Today I’ve got my executive producer, clinical advisor and an amazing human being Dr. Ray Power. And we’re going to talk today about why is Fixing Healthcare, our documentary film, an international film. I mean, it’s easy to assume, depending on your perspective, that the problem is very specific to a nation or to a political order. But the truth of the matter is, is that at the end of the day, the real shift that has to happen is we need to transition into the logical maturity of where we need to go. In other words, healthcare is a subject of what we refer to as a maturity model. We started with first aid, we created incredible biomedical knowledge and entered into infectious disease, which was beautiful and incredibly, just an amazing time. And then we moved into modern medicine where we scaled healthcare and made it available to a lot more people. And then, of course, we moved into hyper intervention where we kind of doubled down on this idea that our job in healthcare is to fix people in crisis. And that’s interesting, and we do a good job of it. But you know, as as an innovator, I think what’s really exciting is, why don’t we use our innovative prowess, not just to fix people in crisis, but to keep people from being in crisis that seems more humane, and it also seems more scalable. And I think at the essence, that’s really the message of this film is, let’s make that transition. So we can have everybody have more access to health care that we can reestablish the doctor patient relationship, to where we can leverage all these incredible tools to make things a lot better through innovation. So I think that shift that we’re talking about is a global shift. And, Ray, I’d love to get your take on this. And I know you had some really interesting insights on planetary health as well.

Yeah, thank you, Nick. And yes, I mean, the privilege that we have is that we live in a global economy. And thank goodness, we’ve had the privilege of traveling from continent to continent to meet each other and to establish personal and professional associations. And on our journey, Nick, what has transpired is that we’ve leveraged our relationships, in four continents, in the States, here in Ireland, in Australia and also in Israel. And what we’re intending to do is to create a catalogue of the light mindedness says we can define us capture over those four continents. Because, guess what, when you look at how you define wellness, it actually is going back to the WHO, back 50 or 60 years ago. And it’s not just about the absence of disease and pain. It’s also about positivity, and terms such as vigor and freedom to perform natural functions are part now of the definition of wellness and health. And what we’re looking at is an international model because indeed, there is research from however, don’t go back as far as a landmark paper in 1959, a very famous International Public Health physician, and he’s saying that peak wellness is actually beyond national boundaries. So we’re looking at international collaboration for this purpose because we have to talk through this podcast some of the amazing individuals who are joining us on the journey, and it’s not just professionals, Nick, it’s very important that we share with our group that this is where we’re looking to bring a population group and a number of constituents and patients on the journey with us. So they will be very much in the middle of center of our documentary.

You know, I love what you said about vigor and happiness and a sense of well being. You know, it’s interesting because the dialogue has been for so long about access to healthcare, certainly here in North America. There has been major major movements around we demand more health care, especially for the underserved and I understand it I appreciate that because indeed, these populations are not getting access to treatment intervention, but I think there’s a there from a humanity perspective. If you take a look at the very wealthy, they have the benefits of concierge health. Where they get the kind of health that we’re prescribing for everybody. Everybody should have access to feeling great and looking great and being great and having that sense of, of well being. And I know in the documentary we’ll be talking to Dr. David Barron, a psychiatrist and Dr. Dan Wilson, a psychiatrist and anthropologist about the impact of well being and an emote and, and mental health on our ability to be great. So I think your point is really, really well taken. Right?

Yeah. Well, now, it’s interesting, because it’s not just that what defines us is how we’re feeling in ourselves, but it’s also about how we’re able to achieve our full potential as individuals and as a community. And the psychology famously describes Maslow’s hierarchy of needs and fundamentally, at the apex of the pyramid. We have this journey and this quest for self actualization. And that is coming from the empowerment and inspiration to individuals in the community, for them to take the ball and run with it because you can’t actually give people the opportunity to take that responsibility. And that is where we’re looking to shift from this model of dependency to an independence where the patients and the community at large shared this purpose and shared this well being vitality together. Absolutely, you know, and when I think

about when I think about the humanity of all this, right, I mean, nobody should be dependent on a drug company, on a device company or even a caregiver. They should be in the ultimate state of human health where they are independent of these interventions. Now, certainly there are congenital diseases and things that make it impossible, of course, to be independent. Much of this is controllable and I think that there is a sort of authoritarian and a prescriptive and an unfortunate vantage point. Certainly in the industrial machinery that is healthcare. I think liberating people from dependency on treatment is far more interesting than demanding treatment. And I know that may sound controversial, but yeah, remember this is about humanity. This is about giving the opportunity of health and wellness for everybody, no matter who you are.

Yeah, but come let me go back. This is just such a interesting paper and it’s really a landmark and historical paper from harbor done. It says Indeed, this is from 1959. Global wellness in the modern era is predicated upon teaching children, critical appraisal skills early in life, and the ability to listen to opposing views while searching for points of mutual agreement, rather than focusing on quite a diverse individuals word against, John proposed a universal philosophy of living that all humans would be for a philosophy which will permeate the minds and hearts of philosophy which men and women of goodwill, regardless of race, creed, and nationality can be for a unifying type of philosophy, which can be embraced and lived by all within their own cultural background. That’s, that’s our journey.

Yeah, there you go. And that’s where and that’s where we have that’s what this film is really all about, right is having these discussions. And, you know, we may have some of this wrong. I don’t know it feels to me like the discussion and the ideas that we’re getting from these incredible guests have really helped us. You know, what, what I like about it is I’ve talked to all of our guests and our cast members and these are people from from all around the world from different corners of healthcare and they all seem to share the same idea. That the obvious transition, the main transition is a lack of dependency on the healthcare machinery and a movement towards prevention, over intervention. Now, this isn’t a new concept, but what I believe is possible. And what we’re going to learn from some of our colleagues is that this is already being done in Israel. It’s already happening in other parts of the world, we’re already seeing that these models are now being applied with great success. So I really, really hope that we can drive some momentum because I think this is the main thing to do.

Well, the interesting thing, Nick, is that we’re so pushing an open door with our patients. And what we’re aligning will be the training and the knowledge and skills of the physicians of the future have to be able to leverage that openness and that actual and willingness the patients have to take responsibility for themselves. Last week, we were privileged to have a conversation with your colleague at Western U, Professor Paula Chrome. And I was really impressed with how the curriculum at Western U, not just for med school, but across all of the health disciplines is about shared learnings, working as a team, and having an emphasis on wellness and not just about sickness intervention. And that is the skill set and the knowledge set of the right attitudinal set that we need to give to the physicians of the future. So we got a parallel journey here, where we’re creating this fusion of a new mindset for our patients. While it’s actually not a new mindset. It’s listening to the mindset our patients have had long standing, but aligning the mindset of the physicians of the future alongside to create this wellness model.

Absolutely. And you know, one of the things that has to happen is we talked about in the film, we have to look at all of the various DNA components of how we actually fix healthcare. I mean, there are many organizations, including your own, that are taking a team approach towards health care in the delivery of a continuum of care. And that’s a beautiful thing. Unfortunately, the machinery oftentimes depending on the on the country and the and the structure is not really supporting a continuum of care, it’s not supporting interdisciplinary care, it’s not really doing much to really support the things that really need to happen in order to achieve the ultimate goal of patient centrism. And that’s really I think, the message here and I hope that we can, you know, start to change conversations and get clearance to have this sort of patient centric approach really come to life.

I know that you talk about some of the guests and participants from the US but just to lead in perhaps, Nick, I might be able to share with you some of the credible colleagues that will be bringing their own patients with them to describe these experiences. And Dr. Pat Harold, who is a rural GP and a columnist in international newspapers will be telling us lovely stories about rural patients and rural communities on how they are able to be able to create this wellness model together. We have a number of the medical schools in Ireland where the professors would be describing a very similar model indeed to Professor Paula Crone in Western U around this emphasis moving towards the wellness and that type of preventative model. And we have got quite a few younger physicians in Ireland who are creating the energy through our social media platform which in fairness to you Nick, you’re putting a lot of emphasis on because it’s not just about our film documentary, but also about how through the Healthcare Cure website, we’ll be able to harness that collaboration across continents. And then maybe just while I have the microphone in Australia, I’m thrilled from having lived and worked in Australia for seven years in the 1990s. Two of my most profound mentors, Professor John Murcia, who is a kind of a doyen of publishing for general practice in Australia. Professor Max Cadian who is the foundation professor of general practice at the University of Western Australia are both going to be part of our documentary, as is Dr. Professor, excuse me Tosere Silva, who has an incredible project called Origins WA which is, can you believe tracking 10,000 young families through the first five years of their lives. And looking at how shaping the health and wellness in young people has such a profound effect on them later on. And Susan Prescott from planetary health and Dr. James Fitzpatrick, an old friend and colleague, who is a pediatrician from pastures pediatrics in Western Australia are also going to be part of our participation in Australia. So you can see we really do have a wealth of those contents on not just one more, sorry. And that is in Israel. We had a wonderful conversation yourself and myself only a couple of days ago with Dr. Yossi Hogan, and he’s going to be telling us about the amazing projects where they have already connected 4.5 million people and gathering data around prevention primary prevention, secondary prevention and tertiary prevention amongst a large population in Israel. So, really proud of the cast participants and colleagues that are joining us along with their patients.

Right. It’s just incredible. I loved his story. And you know, at the end of the day, they’re saving lives. And, you know, again, it’s so easy to believe that digital health is subtractive, when in fact, it’s so critical to us being able to achieve the ultimate goal of fixing healthcare. And I think that what I love about this is we’re going to have some great patient case studies. We’re going to have some really new thinking that, that we’re gonna get from around the world from so many different vantage points that I really believe at the end of the film, we’re going to deliver a prescription for fixing healthcare.

Yes, you’ve had some amazing conversations already eith inspired colleagues who are looking at the whole perpetual technology and engagement of connected technology pieces.

Absolutely, and we, you know, the one thing is for sure is that they we will get to a point of continuous patient monitoring. And when we do, it’s going to help fix healthcare. It’s going to improve the relationship between caregivers, and the patient. It’ll provide all kinds of great tools to save lives and to and to get people to a state of wellness. You know, again, we really, I think a big philosophical difference between the sort of ether that’s out there is that fixing healthcare isn’t about throwing more money at a model that has failed here in North America. We keep throwing money at healthcare, or I should say intervention. And in fact, we’ve increased the cost of healthcare five times over the last 70 years, and yet we have the sickest population of any developed nation in the world. So it you can’t fix this by scaling interventions. The only way that you can fix this and I know I’m sounding redundant is by developing the resources to be able to allow caregivers and doctors to be able to offer up these solutions that move us from a reactive approach,

What you’ve said a number of times as we’re really crafting, the message that we’re concentrating on is that what we’re trying to do is to enable environments which gives physicians care teams, the time and the data that they need to have those profound impacts on the lives of their patients. The time that they need to look at prevention and not just reach for the prescription pad or referral to another specialist. And the time that they need to really, I suppose, nurture this special elixir the secret sauce as I would describe it, which is the trust based relationship between patients and their physicians. It’s like Back to the Future, how they like some doctor model Mally Michelson, who you referenced in your introduction to Healthcare Mandate practice in Bellevue in Iowa back 50 years ago. That is the spirit of the power of partnership, equal partnership between patients and physicians that we want to shine a light on on the documentary.

Absolutely. And I there, you know, I’ve come to realize there are really three things that we need to have in play now. One is that doctors and patients are demanding and need more time with each other. Because you cannot I mean, I’ve, in my consulting practice, I’ve seen patient flow analysis, patient throughput methodologies. These are new bodies of work where we’re actually trying to create a means of increasing the speed of the conveyor belt. Now, this isn’t theoretical. I see it in my work as a consultant. This is a new body of work, how fast can we get them the heck out of here? Unbelievable, right. So they need more time, not less time. The second thing that they need is better data. Doctors if they had, imagine the power as a primary care physician, right? Imagine having a patient present themselves, where you have six months of historical minute by minute data on blood pressure, oximetry, blood sugar, all of these incredible biomarkers. They’re interesting in a sliver of time. But they’re phenomenally interesting when you have lots of them being looked at over a period of time and then super powering those by aggregating them and having them looked at through AI to where the machine can help understand the meaning of those disparate signals. That’s incredible. But the third thing that I’ve come to realize that we need to do is that we need to be able to provide health and wellness and mental health resources. You know, one of the things that’s always been surprising to me is to see how little training primary care physicians get in nutrition, in fitness, in health, in holistic health, in integrated health in virtually all of these and certainly in mental health. And we need to equip our caregivers, our doctors with a quiver of unbelievably powerful resources. And we don’t have those today. And I know that when we talk to psychiatrist, Dr. Baron and psychiatrist Dr. Wilson, they’re going to give us some insights as to just how impactful mental health is in in the scheme of things. And then lastly, I you know, the one thing I remember from having the great honor and opportunity to meet Dr. Michelson is he always talked about the importance of ethnography of understanding how people lived in their tribes, how they lived in their homes, what were their living conditions, and how did that play into their health and wellness? How did it play into their ability to comply with health regiments and even interventions and pharmacological regimens. He knew that the more that he knew about that patient, the better he could serve them. And it is really a beautiful, beautiful thing. The other thing is, he was an expert on farming. He knew farming, he knew the business that most of these farmers were in. And so he understood what their days were like.That was really impressive to me. And how much they’re in the sun and how much how long their days were and what their diet typically comprised of. So again, I think if we can equip our, our doctors and our patients with these amazing resources, we will definitely fix healthcare.

I agree with that hundred percent. And one of the beautiful aspects of being a family physician is the privilege to get to know families as well as individuals so you have that absolute context. To visit their homes, not as much as previously, but you do get to visit, see those patients in their environment. And that would be a model for the future where I see a lot more emphasis on that, where there will be more of the prevention of that is an opportunity that a lot of the health systems in the US are looking at as a future way forward. Because it just makes great sense.

Absolutely. You know, I love the fact that when you and I started this project, we thought, Well, you know, let’s, let’s take a look at what we’re doing here in Ireland and what we’re doing in North America. And let’s, you know, see if we can find the best of the best in terms of thinkers and ideas so that we could actually deliver on the promise of prescribing a solution that would actually fix healthcare. But I love the fact that under your leadership, you said no Nick, you know, guess what, North America and even Ireland doesn’t know everything. Let’s scour the planet, let’s go where the cool people are doing amazing things. And let’s learn from them. Let’s make this a global movement so we can get the best ideas. And that is really taking this to such a different level for me. It is so exciting that this film has turned into a global movement to ask tough questions, and in many cases, to demand, the time and the resources and the data and all the things we talked about in the film. I just, this is exciting.

Well, we all share the same purpose Nick and again, as a professional caregiver myself, it really is a privilege to be something that is meaningful. I do have a purpose for making a difference. And it’s just a joy to me to be on this international journey, which for me is going to be at least a 10 year journey, Nick, so fasten your seat belts. Right.

Well, yeah, you know, I mean, we’re talking about, you know, the other aspect we’ve been talking about is we’ve talked about heyday. And you know what does the mental well being and the happiness and I never thought in my life, I would write a book on happiness. But now, fortuitously, we’ve got some of that that will fold into the film as well, you know, is happiness an important part of health? And I think that we all know that it is. And so is it comes back

to to Dr. Jonah, describing peak wellness is all about embracing vitality, and the full potential of an individual. That’s your heyday. It is Yeah.

And we’ll have a link to the heyday message and what we’re planning on doing there, which may very well likely be our next documentary film. And it’s a very exciting project as well. But happiness is an important part of this seems weird, but it’s true. Well, listen, Ray, thanks again for taking your time away from your busy night. And I’m looking forward to our ongoing interview. I don’t know who we have for our next interview, but I know that we’re going to continue to interview our cast members and other experts to get their keen insights as to how we can work together to ultimately fix healthcare.