{"version":"1.0.0","segments":[{"startTime":7.695,"endTime":9.999,"body":"Welcome to m New"},{"startTime":10.087,"endTime":12.835,"body":"Direction Fertility Centers"},{"startTime":13.455,"endTime":14.515,"body":"podcast."},{"startTime":20.055,"endTime":22.943,"body":"We will explore the things"},{"startTime":22.999,"endTime":24.715,"body":"that haven't been explored."},{"startTime":25.815,"endTime":28.807,"body":"Things that are more"},{"startTime":28.871,"endTime":31.687,"body":"important than things you've thought"},{"startTime":31.711,"endTime":33.265,"body":"of before."},{"startTime":34.925,"endTime":36.105,"body":"Lots of things."},{"startTime":38.005,"endTime":39.385,"body":"Even more things."},{"startTime":43.525,"endTime":44.705,"body":"Just kidding."},{"startTime":65.315,"endTime":67.875,"body":"I'm Dr. Mark Amol and"},{"startTime":67.915,"endTime":70.427,"body":"this is Taco About"},{"startTime":70.491,"endTime":71.695,"body":"Fertility Tuesday."},{"startTime":73.875,"endTime":76.655,"body":"This is the first episode of many."},{"startTime":79.195,"endTime":81.987,"body":"I want to start this podcast because I feel"},{"startTime":82.011,"endTime":84.215,"body":"there's a lot of misinformation out there."},{"startTime":85.315,"endTime":87.867,"body":"I get patients ask me questions all the"},{"startTime":87.891,"endTime":90.495,"body":"time about things that they"},{"startTime":90.535,"endTime":93.133,"body":"read on, Facebook blog"},{"startTime":93.189,"endTime":96.053,"body":"post or heard from"},{"startTime":96.109,"endTime":98.545,"body":"their local taco dealer."},{"startTime":99.965,"endTime":102.733,"body":"The point is, I want to make a"},{"startTime":102.749,"endTime":105.145,"body":"podcast where each week"},{"startTime":105.445,"endTime":108.149,"body":"I'm going to discuss topics I think are"},{"startTime":108.197,"endTime":111.185,"body":"important things in the news"},{"startTime":112.645,"endTime":115.345,"body":"and answer questions directly from you."},{"startTime":117.635,"endTime":120.611,"body":"Additionally, the reason"},{"startTime":120.643,"endTime":123.363,"body":"I started this podcast is"},{"startTime":123.419,"endTime":126.283,"body":"because I love tacos. My"},{"startTime":126.299,"endTime":129.283,"body":"whole family, we all get together on Tuesdays and we"},{"startTime":129.299,"endTime":131.795,"body":"eat tacos. I also love"},{"startTime":131.835,"endTime":134.815,"body":"fertility and to me I thought,"},{"startTime":135.435,"endTime":138.015,"body":"I like tacos and I like fertility."},{"startTime":138.475,"endTime":140.875,"body":"Why not we taco about"},{"startTime":140.915,"endTime":142.955,"body":"fertility on Tuesdays?"},{"startTime":146.295,"endTime":148.995,"body":"One question I get asked a lot"},{"startTime":150.215,"endTime":152.551,"body":"is why did we start New Direction Fertility"},{"startTime":152.583,"endTime":155.447,"body":"Centers? Was it just an idea"},{"startTime":155.471,"endTime":158.343,"body":"I came up with? What was a way to beat"},{"startTime":158.399,"endTime":159.235,"body":"other clinics?"},{"startTime":161.335,"endTime":163.955,"body":"What's the whole thing behind our clinic?"},{"startTime":165.255,"endTime":168.051,"body":"Well, it all starts back"},{"startTime":168.083,"endTime":170.899,"body":"when my wife and I had problems having"},{"startTime":170.947,"endTime":173.803,"body":"kids. My wife and I have"},{"startTime":173.819,"endTime":176.575,"body":"been together since we were 15 years old"},{"startTime":178.155,"endTime":180.675,"body":"and have never had an accident of getting"},{"startTime":180.715,"endTime":183.715,"body":"pregnant. I've always"},{"startTime":183.755,"endTime":185.295,"body":"wondered there was something wrong."},{"startTime":186.955,"endTime":189.944,"body":"But, like many of you probably didn't want to find out,"},{"startTime":192.004,"endTime":194.85,"body":"in medical school, I had multiple friends"},{"startTime":194.962,"endTime":197.89,"body":"who were becoming pregnant and we"},{"startTime":197.922,"endTime":199.974,"body":"tried and"},{"startTime":200.634,"endTime":202.894,"body":"like many of my patients, failed."},{"startTime":204.394,"endTime":206.874,"body":"So when I got to fellowship at the Mayo"},{"startTime":206.914,"endTime":209.666,"body":"Clinic, I"},{"startTime":209.69,"endTime":212.602,"body":"decided, let's figure out what's wrong. And we saw a"},{"startTime":212.618,"endTime":215.073,"body":"fertility doctor. Now, interesting"},{"startTime":215.129,"endTime":218.041,"body":"enough, I was actually always planning"},{"startTime":218.073,"endTime":220.855,"body":"on going into fertility. I was fortunate"},{"startTime":220.895,"endTime":223.315,"body":"enough to meet a doctor named Dr. Desai"},{"startTime":223.815,"endTime":226.275,"body":"who was at the Mayo Clinic when I was rotating"},{"startTime":227.055,"endTime":230.007,"body":"as a medical student. And I also knew"},{"startTime":230.031,"endTime":232.615,"body":"her when I was a nurse in the"},{"startTime":232.655,"endTime":234.903,"body":"or. I fell in love with"},{"startTime":234.919,"endTime":237.743,"body":"fertility and knew I would eventually go into"},{"startTime":237.759,"endTime":240.727,"body":"it. What I didn't"},{"startTime":240.751,"endTime":243.575,"body":"know was that my wife and I were also"},{"startTime":243.615,"endTime":244.635,"body":"need fertility."},{"startTime":247.115,"endTime":249.215,"body":"So after seeing the fertility doctor,"},{"startTime":250.275,"endTime":252.095,"body":"we found out that I have"},{"startTime":252.595,"endTime":254.535,"body":"severe sperm counts."},{"startTime":255.355,"endTime":257.695,"body":"The only option is ivf."},{"startTime":259.635,"endTime":262.483,"body":"At first we thought, okay, just a"},{"startTime":262.499,"endTime":265.131,"body":"male factor problem. That's one of the best"},{"startTime":265.163,"endTime":268.147,"body":"prognosis. We"},{"startTime":268.211,"endTime":269.975,"body":"started IVF and unfortunately"},{"startTime":271.415,"endTime":274.343,"body":"my wife wasn't responding well. So we"},{"startTime":274.359,"endTime":276.115,"body":"had to stop the IDEIA process"},{"startTime":277.935,"endTime":280.839,"body":"and put a new plan together so we could have"},{"startTime":280.847,"endTime":281.875,"body":"a better outcome."},{"startTime":284.295,"endTime":287.231,"body":"Now, although that sounds great, as many"},{"startTime":287.263,"endTime":289.703,"body":"of you know, the cost of even five days of"},{"startTime":289.719,"endTime":292.115,"body":"treatment is extremely expensive."},{"startTime":293.095,"endTime":295.887,"body":"But we wanted to have a child, and we"},{"startTime":295.911,"endTime":298.867,"body":"said, let's go. So again we did"},{"startTime":298.931,"endTime":301.755,"body":"another cycle, and this"},{"startTime":301.795,"endTime":304.691,"body":"time we were able to get a few eggs. And"},{"startTime":304.723,"endTime":307.695,"body":"luckily two were able to be transferred."},{"startTime":308.795,"endTime":311.571,"body":"One did not implant, but the other did, and it"},{"startTime":311.603,"endTime":313.859,"body":"split. And I got my"},{"startTime":313.907,"endTime":316.375,"body":"amazing identical twin daughters."},{"startTime":318.355,"endTime":321.283,"body":"I always wanted to be a dad. I"},{"startTime":321.299,"endTime":323.927,"body":"don't think I've wanted to be anything more in life than just be a"},{"startTime":323.951,"endTime":326.823,"body":"dad. When"},{"startTime":326.839,"endTime":327.995,"body":"I got my daughters,"},{"startTime":329.535,"endTime":332.343,"body":"so much in my life were fulfilled and my life"},{"startTime":332.479,"endTime":333.875,"body":"became more purposeful."},{"startTime":336.855,"endTime":338.275,"body":"It just further"},{"startTime":339.535,"endTime":342.035,"body":"encouraged me to go into fertility,"},{"startTime":342.975,"endTime":345.583,"body":"to not only help people, but now have an"},{"startTime":345.599,"endTime":348.319,"body":"idea of how I'm helping people"},{"startTime":348.407,"endTime":349.955,"body":"since I've gone through it myself."},{"startTime":351.245,"endTime":352.865,"body":"As I continued through my"},{"startTime":353.685,"endTime":356.669,"body":"Redan fellowship, I started"},{"startTime":356.717,"endTime":358.985,"body":"looking into the cost of ivf."},{"startTime":360.205,"endTime":362.861,"body":"And to my amazement, the"},{"startTime":362.893,"endTime":365.797,"body":"cost was nothing near the cost we were"},{"startTime":365.821,"endTime":368.781,"body":"charging. I said"},{"startTime":368.813,"endTime":371.185,"body":"to my wife, it's interesting."},{"startTime":372.525,"endTime":375.109,"body":"Why did we have to pay so much when the actual"},{"startTime":375.157,"endTime":376.865,"body":"cost isn't that much?"},{"startTime":379.125,"endTime":382.077,"body":"And taking a pad and paper, I calculated the"},{"startTime":382.101,"endTime":384.365,"body":"actual cost of going through a IVF"},{"startTime":384.405,"endTime":387.269,"body":"cycle and determined how many"},{"startTime":387.317,"endTime":389.941,"body":"cycles it would take of IVF to get the cost"},{"startTime":389.973,"endTime":392.925,"body":"down. I held"},{"startTime":392.965,"endTime":395.941,"body":"this belief for many years. I spoke to many people."},{"startTime":396.133,"endTime":398.917,"body":"I spoke to people about business. I spoke to"},{"startTime":398.941,"endTime":401.341,"body":"people about the logic I had behind"},{"startTime":401.373,"endTime":404.183,"body":"this. But to do"},{"startTime":404.199,"endTime":405.995,"body":"it is a different thing."},{"startTime":407.175,"endTime":410.095,"body":"I wanted to do something that hasn't been done,"},{"startTime":410.255,"endTime":412.943,"body":"or so I thought. So"},{"startTime":412.959,"endTime":415.847,"body":"in 2011, I got a"},{"startTime":415.871,"endTime":418.695,"body":"job in Arizona with a great"},{"startTime":418.735,"endTime":421.635,"body":"doctor and started practicing."},{"startTime":422.695,"endTime":425.567,"body":"My dreams of opening up a clinic that's"},{"startTime":425.591,"endTime":428.191,"body":"affordable but yet has high success"},{"startTime":428.223,"endTime":430.987,"body":"rates would be put on the back burner"},{"startTime":431.091,"endTime":433.975,"body":"since the risk was too great to start at that time."},{"startTime":436.035,"endTime":438.531,"body":"After three years of practicing with that doctor,"},{"startTime":438.723,"endTime":441.643,"body":"unfortunately, things didn't work out and we had"},{"startTime":441.659,"endTime":444.603,"body":"to separate. It"},{"startTime":444.619,"endTime":447.603,"body":"was at that time that I determined if I was ever going to"},{"startTime":447.619,"endTime":450.415,"body":"do this plan that my wife and I talked about years ago."},{"startTime":451.115,"endTime":453.611,"body":"Today was the day. And so I reached"},{"startTime":453.643,"endTime":456.191,"body":"out to a person named"},{"startTime":456.263,"endTime":457.715,"body":"Scott Robinson."},{"startTime":458.935,"endTime":461.919,"body":"And Scott, who worked for a company"},{"startTime":461.967,"endTime":464.735,"body":"called Practice Setup, help me"},{"startTime":464.775,"endTime":467.395,"body":"build this business. I told him my plan,"},{"startTime":467.895,"endTime":469.755,"body":"and he was behind me 100%."},{"startTime":472.215,"endTime":474.767,"body":"While building it, I learned about another"},{"startTime":474.791,"endTime":477.607,"body":"doctor who also was doing"},{"startTime":477.671,"endTime":480.651,"body":"something similar to me. I reached out"},{"startTime":480.683,"endTime":483.395,"body":"to him and asked him,"},{"startTime":483.515,"endTime":486.375,"body":"should I be scared or is this going to work?"},{"startTime":487.395,"endTime":490.135,"body":"And he told me, it's going to work."},{"startTime":491.235,"endTime":493.475,"body":"At that point, I felt"},{"startTime":493.515,"endTime":496.099,"body":"comfortable. I knew my heart was in the right"},{"startTime":496.147,"endTime":498.739,"body":"place, my wife's heart was in the right"},{"startTime":498.787,"endTime":501.699,"body":"place, and I knew we were going to be"},{"startTime":501.747,"endTime":504.707,"body":"successful no matter what. I just didn't know about"},{"startTime":504.731,"endTime":507.263,"body":"the numbers. But after that day,"},{"startTime":507.439,"endTime":508.795,"body":"he reassured me."},{"startTime":510.815,"endTime":513.755,"body":"We opened up in 2015 and I remember"},{"startTime":514.095,"endTime":516.715,"body":"it was funny. People would come to our clinic and say,"},{"startTime":517.215,"endTime":520.015,"body":"so what's the deal? Why are you guys so much cheaper?"},{"startTime":520.055,"endTime":522.715,"body":"What's the catch? And"},{"startTime":523.255,"endTime":526.117,"body":"I would tell them the truth. I'd say, we"},{"startTime":526.141,"endTime":529.069,"body":"make less money. And they laugh and they're like, no, but really, I go,"},{"startTime":529.117,"endTime":531.717,"body":"no, really, we really do make less money than everybody"},{"startTime":531.741,"endTime":534.487,"body":"else. But again, on paper, I"},{"startTime":534.511,"endTime":537.455,"body":"knew if we were able to do more"},{"startTime":537.495,"endTime":540.215,"body":"cycles, then everybody can do it for less"},{"startTime":540.255,"endTime":542.835,"body":"money and we can get more people pregnant."},{"startTime":543.455,"endTime":546.327,"body":"I didn't make fertility affordable because"},{"startTime":546.351,"endTime":548.595,"body":"I wanted to just make it affordable."},{"startTime":549.215,"endTime":552.087,"body":"I made it affordable because my"},{"startTime":552.111,"endTime":554.999,"body":"wife and I had to wait six years between"},{"startTime":555.087,"endTime":557.615,"body":"our first IVF and our second"},{"startTime":557.655,"endTime":560.629,"body":"ivf. We couldn't afford to do it again. And"},{"startTime":560.637,"endTime":563.425,"body":"to be honest, if we would have failed that first time,"},{"startTime":564.085,"endTime":566.981,"body":"I probably wouldn't be a parent, at least with my own"},{"startTime":567.013,"endTime":569.869,"body":"kids, and we would have adopted, which"},{"startTime":569.957,"endTime":572.645,"body":"I completely support and plan to do myself, possibly in the"},{"startTime":572.685,"endTime":575.465,"body":"future. But that wasn't my original plan."},{"startTime":576.685,"endTime":579.485,"body":"And I felt not everyone is fortunate"},{"startTime":579.525,"endTime":582.525,"body":"enough to make 16, 20"},{"startTime":582.565,"endTime":584.885,"body":"eggs and some of us"},{"startTime":585.265,"endTime":587.405,"body":"might need more than one IVF cycle."},{"startTime":588.585,"endTime":591.017,"body":"So part of my reason of wanting to make fertility more"},{"startTime":591.041,"endTime":593.857,"body":"affordable was not only to open the door"},{"startTime":594.001,"endTime":596.405,"body":"to other patients,"},{"startTime":596.825,"endTime":599.561,"body":"but to also make it possible for people who can't get"},{"startTime":599.593,"endTime":602.205,"body":"pregnant on a one shot basis."},{"startTime":604.985,"endTime":607.605,"body":"Fast forward four years later."},{"startTime":609.105,"endTime":611.965,"body":"We are now one of the more successful clinics"},{"startTime":612.415,"endTime":615.375,"body":"in the valley. Our pregnancy"},{"startTime":615.415,"endTime":617.915,"body":"rates, our tops"},{"startTime":619.815,"endTime":622.591,"body":"and overall, our customer"},{"startTime":622.663,"endTime":624.995,"body":"service skills are top notch."},{"startTime":626.775,"endTime":629.775,"body":"I'm not proud of our clinic to"},{"startTime":629.815,"endTime":632.375,"body":"become the best when it comes to numbers."},{"startTime":632.535,"endTime":635.511,"body":"I'm not proud of our clinic because we just"},{"startTime":635.543,"endTime":638.491,"body":"get a lot of people pregnant. I'm"},{"startTime":638.523,"endTime":640.995,"body":"proud of our clinic because over the last four"},{"startTime":641.035,"endTime":643.935,"body":"years we've kept to our mission."},{"startTime":644.755,"endTime":647.295,"body":"We offer fertility affordable"},{"startTime":648.275,"endTime":651.215,"body":"and we provide the best care we possibly can."},{"startTime":651.955,"endTime":654.851,"body":"We all truly care. Everyone in that"},{"startTime":655.003,"endTime":657.667,"body":"department cares. I"},{"startTime":657.691,"endTime":660.475,"body":"handpick everyone and I remind"},{"startTime":660.515,"endTime":662.775,"body":"them why we're doing this every day."},{"startTime":663.175,"endTime":666.031,"body":"It's hard sometimes it's hard seeing"},{"startTime":666.063,"endTime":668.975,"body":"people not get pregnant. We work so"},{"startTime":669.015,"endTime":671.835,"body":"hard for the same goal and we come up short"},{"startTime":672.415,"endTime":675.223,"body":"and don't think for a second that we"},{"startTime":675.239,"endTime":678.151,"body":"don't go home wishing the outcome"},{"startTime":678.183,"endTime":681.111,"body":"was different too. But I can"},{"startTime":681.143,"endTime":683.355,"body":"say after these four years,"},{"startTime":685.535,"endTime":688.247,"body":"this has been the most exciting time of my"},{"startTime":688.271,"endTime":691.101,"body":"life and, the most rewarding"},{"startTime":691.133,"endTime":694.053,"body":"time of my life. And that's why we"},{"startTime":694.069,"endTime":696.545,"body":"will continue for years to come"},{"startTime":696.885,"endTime":699.665,"body":"to provide high"},{"startTime":700.485,"endTime":702.905,"body":"successful fertility rates"},{"startTime":703.205,"endTime":706.025,"body":"at extremely affordable rates."},{"startTime":706.885,"endTime":709.637,"body":"And we're working every day to make other areas of"},{"startTime":709.661,"endTime":711.665,"body":"fertility affordable as well."},{"startTime":713.045,"endTime":715.235,"body":"But most of all, I thank"},{"startTime":715.735,"endTime":718.631,"body":"all the patients who have made this"},{"startTime":718.703,"endTime":721.595,"body":"possible. We don't advertise."},{"startTime":722.455,"endTime":725.287,"body":"We leave it to our patients that tell other"},{"startTime":725.311,"endTime":728.047,"body":"patients about us. And it's because of"},{"startTime":728.071,"endTime":730.647,"body":"you that we have become so"},{"startTime":730.711,"endTime":733.675,"body":"successful. And we will not lose sight of that."},{"startTime":735.095,"endTime":737.943,"body":"Tonight, I wasn't expecting to answer"},{"startTime":737.959,"endTime":740.603,"body":"any questions since this is our first"},{"startTime":740.659,"endTime":743.221,"body":"episode. And, I didn't think we'd have any"},{"startTime":743.253,"endTime":745.345,"body":"questions before the first episode."},{"startTime":746.125,"endTime":746.865,"body":"However,"},{"startTime":748.925,"endTime":750.705,"body":"on the announcement,"},{"startTime":752.005,"endTime":754.345,"body":"person named by the name of Jesse"},{"startTime":755.565,"endTime":758.101,"body":"asked me to discuss why the"},{"startTime":758.133,"endTime":760.505,"body":"costs are so different between states,"},{"startTime":761.365,"endTime":763.865,"body":"what that process is for people out of state,"},{"startTime":764.805,"endTime":766.105,"body":"and if it's easy."},{"startTime":769.665,"endTime":772.005,"body":"Stay with us. We'll be right back."},{"startTime":773.705,"endTime":776.085,"body":"Levant Pomp"},{"startTime":776.505,"endTime":779.281,"body":"the Latin Minute is your new favorite bilingual comedy"},{"startTime":779.313,"endTime":782.289,"body":"podcast where two Latinos living in southwest Florida"},{"startTime":782.337,"endTime":784.705,"body":"serv up some spicy takes on the hottest celebrities,"},{"startTime":784.785,"endTime":787.473,"body":"gossip, juicy cheeseme, and just a"},{"startTime":787.489,"endTime":790.329,"body":"sprinkle of politics. With humor, culture and"},{"startTime":790.377,"endTime":793.361,"body":"plenty of laughs, this podcast brings the best of both"},{"startTime":793.433,"endTime":796.349,"body":"worlds. So make sure to check out the Latin Minute."},{"startTime":796.397,"endTime":799.277,"body":"You can follow us On Apple Podcast,"},{"startTime":799.421,"endTime":801.813,"body":"iHeart and Spotify."},{"startTime":801.989,"endTime":804.789,"body":"Also visit our Facebook page, the Latin Minute."},{"startTime":804.837,"endTime":805.905,"body":"We'll see you there."},{"startTime":812.845,"endTime":815.305,"body":"I think this is a great question"},{"startTime":816.085,"endTime":818.989,"body":"because as I discussed tonight,"},{"startTime":819.077,"endTime":822.033,"body":"why I wanted to start a clinic that was"},{"startTime":822.049,"endTime":825.009,"body":"affordable, I"},{"startTime":825.057,"endTime":827.325,"body":"never really grasped"},{"startTime":827.985,"endTime":830.793,"body":"how important this would be to people outside of"},{"startTime":830.809,"endTime":831.685,"body":"Arizona."},{"startTime":833.865,"endTime":836.649,"body":"When we first started the clinic, we"},{"startTime":836.697,"endTime":838.685,"body":"actually didn't take out of state patients."},{"startTime":839.425,"endTime":842.245,"body":"We had people call us up and ask to be patient,"},{"startTime":843.545,"endTime":845.889,"body":"but it was never our"},{"startTime":845.977,"endTime":848.615,"body":"plan and so we said no."},{"startTime":850.155,"endTime":853.075,"body":"And then people started flying in from other"},{"startTime":853.115,"endTime":855.955,"body":"states pretending to be patients"},{"startTime":855.995,"endTime":858.851,"body":"in our state and it blew"},{"startTime":858.883,"endTime":861.755,"body":"my mind. I couldn't believe it. Could we be that much"},{"startTime":861.795,"endTime":864.755,"body":"more affordable than the rest of the country"},{"startTime":864.835,"endTime":867.363,"body":"that people would fly in pretending to be"},{"startTime":867.539,"endTime":870.371,"body":"an in state patient just to go through our"},{"startTime":870.563,"endTime":871.415,"body":"practice?"},{"startTime":873.575,"endTime":876.355,"body":"It was at this point that I realized"},{"startTime":876.975,"endTime":879.807,"body":"it wasn't right to not let"},{"startTime":879.911,"endTime":882.555,"body":"out of state patients in and"},{"startTime":883.175,"endTime":886.055,"body":"it was harming them by making them have to spend even more"},{"startTime":886.095,"endTime":888.915,"body":"money trying to become an out of state patient."},{"startTime":889.895,"endTime":892.743,"body":"So at that time we made the decision to see"},{"startTime":892.759,"endTime":893.875,"body":"out state patients."},{"startTime":894.975,"endTime":897.915,"body":"Unfortunately, it did not go well."},{"startTime":898.7,"endTime":901.605,"body":"we were not prepared for it and"},{"startTime":901.725,"endTime":904.581,"body":"we definitely heard the feedback of how bad it"},{"startTime":904.613,"endTime":907.485,"body":"was. And so we then"},{"startTime":907.525,"endTime":910.405,"body":"closed it. And we explained why we closed it because"},{"startTime":910.445,"endTime":913.421,"body":"we just felt our goal isn't just to be affordable,"},{"startTime":913.533,"endTime":916.109,"body":"but our goal has always been to provide great"},{"startTime":916.157,"endTime":918.745,"body":"care, great stats,"},{"startTime":919.325,"endTime":920.625,"body":"and be affordable."},{"startTime":923.065,"endTime":925.285,"body":"I took the feedback that we were given"},{"startTime":926.465,"endTime":929.405,"body":"and we then put together an out of state program."},{"startTime":930.065,"endTime":932.745,"body":"We got a nurse just to be an out of state"},{"startTime":932.785,"endTime":935.441,"body":"coordinator. We took all the"},{"startTime":935.473,"endTime":938.257,"body":"problems that we found and the feedback that we were"},{"startTime":938.281,"endTime":941.233,"body":"given and made the"},{"startTime":941.289,"endTime":944.245,"body":"program not what it is today,"},{"startTime":945.625,"endTime":948.193,"body":"but the foundation of what it is"},{"startTime":948.249,"endTime":950.745,"body":"today. And then built on that."},{"startTime":952.365,"endTime":954.981,"body":"I feel pretty comfortable to say that"},{"startTime":955.133,"endTime":958.021,"body":"most of our out of state patients do"},{"startTime":958.053,"endTime":959.705,"body":"feel like it's a good experience."},{"startTime":960.965,"endTime":963.789,"body":"I feel one of our systems that has helped a"},{"startTime":963.797,"endTime":966.741,"body":"lot is a text messaging"},{"startTime":966.813,"endTime":969.717,"body":"service called Clara. And I"},{"startTime":969.741,"endTime":972.693,"body":"feel that has really helped. Patients who are out of"},{"startTime":972.709,"endTime":975.105,"body":"state feel like they can get answers"},{"startTime":977.325,"endTime":978.665,"body":"fairly rapidly"},{"startTime":980.125,"endTime":982.552,"body":"and feel like they're always in touch with the clinic."},{"startTime":984.412,"endTime":987.348,"body":"On the day the new"},{"startTime":987.38,"endTime":990.112,"body":"patients arrive at our clinic out of state,"},{"startTime":991.572,"endTime":993.432,"body":"the state coroner meets with them."},{"startTime":994.332,"endTime":997.044,"body":"They meet me and throughout the"},{"startTime":997.108,"endTime":999.796,"body":"IVF process I'm doing the ultrasounds"},{"startTime":999.924,"endTime":1002.748,"body":"so I have a chance to ask questions. And I'm always reassuring"},{"startTime":1002.78,"endTime":1005.752,"body":"them it's not perfect yet."},{"startTime":1006.572,"endTime":1008.752,"body":"We're always working to make it better"},{"startTime":1010.092,"endTime":1012.432,"body":"and we hope to keep making it better."},{"startTime":1013.172,"endTime":1015.636,"body":"We've m even looked at possibly"},{"startTime":1015.684,"endTime":1018.452,"body":"putting ultrasonnographers in other"},{"startTime":1018.492,"endTime":1021.308,"body":"states to allow patients to stay in"},{"startTime":1021.34,"endTime":1023.764,"body":"their state until the retrieval or the"},{"startTime":1023.788,"endTime":1024.552,"body":"transfer."},{"startTime":1026.212,"endTime":1028.988,"body":"So with regards"},{"startTime":1029.06,"endTime":1031.781,"body":"to what the process is like,"},{"startTime":1032.521,"endTime":1035.181,"body":"it usually starts with a ah, consult"},{"startTime":1036.001,"endTime":1038.081,"body":"that starts with my nurse"},{"startTime":1038.121,"endTime":1041.089,"body":"practitioner who is"},{"startTime":1041.145,"endTime":1044.009,"body":"amazing, who basically takes all"},{"startTime":1044.025,"endTime":1046.865,"body":"the information and then"},{"startTime":1046.993,"endTime":1049.913,"body":"compiles it for me. I then"},{"startTime":1049.977,"endTime":1052.781,"body":"review all that information, review the records"},{"startTime":1053.521,"endTime":1056.222,"body":"and then I do a consulte. At that"},{"startTime":1056.262,"endTime":1058.802,"body":"point I'm trying to determine"},{"startTime":1059.182,"endTime":1061.242,"body":"is this the best thing for the patient"},{"startTime":1062.182,"endTime":1064.202,"body":"and what the best proocol will be."},{"startTime":1066.102,"endTime":1069.078,"body":"I'm asked why do we make people get"},{"startTime":1069.11,"endTime":1072.11,"body":"these extra labs? Why do I make them repeat"},{"startTime":1072.166,"endTime":1074.642,"body":"certain tests before coming to our clinic?"},{"startTime":1075.222,"endTime":1078.134,"body":"And the reason is because when we first started doing out"},{"startTime":1078.158,"endTime":1080.686,"body":"of stay patients, we found"},{"startTime":1080.734,"endTime":1083.48,"body":"that the testing that was done was"},{"startTime":1083.536,"endTime":1085.812,"body":"so poor by the other clinics"},{"startTime":1086.792,"endTime":1089.592,"body":"that we would make wrong decisions on the protocol and people"},{"startTime":1089.632,"endTime":1092.572,"body":"would get a poor IVF cycle."},{"startTime":1093.392,"endTime":1096.012,"body":"So at that time we determined we had to use"},{"startTime":1096.592,"endTime":1099.232,"body":"a company with consistency that we felt was"},{"startTime":1099.272,"endTime":1101.808,"body":"accurate. So I can make great"},{"startTime":1101.88,"endTime":1104.212,"body":"decisions to give the best care."},{"startTime":1104.712,"endTime":1107.576,"body":"Additionally, there are some clinics"},{"startTime":1107.664,"endTime":1110.504,"body":"who tell people they need to do IVF when they"},{"startTime":1110.528,"endTime":1111.652,"body":"don't need ivf."},{"startTime":1113.072,"endTime":1116.03,"body":"And I wouldn't be able to sleep at night if I"},{"startTime":1116.046,"endTime":1119.03,"body":"knew patients were flying in to do IVF with"},{"startTime":1119.046,"endTime":1121.602,"body":"us and I knew they didn't need it."},{"startTime":1122.582,"endTime":1125.366,"body":"And so part of the reason why I"},{"startTime":1125.414,"endTime":1128.242,"body":"personally review everything and consult with the patients"},{"startTime":1128.942,"endTime":1131.922,"body":"is to reassure them that if they do need IVF"},{"startTime":1132.542,"endTime":1135.362,"body":"they should proceed with it. And if they don't"},{"startTime":1136.452,"endTime":1139.272,"body":"recommend certain things that they can do"},{"startTime":1140.332,"endTime":1142.232,"body":"to not need to come to our clinic."},{"startTime":1144.252,"endTime":1147.143,"body":"Now, from a business point, that doesn't seem to"},{"startTime":1147.167,"endTime":1150.143,"body":"make sense, but anyone"},{"startTime":1150.167,"endTime":1153.159,"body":"who has ever met me knows I don't do this just to"},{"startTime":1153.175,"endTime":1155.983,"body":"make a dollar. I do this because I"},{"startTime":1156.007,"endTime":1158.851,"body":"want everyone to be able to enjoy"},{"startTime":1159.271,"endTime":1161.131,"body":"being a parent like I am."},{"startTime":1162.561,"endTime":1165.461,"body":"It's one of the greatest things I've ever enjoyed."},{"startTime":1166.721,"endTime":1168.741,"body":"So to the question of"},{"startTime":1169.561,"endTime":1171.821,"body":"why does the cost vary state to state."},{"startTime":1173.681,"endTime":1176.661,"body":"This is a very broad question."},{"startTime":1177.721,"endTime":1180.537,"body":"In general, like all things states to"},{"startTime":1180.569,"endTime":1183.251,"body":"state differences are going be based on supply"},{"startTime":1183.347,"endTime":1186.211,"body":"demand. There are many"},{"startTime":1186.267,"endTime":1187.863,"body":"states who are mandated"},{"startTime":1188.963,"endTime":1191.731,"body":"where fertility is covered. That will"},{"startTime":1191.787,"endTime":1194.503,"body":"also change the cost of ivf."},{"startTime":1197.883,"endTime":1200.823,"body":"There are also a lot of clinics who offer"},{"startTime":1201.123,"endTime":1203.867,"body":"mini IVF for a lower"},{"startTime":1203.915,"endTime":1206.731,"body":"cost. And it's important to"},{"startTime":1206.787,"endTime":1209.659,"body":"understand that what we are doing is not a mini"},{"startTime":1209.691,"endTime":1212.339,"body":"ivf. We are not giving you a"},{"startTime":1212.371,"endTime":1215.163,"body":"lesser service, lowering the cost."},{"startTime":1216.023,"endTime":1218.643,"body":"We are providing you the highest service"},{"startTime":1219.223,"endTime":1222.111,"body":"at a lower cost. Now the"},{"startTime":1222.127,"endTime":1224.567,"body":"question isn't how do we get the cost"},{"startTime":1224.615,"endTime":1227.323,"body":"lower. The question really is"},{"startTime":1228.303,"endTime":1230.203,"body":"why do they charge so much?"},{"startTime":1231.183,"endTime":1233.403,"body":"And this comes down to supply and demand."},{"startTime":1234.623,"endTime":1236.935,"body":"If more people are going through"},{"startTime":1236.959,"endTime":1239.751,"body":"IVF then you can charge"},{"startTime":1239.807,"endTime":1242.429,"body":"less because you'make up the"},{"startTime":1242.461,"endTime":1245.153,"body":"differences in the number going through."},{"startTime":1247.093,"endTime":1249.833,"body":"If the clinic is seeing fewer patients,"},{"startTime":1250.453,"endTime":1253.229,"body":"then they will need to increase their cost of their"},{"startTime":1253.301,"endTime":1255.949,"body":"services to be able to keep up"},{"startTime":1256.061,"endTime":1258.793,"body":"with overhead. I think"},{"startTime":1259.253,"endTime":1261.913,"body":"one of the most important aspects of this"},{"startTime":1263.293,"endTime":1266.073,"body":"is that years ago"},{"startTime":1266.833,"endTime":1269.573,"body":"clinics like CCRM"},{"startTime":1269.913,"endTime":1272.293,"body":"who were considered some of the best in the country"},{"startTime":1273.033,"endTime":1275.673,"body":"were making their own media or making their"},{"startTime":1275.713,"endTime":1278.401,"body":"own incubators. They were doing"},{"startTime":1278.457,"endTime":1281.297,"body":"everything from scratch. But"},{"startTime":1281.345,"endTime":1284.213,"body":"today everything is pre made."},{"startTime":1286.073,"endTime":1288.585,"body":"Most of the things that we use are made by other"},{"startTime":1288.649,"endTime":1291.497,"body":"companies. So the reliability"},{"startTime":1291.545,"endTime":1294.139,"body":"is high and the reproducibility is"},{"startTime":1294.171,"endTime":1297.003,"body":"high. So therefore, if you"},{"startTime":1297.043,"endTime":1299.943,"body":"know this, through the country"},{"startTime":1300.483,"endTime":1303.251,"body":"rates are starting to become the same across"},{"startTime":1303.307,"endTime":1305.463,"body":"clanks. Ensure there are some that are better."},{"startTime":1306.083,"endTime":1308.987,"body":"We obviously strive to be better, but in the end"},{"startTime":1309.075,"endTime":1311.659,"body":"it's not like the rates are 70% at one"},{"startTime":1311.691,"endTime":1314.467,"body":"clinic and 30% at another."},{"startTime":1314.595,"endTime":1316.823,"body":"That's extremely uncommon. To c"},{"startTime":1317.403,"endTime":1320.343,"body":"the difference is now between the very best clanks"},{"startTime":1320.783,"endTime":1323.719,"body":"and the average clinic are maybe 10"},{"startTime":1323.751,"endTime":1326.638,"body":"to 20% differences in pregnancy rate. Now,"},{"startTime":1326.588,"endTime":1329.148,"body":"yes, that is obviously a big"},{"startTime":1329.204,"endTime":1331.876,"body":"difference, but the point is"},{"startTime":1332.068,"endTime":1334.6,"body":"it doesn't justify the cost anymore."},{"startTime":1336.18,"endTime":1338.964,"body":"Although we are unique in trying to be the"},{"startTime":1339.012,"endTime":1341.96,"body":"top clin in the country and they'affordable"},{"startTime":1343.06,"endTime":1345.828,"body":"I hope that there are many other clinics who will"},{"startTime":1345.884,"endTime":1348.878,"body":"also become affordable. And even"},{"startTime":1348.894,"endTime":1351.67,"body":"if they don't have the top Rates people"},{"startTime":1351.71,"endTime":1354.13,"body":"will understand it's still worth it to go there"},{"startTime":1354.91,"endTime":1357.87,"body":"then to pay other clinics more"},{"startTime":1357.91,"endTime":1360.77,"body":"money for almost the same service."},{"startTime":1362.27,"endTime":1364.81,"body":"The one thing I can definitely tell you is this."},{"startTime":1366.07,"endTime":1369.014,"body":"It does not cost as much as other clients"},{"startTime":1369.062,"endTime":1371.13,"body":"charge for ivf."},{"startTime":1371.95,"endTime":1373.97,"body":"The materials don't cost that much,"},{"startTime":1375.38,"endTime":1377.24,"body":"the time doesn't cost that much,"},{"startTime":1378.14,"endTime":1380.0,"body":"the staff doesn't cost that much."},{"startTime":1381.22,"endTime":1384.06,"body":"Unfortunately, fertility is one of those"},{"startTime":1384.1,"endTime":1386.84,"body":"things that we all want"},{"startTime":1387.74,"endTime":1390.04,"body":"and right now there is not a lot of coverage for."},{"startTime":1390.66,"endTime":1393.356,"body":"And so supply is"},{"startTime":1393.388,"endTime":1395.92,"body":"plentiful and demand"},{"startTime":1396.42,"endTime":1399.252,"body":"is plentiful and they can"},{"startTime":1399.276,"endTime":1402.208,"body":"charge those prices. But there will be"},{"startTime":1402.224,"endTime":1404.952,"body":"a time which I believe will not be too"},{"startTime":1404.976,"endTime":1406.42,"body":"much further in the future"},{"startTime":1407.92,"endTime":1409.1,"body":"where there will be"},{"startTime":1411.96,"endTime":1414.54,"body":"multiple clinics like ours"},{"startTime":1415.36,"endTime":1417.38,"body":"offering affordable fertility."},{"startTime":1418.44,"endTime":1421.44,"body":"And when there is plenty of us, the prices"},{"startTime":1421.48,"endTime":1424.352,"body":"will come down everywhere just like in"},{"startTime":1424.376,"endTime":1427.358,"body":"many other markets when clinics like myself"},{"startTime":1427.414,"endTime":1429.21,"body":"come in to disrupt them."},{"startTime":1430.95,"endTime":1433.21,"body":"This is not a me against them moment."},{"startTime":1434.23,"endTime":1437.03,"body":"I actually love all my colleagues. I think they're all great"},{"startTime":1437.07,"endTime":1440.05,"body":"people. I just think that"},{"startTime":1441.11,"endTime":1442.93,"body":"until fertility becomes"},{"startTime":1444.59,"endTime":1447.334,"body":"affordable, it's just not"},{"startTime":1447.382,"endTime":1449.59,"body":"right. Fertility will always be"},{"startTime":1449.63,"endTime":1451.69,"body":"expensive because"},{"startTime":1452.89,"endTime":1455.27,"body":"hope is a very strong"},{"startTime":1456.49,"endTime":1459.458,"body":"motivator. I"},{"startTime":1459.474,"endTime":1461.15,"body":"don't believe the other doctors"},{"startTime":1462.37,"endTime":1465.03,"body":"want to make more money off of people."},{"startTime":1465.85,"endTime":1468.29,"body":"I don't believe the other fertility"},{"startTime":1468.33,"endTime":1470.35,"body":"clin are greedier."},{"startTime":1471.41,"endTime":1474.346,"body":"I think they just don't understand it could be done this"},{"startTime":1474.378,"endTime":1477.354,"body":"way. I have many, many people"},{"startTime":1477.402,"endTime":1480.368,"body":"ask me how do you see this many patients? How"},{"startTime":1480.384,"endTime":1483.22,"body":"do you do it? And yes I do work hard."},{"startTime":1484.04,"endTime":1486.736,"body":"When I come to work at 8am, I leave at"},{"startTime":1486.768,"endTime":1489.696,"body":"5pm and yet I'm able to"},{"startTime":1489.728,"endTime":1492.696,"body":"still do it. And I think once they realize"},{"startTime":1492.888,"endTime":1495.392,"body":"that the model they are using is"},{"startTime":1495.416,"endTime":1498.184,"body":"outdated or is"},{"startTime":1498.352,"endTime":1500.944,"body":"perfect for maybe a niche"},{"startTime":1501.112,"endTime":1502.22,"body":"group of people,"},{"startTime":1503.74,"endTime":1506.668,"body":"then most, of them will turn to what"},{"startTime":1506.684,"endTime":1507.48,"body":"I'm doing."},{"startTime":1509.14,"endTime":1511.84,"body":"Anyways, thanks for the question Jesse."},{"startTime":1513.5,"endTime":1515.56,"body":"Now on a serious note,"},{"startTime":1518.5,"endTime":1521.428,"body":"what is my favorite taco? This is one of"},{"startTime":1521.444,"endTime":1523.92,"body":"my toughest questions"},{"startTime":1524.22,"endTime":1526.94,"body":"I think I've been asked. And it's tough"},{"startTime":1527.02,"endTime":1529.572,"body":"because there are a lot of good tacos out"},{"startTime":1529.596,"endTime":1530.16,"body":"there."},{"startTime":1533.03,"endTime":1535.491,"body":"Some tacos are technically not even"},{"startTime":1535.515,"endTime":1538.499,"body":"tacos such as the Jack in the Box"},{"startTime":1538.539,"endTime":1541.499,"body":"taco. It not a taco but it sure"},{"startTime":1541.539,"endTime":1542.359,"body":"tastes good."},{"startTime":1544.539,"endTime":1547.461,"body":"But when I look deep down and ask whats my"},{"startTime":1547.485,"endTime":1550.461,"body":"favorite taco, it has"},{"startTime":1550.485,"endTime":1553.329,"body":"to be the one that I make at home with my family."},{"startTime":1554.089,"endTime":1556.789,"body":"There's just nothing like making your own tortillas."},{"startTime":1557.449,"endTime":1560.289,"body":"A warm tortilla, warm"},{"startTime":1560.329,"endTime":1563.001,"body":"meat and family around"},{"startTime":1563.025,"endTime":1563.589,"body":"you."},{"startTime":1567.089,"endTime":1569.549,"body":"Thanks everyone for being part of the show today."},{"startTime":1570.929,"endTime":1573.657,"body":"I hope you enjoyed this first episode, although there"},{"startTime":1573.673,"endTime":1576.657,"body":"wasnt much to it. I look forward to"},{"startTime":1576.673,"endTime":1578.549,"body":"your questions and next week,"},{"startTime":1579.389,"endTime":1582.253,"body":"I answer them. Have a great week."},{"startTime":1582.381,"endTime":1585.16,"body":"And I'll see, you next week for taco about"},{"startTime":1585.28,"endTime":1586.24,"body":"fertility Tuesdays."}]}