Reimagining Healthcare: A Conversation with Dr. Oza on Concierge Medicine

What happens when a physician reimagines healthcare from the ground up? Dr. Oza takes us behind the curtain of his concierge medical practice, revealing a revolutionary approach to patient care that prioritizes time, relationships, and prevention over the traditional revolving-door model.

As a third-generation physician who transitioned from hospital medicine to concierge care, Dr. Oza explains how the membership-based model allows him to provide same-day appointments, 24/7 access, and consultations lasting up to an hour – a stark contrast to the rushed 15-minute visits common in traditional practices. The conversation delves into how price transparency empowers patients, giving them control over their healthcare decisions without surprise bills appearing months later.

Perhaps most fascinating is Dr. Oza's innovative incorporation of fitness directly into his medical practice. He discusses working out alongside patients in his in-office gym, creating natural opportunities for meaningful conversations about health optimization. This relationship-centered approach extends to his treatment of weight management, where medications like semaglutide and tirzepatide serve as tools within comprehensive lifestyle programs.

Throughout the episode, Dr. Oza separates health fact from fiction, addressing everything from the legitimacy of various supplements (creatine gets a thumbs up; "proprietary blends" don't) to the core pillars of longevity: exercise, high-quality sleep, cancer prevention, and maintaining strong interpersonal connections. He also touches on the growing mental health crisis and the shortage of psychiatrists to address it.

Whether you're frustrated with the current healthcare system, curious about weight loss medications, or simply interested in evidence-based approaches to longevity, this conversation offers refreshing insights from a physician dedicated to transforming how we think about health and wellness. Ready to reimagine your relationship with healthcare? This episode is your blueprint.

Transcript

Introduction to Concierge Medicine

Justin 0:15

I did a. I think it was the second podcast I did was with the vet in New Albany. Animals Are Special Did the whole thing never hit record, no way. So I had all the audio, which is fine, but I had no video.

Dr. Oza 0:35

Oh, that sucks. You live and you learn.

Justin 0:36

That's right, so we're recording. Welcome to Brick House Blue. Oh, thanks for having me, man, it's a, so we're recording. Welcome to BrickHouse Blue.

Dr. Oza 0:41

Thanks for having me, man.

Justin 0:42

It's a cool spot. Yeah, it's a really good spot.

Dr. Oza 0:43

I didn't even know it existed.

Justin 0:45

Well, good, Now you do. So we've got Dr Oza right. Am I pronouncing that correctly? He's joining us today from your Concierge MD, that's right. So thanks for coming. Absolutely thanks for having me.

Dr. Oza 1:02

I've got a ton of questions.

Justin 1:03

Yeah, um, and I've talked to a bunch of people and I'm like give me some questions and then they send me like a thousand things yeah uh, yeah, you know, I feel like health, like health is always super popular, yes, and there's always like trends in health, yeah, and so I think there's always like questions like are eggs good to eat or not? And they are good for a while, and then they're not good, and then they are good.

Dr. Oza 1:25

So a lot of confusion, a lot of disinformation these days.

Justin 1:28

Yeah, yeah, absolutely We'll, we'll, we'll. We'll get into some specifics, but let's start with your practice. Um, so tell me about your concierge MD.

Dr. Oza 1:35

So when I um, I did my residency at family medicine and at Ohio state. When I did my residency at Family Medicine at Ohio State, when I graduated I went into hospital medicine. So for most of early on in my career I was seeing hospital patients in the ICU on the floor, managing their stay and not getting to do anything that the family docs were doing, so not really making that much of a difference in people's longevity. And so as my career grew forward, I started to get interested in the longevity space and primary care, and so about five years ago I purchased a practice in Marion and I scaled it over the last five years, but we were primarily doing disease management there, where you're managing diabetes, chronic kidney disease, afib, and these people have a disease that's so far gone that there's no preventative strategy here At this point you're just doing maintenance medicine and if you look at healthcare it's kind of broken and 15 minutes is not enough time, or 30 minutes sometimes is not enough time to really do a deep dive with these patients.

Dr. Oza 2:36

So really, my passion for creating a model that emulates customer service and health care because I think health care is a missing customer service piece, something that I've been working on at both practices Just really focusing on that client, that patient, being sure messages they get back, you know, to people on time, get patients referred out on time, get them labs, because health care is very personal. So created a business model that caters to patients with the customer service in mind getting patients in the same day, there's same-day appointments, you just pay an annual fee and then it's unlimited visits.

Justin 3:12

Yeah, so membership-based.

Dr. Oza 3:15

Membership-based Price transparency. If you wanted an x-ray, it's right there. It's $150.

Justin 3:22

If you want an ultrasound, it's $300.

Dr. Oza 3:24

So a lot of times in the traditional healthcare model sometimes your physician will order a test, an MRI, and you'll find out three months later that it cost you $2,800. And you had no say in that. You had no say in that decision making and I think with the price transparency you actually get some of that control back. Yeah, yes, I want this test, I'm just going to pay for it. And you know, no prior authorization, none of that, you just pay for it up front.

Justin 3:48

Yeah, has healthcare always been that way, like no customer service and kind of just this like mystery about it, like is that something that's evolved to where we are now, or has it just always been that way?

Dr. Oza 3:59

So I think over the last five years there's been a resurgence of this model called the direct pay model, where there's no insurance.

Dr. Oza 4:06

You, just directly pay the provider. I think that model is actually definitely trending, with insurance covering more catastrophic things only and focusing less on primary care. I think that this model is going to continue to grow and this is kind of where the future is. Yeah, there's many different levels to this. There's you can certainly find the same care at $50 per month and $100 per month and $200 per month. Just depends, yeah, on the facility and the quality of service you're getting.

Justin 4:35

Yeah, interesting, because I think sometimes when you think like concierge, it's like oh, this is just really really expensive out of pocket, like I would never, even, like I could never go there.

Dr. Oza 4:45

Yeah.

Justin 4:45

But it seems like maybe that's not the case.

Dr. Oza 4:47

At the end of the day, actually, if done correctly, it can actually save you money in the long run, because now you have someone that's really dialed into preventing you getting from getting a disease or a cancer that could cost you $100,000 eventually a disease or a cancer that could cost you $100,000 eventually. So really spending money on that front end, on your health, I think this is as much as a good gym would cost, and so I don't think we priced it with that in mind.

Justin 5:11

Yeah, I don't want to get political and I don't want to bash any industry, but it does. It seems like it's perpetuating, like there's not a lot of incentive in preventative care because, like it makes a lot of money. But I get what you're saying. Like it's like my vehicle If I take care of my vehicle, I'm not going to need to buy a new one. It's going to save me money to spend that up front.

Dr. Oza 5:35

And I'm not trying to bash my other colleagues that are in the traditional healthcare- system because they're really trying their best.

Dr. Oza 5:40

It's really the way that the compensation structure for those physicians is tied to insurance, and you need to see a certain number of people a day, which is really hard to do. When you're seeing 25 people a day, and 20 people a day, I think that how much time can you spend coaching these patients? Now? Granted, physicians are not meant to be coaches, they're meant to give you an expert opinion. Still, I can see that there could be some improvement in reimbursement for those physicians so they could spend more time doing what they actually want to do.

Justin 6:11

Yeah, it seems like family doctors, like they don't make enough.

Dr. Oza 6:16

Yeah, they actually make the least out of all specials.

Justin 6:18

Yeah, I mean for the amount of schooling they put into it and how important what they do is.

Dr. Oza 6:22

Yeah, and pediatrics.

Justin 6:23

Yeah, I saw it with our pediatrician. Our insurance has changed so we got a new pediatrician, but we loved the one we were at. It was just like, yeah, you could kind of see that they're just grinding through so many kids.

Dr. Oza 6:36

A pediatrician at Nationwide Children's makes $95,000 a year.

Justin 6:41

Yeah, that's crazy.

Preventative Care vs Disease Management

Dr. Oza 6:43

And they were probably one of the hardest working docs, I mean at least last I remember it was like $95,000 or $140,000, but it's a lowest paying specialty. Yeah, and we need them the most. Yeah, so yeah.

Justin 6:59

Wow, well, we'll get into a little bit of like, get deeper into the practice. But I also want to kind of get to know you so like, how'd you get into healthcare? What? What drove you into this?

Dr. Oza 7:08

So I'm a third generation, third generation physician. My father was a doc. My grandfather is a doc. I was born and bred to be a doc.

Justin 7:19

And did I see on the website in Mumbai.

Dr. Oza 7:21

Yeah, in Mumbai is where I went to med school.

Justin 7:23

Okay.

Dr. Oza 7:25

And when I moved to the States I had to take my US EMILIs again and I went to residency at Ohio State and, honestly, I think it comes to me very naturally. I'm an empath and typically my consults are an hour long and I get to know my patients really well. Oh, wow, after that conversation, the relationship, I really get to know people really well and so this model really helps me really dive in with my patients and develop that relationship. And the compensation model also supports a living. Yeah, so that's a reasonable number. We are looking to make this a limited engagement. I don't really want a lot of patients necessarily. I think I would want to limit it to about 500 patients, yeah, and then you can provide high-quality care to those 500 people.

Justin 8:14

Yeah, I mean, I love the concept because it is. There's so many facets to health, right, there's just so many aspects to it. So what all does? And maybe we can kind of go one by one. But what are all the services that you can get at your concierge MD?

Dr. Oza 8:33

So everything a primary care doctor does.

Dr. Oza 8:34

So you get your labs there, you get your annual physical, all the referrals to all the physicians that you need, and then, on top of what a regular practice does, we have 24-7 access. So you call an exchange, you call a phone number that somebody answers 24-7. And then so we're available on the weekends as well. So that's definitely an added perk. Same day appointment so if you call either the same day or the next day, you see a provider. So there's no long wait times. And when you're in the office, I think usually our wait times are less than five minutes. Wow, so you get room right away, get seen, get what you need, get out. Yeah, it's really, for this is right now. It's kind of geared towards executives who really don't have the time to make an appointment, to wait two weeks. They've got people waiting on them.

Dr. Oza 9:21

Yeah, I need to get get in and get out, and this model serves really well for those, and so, for that reason, we do have a lot of executives that choose to join our membership.

Justin 9:31

Yeah, yeah. And then you, we were talking a little bit about you have a gym in the office now.

Dr. Oza 9:36

Yeah, that's right. You know my goal always was to do performance over prescription. I don't really like medications or prescribing meds unless they absolutely need it. But I think a unique way to bond with my patients is to do a workout with them. So at 4 o'clock I'm working out with two of my patients. It's like an hour. We have a trainer that comes in and, you know, puts us through like a workout and it's a way that we talk about peptides, we talk about supplements. We could talk about what they can do to optimize their sleep. It's a part of your annual physical.

Dr. Oza 10:08

It's like a workout with me, and that's something that we just started. It's unique.

Justin 10:12

It's really cool. There was a cardiologist in New Albany who started Walk with a Doc. Yeah, and that was really cool, like he would just literally go walk with the doctor yeah and just talk heart health like what's real. I'll never forget I went and watched him talk and he was like two cups of coffee is better than one and I like ran with that.

Dr. Oza 10:31

I was like heck yeah no, I love that idea of just bringing that consultation outside the exam room, where there's you know, it seems so intimidating and being in an environment where you're relaxed, you can ask.

Dr. Oza 10:42

Hey doc, I just you know I forgot to ask you, but I just want to. What do you think about creatine? Or what do you think about this supplement? Should I be taking this? Should I be drinking athletic greens in the morning? Like just you know, the conversation varies and I'm really enjoying developing that piece of the relationship with the patient.

Justin 10:58

Yeah, it's interesting because, like yeah, you know as well as anybody like it is. It's intimidating. Like I got referred to get my skin checked for moles, yeah, and they're like any abnormality, like, have you noticed anything? I'm like mm-mm, like nope, nothing, I'm good right.

Justin 11:14

Yeah, I wasn't going to say like yeah, you know this one. I noticed that kind of looks funny. I'm just like good luck, you better find it, because I'm not telling you about it Exactly Right. Yeah, no, that's, that's interesting. So, and then I saw so you've got peds. Yeah, is it the same kind of style then, like same day appointments? Is it like how many doctors are there?

Dr. Oza 11:34

So it's just me and one nurse practitioner.

Justin 11:36

Oh, wow.

Dr. Oza 11:36

Okay, I'm trained in family medicine so I'm comfortable seeing kids above the age of five. Okay, we just don't do the younger kids. Yeah, we used to have a pediatrician on staff. Yeah, but now we see kids just five and over. I think that most people find it a convenience factor. Yeah, it's Sunday night. My kid needs this, you know. Can I come see? Can he be seen first thing tomorrow morning? Yeah, sometimes I've gone over to patients' homes with medications and, you know, provided at-home care. It's priceless, it's convenience 100%, yeah, yeah.

Dr. Oza 12:14

So we have an in-house pharmacy. So we have all the meds antibiotics, creams, eye drops, whatever somebody might need. On a weekend If CVS is closed, I just meet the family at the office, give them what they need.

Justin 12:28

Man, how nice is that.

Dr. Oza 12:29

Yeah, it's really something. You have to experience it one time.

Justin 12:32

Yeah, that is yeah, because normally like so I've got four little ones, okay. You'd be at the er that yeah, like, do we need to go to the doctor? I don't know, and my wife's a nurse. She works at the surgery center right over there by you, gotcha um. But yeah, it's always like does this need to be seen? Can we wait, should we not? And I think like sometimes it's like probably could wait because we don't want to go sit there all night, yeah, um I had a um.

Dr. Oza 12:56

I had a client on on a Sunday night text me and he was freaking out that he had a mole and it was cancer. He was 100% sure it was.

Dr. Oza 13:03

Yeah, took a picture of it, sent me every angle, and so I said, okay, I don't know, it kind of looks odd, let me find out. So I text my dermatologist friend these pictures, yeah, and he's like oh no, it's nothing, it's, you know, time to come see me on Tuesday. So I was able to text him back and comment how nice is that. I mean, that can be.

Dr. Oza 13:21

I don't know how to advertise for that, but If you're scared of a mole, yeah, no, it's just, you know, it's that convenience factor, that peace of mind that you have someone on speed dial should something happen.

Justin 13:32

Yeah, yeah, absolutely, I mean I. It seems like healthcare in general should be better. It should be something that we value more. I can't think of anything more important.

Dr. Oza 13:48

Yeah, exactly I agree, and in today's day and time, I feel like there's a lot of wellness spas and a lot of non-physicians giving medical advice that I see online and on TikTok and it's sad to see because there's a lot of them are peddling pseudoscience. It's just hard to watch.

Justin 14:07

Yeah. So that's a question I have for you. Like when I see Gary Brekka and he's like you, really should you know, get this genetic testing? Or and I'm just using that as an example like how do you decipher through? Because I'll be honest, like Gary Breck, at least early on, I kind of prescribed to him like some of this stuff makes sense, and now it's like he's like is he selling? Now I just feel like I'm being sold.

Weight Loss Medications and Body Transformation

Dr. Oza 14:29

So I think what I've been using lately with patients has really immensely helped me is a simple chat. Gpt search.

Justin 14:35

Okay.

Dr. Oza 14:35

Well, actually it, it's quite normal and it's not right or left-leaning. It just gives you the evidence. Yeah, there's another company that is dispelling myths. It's really good. It's called openevidenceai. Okay, you can look up anything on openevidenceai and AI will tell you if something is real or bullshit. Interesting.

Justin 14:53

I think it's a great start.

Dr. Oza 14:55

Yeah, I get all sorts of random DMs from clients and friends saying, hey, why is my child getting 70 vaccines when five years ago it was only like seven?

Justin 15:07

Yeah.

Dr. Oza 15:08

And I was. I didn't know how to answer it and I just asked ChatGPT is this even true? Like, why is he saying this?

Justin 15:13

Yeah.

Dr. Oza 15:14

Send me like a four-page explanation. I copy and paste and send it to him and he's like, oh, I can't argue that, yeah, that's interesting. So so are you using?

Justin 15:26

AI in your practice.

Dr. Oza 15:27

Then I use AI. I use open evidence that, yeah, we definitely use some scribing. You know we use AI for skin detection. We have a derma sensor that you can use on any mole in your body that can tell you with 98 confidence if it needs to be biopsied or not wow. So we use ai in that form my guy just used a magnifying glass. Yeah, see, I don't have those dermatology yeah, so I rely on technology.

Justin 15:51

Yeah, so um, that's interesting because I always think like when I'm I just tend to be like super like cautious, yeah, like I, I see something and I'm like, and then, and then nowadays you're right, like they're like Google search, I mean, it's AI will give you a response, which I tend to like.

Justin 16:08

But otherwise I'm like I I'm trying to figure out like who's you know who's selling what? Yeah, and that's why they're pushing this, because I kind of like I don't know, I just feel like about like everything in moderation of balanced diet and like do you really need like that's my wife, the nurse is like cause I take supplements and I used AI to figure out what supplements I wouldn't wanted to take. That's fair. Um, and I think all he really added to what I was doing was like some magnesium from thorn is like all I really added. But, um, yeah, it's just like how, how's just like? How do you decipher through all that information and make that decision? And is it all necessary? Because we've been living this long without like all these supplements and yeah, you know.

Dr. Oza 16:47

Yeah, supplements is definitely more of a scammy situation, you know, because they can only get you that far. The core values of longevity are exercise number uh. Two, high quality sleep, and then I think three is preventing and finding cancer before it finds you yeah I think that's more relevant for our generation.

Dr. Oza 17:08

Um, and then interpersonal relationships like these are some of the like, core values of, like, the people that live longest and that are in the blue zone. Outside of that, like avoiding alcohol I think it would be a number five for longevity which people will drink alcohol before take a vaccine? Yeah, and it's odd to me. You know that that happens in today's day and time. So but yeah, you know, I think these are the core pillars of, like, what I emphasize on. Yeah, outside of that, there is not much value.

Justin 17:38

you know yeah.

Dr. Oza 17:39

And that's why we built the gym, because my core values are exercise. If you want to live longer, you have to exercise, you have to lift weights.

Justin 17:45

Yeah, so so I can stop my supplements, yeah.

Dr. Oza 17:49

Some are good for recovery. I like creatine I think that has really good evidence. I like magnesium for recovery. That has really good evidence. Yeah, um, you know it's fish oil. I'm somewhat on the fence about um, but beyond that I don't know a lot of supplements that really help.

Justin 18:05

Yeah, uh, that you should like you should be getting that stuff in your diet anyways. Right, I mean, if you're for the most part.

Dr. Oza 18:11

If you're eating clean and balanced diet, you should be getting enough mag and creatine. Uh, for you to do, you do, but if some people are doing intensive workouts, I think Novak Djokovic takes 10 milligrams of creatine a day, but he's also working out four hours a day, so it just depends Exactly.

Justin 18:28

Yeah, I see these guys that are spending four hours in the gym and this is their supplement regimen and I'm like I'm lucky if I get 20 minutes in the gym. I don't know, just a glass of water in a protein bar. Can we talk specifically about some of those things? Yeah, sure. Did you mention Athletic Greens?

Dr. Oza 18:48

Yeah.

Justin 18:49

Or whatever brand of that. What's your take on that.

Dr. Oza 18:53

Anytime anybody says proprietary blend, I'm out. Perfect. I think proprietary blend is just a way of saying, hey, there's nothing actually really in here because I can't prove the evidence it works, yeah. So I'm just going to say, hey, it's a secret blend, it's actually just fiber. So when people poop better, they love athletic greens.

Justin 19:12

Yeah. So it's a very they feel like something happened yeah.

Dr. Oza 19:15

They're like this is good, wow, okay, so it's just fiber.

Justin 19:19

Yeah, um, all right, that's, that's good. Uh, and then you mentioned creatine. So, if you don't mind, just like real quick what does creatine do? How do we produce it? Do we produce it? How much do we produce Like? What's it used for?

Dr. Oza 19:33

Um, creatine is basically a precursor, that, uh, something that your muscles use to generate energy. We have a certain amount that we get from a diet, but in today's diet we can't get enough for these intense workouts that we're doing every day or every other day. So typically most people can take around five milligrams to see the benefit. There's evidence that it also actually helps your brain and your neurocognition, and people taking creatine tend to cognitively feel a little bit more sharper. Helps with mental fatigue. So very good evidence behind this, and so that's why I tell my patients to take it. Yeah, any side effects to it? None have been. Actually we've. In the beginning, I don't know if you remember, but creatine was like people. 10 years ago people would say, oh, it can cause renal failure and it can cause all of these things. But over the last 10 years I think we've seen that evidence wise, it's pretty safe to take.

Justin 20:29

And so everybody like I remember when I was in college like working out a lot and what else can we cover? So we got the creatine out of the way, we got the athletic greens. What are some other like?

Dr. Oza 20:49

trendy. We can talk about weight loss drugs.

Justin 20:51

Okay, that's definitely my wheelhouse. So do you guys do that in your office as well?

Dr. Oza 20:56

We do prescribe it, yes.

Justin 20:57

Okay.

Dr. Oza 20:59

And actually, yeah, we do a lot of weight loss. Actually it's been very popular because the new drugs that have come out are really efficient for weight loss that have come out are really efficient. Yeah, weight loss um and um that really is has helped us out a lot, because I mean the drug does most of the work.

Justin 21:14

Yeah, so tell me, like tell me your take on it.

Dr. Oza 21:17

Um, and we're talking, I'm assuming like semi-glutides, yeah, semi-glutide, ozempic redditutide uh, there's three new in the pipeline that are going to be out pretty soon. Okay, but yeah, these drugs have changed a lot of lives, including mine. I used it about three years ago.

Justin 21:34

Oh, wow.

Dr. Oza 21:35

And it changed my life because that drug was made for someone like me. I was addicted to food. I think I just as somebody that cooks and somebody that's just always around food and going to restaurants, I think, um, it really helps me dial my diet in and I was able to really focus on my nutrition and it. It was game changer for me.

Justin 21:56

Yeah.

Dr. Oza 21:56

And then, um, I started doing it because I was able to do that in patients and I was like, well, if I'm helping everyone else lose weight, I should also look the part. So, uh, that's kind of when my journey started. That was about four years ago.

Justin 22:08

Um, and then um which is funny because my doctor, like you should. You should keep an eye on your weight, and I'm thinking to myself maybe yeah, you know, it's all about body fat percentage and sometimes um.

Dr. Oza 22:22

If you're at 20 plus percent, like at my worst, I was about 24, but it still wasn't healthy yeah, you know yeah, um 30 is where obesity is. You know it's considered obesity, but I think even someone at uh, I've had somebody at 24, 25 percent get down to about 12 percent wow and be in the best shape of their life. Yep, uh. And now? Now they're at 12 body fat. They're so dialed in. They're just a differently.

Supplements and Core Pillars of Longevity

Justin 22:45

They're just a different person now do you find like like um, I guess it's all it's. It seems easy to get started and, like you get, you're excited about it. You start to see some changes and like what? What do you? What's your advice or what do you have to offer to like keep people going? Cause I find myself, I do it, I'm I'm like in the gym for four months out of the year and I'll like go strong. Every day I get over like the late onset, muscle soreness and I'm good to go.

Dr. Oza 23:15

It's a routine, and then like something happens, and then life gets in the way, and then sports gets in the way and like. So just like any alcoholic or any, every food addict, I think that accountability is huge. So just bringing in you every month. You get on the in body. You look at what has happened to your body. Sometimes you think you've gained weight. You've actually gained muscle. So we look at your in-body score, see how you've performed and then see what worked, what failed, and kind of reinforcing some of the good habits. And sometimes the medication in the beginning really helps with the food, noise and with volume control. And so we always I mean we're quite successful in this model so patients will come and say, wow, this, I can see why this is going to work. And so just bring them in every month. Sometimes you have to titrate the dose up.

Dr. Oza 23:59

You know, and just go with them through the journey. Usually, I think on average, most people can lose about four pounds of body fat a month.

Dr. Oza 24:06

Okay so it's a slow and steady loss versus this rapid weight loss that people think it's going to give you. That's actually not true and at some point it does plateau. At some point there's a max effect that you can get which is up to 20% of your body weight. Beyond that, you're not going to get it off the drug. You may have to change your life and really indulge in what you're trying to do so guiding patients through their whole weight loss journey.

Dr. Oza 24:29

sometimes it takes a year, it takes a year and a half really transformations and I think my model provides for the ability to do that.

Justin 24:38

Yeah, so these drugs weren't initially designed for weight loss.

Dr. Oza 24:43

That's correct, okay so Well, I want to say the first generation drug like Victoza Bayeta. We did notice that that drug also did contribute to weight loss, but it was 6% of your body weight. And it was a once daily shot and over the last 25 years there's been about five or six generations of this drug.

Justin 25:03

Yeah.

Dr. Oza 25:04

After Bayeta and Victoza, there was Bidurion, there was Trulicity, there was um, uh, was M pick, and then finally came when jar, oh, and now it's going to be red or two tide and keg really in a tide. Um but these peptides have evolved, they're getting better, they're more sophisticated, um and so now they are designed strictly for weight loss.

Justin 25:23

Is that correct or no?

Dr. Oza 25:24

noempic was uh, I think 10 years ago. They discovered that ozempic you get up to 12 of your body weight okay diabetics were losing weight on ozempic eating less, and so they're like. So then they did a study called the select trial, which was where they took 17 000 non-diabetics okay put them on ozempic and when they studied them over seven years, they noticed that there was a reduction in all cause mortality, mortality.

Justin 25:46

Oh, wow.

Dr. Oza 25:47

Every single cause was reduced in that group. So they said why can't non-diabetics take this? So Eli Lilly then came out with Monjaro, which had a GIP inhibitor. It's got two hormone blockers versus one that Ozempic does. And so the second one, they think, is the magic in the drug where it reduces on a mental level, it reduces food noise and there's some permanence to it. They think if you take it for two years you could permanently alter your relationship with food, oh wow.

Dr. Oza 26:17

And for someone who has lifelong not eaten correctly, has a dysregulated appetite, this drug is a game changer.

Justin 26:25

Yeah.

Dr. Oza 26:26

And I can tell you countless stories of people that come up to me and they're like dude, you changed my life.

Justin 26:30

Yeah.

Dr. Oza 26:31

And I get these text messages now and people send me selfie pictures and that never happened in clinical practice. Yeah, no, you know.

Justin 26:38

I'm not texting my doctor. Yeah, exactly, that's really interesting because it does kind of have a negative stigma to it.

Justin 26:45

Right, like I feel like, and I, I again, I'm very like, uh, like, uh, I'm like I'm not sure like this could be good, cause I've never like struggle with weight loss, like or weight gain, so I can't really relate to somebody who does. But then I'm like, if you can kickstart that journey, if you can like help them get going, yeah, Cause I know what it's like just in my athletic career, like my workout, like once I start to see some results, like, then it's like, then it's go time.

Dr. Oza 27:12

I think if you don't have a dysregulated appetite or you don't recognize your dysregulated eating, it's really hard to understand um what's being described. Yeah, you have to experience food noise to know what food noise is so what?

Justin 27:26

what is food noise?

Dr. Oza 27:28

Food noise is at breakfast. I'm thinking about what I'm getting for lunch. I'm obsessed with what I'm eating for dinner. I'm planning dinner, I'm thinking about it. I need a snack, I'm hungry. You look at the pantry. You want something sweet, then you want something spicy. Constantly thinking about food it sometimes is a stress response for some people People like me that had desk jobs, like sometimes you ate and you worked at the same time and it was like a coping mechanism. When you take Manjaro, it's the first time you experience absolutely a calm, quiet, no noise.

Justin 28:03

Wow.

Dr. Oza 28:03

And that's the day you realize that, wow, this is going to work. And a lot of people that experience this calming of the food noise will be the loudest proponents of this drug, because they've experienced something that they've not experienced in an entire lifetime. So they call me 48 hours later. They're like oh my God, I just understood what you were talking about.

Justin 28:21

Yeah, I can't. I don't know. I mean I like to eat, I don't know if I have food noise. I mean I like to eat, I don't know if I have food noise, but yeah, I mean I'm all for like it's a massive segment of the population. Yeah, and I don't know. Like I always try and think like ancestrally, like you always hear, like we like sweets because they weren't readily available and our bodies are just kind of made to like store those, or we went periods of time without eating.

Dr. Oza 28:53

Then when we do eat. We'd eat a lot and then we would fast like. What are your kind of thoughts on that? So I think as a society, over the last 20, 30 years, we've all developed what we're describing as leptin resistance, and what that is is that when, when you eat normally and your your stomach secretes ghrelin and leptin, that that's your cue for your brain to stop eating.

Justin 29:08

Yeah.

Dr. Oza 29:14

But over time, because of processed foods or because these high sugar foods that satisfy your brain and give you this?

Justin 29:17

like huge you know dopamine hit.

Dr. Oza 29:18

Yeah, that brain now stopped responding to leptin and ghrelin. Every time you secrete it it's like, oh no, you can eat some more. You can go back for seconds, or you need more food. You need more food, you need more food. So this medication targets that part of your brain where it locks it. You know it makes you sensitive to your own ghrelin and leptin so immediately your own body tells you to stop eating and you stop eating.

Justin 29:39

Wow, and that's really kind of how the medication works and I've always like, I've always heard, like the faster you eat, like it takes your body some time to realize it's full. Is that what this is? That's correct, yeah.

Dr. Oza 29:52

But in this it triggers you right away. Most people will eat about 30-40% of what they put on their plate and have the same sense of satisfaction if they finish the whole plate. That's when they know that they're going to succeed. Because they don't end up finishing their plate or going for seconds. They're like I'm going to lose weight.

Justin 30:08

I think I could beat the drug I'm still going to need to finish my plate. No, I'm kidding. I was at a wedding this weekend and really nice wedding. Cleveland Art Museum really really nice, beautiful, and the food was amazing. But it was like normal portions and I could kind of see people looking around like can.

Dr. Oza 30:26

I go back up. Yeah, I need some more.

Justin 30:28

Because it looked like normal. But then I had the same thought. I was like this isn't very much, but then I finished it and I was okay. I just kind of took my time because I didn't want to be the only person at the table scraping my plate clean. Exactly, that's really interesting. What else I'm trying to think of some other, like fads or things that we touched on.

Exercise, Mental Health, and Technology

Dr. Oza 30:53

I think there's a big movement about not drinking anymore. Yeah, I think there's a lot of people I mean, at least the next generation is very much diving into non-alcoholic events, workout events very much diving into non-alcoholic events, workout events? Yeah, I hope that New Albany has its own version of, you know, coffee and chill. A lot of large cities are doing this Saturday morning coffee and chill where you go, work out, meet a bunch of like-minded people a run club.

Dr. Oza 31:23

what have you? And I see a lot of executives struggling with their life, their social life, having a happy hour on Tuesday, wednesday, thursday, friday, and now it's the weekend and all of a sudden you've had way more drinks than you intended to. But you can't seem to navigate social life and not drinking.

Justin 31:42

Yeah.

Dr. Oza 31:42

It's really difficult.

Justin 31:47

I think the younger generations, yeah, it's not as big a part of what they do, no, whereas, like I grew up in a small town and like that's just what everybody did, yeah, it was like that was the norm. And then, yeah, getting out of that small town and like being like it's not what everybody does, yeah, like there is a world out there. So I think you're right, it seems like there is a trend and it's like Not our generation, but maybe the generation after us.

Dr. Oza 32:14

I think they're definitely dialed in and those are some of our patients also. We really get some young patients that come in and they really want the help with the exercise piece or injury piece. High-performing athletes definitely like to come to our practice.

Justin 32:30

Yeah, yeah, I could have used you when I was running track in college for sure? No, it's funny man, I ate super clean. It was like some of the healthiest years of my life was in college.

Dr. Oza 32:39

Is that right?

Justin 32:40

Which I know people are like the freshmen, whatever, right, yeah, I just didn't. I was so focused on track In like the cafeteria there was always like really good options. Yeah, I was just super lean and I was just running all the time, didn't really go to parties, didn't like not much of that, like just super healthy, nice. Yeah, I look a little different than I do now, but I try and run now, like for somebody. I'll just give you my excuse, which I'm sure a lot of people have, is like I, I'm just I'm too busy. Yeah, I'm I'm too tired to get up in the morning. I'm too busy like what is your like if you're just shooting, if?

Dr. Oza 33:22

you, if I was your patient, you're shooting me straight, like what would your?

Dr. Oza 33:26

so I think there's. There's very few organs in your body that you can manipulate, and muscle is like one of them. Sometimes, when you do things like exercises like running or just rowing or just one type of exercise, sometimes you're missing out on a lot of muscles that you could be hitting as well, you know. So I definitely believe in an all-body workout. Um, it cannot replace any form of long form that you're doing. Long form running, I think, can be disadvantageous in the long run, because you really want to preserve a lot of muscle and sometimes when you do long running, you can actually not preserve as much muscle. And as we get older above the age of 40, you lose about 1% a year, and so it's the race to the wheelchair, right.

Dr. Oza 34:07

It's like how much can you kick that ball down the road? Do you want to be 80s or 90s? Yeah, you want to stay strong. You want a lot of muscle, uh, and you want a combination of different workouts yeah, so no I like it. So every patient, I just prescribe a multiple different exercise regimen not just like one form.

Justin 34:24

So my wife's like you need to go out and run and be like nope doc said I don't have to, exactly, uh, I I do. I like running. Um, I was a sprinter so I really like I.

Dr. Oza 34:34

I can't do that anymore, but you go to the gym and lift weights, yeah yeah, yeah, okay, that's yeah.

Justin 34:40

So we hear this all the time too like why is strength training, why is resistance training so important, for both males and females?

Dr. Oza 34:48

So I mean that's just what the evidence says, because if you look at the body composition scores of people that are just associated with a long life, usually people with a higher muscle mass tend to do better. Also, with higher bone density they tend to have less fractures, less injuries, longer time till they get into a wheelchair and much later in life they are less independent. So all of these factors you know. Also they talk a little bit about the mind and say when you play some racket sports or when you play things that keep your brain active with relations to coordination, that can also lead to a longevity for your brain. So definitely racket sports has been shown to have the most longevity. I think it's because of keeping the cerebellum. The hand-eye coordination part of the brain is very activated in that sport. 00,00,00,00.

Justin 35:44

Yeah, that's interesting. So pickleball is a good thing. 00,00,00,00. Pickleball is a good thing 00,00,00, Nice, Not just for the body but for the mind.

Dr. Oza 35:51

The only problem with pickleball is that sometimes people overdo it and not realize that moving a certain way can really can cause a lot of pickleball injuries. Uh, I know my orthopedic surgeons are really happy.

Justin 36:03

I bet, yeah, you're keeping them.

Dr. Oza 36:04

We're going to retire and they're like you know what, no.

Justin 36:07

Pickleball's back.

Dr. Oza 36:07

Yeah, that's great. It's keeping them in business.

Justin 36:10

Yeah, well, good, I think it's good. So on the mental thing.

Dr. Oza 36:26

Like let's talk a little bit about mental health and just kind of like what's your take on current events in mental health and like where maybe the trajectory of like mental health care is going. Yeah, I think you know actually now if you look at residency spots. Psychiatry is the new dermatology.

Justin 36:34

Really.

Dr. Oza 36:35

There's fewer psychiatrists than there ever was, ever before. Wow, some of the gap is being filled by nurse practitioners that are have done psychiatry rotations. But true child psychiatry and psychiatrists are few and far and that demand is just going up. I see that in 10 years there's going to be a huge shortage. So some of us family physicians that have an interest in psychiatry we try to pinch, hit and try to be the gap between seeing the psychiatrist and maybe we can, you know, help fill the gaps in the care.

Justin 37:10

Yeah.

Dr. Oza 37:11

But I definitely see a long wait time, and even in the future, for a psychiatrist. Yeah, psychologists, I think there's. There should be much more. There should be more people out there helping. I think social workers are also now helping fill in the mental health care gap. Yeah, but it's going to be an interesting next few years in the psychiatry world.

Justin 37:32

Yeah, because I mean, do you feel like post-COVID is there more awareness around it, or do you think there's still some lingering like maybe results of it, or just like it just seems like the world changed really fast?

Dr. Oza 37:47

Yeah, I think you know a lot of telehealth practices. A lot of psychiatry went mostly to telehealth. Now it's rarely you'll find a psychiatrist that will want to see you in person. You can mostly see them online.

Justin 37:57

Wow.

Dr. Oza 37:59

That was definitely transformational for psychiatry. I would say but yeah, I think that you can. Now even there's a direct cash pay model for psychiatrists where you can pay I think it's $800 to see a psychiatrist online for your initial consultation. Um, it's, it's expensive, yeah.

Justin 38:18

Yeah, it's interesting. I mean, I just feel like, again back to like just how we're evolving as humans. I feel like I say this all the time, like I was in Cleveland and we're up and down 30 to 32nd floor to 18th floor, and I'm looking at my wife, I'm like our bodies. I just don't feel like we're supposed to be doing this right now, cause I'm like getting vertigo, like she kept forgetting.

Justin 38:39

So I had to keep running up and down from our room to my brother's room Cause she kept forgetting stuff and I'm like I don't know if I'm going left right up down, like I just sometimes I feel like technology, at least for me, and I don't know, maybe like it just seems like it's going so fast that like we're just not built for it.

Justin 38:56

You know, like I don't know, they're like I love this, like this is so fun and like seems real and like I don't know what it is about. Like long form conversation or like sitting down with people is so much more rewarding to me than like like doom scrolling which. I do plenty of just ask my kids like dad, get off the phone.

Dr. Oza 39:15

Yeah, same thing yeah.

Justin 39:16

But it's like, I don't know. It's like or can we catch up, or am I just making it? Did I just ramble and make all that up?

Dr. Oza 39:22

No, I you know it's so easily accessible. Yeah, you could be watching a video about a whale and then you're watching a video about like a dog, yeah, and then you're watching a health video and then you get triggered by some other random stuff yeah it's definitely overstimulation and we're addicted to it yeah, it's just like playing a slot machine exactly, yeah, um, I think I think you have to be.

Dr. Oza 39:46

I think now you have to be mindful about how much time you're spending on your phone. Yeah, take it, you know, try to spend less time. I try every day, but I'm struggling with it.

Justin 39:54

Yeah Well and sometimes, like again, I'm really good at excuses. I'm like I have to for work. I have to, but it's like you don't have to spend that much time. I don't know, I like the idea of like getting a flip phone and then just having all your apps on your laptop, so that it's like there's that like separation, because I've tried hiding my Instagram on my phone. Yeah, it takes like two hours. Like it doesn't matter where I hide it, I just get like I know exactly how to get to it.

Dr. Oza 40:20

I might need to do the same thing.

Justin 40:21

Yeah Well, I know you don't have all day, yeah, so who needs your service? And if they're looking for it, just kind of, how do they find you? And who is your ideal patient?

Dr. Oza 40:38

I think an ideal patient of mine is someone that doesn't have the time to wait in a medical office for 30 minutes and needs to get on with. It is like my ideal client.

Justin 40:51

Yeah.

Dr. Oza 40:51

Hey, I have 20 employees that are waiting on me. I need to go, I need to get my appointment, I need to get out. I also have people that just value their time. I think that's definitely somebody that would be interested in our practice.

Justin 41:03

Yeah.

Dr. Oza 41:05

And certainly somebody who's having trouble navigating the healthcare care system and is not getting what they need. I think that that may be our client.

Justin 41:13

Yeah yeah. Your client is the guy who's like checking his mole out Sunday night, convinced. Google has convinced him he has cancer and he needs to like.

Dr. Oza 41:22

No, no, not necessarily.

Justin 41:24

I'm kidding, yeah Well, anything else, no, I don't know. One last thing Do you live in New Albany?

Dr. Oza 41:31

Yeah, I do yeah.

Justin 41:32

Okay, I thought so.

Dr. Oza 41:33

Yeah, I live right by the country club on Yantis.

Justin 41:35

Okay, nice.

Dr. Oza 41:36

We've been there for about five years and I don't think we'll ever leave, hopefully.

Justin 41:41

Yeah, it's an awesome community.

Dr. Oza 41:42

Awesome community. We love the club.

Justin 41:52

I think we spend a lot of our time. Our kids play tennis. I played tennis there. Yeah, yeah, what's something. Is there anything specific that you see in, like the community of new Albany regarding health? Like, if, if you could, if you could reach everybody in new Albany to to help them out with one thing, what would it be?

New Albany Healthcare and Closing Thoughts

Dr. Oza 41:59

You know, I think most people in new Albany are very healthy. They see their doctor, they they take their meds. This is not a community that's generally healthy.

Justin 42:06

Yeah.

Dr. Oza 42:07

And I think that most people are looking for ways to augment their health or, to you know, whatever they can do to get healthier.

Justin 42:15

Yeah.

Dr. Oza 42:15

You know, and I think that that's what my practice is focused on is just really getting healthy people healthier, really guiding them to. What should they take? How much should they exercise? Looking at their quality of their sleep, looking at the quality of their you know how their heart's functioning, how their lungs functioning through VO2 max testing. So that is something that we aim to do.

Justin 42:35

Yeah, that's awesome. We could go on and on.

Dr. Oza 42:38

I know I could talk about this all day.

Justin 42:40

Well, we'll have to do it again sometime. I'm sure I'm going to get people that are like I told you to ask about this and you didn't, you know, but um yeah, we, yeah, we did. We should 100%. Um, cause I know I'm going to listen back to this and be like I cannot believe I didn't ask this or something's going to come up on my Instagram and be like dang it, but we can message you, right.

Dr. Oza 42:59

Yeah, for sure. Yeah, send me a message. Uh, I would. I would ask you to come toward the facility, come check it out. We've built it out over the last couple of years. We're still building pieces and parts out of it. Um and uh, yeah, I'm excited.

Justin 43:11

I mean a doctor's office with a gym. Yeah, it doesn't get any better than that. Exactly Well, doctor, uh, I appreciate it, and yeah, let's consider part two.

Dr. Oza 43:20

Yeah, all right, thanks, all right, take care of me.

Justin 43:21

Yep.