was traveling and people that were traveling with me were positive for COVID. So they told us that they were positive for COVID.

[00:33:23] So I decided, even though I had no symptoms, that I wanted to get tested just in case, just because I wanted to be responsible. Um, there are no tests in the stores where I live, none whatsoever. They don't exist anymore because since it's not a pandemic, then they don't sell those anymore. I called the doctor to come to my place and she said, but you are not coughing and you are not sneezing.

[00:33:53] So you don't have any, any symptoms. And I said, well, I don't, but I might have COVID and I might, um, be contagious. Right. And she said, yeah, but you know what, even if, even if you tested positive and I am not going to test you because I do not have a test, but even if it tested positive, I mean, you have the vaccine, so you wouldn't be told to stay home. Um, so basically it's the same whether or not you have COVID.

[00:34:22] Um, so I was thinking some patients do try to do the right thing and it is the system that forbids you from doing it. Have, had you ever thought about it? Mm-hmm. Yeah. That's a very good scenario. And so you, you think about that, that that provider brought all of their own personal biases, some perhaps clinically relevant, perhaps backed by data.

[00:34:49] Um, but think about the, the other component there. That was an opportunity, quite frankly, to approach that differently and engender trust in you. But instead the approach that this provider took basically just reinforced your distrust and mistrust and despair from the system. And so, although, yeah, yeah. Okay, good. What are we going to do differently? Yeah, no, but you know, how can we deliver that message in a way?

[00:35:19] That's a lot more reassuring for the patient rather than just, because that sounds like the way you presented that conversation. Sound like she's just, you know, sort of blowing you off. Okay. And that happens in healthcare, unfortunately, a way too much. Look, I'm not here to take on your burden per se emotionally or any of that thing. But as a professional, I do have an obligation, I think, uh, to address your problem in a very professional manner of that.

[00:35:45] But even if it don't tell you what you want to hear, I told you what you needed to hear. Okay. In a very professional way that delivered the message and you basically were okay with that. And so I, I tell patients that all the time, I may not have the answer, but two things I'm not going to do. One is I'm not going to tell you, I can have the answer and I don't, I'm not going to tell you a lie. And if I don't, I'm going to tell you, I don't. Okay.

[00:36:10] So, I mean, and, and we're going to be able to communicate with each other on the, on a level playing field in regards to information. But here's also the, the other component of that. I'll do all I can to figure out, you know, what, what, what we can do. Okay. To try to help facilitate and help you navigate whatever the difficulty is that you're having. And so I, I, yeah, people, this used to happen early in the days of Google, they were bringing the Google sheet where they printed something off. Everybody's so excited about Google.

[00:36:41] And I had this lady, uh, she came in and she had printed off some beautiful dissertation from Google back in those days, probably however long ago Google was founded. But, um, she brought this in and she was convinced that, you know, this is her issue. And I said, man, this is fantastic. Okay. I said, I'm so glad that you did this because this tells me that you're really engaged and you're really concerned about your condition. Okay.

[00:37:09] But I do have to tell you that the condition that you printed off really has nothing to do with what we're going to talk about here today. She's like, what? They told me. Yeah. I said, but it's in a totally different context, unfortunately. Okay. It didn't mean anything, you know, I didn't blow her off.

[00:37:30] And, you know, no, I said, no, I, I, you know, you take the positive, uh, direction, which says it, I, and then quite frankly, I was very happy that she's an engaged patient. We're going to have a good, we're going to have a good conversation. Uh, she's going to go and do her research after she leaves and she may come back with, with, um, more, um, uh, poignant or more direct questions related to her condition. But she didn't because we did a great job of thoroughly covering everything in that encounter.

[00:37:59] So, you know, we see these things and, and, you know, I, I think the other thing that's happening here is we have such a fast paced, um, a rate of new information being, uh, put out there as, as it relates to health. You think about COVID, for example, I mean, gosh, I mean, you go search COVID now, I mean, as God, it's everywhere. You think about the weight loss craze, for example, with the GLP ones.

[00:38:26] I mean, it's just so much information. And, and then what happens is, is that in, you know, to be, to some extent, defense in defense of, of practitioners is everybody thinks we've got the answer for everything. Well, no, we really don't. Everybody thinks I can remember all their health records. Well, no, I can't. Okay. Uh, I can go through a snapshot and look at your record when you come to see me.

[00:38:53] Um, but I really have no idea why you got here. And people say, well, why? I get that question all the time. Why did I develop this? I, I ate right. I don't smoke. Um, and you have to go through all of the potential risk factors. I'm talking about coronary artery disease right now, uh, with them to try to identify, uh, what those issues are. And it can become challenging.

[00:39:18] I enjoy our talks so much, but I, I need to go to the last question, even though I could stay, but it's already been like 45 minutes. Um, so Dr. Cooper, we do have to wrap up. I am looking forward to the next episode, but, um, I love when you give advice to our listeners.

[00:39:39] So for those listeners who feel powerless in the face of these inequities, what advice would you give them to navigate the system and advocate for themselves and for loved ones? Yeah. So, um, you know, if, if you feel like you're not being seen, you're being marginalized, you're not being heard or mistreated by the healthcare system. Just remember, unfortunately, you're not alone. I hate to say that, but you're not alone, but you also deserve better.

[00:40:05] In addition to that, know that there are professionals out there like myself and others who really do care, who want to hear from you. Okay. And, and also just be encouraged that I think despite the state of our, uh, political climate right now in America and the state of, of our healthcare system and the changes and the, just, it seems barrage of new technologies coming at us. Change is coming, but it's going to be positive.

[00:40:33] Uh, but I think you also have to engage, empower yourself, uh, never stop asking questions, demand clarity, get second opinions. That's why we exist at Primo health partners, Primo professional resource for independent medical opinions. Come and see us. If you have those questions, we can help you get your records and then give you an idea of what's going on. Utilize the technology that's out there.

[00:40:56] People are buying these things and they're just, I mean, they're like little trinkets, but utilize technology to take control of your medical records, your health decisions, uh, your choice of providers. Um, and then use that to connect with those providers who do listen and who do respect your concerns.

[00:41:14] Um, and to those people that are in healthcare, our healthcare providers, you, you, we have a responsibility to all do better, uh, continually seek to improve our professional, um, uh, decorum and how we deliver care. Uh, equity isn't just a policy issue. It's a moral obligation. In my opinion, we, we have to ensure that, uh, the, the care that we provide is fair, Justin, and, and that we provide access to all that.

[00:41:39] I mean, that's our oath. That's the oath that we all took. Uh, and I think together we can all create a system where, you know, nobody gets left behind. Um, so, you know, it's, it's, it's all of these things are really, uh, part and parcel to our personal experience as human beings, um, looking at the system as a whole and then thinking to ourselves, okay, what can we do to make, uh, make a better, make a change for the positive?

[00:42:05] So, um, yeah, let's keep it up. Let's keep talking. Let's keep engaging. Let's keep looking for solutions. Thank you. Dr. Koop, thank you so much. I'm looking forward to the fourth episode of the Care Oasis. And as usual, it's a pleasure and a joy talking to you. Awesome. Thank you. I look forward to it as well, Ursula. Maybe we'll be back in this beautiful setting again next time. Okay. Hopefully. Awesome. Take care. Have a great one.