The Adam and Dr. Drew Show - #1832 He's Abused Us Both

Episode Date: February 28, 2024

This week, Dr. Spaz returns! Dr. Bruce Heischober reunites with Dr. Drew in the studio for a long awaited catch up, they share their views on the rise of Ozempic, HGH treatments, and what's happened s...ince the pandemic. Plus, the impacts of the Harrison Narcotics Act from 1914, and a quick call-in from the Aceman. Please Support Our Sponsors: Take charge at Biotiquest.com, with code DREW15 The Jordan Harbinger Show - Available everywhere you listen to podcasts

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Starting point is 00:00:25 and start streaming Pluto TV stream now pay never hey everybody good news we're doing the comedy fantasy camp again Jay Leno's gonna be there I'm gonna be there John Lovitz is gonna be there Caroline Ray is gonna be there many many other big comedians are going to be there. February 29th through March 3rd, tickets are going to go fast, and it's all going to culminate at the world-famous Hollywood Improv. So come and join us at the Comedy Fantasy Camp and work with the pros. Get your tickets at ComedyFantasyCamp.com. This is Below Deckcks Captain Lee. Listen to my new podcast, Salty with Captain Lee.
Starting point is 00:01:10 Um, don't you mean our podcast? Uh, yeah, I guess I do. Anyhow, listen to Salty with Captain Lee, co-hosted by my assistant, Sam. And we will be talking about the latest pop culture news and all the gossip every week. So does this mean we have to talk by ourselves, about ourselves, or can at least have some guests on? I don't know, I find
Starting point is 00:01:34 myself pretty interesting, but yeah, we can have some guests on. Some of our reality TV friends and some stars. Works for me. Listen to Salty now on Apple Podcasts, Spotify, or wherever you get your podcasts. Recorded live at Corolla One Studios with Adam Corolla
Starting point is 00:01:55 and board-certified physician and addiction medicine specialist Dr. Drew Pinsky. You're listening to The Adam and Dr. Drew Show. Get it on. Got to get it on. No choice but to get it on. Mandate. Get Pinsky. You're listening to The Adam and Dr. Drew Show. Get it on. Got to get it on. No choice but to get it on. Mandate. Get it on.
Starting point is 00:02:09 I'm disappointed that Emmy didn't have a special intro for today's show. We have one for Mark Garagos for not for the one and only Dr. Bruce. I was trying to figure out how we can do doctor and doctor.
Starting point is 00:02:18 You can just next time just jump in. It's the Dr. Drew. Dr. Bruce. Dr. Bruce, yes, and Adam show. And Drew show. So in any event, Bruce, thank you. One of the things I like about doing this show is Adam, you know,
Starting point is 00:02:32 he fucks off occasionally and I get to see my friends in here. Yeah, we can talk shit about Adam. Oh, hell yeah. He's abused us both and less me than you. So let me, let me let me, well, okay. So Bruce Heishober is a physician and friend.
Starting point is 00:02:51 We've been running parallel paths in medicine since we were in our 20s. Don't, don't. Right? 30s, man, 20s probably. I was telling someone, and you know who it is, Dr. Bruce and Dr. Spass. I was telling someone, and you know who it is, Dr. Bruce and Dr. Spass. And I was telling someone about my own history with mental health when I was an adolescent and how that got me interested in mental health for adolescents a little bit. And then I started thinking about those days we used to hang around the whole adolescent health community.
Starting point is 00:03:21 Remember that? Oh, yeah. Dr. McKenzie at USC. We were both on faculty there. That's right. And I don't, because SC has been so weird about the faculty positions. Like I just left, I was in the department of psychiatry for like 10 years or 15 years. And I just left it on my CV. They called me like, how dare you, blah, blah, blah. So I've been afraid to put the McKenzie thing on there because he's gone and can't stand up, can't tell anybody that, yes, we were on the faculty of pediatrics or adolescent medicine through Department of Pediatrics.
Starting point is 00:03:53 So I've had three different faculty positions. Wow. Yeah. Well, that was a nascent field. Right. The first boards were early 90s. You took them. Yeah, I did. You took them. Yeah, I did.
Starting point is 00:04:06 You took them twice, I remember, right? That one once. I've taken so many. I've taken emergency medicine four times. That tells you how old I am. Wow. So you've taken internal medicine, emergency medicine, addiction medicine, adolescent medicine. Right.
Starting point is 00:04:17 And I can't remember anything. I've got the same problem. You have a steel trap, Drew. Come on. But we've had all this. Listen, I couldn't remember whether I told you about my shoulders. And I know we kind of talked about your eyes, but I couldn't remember if it was before or after your eye surgery. That's how my memory works now.
Starting point is 00:04:34 It's like vague. Everything's vague. Well, you know, we can use the GLP-1 agonist for neurocognitive issues. Can we? I heard that. And then for addictions, we could talk more about that later. Okay, so you saw about Ozembic, right? And Ozembic, I also saw Mood, Mood treatment.
Starting point is 00:04:51 Yes. To help with Mood. Oh, for everything. For everything. Well, let's get into it. So what do you think about Ozembic? I don't know. I mean, you know, it has its place.
Starting point is 00:05:01 I think those are just speculative. Those are, you know, there's not good verifiable studies on that. But I think that how long are you going to have to get these injections, right? What's the – What's the duration of treatment? Duration of treatment, people stop, and it's like a lot of weight management programs. They end up being a disaster. Yeah.
Starting point is 00:05:24 Remember Fen-Phen? Oh, well, you know, people are getting Phenermine still. Still, I know. Which I don't understand. And even in medical systems. I know. I understand. There are weight clinics where people get it.
Starting point is 00:05:35 There's still people pushing HGH and all kinds of crazy stuff in weight clinics. So what are your concerns about HGH? Because people ask me about that all the time. Human growth hormone. Right, right. Yeah, no. Well, I'm trying to think of what I told my last patient that went to a – it just – so what – my concern is, first of all, is what age are you going to replace? It's like testosterone.
Starting point is 00:06:00 What an endocrinologist friend of mine said, if you're going to do HGH, do testosterone. It's cheaper and you get the same result. There's no increase. As far as your telomeres, those are going to splice off at the same rate. So it doesn't extend life. It does later in life what my endocrinologist friend said. He said, look, if you're measuring know, measuring HGH is more difficult. It's less accurate, more difficult.
Starting point is 00:06:27 But if you're down less, if you're way, way down on testosterone, low on HGH later in life, and you want to replace to maybe two-thirds of physiologic what it would have been when you were 20, that's reasonable. But a lot of these places, the younger patients I have, they go and they're still being encouraged to get super physiologically real high levels. That's insane. That's insane. That's insane. Now, I just say this one. And by the way, they do it without a diagnosis.
Starting point is 00:06:52 Oh, yeah. Like, oh, you have low testosterone. Why do you have low? It's like saying you have a fever. Why? Why do you have a fever? What's going on? And if they do measure and it's in a low normal, it's in the normal range.
Starting point is 00:07:03 And they say, oh, you're low. We need to replace. So now for us. Us older guys. Us older guys. I was talking to my primary about it. And he goes, don't even want to measure it. I go, why not?
Starting point is 00:07:13 And he goes, well, 14% of individuals have an MI within six months if they're over 65. Of taking the medicine. If they get testosterone replacement. And I don't know what the coronary artery picture is for everybody, all comers or what. Or what if they just got a calcium score and then measured your testosterone and then give you the – I'm a – listen, I was talking to a woman yesterday or Saturday, and she was complaining about some postmenopausal stuff. And I said, well, are you on hormone replacement?
Starting point is 00:07:39 She's like, no. And I was like – and I thought to myself, would you say the same thing about thyroid hormone? I mean, when your endocrine organs start to fail, it's okay to replace them. Now, I understand you could argue that thyroid shutdown is a pathological state while ovarian shutdown is a normal part of aging. I would argue the degree to which we live to the point routinely where your ovaries shut down is not normal. That's kind of weird that we live as long as we do. So why not replace when your organs start to fail? And I understand it's not for everybody, but, I mean, why recoil in horror?
Starting point is 00:08:17 No, of course not. It's like, yeah, you should think. I've seen some – Susan's on it. It's changed her life. Right. Well, you know, I don't do primary care internal medicine like you do. So it's just daunting to me to manage as people's life extends. What do you do with these different systems that don't – they don't change or they don't degrade proportionately at the same time?
Starting point is 00:08:37 And I have patients ask me, it's like with the hormone replacement therapy for women, I don't – you could educate me because – It's all over the place. Right. So I'm a fan of it. When the Women Health Initiative was done and it showed that we should not be putting people on hormones, you're a witch doctor if you put – you're no better than a witch doctor. Turned out the study was flawed, shocking, because we took all these women off hormones and they fell apart.
Starting point is 00:09:03 They became depressed. Their bones crushed. They became depressed. Their bones crushed. They became demented. And we were being told, you get dementia if you put them on estrogen. No, wrong. Some, maybe, perhaps. Breast cancer, yes, an issue. But with the progesterone, it turns out with testosterone,
Starting point is 00:09:17 women on estrogen with testosterone may have lower risk of breast cancer than average. And not everyone responds to each of these hormones the same way. That's the really crazy part. Some women, you give them testosterone, they just get aggressive and lose their hair. And that's it. They don't feel better. My wife changed her life, brought a part of her back to life. Her mood was improved.
Starting point is 00:09:37 Her sleep was improved. Energy level, everything better. But she's not everybody. So you have to kind of individualize it. Right. I rely on other – the people I work with. I know a lot of the primary care docs still routinely refuse to provide HRT for postmenopausal women. And so I get confused because –
Starting point is 00:09:58 I get confused by that too because it doesn't make any sense to me. They're clinging to a study that was flawed. Right. And there's lots of good new studies out there that suggest it's a mixed bag, and we should be making individualized decisions. Right. Well, I think in a lot of things in my area of medicine, I get a lot of referrals to decrease polypharmacy. Well, tell them what you're doing now. Tell them what you're doing these days.
Starting point is 00:10:19 Well, I wasn't a hero. I must admit. So during COVID, I stopped doing emergency medicine probably to the benefit of the poor patients. I'm doing addiction medicine three days a week. I'm sort of half-time addiction medicine and then half-time pain medicine, working as a consultant with the pain department. For Kaiser. Right, to get people off their opiates. Yeah.
Starting point is 00:10:48 opiates. And we're really, I must say, the Yale New Haven people that did the studies on buprenorphine or Suboxone, Subutex for chronic pain, and introduced it nationally in the Veterans Administration, did the study for DOD. We're paralleling what they did about 15 years ago, looking at all the furor of everybody's on opiates for chronic pain. I know in the 90s when they'd come in and inspect the hospital, the Joint Commission, if they looked at the charts and reviewed and there was a frowning face, somebody with chronic pain, why didn't you encourage their basically pressure? Oh, no, no, no, no, no, no. Not just with chronic pain.
Starting point is 00:11:26 With any pain. Right. So my heroin addicts in withdrawal who had frowny faces, Jayco would say, why aren't you giving them a painkiller? Why are you giving them opiates? Because they're – it's part of the withdrawal. What is wrong with you? I was so incensed by that.
Starting point is 00:11:54 Listen, man, the playbook of the way that the pain medicine world and the drug companies got control of the regulators was the exact playbook that was used in the vaccine rollout. Exact playbook. Same exact playbook. Evangelical physicians, pain medicine in the case of opiates, Dr. Deborah Birx in the case of the vaccine rollout and lockdown, both. That was the playbook. Then you get the regulators, then you get the government, then you get everyone, and then you silence and crush people who, during the opiate thing, I was sanctioned by my hospital administration, the Joint Commission, the Department of Mental Health, California Medical
Starting point is 00:12:21 Association, for daring to say that we should not be giving opiates to opiate addicts. Yeah. It's crazy. Right. So, you know, I read the book, The Empire of Pain. I mean, I agree the pharmaceutical industry had a big hand in that. Duplicitous. They were duplicitous.
Starting point is 00:12:37 Right. But the people, the JCH, the bureaucrats. They were the perpetrators. Right. They were the perps. Right. And no one knows that except you and me because we had to live through it. And people don't want to hear it.
Starting point is 00:12:46 They want to. It's much more fashionable to go after the Sackler family. And you should. I mean, they were duplicitous. But it's always our profession. It's always us. Right. It's always us.
Starting point is 00:12:56 And as we become more employed, more employees, and less thoughtful, academic, independent, the more of this shit we're seeing. It's just that COVID was eye-opening for me. I don't think we've done a show since COVID, you and I, have we, in this show? No, I know the path you've taken is very interesting. Very interesting. I'm sure it's against the narrative. I'm not strictly speaking against the narrative so i i'm not strictly speaking against the narrative i'm interested in a
Starting point is 00:13:26 accurate refined application of the narrative for instance should a 22 year old male with zero risk from omicron one out of five thousand risk of myocarditis let's just use that as a arbitrary it might be one out of eight hundred might be one out of ten thousand a risk of myocarditis. Should that person with zero risk from Omicron, who is not going to transmit it to anybody or not going to limit their transmission with a vaccine, should we be giving that 22-year-old male a vaccine? That's my question. No.
Starting point is 00:13:56 That's it. I don't think so. Why are we pushing it then? Why are we pushing it? What about a six-month-old? Why are we pushing it? Yeah. Why?
Starting point is 00:14:01 What's going on there? I don't get it. But that's the narrative. I'm saying you're sort of – I don't think there's going to be the ad hominem attacks on you for not going along with the narrative. But I still see people driving in their cars by themselves with masks on. Oh, my God. Do you see – what's her name? The journalist talking to the libs of TikTok. She was outside in a coffee shop in a restaurant wearing a 95 mask
Starting point is 00:14:28 outside still virtue signaling that is so crazy but it has no basis i mean that's insanity in terms of what she's doing and of course in terms of wearing a talisman and virtue signaling and saying a member of a certain team of course it does does that, but that's all it does. In California, I can still get censured by the medical board. If I tell a patient, which I do, masks are useless, and then I explain in what situation they are helpful. But in general, if somebody calls, right, isn't there that they're past that act where- No, they didn't pass it. Oh, they didn't.
Starting point is 00:14:58 Yeah. Okay. But listen, I'm a moderate on masks too. My thing is, hey, you're not going to protect anybody else, so stop it. But if you would like to protect yourself, you're going to have to wear a carefully fitted N95. And if, by the way, your glasses are steaming up because there's air. Not only is it going 30 feet, it may go 60 feet now. It's not going six feet.
Starting point is 00:15:22 It's going at least 30. It's an aerosolized virus. So now you've done nothing. Let me talk to Adam here real quick. Hey, Adam. I'm doing the Adam and Drew show with Dr. Bruce.
Starting point is 00:15:37 So, Bruce, say hi to Adam. Hey, Adam. How you doing? Bruce saying hi. I'll knock it out of the ballpark. You will. Don't you worry. You traveling?
Starting point is 00:15:49 Yeah. Where are you off to? Vegas. Nice. All right. Have good shows. Me and Bruce are going to have that here for a while. All right.
Starting point is 00:15:57 Bye. Bye. Why not? He's driving his car, huh? Let me tell everybody about Biotic Quest. Why not? He's driving his car, huh? Let me tell everybody about BiotiQuest.
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Starting point is 00:17:07 So where were we? We were talking about the craziness with the vaccine, the craziness with lockdowns, the craziness with masks. But the point is these absolute and extreme positions are dangerous. That's the reality. And it should be more nuanced. It should be one doctor talking to one patient, all this centralized stuff. It makes things – it's terrible. Right.
Starting point is 00:17:31 And getting back to what I'm doing, so basically addiction medicine, a large amount of what I'm doing is buprenorphine replacement or – And it works great. Opiate addicts. Have you ever had a failure? It works almost always, right? Well, I don't... You know, if a patient doesn't want to work a program and, you know, the kid that comes in, the average 20-year-old started using when they're teens and they have no...
Starting point is 00:17:56 You're confusing two populations. One's chronic pain and one's drug addicts. Right, right, right, right. Okay. Right. With drug addicts, I get it. That's a whole different thing. Okay, right.
Starting point is 00:18:03 And so chronic pain, where I was going with that, so we had this push to prescribe lots of opiates until the patient's pain went away. And whether that was – there was sort of the confluence of bad guys and around – Evangelism and bad guys. Right. the one truth that everyone must know, and you can appreciate this, that when social evil is done, whether it's on a government scale, a local community scale, or a medical disposition or a medical rollout, it's always in the name of doing good. Always. They're evangelical and they're commitment to the good. And that's how evil is done. That's how it's done. Always in the name of good. Right.
Starting point is 00:18:45 And if you're a practicing physician and you go against that narrative practice, there's that initial turnaround where you can get into trouble with the agencies. The regulatory agencies. I've been involved. During the opiate thing, they were killing my patients hand over fist, and I couldn't not speak up. And it was hard. Right.
Starting point is 00:19:10 Well, I think having a high – you have a high profile, and then anything you do is going to be scrutinized. Anyway, so I don't know what detail I can go into. But basically – Well, you can go into any detail about anything, whatever you want. Right. So basically around what? Between 2005, 2010 2010 then there was
Starting point is 00:19:26 this turnaround where uh looking at anybody on opiates that's it became a problem and let's get you know where that came from no i i was there the moment it turned around so it because it's crazy people don't know this so uh the trump administration had a symposium, a day-long symposium that allegedly was headed by Melania. It was actually – what's her name? What's the – Kellyanne Conway. Kellyanne. Right.
Starting point is 00:19:54 You told me about this. Yeah. We went and we spent the whole day, cabinet-level officials all day long talking about what the nature of the problem was, what they wanted to do with it. And it was Jeff Sessions, the attorney general, stepped in. He goes, I see what this is. I know how to change this. He goes, I'm telling you, in six months, it's going to change. You watch what I do.
Starting point is 00:20:15 He put a half dozen physicians in prison, and it stopped. Like within a month, it was over. All he had to do was put the excesses in jail. And, of course, that's one of the ways we got into the trouble. various states, various attorneys in various states, to put physicians in prison or find them outside of their medical practice, their malpractice, for patient abuse, for inadequate treatment of opiates. You've got to get more. And we all kind of froze again.
Starting point is 00:20:57 And we sent everyone to pain medicine. Pain medicine, we're evangelists. And off it went. Well, that's about, what, 2018? When it turned around? Yeah. Yeah, and what else pissed me off about that day was Trump was not supposed to be involved with that, but he came in at the end of the day, and he sort of does his Trump thing,
Starting point is 00:21:16 and he, at the end, was going, I don't know, we got to do something here with the people that distribute these things. In some countries, they make them pay the ultimate price, but I don't know what we're going to do. people that distribute these things. I mean, you know, in some countries they make them pay the ultimate price, but I don't know what we're going to do. Entire day, entire day, nothing is reported except Trump says we should be killing drug dealers.
Starting point is 00:21:31 That's the only thing reported by the press. That's when I thought, oh shit, I can't believe anything that comes out of the White House in terms of what the press is reporting. Right. That stuck with me. You told me that story. And it just reinforces what we know about the institutionalized media right now. I didn't listen.
Starting point is 00:21:50 It wasn't as bad then as it is now. You know what I mean? Now it's just ridiculous. Now you can't believe anything. Hey, before we keep going, let's hear a word from our friend Jordan Harbinger. You're about to hear a preview of the Jordan Harbinger show with the investigator who solved a serial killer case that had gone cold for decades.
Starting point is 00:22:09 There was a definite spike in serial predator crime in the 1970s. Joe D'Angelo was a full-time law enforcement officer. He's breaking into houses in the middle of the night, raping women or girls
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Starting point is 00:23:02 Yeah, so go ahead. I keep interrupting you on your distribution. So around 2010 in our system, it's interesting because the pain management department and the addiction department, it was like, who's better to know about opiates and pain management? Oh, boy. And then there was a turnaround. And it was the same thing. The doctors that were tasked with managing chronic pain and knew how to safely keep people on opiates, supposedly, were pressured to prescribe more opiates. It was a crazy situation. Then the
Starting point is 00:23:30 turnaround came around 2010. And then we started having a clinical partnership with clinical pharmacy. And we put pain, addiction, psychiatry together. And it's been a great system. And this is when I mentioned Yale and New Haven. They started looking at polypharmacy and opiates. So they had the opiate reassessment clinic. And we did the same type thing. And you had the pressures from the regulatory agencies, which have become really draconian in a way. I mean, you've got the cures database, and the DOJ knows exactly what's being prescribed in a way. I mean, you've got the Cures database and the DOJ knows exactly what's being prescribed in a system. Now you can't get a patient with pain opiates, which is terrible. It's all bad medicine. Let doctors practice medicine for God's sakes. Right. And then they cause the problem
Starting point is 00:24:17 and then they want to blame and regulate physicians as though, well, we were kind of the cause, but they were the ones that really amplified it, the regulators. Right. It does get very difficult because now you have the beers list from Dr. Beers in the 90s, and there are even antibiotics on there. And it's true. There are medications that are sedating and that there's a risk of respiratory arrest. So the beers list is this list of overprescribing, essentially.
Starting point is 00:24:44 It's an overprescribing list, and the word de-prescribing has become very fashionable now, which I'm very much in favor of. But I think I sent you – You did send me some stuff, yeah. Yeah, just medication lists. And what happens, especially in a time of specialists, somebody goes – they have their psychiatrist, they have their pain doctor, they have their their primary care doctor they have a rheumatologist neurologist and as people live longer and and the maybe the first line medication if somebody's got rheumatoid arthritis you know or someone that has fibromyalgia um you know so the so what happened what for me was uh in doing addiction medicine i get a lot of referrals of chronic pain patients.
Starting point is 00:25:26 And the docs would say, hey, they're on tons of opiates. And this is around 2010 started. And they'd say, use that magical stuff you have to detox them, which was buprenorphine. And so a lot of the patients would say, that stuff gave me, some people, fantastic pain control, good pain control. But I could think straight. And I wasn't sedated. And I wasn't out of it. And so that became, which is now first line if someone needs an opiate. Again, opiates-
Starting point is 00:25:49 It's first line for chronic pain now? Yes. Oh my God, that's amazing. If someone needs an opiate. That's great news. No, no, it's not first line for chronic pain. It's first line if you need an opiate, right? It's the safest opiate to use. Because opiates are- But before they weren't letting you use it for pain.
Starting point is 00:26:02 Right, right. Which is amazing. So last time we really kind of got into this, you were having some issues being able to prescribe it for pain. Right. That you had to prescribe it only for addiction. Right. And there's some caveats that, which stem from the Harrison Narcotics Act, where you were – Certain kinds of people. It's interesting.
Starting point is 00:26:20 In the late 1800s, early 1900s, there was a lot of opium. That was our first opiate epidemic. And then morphine addiction. I read a claim that they put 20,000 physicians in jail with the Harrison Narcotic Act. Because what they were doing, unscrupulous doctors, they were advertising this elixir to cure their opiate addiction, and they were all containing morphine or codeine. And then— Cocaine. Right, right. And the Harrison Narcotics Act made sense in a way.
Starting point is 00:26:49 I mean, of course, it overshot the—as usual. As they always do. Right. But you can't prescribe an opiate to an opiate addict to treat their cravings. So let's go—even though they were trying to demand I do it back in the days of the underprescribing of opiates, demand I do it back in the days of the under-prescribing of opiates. We had these pain-scaled, happy to sad faces that every doctor had to fill out every day and every patient as the fifth vital sign. Think how insane that was.
Starting point is 00:27:15 Assholes. And then demand that I give a drug addict and withdrawal opiates. It's, oh, you guys are brilliant. Let's finish Ozambic. We didn't finish Ozambic. We started with Ozambic. We got to finish with Ozambic. So what do we think?
Starting point is 00:27:29 Should people be taking it for weight loss or not? You're the primary care. What do you think? I had two patients recently. They were exquisitely good candidates for this. They'd been overweight forever. They had multiple attempts at weight loss unsuccessful. Their type 2 diabetes was barely under control, like sort of marginal,
Starting point is 00:27:53 and both of them refused it. So it was weird. It was weird for me while I get people calling me for it just for an eight-pound weight loss all the time who shouldn't be taking it. My concern for anything that's a quick fix in medicine is that's the problem, whether it's addiction, whether it's an X-ray. Whether it's a vaccine. Risk-reward has gone out the window. And that is – weren't we trained only on that with every decision? Right.
Starting point is 00:28:20 Right. I tell patients – I tell – we have a committee where we review polypharmacy patients, high opiate patients, and it's like a doctor that wants to drop the opiates. I say, what's the risk? What's the benefit? But in these patients, to me, one of the problems is in medicine, we have less and less time allotted for patient care. And so how long does it take to work with a patient and explain rather than Ozempic, let's look at these other interventions, I'll see you back in a week, blah, blah, blah. Well, here's the deal.
Starting point is 00:28:49 So, okay. So, if you're by yourself, you can see the patient back in a week. If you're in a big system, can't you get nursing to do the education or some patient educator or some ancillary staff? Well, yeah. So, instead of getting somebody to do a zampic in other words then it's they still feel like they're being hit to me there's some there's something sort of sacred about the doctor patient relationship and still right yeah so it's like okay you want to do a
Starting point is 00:29:16 zampic it'd be easier now i'm not i'm not doing primary care so i say go see your pcp your primary care but if if you're thanks for that by the way. It pisses me off so much when the subspecialists do that. No, no, no. But you're the quarterback. I get it. So what I'm saying is – Except for the shit you don't want to do. That's where the quarterback –
Starting point is 00:29:36 Right. Well, I'm not guilty of any of these sins. But what I'm saying is if I can spend the time in walking the patient through some lifestyle changes, exercise, whatever, rather than jumping to the Zempik. If I say, oh, I'll see you in three months, but go talk to this nurse every week. That's not the same as me. Yeah, I know. And this thing where you have 15 minutes for a follow-up visit and tell the patient only one complaint.
Starting point is 00:29:59 I mean, give me a – I know. I know. It's terrible. People don't know how terrible it is. That's why I'm working with the wellness company now. I'm trying to get things into the hands of patients. There's so much that patients can do on their own.
Starting point is 00:30:12 I mean, they know how to use antibiotics. They know how to use topical. These things have been in the lexicon forever, and people know how to use them. They should have them. Why do they have to wait for a doctor's appointment? Why do they have to wait for going into an urgent care center? It makes no sense to me. And if we were still able to practice medicine, well, sure. Yes, of course, we'd want that. But we're not able to anymore. No, I could plug for Kaiser. They're very wellness and prevention oriented. So
Starting point is 00:30:37 what do they do? Well, it's very focused on looking at- They get people to work out? They get people to – Absolutely. They get their diet? Do they have success with that? Do they – Like you said, nurse follow-ups for diet.
Starting point is 00:30:51 There's diet. There's all kinds of – patients have blood pressure issues, diabetes issues. There are programs that they can get into. There's a lot of that. Structure of these community – Yeah. What do they call the – there's a name for these things, these community health organizations. Yeah, well, they have their own.
Starting point is 00:31:07 But the problem is there are more and more people coming in the system, especially in California now. It's like people getting health care coverage. And when it comes to treating the chronic diseases once they take hold, it gets very challenging. I think patient expectations are unrealistic. Oh, my God, ridiculous. But also, it is extremely hard to change behavior before trouble starts, get them to not go to the 7-Eleven and to go to the grocery store and stock up on groceries and things.
Starting point is 00:31:37 People don't do it. So I'd be curious to see their data because it's hard. It is hard. And it lets you acknowledge how hard it is and really have ways, strategies for getting at that. I mean, by strategies, I mean lots of strategies. Well, at least I – so I don't always say go see your primary, but I do know here's an 800 number. Here's smoking cessation. Here's weight loss.
Starting point is 00:31:59 And there is a program. See, that feels very impersonal to me. It feels very – those things I've never had any results with, ever. And I've sent people to smoking cessation my whole career and never. No, but in other words, it's in addition to what I provide in terms of that. Now, with the weight loss, sports medicine, there are ancillary clinics that provide education and group encounters and support. All right. I'm all for it.
Starting point is 00:32:28 I'm all for it. All right, everybody. That does it for today's show. Bruce could be in here with me all week. Maybe Adam will call in next show as well. Forget that Bruce and I are here. Thank you for that. I'm at that man's beck and call.
Starting point is 00:32:41 That's all. Just whenever he needs me, I'm here. Bruce, where can people find you? Where can they find me? Do you want them to go anywhere? Do you want them to read anything? Do you want them to – I don't have –
Starting point is 00:32:53 You can go listen to the old – what was our show called? Weekly Infusion? Was that what it was called? We had a great little podcast that's still up at drdrew.com. You can find it there. Yeah. The disagreement was I said it needs to be on the fifth grade level, and Drew wanted it in a more erudite presentation.
Starting point is 00:33:09 No, I just wanted it more – I don't like dumbing things down. I just think people can respond to stuff. They get it. Drew, when you're dumbing things down, it's more to my level. Stop it. I love when people talk like that because I know immediately they're brilliant. We'll talk more when we get back. I'm here with Dr. Bruce.
Starting point is 00:33:30 You can find me Tuesday, Wednesday, Thursday, 3 o'clock Pacific time on Rumble. Please subscribe to my Rumble channel and pretty much everywhere else out on streaming. And don't forget the Dr. Drew podcast. We've got some great guests there as well. And we will see you next time. Mahalo. Pluto TV is as easy as it is free. And it's totally free.
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