PRACTICE: IMPOSSIBLE™

028 - Breathing Through Life Powerfully with Dr. MeiLan Han, MD

April 07, 2022 Coach JPMD Season 1 Episode 28
PRACTICE: IMPOSSIBLE™
028 - Breathing Through Life Powerfully with Dr. MeiLan Han, MD
Show Notes Transcript

In this episode, Coach JPMD interviews one of America’s most prominent Pulmonologists, Dr. MeiLan Han, MD on the importance of pulmonary health, interpersonal awareness, while she promotes her new book “Breathing Lessons: A Doctor’s Guide to Lung Health”. 

Dr MeiLan Han, MD MS, is a Professor of Medicine in the Division of Pulmonary and Critical Care at the University of Michigan. Originally from Idaho, Dr. Han received her medical degree from the University of Washington in Seattle, WA. She completed her residency in Internal Medicine and fellowship in Pulmonary and Critical Care Medicine at the University of Michigan. She is the co-chair of the University of Michigan COPD Quality Improvement Committee and co-authored the University of Michigan COPD Guidelines. You will not want to miss this episode as we discover more about Dr. Han and her passion and gift for simplifying complex systems as she practices impossible!

Show Notes



Intro  0:00  
Welcome to the practice impossible podcast where your host Jude Pierre MD, also known as Coach JPMD discusses medical practice topics that will guide you through the maze that is the business of medicine, and teach you how to increase profits and help populations live long. Your mission should you choose to accept is to listen and be transformed. Now, here's your host, Coach JPMD.

Coach JPMD  0:24  
Hello, hello, hello. Welcome to the practice impossible podcast with your host Coach JPMD. And that's me. And this week, we have the privilege and honor of interviewing Dr. MeiLan Han, a professor of medicine and chief of pulmonary and critical care at the University of Michigan, she and her team reached out to the practice impossible team to introduce her book, a book that was written for patients to understand the lungs and the organ that is alone. And the title of the book is Breathing Lessons: A Doctor's Guide to Lung Health. And it's gonna be interesting to hear her origin story. And at the end, she gives us one thing that she thinks that physicians can do that can help them practice impossible as she is doing, and you'll hear what she's done and what she continues to do in her practice up in Michigan. And I can't wait to share this conversation with you. So here we go. We are here today with Dr. may lean or Malan Han, I'm sorry, I'm butchering that name, probably Dr. Han. But she's a chief of pulmonary medicine at University of Michigan professor in medicine, and also a spokesperson for the American Lung Association and author of a recent book, breathing lessons, a doctor's guide to lung health. And we're so happy and honored to have Dr. Han on our practice impossible podcast talking about her experiences through life and what she's done and how she's able to manage all the things that she's doing. So Dr. Han, you want to introduce yourself and tell us what you do?

Dr. MeiLan K. Han, MD  1:53  
Well, thank you for that introduction. So yeah, my name is MeiLan Han and I am Chief of Pulmonary and Critical Care Medicine at the University of Michigan. That's actually a relatively new title for me. I've been at the University of Michigan since 99. If you can believe it. I did both my residency and fellowship there and then I've been practicing ever since. But yeah...

Coach JPMD  2:18  
So why did you go to medical school? 

Dr. MeiLan K. Han, MD  2:20  
So well, okay, so this is maybe maybe this is interesting for your listeners. I grew up in Idaho. 

Coach JPMD  2:26  
okay. 

Dr. MeiLan K. Han, MD  2:26  
In a town called Idaho Falls, it was in a very unusual place to grow up. We had potato farmers, it's a heavily Mormon area. And then we had nuclear engineers, which is where my dad and my family fit in, because they had a fully operational nuclear test facility in the desert. And then they also had Navy there because they had a fully operational submerged nuclear sub in the desert as well. So it was...

Unknown Speaker  2:56  
I'm sorry, I'm sorry. You said a nuclear submarine in the desert. 

Dr. MeiLan K. Han, MD  3:01  
Yeah. 

Coach JPMD  3:01  
Can you maybe explain that. Because I've never heard of that before.

Dr. MeiLan K. Han, MD  3:04  
It was a well, it was a test site for the Navy, right for them to learn how to operate nuclear submarines.

Coach JPMD  3:11  
Okay, so they, they sorry for my ignorance here. So so they brought in water into the desert?

Dr. MeiLan K. Han, MD  3:17  
You know, what, I was never actually at the test facility, but it was classified, but that my understanding is that it was a fully operational test facility. So it was a high mountain desert area, but everyone would get on the bus in the all the dads in this era would get on the bus and they would go out to quote unquote, the site. Okay, that was where all this nuclear research was going out. So it was a very kind of odd place to grow up. So Idaho does not have a medical school. Okay, neither does Montana, Wyoming, or Alaska. And so all of those states feed in they actually buy slots at the University of Washington. Okay. So I think it's funny because I live in Michigan now. And I can't remember now we've got seminary, medical schools, just in one state alone. Yeah. But out west, there's almost none. So as an aspiring young physician, actually my mother was a nurse. And I actually was originally not very interested in medicine just because of how rough life was for her. But I had the opportunity to volunteer at a small hospital in Idaho, and just being in the emergency room, I was completely hooked. I loved it. I just thought it was the coolest thing ever. So anyway, went off to University of Washington for undergraduate thinking I'd like to stay for medical school, ended up getting one of the 20 slots that was allotted for Idaho students. Okay. But then your first year as an Idaho student, actually for all of the students coming from those non Washington States, you spend your first year in your respective state, but they actually send a few of the Washington students to Idaho they call it getting wwamied because the program is called wwami which now stands for Washington, Wyoming, Alaska, Montana, Idaho. So anyway...

Coach JPMD  3:37  
okay. 

Dr. MeiLan K. Han, MD  3:44  
I spent my first year of med school in Idaho learning anatomy on like cow livers because they had to utilize the vet school that was there for resources.

Coach JPMD  5:09  
Oh, wow.

Dr. MeiLan K. Han, MD  5:13  
But anyway, I finished up my medical school training in Seattle and then came out to do residency and then fellowship at the University of Michigan in Ann Arbour.

Coach JPMD  5:24  
So you were practicing impossible, even before a podcast came out, right? That's just, I never knew that about those states. Because I had a buddy of mine that went to University of Washington, Seattle, and he came from New York, I think they have a great surgical program, right is there?

Dr. MeiLan K. Han, MD  5:40  
They have quite a few things... at the time, they were really known for rural medicine, and, I thought I was going to go back I did a lot of rotations in Idaho. And there are a lot of things about Idaho that I still love. But when I came out here, I ended up falling in love with pulmonary medicine. And you know, I think is, you know, nobody really like loves an organ necessarily, but you love the people you work with, and the kinds of things you get to do and the patient populations. And so after I finished, I actually gotten married during residency, my husband is a cardiologist, and he found a job here, Michigan, his family's all from Michigan. And so for family reasons, it was decided I should try to get a job here and actually got hired on at the University of Michigan at a time when they really were still trying to focus on doing what academics traditionally do, which is you've got to do research, you got to teach, you've got to meet all the missions. And I was a little bit of an unusual hire, because I had completely flunked out of the lab, I am not good in the lab. And I was actually brought on as a purely clinical hire, that's much more common now for academic institutions to hire people to do primarily just clinical work. But at the time, it wasn't common. When I started, the goal was that I would be primarily clinical because I clearly wasn't going to be a bench scientist... 

okay. 

And then I actually had the opportunity at that point to get a master's degree in clinical research, a funding slot had come open randomly and so not knowing a lot about it, I thought, well, the doors open, you either take the opportunity you don't, it's probably not going to open again. So I thought, you know, maybe it'll be interesting. I like you know, epidemiology and in med school, maybe this would be fun. And that just sort of ended up being like a whole separate career path for me in clinical research and sort of how I sort of landed where I'm at today.

Coach JPMD  7:24  
So part of your work is clinical research, or is are you doing more ICU work, or what's your percentage of work breakdown?

Dr. MeiLan K. Han, MD  7:31  
Over time, I have ended up doing more and more clinical research. So my bread and butter practice has been mostly outpatient medicine for a long time. But it's been kind of all over the place. I have done work in interstitial lung disease. I've also worked in our transplant program, I do a lot of COPD actually have an interest in women's health. But over time, clinical research has become a bigger and bigger focus of mine. So I do spend quite a bit of time doing that, in particular, working not just in clinical trials, but also a lot with the National Institutes of Health trying to look at patients with COPD. And I do a lot of work also with imaging, and how we can quantify some of the information from CT scans and use that for patient prognostication and things like that.

Coach JPMD  8:18  
Okay. So I know that, you know, our audience is mainly looking in, or at least, I'd like to my audience to be more interested in managed care and what your you and your team reached out about the book that's coming out or that came out. And I have always thought of season one of practice impossible was about managed care. But what about teaching physicians about research medicine? What about teaching physicians about learning about academic medicine? So those are some of the things that I hope to do in the future, especially because not a lot of us go into research medicine. I did some research on this before this podcast, and it's only 1% of physicians actually do research medicine, which is crazy. I mean, I guess it started about 50 years ago, there are more PhDs, I guess that are doing research, but MDS are not doing a lot of clinical research. So I'd love to be able to kind of pick your brain in the future about how that works. Because there's money to be made in any field of medicine. But I think what we need to do is look at what you want to do and what the physician wants to do coming out. And I think how allowing you or are having you on our podcast allows us to see a different avenue a different way of practicing. And that's why I'm happy to have you. So it sounds like you're doing a lot. Right. So you wrote a book, Professor of Medicine, Chief of pulmonary critical care, wife, a mother. Oh, when do you have time to do all this stuff? How do you divvy your time? What is your day look like?

Dr. MeiLan K. Han, MD  9:37  
Yeah, I just got groans for my husband when he found out I was still on doing work in the evening now, so I don't have some perfect solution. I am... Since I took over this new job. I am really burning the candle at all ends right now. And I think it's really hard. My day is changed so much during the pandemic. So I am the life of the interesting thing about being an academic physician is I have a lot of, in some ways, I have a lot of freedom to pursue passion projects and different research projects and even to kind of change how much clinical care I do and what I do it in even so, you know, an average day for me really depends on whether I'm on service or not. So if I'm, if it's one of my weeks on service that I'm going into the hospital every day, and I'm rounding with mostly actually, the services I run are now with advanced practice providers, because their pays are in piece, because they've really shrunk back even in academic medicine, the number of residents that are available. So we are struggling with changes in even how we you know, have traditionally practiced which has been sort of that resident attending model that everybody remembers from their own residency. So we are increasingly utilizing APPS for certain services, as well as you know, having hospitals run services that don't involve residents at all, so but on my non days, I might be doing clinic, and that could be either at the hospital or it could be virtual now. And then to be honest, the rest, it's Zooms, Zooms, Zooms that start at seven in the morning and end at seven at night. And those might be meeting with faculty or trying to clean out clinical logs. I'm sorry, it might be with research staff and trying to sort through problems with some of the clinical trials we're doing so..

Coach JPMD  11:18  
So are you involved in the financial aspects of the academic side of medicine? Do you look at insurance contracts or look at how reimbursement is affecting your ability to hire additional staff hire additional team members?

Dr. MeiLan K. Han, MD  11:31  
The financial models in academic centers are really different and really complicated. So I oversee about 70 faculty...

Coach JPMD  11:40  
okay

Dr. MeiLan K. Han, MD  11:40  
And I do have to make sure that our cash in is greater than our cash out. But that looks at all sorts of things, including our views for physicians, but also grant dollars. And so there's just lots of different kinds of income streams that I'm having to look at.

Coach JPMD  12:00  
I did some research on Medicare Advantage penetration, just to kind of give a flavor them a flavor here, and Florida ranks number one and four at 48.7%. But Michigan has 45% penetration. So of the patients who have Medicare, they are enrolled in a Medicare Advantage plan. And so I'd be interested in finding out what county are you in because there's a website, and I can share that in the show notes called Better Medicare alliance that allows you to kind of determine what the penetration is in your county. So what county or are you working in?

Dr. MeiLan K. Han, MD  12:30  
I am in Washtenaw County, Washington.

Coach JPMD  12:34  
So I'm going to website now because I was just interested. And I didn't know that. So if you look at Washtenaw Rushton now, Washtenaw County, so you have 62,000, Medicare Advantage eligibles, and 25,000 are enrolled in a Medicare Advantage plan. So it's 41% penetration, which is higher than the national average. So for us, what we try to do is kind of understand where our patients are going. Because a lot of times when they go to the university, the University systems are not as cost conscious as the community hospitals. So do you see any of that? Or do you even deal with any of that?

Dr. MeiLan K. Han, MD  13:14  
No it's funny, I just looked it up. So there is a document I see here called the Michigan medicine participation status in Medicare Advantage plans. And so it looks like there are some that are considered in network. And some that are a lot that are out of network, it's sort of a mix, and then a few that require prior AUTHS. So I'm just looking through all of the ones they must have them on this list because of them being available in Michigan. But I would say just roughly eyeballing this list, maybe 75% we don't participate in.

Coach JPMD  13:50  
Interesting, that is something I hope our audience understands, because one of the things that I try to tell our residents are new grads, so when you're going into a population, you kind of have to know what your pair mixes and what you accept to what you don't. And sometimes physicians get upset and oh, well, this insurance is not covering this and well depends on where you are. So if your penetration is only 10%, then most of it is going to be accepted because it's fee for service. But if your penetrations 40%, then you may have some struggles and you know, it's just about awareness. That's what we're trying to bring to our to our audience. I'm gonna ask a question now. So about residents and fellows so I'm sure you're gonna have some residents and hopefully some fellows and maybe even your ICU team listening to this podcast. So what would be something that your fellows would be surprised to know about you today?

Dr. MeiLan K. Han, MD  14:35  
I suppose they might be surprised to know that when I was growing up, I was in an extremely conservative environment and an extremely conservative school. I actually wanted to when I was, I don't know, six or seven and I understood it was an expectation that I go to college most people my family unfortunate had been to college. I actually planned on majoring on home economics. I don't know that that's even a thing anymore.

Coach JPMD  15:03  
I guess I'm old enough to know what that is because I actually liked home ec.

Dr. MeiLan K. Han, MD  15:08  
I did too, I was gonna fun to bake pies and learn how to sew aprons and things like that. But there is a side of me that loves to garden. And still, like I used to sew all my own clothes. And I still well, gosh, I don't have much time to knit anymore. As much as I enjoy all of those things. I have very little time for all of those things anymore and ended up I think finding a good alternative career planning in medicine. But that was the original plan.

Coach JPMD  15:35  
A little more lucrative, I think. Although your husband might not be grumbling now, if you were knitting. So now you have a book out? 

Dr. MeiLan K. Han, MD  15:47  
I do. 

Coach JPMD  15:47  
Is this your first book? Or have you written other books before?

Dr. MeiLan K. Han, MD  15:50  
So it is my first book... 

Coach JPMD  15:52  
Congratulations

Dr. MeiLan K. Han, MD  15:53  
Thank you know, the funny thing is, you know, you kind of sit down and at some point, you haven't, maybe write it down, and maybe you don't. But somewhere in the back of your mind, you've got a bucket list, right? Things that you would ultimately, you know, if given the opportunity you would like to do, and don't ask me why. But writing a book has always been on the bucket list. But I was never really sure where my niche would be, I'd actually have taken pen to paper a few times before and not really gotten very far. And then at the beginning of the pandemic, as a spokesperson for the American Lung Association, all of a sudden, I was getting called by tons of people, you know how to lungs work, nobody understood. And I, it was just a huge black box for people and I had an opportunity to do another podcast called Freakonomics. And yeah, and had the opportunity to talk about, you know, Mechanical ventilators. And anyway, after the show, I got an email from an editor at Norton publishing. And he said, you know I listened to the podcast, and I did some searching. And there actually are no books that explain how the lungs work for sort of the average person. And would you be interested in doing that? And so I was really intrigued. And we, we got on the phone, and we started, you know, exchanging ideas about what the book could look like. Now, this was at roughly I want to say, April, May of 2020. So we were still, you know, dealing with the surge at the hospital and really, really stressful, we didn't really understand how the viruses transmitted, we were short on PPE, it was a really stressful time. But things started to settle down into that first summer of the pandemic. And the goal was to get the book out quickly because it was an urgent need because the pandemic was upon us. And so I put myself on an extremely strict writing schedule one chapter every two weeks, with the goal to be done with the book in 12 weeks, because there are six chapters, it's a little bit like running a marathon for the first time, because you've never done it, you don't actually know if you can do it. 

Coach JPMD  17:55  
Yeah. 

Dr. MeiLan K. Han, MD  17:55  
And so there was definitely some of that fear and anxiety there. But as I started to get more of the book under my belt, and realize that I could do it in at least I mean, I'd already done a lot of writing academic writing, but this was very different, right? And so I was actually able to finish the book on schedule, believe it or not so.

Coach JPMD  18:15  
Nice.

Dr. MeiLan K. Han, MD  18:15  
But there was tons and tons and tons of editing. Editing probably took longer than that, then the book itself. But yeah, I was felt really fortunate to have the opportunity to do it. And I feel fortunate to have the opportunity to talk about you know, one of the things that I kind of learned, I guess about myself in the process is I think, I'm not saying I'm an amazing writer, by any stretch of the imagination, I can't, I'm sure my work will never compare to that of certain people that are infinitely more famous than I but I do think that I have a skill in terms of being able to take complex things and break them down for people in a way that that makes them much more understandable. I think amusingly, perhaps some of the most flattery that I've gotten from the book is I have gotten a few emails from people that have said, you know, I know that the book wasn't meant for the lay public, but I actually understood it. And then I realized some people actually thought that because the book was entitled breathing lessons a doctors guide to lung health that some people actually thought the book was for doctors.

Coach JPMD  19:17  
Yes, yes, I saw that. And I wanted to ask you that. Actually.

Dr. MeiLan K. Han, MD  19:22  
No, it is a doctor's guide in that I wrote it. It's funny because I actually emailed the publisher about it. And it's funny because not a single one of us actually had thought about that as being potential confusing thing. But at any rate..

Coach JPMD  19:37  
Well, it could be it could be seen as a play on words also, right? Doctors guide. A guide. 

Dr. MeiLan K. Han, MD  19:42  
Yeah. 

Coach JPMD  19:43  
So that's pretty cool. So your target audience are the general public?

Dr. MeiLan K. Han, MD  19:49  
Yes. 

Coach JPMD  19:49  
It's general public, and I did I have to admit that I have not fully read the book or listened to the book. 

Dr. MeiLan K. Han, MD  19:54  
Oh, that's okay. 

Coach JPMD  19:55  
But I started it this past day before yesterday, and I was amazed at it. There's actually you reading the book, because I've listened to a lot of audiobooks, and you expect the author to read it. And most of the books I read, the authors are not reading it. So not only did you write the book, but you also narrated it. How did you do that? So I've always been curious as to what that process is..

Dr. MeiLan K. Han, MD  20:15  
You're right. I learned a lot both about publishing as well as recording audio books, I was fortunate enough to get to do it, I actually had to audition. So what happens is the publisher actually sells the rights to the audio book to someone else. So Norton actually sold my audio rights to Penguin Random House. And then Penguin Random House gets to pick who reads the book.

Coach JPMD  20:36  
Oh, so if you write Sorry to interrupt, but if you write the book, I can't say that I want to read the book?

Dr. MeiLan K. Han, MD  20:42  
Well, I could say it, it's not a guarantee, because they'd already sold the rights. But I worked with the publishers and said I really, really want to do it. And the reason I wanted to do it is because well, first of all, I don't know if I'll ever get to do it again. Right. But I think it's different if you're writing a book about I don't know, the Great Lakes or something, or the snowy owl or whatever, right. But this is doctor's advice. And so and it felt to me so personal, that I didn't see how I could not do it. And so I had to audition, send in a clip of me reading it. And then they actually arranged for me to use a recording studio here in Ann Arbor, I was fortunate that there was one, but it's actually a lot more exhausting than you would think. 

Coach JPMD  20:43  
That's what I've heard. 

Dr. MeiLan K. Han, MD  20:45  
So there are two people listening to you constantly looking for any flub ups. And the second they hear that you've mispronounced anything, or there was a pause or mistake, they will stop you and you re record that section. I would say there's usually it's almost impossible to get through an entire page error free. 

Coach JPMD  21:45  
Oh, wow.

Dr. MeiLan K. Han, MD  21:46  
Almost impossible.

Coach JPMD  21:47  
Is there editing afterwards so that you record it? But I mean, I would think a producer would kind of take out the Uhms and Outs and clique.

Dr. MeiLan K. Han, MD  21:54  
They do but they need solid sections. So they would say okay, we need you to restart at this particular point. And then we'll get you through the rest of it. They reserved three days. I got it done in two, but it actually my voice was almost gone. Even by the end of day one. I was sucking on lozenges, and it's shocking how exhausting it is actually, for your voice to be talking for that long. So it was actually kind of a funny.

Coach JPMD  22:18  
Kudos to you. I know. That's hard work. So I sometimes ask on the podcast is, as you've been practicing for 20 plus years if I'm gathering, right, the numbers, right? 

Dr. MeiLan K. Han, MD  22:27  
Yeah, yeah, roughly..

Coach JPMD  22:28  
Probably graduated around the same time. I didn't even think about that, because I graduated. 

Dr. MeiLan K. Han, MD  22:32  
When did you graduate? 

Coach JPMD  22:32  
I graduated Medical School in 97.

Dr. MeiLan K. Han, MD  22:35  
Okay, I graduated 99. 

Coach JPMD  22:36  
Okay. So what's one thing that you could tell a doctor today, that by telling them it will make everything else easier or unnecessary for them? Or simpler for them? The one piece of advice that you know, if you told them this, if you knew that, it'd make everything else easy?

Dr. MeiLan K. Han, MD  22:53  
Gosh, one thing that would make life easier. I don't know if this really makes life easier. But I think half the struggle with being a doctor fresh out of training is figuring out what stuff to worry about and what stuff not to worry about. At least that's what I felt like I was sweating every single detail. 

Coach JPMD  23:12  
Yeah

Dr. MeiLan K. Han, MD  23:13  
When I first got I mean, like, oh my god, I'm gonna give someone an ulcer if I give them ibuprofen. I mean, I worried about everything. And I think that perhaps I don't know if it makes things easier. But I think perhaps to me makes life a little bit more reassuring is that I think that the one thing you learn as a physician over time is what to sweat and what not to sweat. And that part gets easier over time. And that's so much of what we do does get to be more routine over time. Not that the job is ever quote unquote, routine. 

Coach JPMD  23:43  
Yeah. 

Dr. MeiLan K. Han, MD  23:43  
But I think many aspects of the job do get easier and more straightforward over time, but it takes a while before you really feel like you've hit your groove. I don't know if you agree with that experience or...

Coach JPMD  23:56  
I do. And I think it comes with the more patients you see in our and the more interaction with people that just maybe not even patients. I remember 1998 I got my Florida license. And I was moonlighting in the urgent care at the Jackson Memorial Hospital, which is the largest hospital in the south, I think and it was like 1500 beds. But I was able to see 13, 14, 15 patients in an urgent care at a very young age. 

Dr. MeiLan K. Han, MD  24:22  
Wow. 

Coach JPMD  24:23  
And that allowed me I think to get more experience. 

Dr. MeiLan K. Han, MD  24:26  
Yeah. 

Coach JPMD  24:26  
And it get it speaks to what you're saying. I was able to not worry about certain things earlier than a lot of other physicians as opposed to physicians who I feel like they come out. They don't want to moonlight. They don't want to do this. They don't want to do that. But then it decreases the opportunity to touch a patient and see the experiences that I might have seen two three years earlier. So I think you're right.

Dr. MeiLan K. Han, MD  24:46  
I will say one nice thing about being in an academic setting right after you graduate as it is nice. You're surrounded by so many people that have so much experience it is really easy to just bug someone anyone about what would you do in this situation? What would you do that in this situation? In fact, I even found myself going to the nurses of some of the more senior physician saying, what does Dr So and So usually do when they have one of these? I found that to be incredibly helpful, I think you're right, I think it is important to get through that depth and breadth of experience as painful as it is just to get it under your belt as soon as possible.

Coach JPMD  25:21  
Absolutely. It makes you humble to because you're going to make mistakes, you're going to do things hadn't like Oh. But you know, hopefully, it's not too bad mistakes. But that allows you get that experience. So so how do we find you? How do we find your book? I'm sure some of our audience is gonna want to refer your book to their patients, and maybe even read it themselves, because I was inspired to hear you reading the book. So you know, I eventually want to write a book as well. Not sure if I have the time to do the audio. But how do we find you? How do we get your book? 

Dr. MeiLan K. Han, MD  25:50  
Oh well thank you. So it's available, literally every single major bookseller whether that's Barnes and Noble, or Amazon, or your local indie bookshop, at least for right now. 

Coach JPMD  26:00  
Okay. 

Dr. MeiLan K. Han, MD  26:01  
But, you know, you can also just find me generally speaking on just about every single social media outlet. 

Okay.

As well as my website, DrMeilanhan.com, I think that there's a lot in the book, probably even for physicians, even if you just skim it, in addition to talking about just how the lungs work, and sort of general respiratory diseases, which, you know, maybe physicians would skim that part, I do have a whole section on lung health, and the fact that we don't really think about lung health, or how to be proactive about lung health, in terms of just thinking about things in your environment, and how you can protect the air that you breathe in kind of all phases of life. So there's actually an entire chapter dedicated to that. And that I actually have an entire chapter at the end were sort of my reflections on how it is that we got to be where we're at. And by that I mean in the middle of a respiratory pandemic, where lung disease was the number one cause of death in the United States last year. And yet the funding and awareness for lung diseases has been historically low and unfortunately, remains low, despite the pandemic. And I think what some of the things that we as physicians and leaders need to be thinking about to make that happen. So I think some people are going to be more interested in some chapters than the other, but it's an extremely quick read, and I think most people will find at least one chapter interesting.

Coach JPMD  27:23  
I so appreciate you coming on the podcast and the name of the book is breathing lessons: a doctors guide to lung health. Thank you, Dr. Han, for being on the practice impossible podcast and we'll have links to all the things that we discussed in the show notes. And thank you again. 

Dr. MeiLan K. Han, MD  27:37  
Thank you so much.