Season 2: We're Back. And Healthcare Is Still a Mess

Dr. Adam Brown and Dr. Lara Zibners are back for Season 2 of Unstable Vitals, and they're wasting no time. After catching up on life, including Laura's Arctic Circle dog sledding adventure, Adam's new London life, Calla Lily's first Big Pharma partnership, and a spirited rant about Yorkshire pudding, the duo lays out their ambitious plan for the season ahead.

This episode introduces the "Five P's" framework that will guide Season 2: Politicians/Policymakers, People (patients), Providers, Payers, and Producers. They argue that fixing America's broken healthcare system requires engaging all five groups, and they plan to do exactly that through conversations with health tech founders, clinical innovators, device executives, regulators, and investors.

From the cost of estrogen gel in Europe vs. the U.S. to why walking to the grocery store might be better healthcare policy than anything coming out of Washington, this season promises to be equal parts hilarious and eye-opening.

Topics covered:

• The "Five P's" of healthcare: the season's guiding framework
• Public transportation, walkability, and downstream population health
• Lifestyle medicine and transatlantic perspectives on healthcare costs
• A preview of Season 2 guests and episodes
• What Adam and Lara have been up to since last season

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Transcript

SPEAKER_02 0:00

Unstable Vitals is the podcast that takes the pulse of American healthcare. And the prognosis is critical. Dr. Adam Brown and Dr. Lara Zibners, physicians turned entrepreneurs and business leaders. Expose why the system is unraveling before our eyes.

SPEAKER_01 0:17

Well, hello everyone. It's exciting. We are back for episode one, season two of Unstable Vitals. I'm Dr. Adam Brown. I'm with my very good friend, Dr. Lara Zibners. Lara, how are you?

SPEAKER_00 0:30

I am great. I say that and I'll believe it if I keep saying it.

SPEAKER_01 0:36

Yeah, why why are you not so great? What's what's been going on?

SPEAKER_00 0:40

I am great. I I'm I'm I'm trying this new thing where I'm like journaling gratitude every day, which just sounds like a bunch of you know Nambi pamby horseshit, but supposedly it will change my life. And I'm trying. So I'm grateful for my husband and my children and my family and my friends and the things we're doing here and everything at Caliley and this future I'm building, but I'm tired.

SPEAKER_01 1:04

Listen, I'm with you on that. Now, okay, I don't think the gratitude thing is complete horseshit. Maybe, maybe, you know, like if I'm thankful and grateful, I I the journaling thing, I can't get into it. I I don't know. I I write so much already. It's uh well you do too, but like I it's uh I get an email Monday through Friday.

SPEAKER_00 1:26

I get an email from a website that says, How's your day? And then it shows me a post, it shows me an entry. So I started this. Remember last spring when we talked about shitting our pants, and I said, because I'd gained a lot of weight. Well, I've now lost close to yeah, somewhere between 25, 27 pounds.

SPEAKER_01 1:43

Hell yes, I mean that's amazing.

SPEAKER_00 1:45

Hell yes. Um, thank you. But I started journaling at that point because I was like, oh, I'm gonna journal this and see how you know amazing I well, no, it'll say like three months ago, you said I always start with my weight, and it's been exactly the same for three months. So, but I do get to read about like things that were driving me nuts, and it's kind of reassuring to know that nothing's changed in nine months.

SPEAKER_01 2:12

Except your weight. Like, except your weight. Oh, yeah, no. And hey, like, can I just say as someone who went through a major, major, you know, life change with weight loss about 10 years ago, I mean, I lost like, I don't know, 65, 70 pounds, you know. I was a big thing. I've seen the photos. Um, yeah, yeah, yeah. Let's let's we're not gonna throw those up here. But um, but you know, it is it there is also a lot of good things about like keeping it off for several months, even if you've plateaued. I mean, like if you lost 20 something pounds and you then keep it off for three months, I mean, that is something to celebrate. That's a really good thing.

SPEAKER_00 2:46

That's exactly right. That's what my doctor said. Do a little metabolic reset and kind of just get used to it. And I'm trying to up the weights again because I used to, you know, my Rob finally said, stop saying you used, nobody cares that you used to go to berries five days a week. Like that's a used to. Why don't you do? Because I used to work out six days a week is it's irrelevant. I used to also poop at an appy, but I don't think that's right, right. And maybe I one day will again soon, but there's no relevance.

SPEAKER_01 3:15

Hopefully not soon. Hopefully not soon. Well, I as you can tell, like, with there's a lot going on, and we'll get to more things that have been going on. But I I'm really excited about this upcoming season, and we'll get into more details about that a little bit later. But in short, we are we are going to try to be tack, we're going to try to tackle this uh why is healthcare so unstable? And we're kind of gonna go through different stakeholder groups, which we are going to get to. That is the plan. But we haven't had an episode in several months, and so Laura and I have a lot to catch up on, to catch you up on. But you know, over the past few months, um, other than losing the weight, Laura, what have been some of the big things uh that have been happening with you, happening with Calalily, happening in your world? What's been going on?

SPEAKER_00 3:58

Uh I mean, big stuff, big stuff. So um Calalily is on a roll. We just announced our first official collaboration with Big Pharma. We've signed uh uh early agreement to work with EMD Serrano, known as Merck Healthcare and the rest of the world. Um, and I can't tell you what that is for, but it was a big deal and um It's a BFD. It's a BFD, especially because when we we started dating them in October of 2024 and got the but it was a year before we were allowed to tell anybody we were talking to them, and then it was another three months before we signed the deal, and then it was another two months until the press release in February, and at that point we weren't a clinical stage company, so for them to put that kind of faith in us before we even have put our device into a human being was big, and then we are now officially a clinical stage company. So we have we have finally done all the paperwork and jumped through all the hoops and all the hurdles for us to have the go ahead to start recruiting patients for our first study. So that's all very exciting. And me, I've been doing my usual running around the world, flapping at the air and getting attention for us. And um, personally, I still have three teenagers. Uh Otto, yeah. And we in, you know what we just did? We did the most fun thing. We went to Lapland for their February break.

SPEAKER_01 5:25

Oh, that sounds uh just for everybody, Lapland is up near the Arctic Circle, right? In the Arctic Circle. In the Arctic, excuse me. Yeah.

SPEAKER_00 5:32

You're in the Arctic Circle. And I was like thinking, I have this big Canada goose coat that I was really proud of, and I'm like, nothing gets through my Canada goose. And I got up there and I got out of the car and I was like, holy. So the second place, third place we went, they actually said leave your pathetic southerner clothing behind. And when we got there, they had big garment bags with like real clothes in them, and we put them on because we had to drive our own dog sleds to the hotel. And I learned that the most important part of a dog sled is the handlebar. Because if you let go, you well, no, dogs are super important, but but if you're the person riding it, you have to hold on because the dogs, if you fall off, don't care, they don't look back and say, Are you right? So the first time I went off was the first 90 seconds of my dog mushing career, and I let go, and then the sled and the dogs were all tangled, and they came back and they're like, Oh, we don't know how this is gonna go. But then I got the hang of it. The next time I fell off, I looped my arms through and I dragged behind the sled, screaming, whoa, and the doggy stopped and I got back up, and I felt like like I have checked something off my bucket list.

SPEAKER_01 6:45

I'm a yeah, I mean this is a I think this is a check-off thing. I I don't know. Like, I I you and I talked about this a little bit. This sounds cool and interesting and and fun, and I think I I've always wanted to go dog sledding, and I've always wanted to go to the Lapland, you know, to see like the Northern Lights and live in an igloo igloo, and but it's the amount of doing those things I think that I I I'd like to do them once, maybe, maybe twice, and then see Santa's reindeer up in the top of Norway and Sweden and be like, okay, I'm done.

SPEAKER_00 7:18

And uh, the only other thing I'm gonna add is that I ate a lot of moose. I had moose. I don't know. See, I'd have an issue. I had mousse fillet, which was delicious. I had some smoked moose, and I will say my irritable bowel, so and and there was an outhouse, and it was minus 20 Celsius, and I'm just gonna say that.

SPEAKER_01 7:38

We wish you had a nappy.

SPEAKER_00 7:40

I wish I'd had a nappy because being in an outhouse at minus 20 after smoked moose, that was yeah. I mean, but other than that, it was a fabulous trip. The kids loved it. We learned how to ice fish, and I don't mean trolling immigration officials, I mean drilling through frozen water in search of fish. We caught nothing, but that took up an afternoon, so it was altogether great. I've been busy, so there you go. My company's doing great, my kids are fine, they're teenagers. I get up, I yeah, I'm good. I have my health.

SPEAKER_01 8:16

Good.

SPEAKER_00 8:16

And what how about you?

SPEAKER_01 8:18

Oh wow, so a lot. Also, since the last time we talked, I finished doing some, Steve and I finished some teaching in uh Paris and in London, um, and uh had a thesis, master's thesis student, which was just like really great. Went skiing um over the holidays, which was a lot of fun, although Europe as well as the West Coast have not had that much snow, so that's that is uh it wasn't as great of a ski season. Um but then you know the big thing for us for ABIG is we hired a chief of staff, we hired a couple of other people on full time, and we also are opening up our place and office in London, and that is super exciting. So we now have a flat in London.

SPEAKER_00 9:04

Um Barry's Soho.

SPEAKER_01 9:07

It is, and so you know, you and I were talking about Berry's boot camp, and like um, it's less than one bad bunny song to the berries. So, like, if I put in my bad bunny song in my flat and start, I am at berries before the first song is done.

SPEAKER_00 9:22

That's you're not gonna learn Spanish that way.

SPEAKER_01 9:24

Oh no, I I agree, agree. Like uh, you know, the first time I started learning yeah, yeah, you also need the full song. Um, also the Puerto Rican accent is quite challenging. Uh, that's when I started learning Spanish the first when and when I was in college, was um one of my friends was Puerto Rican and or is, and uh and the accent's very different from like you know, um Spain Spanish. But but anyway, so that that those so Barry's is very close.

SPEAKER_00 9:50

I was just gonna say one time my sister, in one of the stupidest things she's ever said, said, I think I want to adopt a child from South America so I can learn Spanish. And I was like, You want to adopt a baby from South America, so you can you want to think about that for a minute.

SPEAKER_01 10:06

Yeah, yeah, and she's an attorney.

SPEAKER_00 10:08

She's totally an attorney, she's like a smart person, but you know, sometimes we all have those moments. Anyway, I'm so excited you're in London.

SPEAKER_01 10:15

I'm I know we are we are we're doing this like uh transcontinental life, you know, where we're half our time here in DC and continuing to work the business here and then half of our time in London. And you know, I've already paid council tax, I've got a mobile, I've got um aka a cell phone. Um, I know how to put the trash on the pavement, aka a sidewalk. I'm like, and oh shit, I missed one club. Curb is spelled differently, yeah, uh like Clerb. Um I put the trash or the rubbish on the pavement. I take the lift to my flat. I mean, I'm learning. Um I look I've already paid council tax, as I said, so like I'm I'm a Londoner now. See, this I don't get. I'm just and then we'll get on to things, but like I was telling a friend of mine that lives in London, he goes to roast every Sunday. It's like a big thing. And for those that don't know, you know, you you do your in you know, in the US, we go to brunch. There they go to roast, and so you kind of go to a pub and you know, a gastro pub, and you get your uh roast beef or pork or chicken or Yorkshire pudding, and that's what I want to talk about. Potatoes. It is bullshit Yorkshire pudding. It is not pudding, it's not J-E-L-L-O, it's not dessert. Like, I even give Brits a little bit of flexibility in their pudding talk because like English folks call pudding could be a dessert, you know?

SPEAKER_00 11:35

It could be pudding is just a dessert. Do you want pudding? Yes, I'll have an ice lolly.

SPEAKER_01 11:39

Yeah, exactly. And so you get that, got it. But Yorkshire pudding is neither J-E-L-L-O nor is it a dessert.

SPEAKER_00 11:49

It's a flavorless, like a like a saltless, it's puffy, puffy, almost like a cream puff without flavor. Like a cream puff without flavor is a good way to spread it.

SPEAKER_01 12:02

It's a cream puff without flavor. I'm just telling you, it's like a like a and and I don't know like to eat it without anything. I'm angry about this. I don't like the misnomer.

SPEAKER_00 12:11

You can't, you know, there's something in the world to be angry about, and this is what angers you. This isn't just like an oddity. I mean, if Rob, Rob's in Birmingham, Alabama, not Birmingham, UK. And when he gets home, I'm gonna ask him, and when I call him later tonight, I'll ask him about the Yorkshire pudding. I'm sure he'll have an answer, and he'll it'll be so obvious that we'll feel dumb. But I share with you the frustration. I don't know if I'd go quite to anger it. It doesn't seem healthy.

SPEAKER_01 12:34

Oh, okay, this is also true. Maybe, okay, I'm being a little slightly hyperbolic. There is definite frustration. But anyway, let me tell you about what's really frustrating is how effed up and broken our healthcare system is. And so, you know, last season we learned a lot. I mean, we talked about, we talked to former regulators, we talked to congressional candidates, we talked to um, you know, mental health professionals that was both on screen and off-screen. We talked with um we talked with alone and together. Together, uh, we talked with um folks that are uh focusing on pro uh physician burnout and how broken the incentive programs or incentives are in healthcare in the United States, administrative overload.

SPEAKER_00 13:17

We we talked with so many different people leadership, likable badass, how to you know, because we see women sh entering medical school in greater numbers, but they're not represented in the leadership.

SPEAKER_01 13:29

That's right. So we talked with Alison Frigill, like author of Likable Badass. We talked with Jocelyn Woodstein, author of uh um an orthopedic book for women about uh uh bone and and muscle strength and the importance of move medicine.

SPEAKER_00 13:44

Oh, and also what we learned from Jocelyn. So Jocelyn and I are both part of the Milk and Institute Women's Health Network, and at the inaugural luncheon with Dr. Joe Biden in um November when you picked me up at the airport with the best ever driver sign. I saw Jocelyn the next day and I did a little film with her because I said, Jocelyn, the most important thing I learned from you is tell us where vaginal estrogen goes.

SPEAKER_01 14:07

Do you know the forehead? Yeah, it goes in the forehead. Okay, all right. I think it goes in the on the bottom of the feet.

SPEAKER_00 14:16

So it's vaginal. The key is in the word vaginal.

SPEAKER_01 14:20

Estrogen. Okay. Oh, it goes in the vagina. Got it.

SPEAKER_00 14:24

Um I actually have a vagina model right here.

SPEAKER_01 14:26

Oh, yeah, it's clear.

SPEAKER_00 14:28

Everybody and so when I was looking at this, I was like, what is that? Is that like a maggot? Like the rectal maggot? But I realized, you know what that is? That's coccyx.

SPEAKER_01 14:37

Yeah, I was gonna say that's the that's the butt bone.

SPEAKER_00 14:40

Yeah, because there's the rectum. Anyway, anyone not watching the video, you missed out on my vagina model that everyone has should one on their desk.

SPEAKER_01 14:46

Should have one right on their desk. I mean, I don't know why they don't. But you know, that what we learned from it is that there's so many people trying to solve problems around the healthcare system. And so this season we wanted to go further and kind of break it down into um what you know, in the class that I taught or teach and the one that you took is like we talk about the five P's of the healthcare system, and we thought about that framework was really a good one as you're trying to think about like how do you fix the problems in the American healthcare system. Well, you really have to work through these five different groups. Not only do you have to engage all of these different groups, but if you are a person within one of those groups, if you want to solve a healthcare problem, you have to engage all the other people in the other groups too.

SPEAKER_00 15:30

Precisely what so backing up the Milken Institute, that was something else big that happened this year when for those who don't know, uh Dr. Joe Biden is chairing a group coming out of Milken that um was announced last May. It's aiming to be a global group of 200 organizations, exactly to your point, different representatives. So we came in, um, I'm in there as a representative of Calilie, we are one of the startups in that space. They have people from big organizations, they have people from all of these different peas that you're gonna mention, with that exact concept being let's break down the silos and put everyone in the room together. And at lunch, they literally said to us, go find somebody that you don't know who doesn't work in your industry.

SPEAKER_01 16:12

Yeah. And you know, like in the class that I teach, it's a smart, smart way to kind of look at things. Uh, these five Ps are the politics, the pay or policymakers, people, patients. That's number two. Number three are the providers of healthcare, so that's like doctors, nurses, hospitals, uh, EMTs, technicians. The fourth group is the payers of healthcare. So that's like Medicare, Medicaid, um, your pocket, uh, your pocketbook and wallet, um, United Healthcare, like those folks that are actually paying for the healthcare system, taxpayers, and then the producers. So people that are creating technologies to advance health care, tech uh like yourself with Calililly, you know, a drug delivery device. Um, you know, you have uh we have people that uh we'll be speaking to that um on the upcoming season that are pharmaceutical representatives, people that are in the medical device industry. So kind of going back through, it's a nice framework to go through these five Ps: the politicians or policymakers, the people, the providers, the payers, and the producers. It's and the reason why we want to present it this way is because if we want to solve any healthcare problem whatsoever, if you are someone saying, I am an AI software engineer and I'm gonna solve the healthcare problem through some AI process, then great, but you have to have it paid for. You have to have patients under, you know, it has to be a benefit to patients, you have to have doctors, so the providers and hospital systems saying, Yep, we want to adopt this. Policymakers have to regulate it potentially. So you have to engage all of these people, even if you're in one of the P sections, you have to engage all of them to actually drive forward any improvement. So our thesis was to bring people along on this show and on this podcast to have conversations so that you're getting multiple different perspectives.

SPEAKER_00 18:10

And I also just like the letter P because one of my sayings in pediatrics when I would see you know, constipation's a thing. And I would say if you want your child to poop, just feed them foods that start with the letter P. Like peanut prunes, peaches, pears, pepperage farm white bread is actually really high in fiber. So the letter P, I like it. It's like an episode of Sesame Street today. We're brought to you by the letter P.

SPEAKER_01 18:36

Oh, yeah, that's right. Um, but you know what's really good um fiber? Meta muso gummies, and they taste really good.

SPEAKER_00 18:44

So we were at Disneyland last summer, and the lady said they have some starber special gummies, and they're like, they she they warned us, they're like, Don't help yourself to too many because they have weed in them. No, no, no, because they had some sort of like when they got that, everyone was snacking on them and everyone was having to rice to the toilet because they had some kind of like gummy pectin. Sort of like me and smoked moose. Yeah.

SPEAKER_01 19:14

Oh, it was like me and those gummy bears.

SPEAKER_00 19:17

So I'm I'm eating straight up jelly beans today.

SPEAKER_01 19:22

Really?

SPEAKER_00 19:23

I I really because you know I lost the weight, and sometimes I feel like you need 10 jelly beans.

SPEAKER_01 19:31

I get it, I totally get it.

SPEAKER_00 19:33

And I was in the States, and you know something I noticed, I was in Houston last week, I think. I I I'm playing Where's Waldo with myself on the planet every day. Like I wake up and I'm like, oh, where oh, I'm in oh, that's my that is my husband next to me. Let me just double check, right? So I was in Houston, and there's something about America. Have you noticed this? People don't walk. They just don't walk.

SPEAKER_01 19:58

And so that's for sure.

SPEAKER_00 20:00

No, there's parts of America where literally nobody, I don't do they not have legs? What's happened over there? I've lived in Europe for 20. I mean people walk they ambulate, right? Like slow go, no, go, go, go. But they they they don't walk from place A to place B. And so I got to Houston. I was part of this Innovate UK, Texas Medical Center program that was really fun. And I rode an electric or a mechanical bull and I pet an armadillo and I did all these great things. But when I got there, I went, I booked, booked a boot berries boot camp. We're coming full circle. It was like a 20-minute car ride, and I looked and there was a Trader Joe's 0.9 miles from the berries. Those jelly beans were from Trader Joe's. That's what I'm saying.

SPEAKER_01 20:43

Yeah, back in the day, you would just, if you were back in Europe, you'd just walk to it.

SPEAKER_00 20:46

You'd just walk to it. So I left Berries and I was the only person walking, except Was there a sidewalk? Yes, it was on a sidewalk, but I kept having to cross the street because every so often I'd see somebody like stoned on spice who was just standing there, and I'm like, oh, I don't want to want to go that close to him. So I'd cross the street. So it was me and some unfortunate mentally ill people are the only people who walk in a place like Houston. And I think that might be part of what is wrong with healthcare in America.

SPEAKER_01 21:16

So, kind of fun fact on that point. So uh when you're going back to uh policy, like a lot of the policy decisions that are made and incentives that are made end up driving, you know, healthcare outcomes. And so um you're seeing, you know, in in Europe, of course, uh uh, and even in the United States to some degree, in some places, um, greater number of pedestrian walkways, pedestrian walkthroughs. So, like in London, for example, Oxford Street, if you've ever been, is one of the biggest um kind of commerce streets with all the big name department stores and uh all along it. And you know, over the past several years, it's been shifting from a thoroughfare of cars and stuff to then now it's basically taxis and buses. But now they're gonna even shut that down over the next couple of years. And make it a complete pedestrian like a mile and a half long. Really? I don't know if you knew that. But yeah, yeah.

SPEAKER_00 22:05

I did not know that. I was just thinking only a bonehead would drive a car down Oxford.

SPEAKER_01 22:09

Also true. Also true. Oh. But but here's where we're going with it. Um, the the the by creating incentives for public transportation, people are burning more calories just because they have to, because they're walking to pick up food or they're walking to work. So, you know, when we're at our when we're in London, we go to the grocery store about every two days because you you get what you can carry, and you um, of course, wine is a big portion of what we carry, but like you get what you can carry.

SPEAKER_00 22:36

There's no website for that.

SPEAKER_01 22:38

You don't have to I'll oh I need all the education.

SPEAKER_00 22:41

I'll hook you up with it. It's good.

SPEAKER_01 22:43

But like you go to your waitros, you go to your Marks and Spencer and Spencer, which I I love. I've kind of become a big fan. They also have good cookies. Um, but you walk to it and then you walk back to your flat, and then you walk back to your apartment. That's like 150 calories burned right there, just walking back and forth.

SPEAKER_00 22:58

Well, and that means remember last season we we never ended up releasing, we wanted to do a nutrition version of Mahab. We did our bikes, right? And then the nutrition one, we need to full circle that I had bad mics and yeah, and plus I that was right before I started losing weight. So looking at that footage now, I'm like, I don't we don't it's fine. It's okay. It's okay. But we talked about how some of these ideas are not all bad, right? So, like my daughter, we're here and I'm in Austria, and my daughter asked me to pour her a bowl of fruit loops and feed it to her, and because she's 16 and I am a spineless person, I of course ran to the kitchen, poured her her fruit loops, and then proceeded to feed them to her, being silly partly because I was like, you know, you really do have arms, you're 16 years old. But you know what the color the Fruit Loops are?

SPEAKER_01 23:47

Bland?

SPEAKER_00 23:48

So there's like a there's two colors in the box. One is kind of a mauvey purple and the other one's kind of a yellow.

SPEAKER_01 23:54

It's because they banned all the colors of the biggest. Yes! Yeah, I know.

SPEAKER_00 23:58

That's not bad, but then I was looking through the new nutrition guidance for medical schools, and I think we're gonna have to have an episode where we talk about the real value of young physicians in training going to farms to practice soil sampling. Oh, that's and crop rotation. That's in that. So, you know what? Again, we're gonna do what we did last year, which I I really want to hit the nutrition thing this season and and pick apart some of what's both things can be true. It can be terribly crazy and still have some good stuff going on.

SPEAKER_01 24:31

Oh, absolutely. Well, I I you know, one thing I didn't mention that happened over the holidays is I became board certified in lifestyle medicine.

unknown 24:38

Yay!

SPEAKER_01 24:38

And and which is exciting, and also updated my emergency medicine certification. So I am good until mid-2030s in certifications for both, which is exciting. Um, but the lifestyle medicine piece was all about how these does your lifestyle change or can you change your lifestyle? It's in the name from sleep, sexual health, nutrition, exercise, move medicine, um, stress reduction. How can you do those things and what are the things that you can do to really drive improvement in cholesterol, blood pressure, cardiovascular disease, da da da? And I think um what's exciting about having now this kind of transcontinental life, and you have one too, you have like you know, continental Europe, UK, and the US, um, you get to see the different perspectives and how public policy decisions, so like in the UK, France, etc., and Austria, heavy emphasis on public transportation. Okay, well, that has two benefits. One, and environmental pollutants go down because you don't have cars roaming the street. But then two, people have to walk more. You have to. And because you have to walk to get where you're going, that actually has a downstream effect of improving people's overall health, you know, because you're moving more, you're carrying more, you're having to um interact with people more. Um, so those have a lot of benefits that we don't really think sometimes about, but they end up having downstream global population type of health improvements. And they also economic knock-ons, right?

SPEAKER_00 26:09

Uh like the one that's coming to mind is that I don't wear as many high heels when I have to walk places.

SPEAKER_01 26:17

Okay, I can I I don't wear high heels, so I don't I mean, I can imagine.

SPEAKER_00 26:22

Admit it.

SPEAKER_01 26:23

I don't think I ever did. No, never did drag. Not your so I the only time no, mm-mm, uh the only thing time I did something like that was in medical school. I went as Janet Reno for um the Will Farrell version of Janet Reno and walked into a subway, and um, someone immediately was like, dude, that's an amazing Janet Reno costume. And that's the only time I ever came close, and I don't know that you could really say that going as Janet Reno was drag.

SPEAKER_00 26:49

I'm gonna say it's not. I'm gonna agree with that.

SPEAKER_01 26:53

But I don't think it is.

SPEAKER_00 26:54

That is not drag. That's just a thought-out costume. It's kind of like one of my residency counterparts, one of my colleagues during residency, he showed up at a Halloween party dressed as Recessa Annie. So he had the blonde wig, the blue tracksuit, and he looked like a sex dog. No, he didn't look like blue tracksuit, blonde wig, and he had two square um like cardboard things with temple cords coming off them, like defibrillator pads. He did not, that was not drag. You're not dressed in drag if you're dressed as Janet Reno or Recessa Annie. No, you're not gonna be able to do it. I don't want to categorize them any further than that.

SPEAKER_01 27:39

Yeah, I think that's a correct, but going back to what we were talking about, going back, is okay, so you don't don't wear high heels. I get it. So you're out there moving more, protecting yourself more.

SPEAKER_00 27:50

Um, you know, my podiatrist is happy, the fashion industry suffers. I mean, you know, try to not that they were reliant on just me.

SPEAKER_01 27:58

No, no. So I I mean, I think what's what's kind of interesting about what, you know, and kind of our perspectives, what we see, because we're in all these different places, is that you do see that there are healthcare problems across the pond too. You know, like the Europe is not perfect with healthcare by any stretch. I mean, I was just on a podcast, New Orleans, over the last few weeks where we talked about what some of the I was in the audience listening to you.

SPEAKER_00 28:21

I knew that are we?

SPEAKER_01 28:23

I did, I didn't know that until a question came through and it was from you. And the and Glenn, the moderator, asked me a question from you, which was really kind of cute. But um, but you know, you you see that they are struggling too. You know, they have a a big problem with their budgets and healthcare, but they spend in like the UK almost half of what we spend in the United States, but the life expectancy is three, four years more, and they're starting to have population health issues too.

SPEAKER_00 28:48

When I get my estrogen gel refilled in the US versus Europe, it is a 10x increase when I go to pay for it. Today I went to get prescriptions filled and I'm paying cash for them because then I send the receipts to my insurance company. Two different medications, three months worth 50 euros. Yeah, it's it's that's not like the copay, that's the price.

SPEAKER_01 29:12

Yep, that is the price. So I I think that's gonna be, you know, as we look at what we've got coming up, we are gonna be talking about kind of this, you know, how things are on both sides of the pond. Um, you know, in healthcare, we're gonna talk with some health tech founders, uh policy and regulating uh regulatory leaders, because you know, one of the problems in the US is the cost of healthcare continues to rise, and that has big implications to our budget. Um, I'm excited because we've got some clinical innovators, you know, not all doctors and stuff, of course, are on the podcast, uh, and some device executives. You're a device executive, by the way. I'm a device executive. You are, you are, and then some investors and entrepreneurs. So we've got we've got like a host of folks that are coming, um, that are gonna be coming up. Very excited. We'll be doing some of our episodes from London. We'll do some of them from Amsterdam. I think you and I both are going to be at Health um this year. We are, we're gonna be at the and so there's there's a lot of cool stuff that's coming up.

SPEAKER_00 30:09

I'm super excited. I have to say, when we decided it was over a year, it was like what 14 months ago that we were on that second bottle of wine, and I said, Oh, Adam, we're so funny. We should have a lot of fun. Yeah, I know, right? We should do a podcast. And then the team at ABIG was like, that's a lot of work. That was one of the highlights of last year for me. We've had so much fun.

SPEAKER_01 30:31

It has been a lot of fun, and we're gonna have more fun, and we're gonna have some times that are fun and silly and sometimes serious. And no, no, no, because serious.

SPEAKER_00 30:39

I think if we have a guest who's not funny, we should just end it. Like, let's get a hook or something.

SPEAKER_01 30:45

Yeah, yeah, and again, take them off. Listen, some of these decisions and some of these policy things are not super kind of wonky, but you know, but we can spice it up. We'll spice it up. Well, listen, with that, it's been so good to see you. I can't wait for this next season. I'm very excited.

SPEAKER_00 31:03

I'm so excited.

SPEAKER_01 31:04

It's good to be back and stay safe out there. And so our next episode of Unstable Vitals is coming up in a few weeks, and hopefully, hopefully you'll tune in and share it. And so, from me from Washington DC, take care. And Laura?

SPEAKER_00 31:18

Uh, me from where am I today? Vienna, Austria. Healthcare is unstable, and so are we.

SPEAKER_01 31:26

She's more than me, but uh anyway, it's good to see. Bye.

SPEAKER_02 31:30

Thanks for tuning into Unstable Vitals. If you enjoyed this episode, make sure to follow us for more unfiltered conversations on the pulse of healthcare. Connect with us on LinkedIn or visit us on Unstablevitals.com to stay in the loop.