00:00:04:00 - 00:00:26:06 Justin Nabity This is the Doc Nation podcast. We are a movement founded by doctors for doctors dedicated to empowering medical professional to reclaim control over health care decisions and advocating for their fair share of the industry's resources. Please note the views expressed are those of Doc Nation and not necessarily those of our Guest or Reference Health centers. 00:00:26:08 - 00:00:47:19 Neil Dougherty Yeah. All right. So I have my notes here. But so I'm gonna put you, in the driver's seat. Doctor Brian rich. No. Thank you for coming back to us. I think that, with Doc Nation, you've been. It's like on the hill with Brian, doctor Brian rich. Yeah. We're bringing up the hill all the time. 00:00:47:21 - 00:01:07:22 Neil Dougherty So on the hill I have in front of me is this, Bill 10073 to amend title 18 of the Social Security Act to increase the support to physicians and practitioners in adjusting Medicare payment changes. This sounds huge. 00:01:07:24 - 00:01:16:04 Dr. Brian Rich It is, it is. And I'm just pulling up. I'm just checking the actions on it as of today real quick, just to make sure that, you know, back. 00:01:16:04 - 00:01:16:21 Justin Nabity Checking the actions that sounds like 00:01:17:00 - 00:01:18:08 Neil Dougherty This is like a live feed? 00:01:18:10 - 00:01:21:03 Justin Nabity It sounds like a live feed, like there's something in motion. 00:01:21:03 - 00:01:41:02 Reid Lancaster Yeah, I have to do. I have to jump in. So we do. We do podcasts that are every time we do a podcast with Doctor Brian Rich, it is like hot off the press in the background. Something happened illegally and legislate legislation, something happened and all the doc Nation team were like, can we get Brian Rich? Can we get get him on, get him on, get him on. 00:01:41:04 - 00:02:00:06 Dr. Brian Rich Yes, I, I mean I'm, I get I'm, I'm usually on top because I get so many alerts but yeah. Yeah. Let's talk about, let's talk about this real quick because this is, this is so we all have seen, individual pain physicians specifically. A lot of physicians specifically have seen these cuts starting to come through. We get to the end. 00:02:00:06 - 00:02:23:07 Dr. Brian Rich They're like, oh, great. They're going to cut this much. And the last minute they stop it. And what they're really doing is in the last they've done that for the last four years. And what they're really doing is they're so they're just literally amending the the original bill or the original code to add one more year. Like, I think that that's why I sent you the original language on that. 00:02:23:07 - 00:02:51:22 Dr. Brian Rich Neil, you could see where it where it shows it started 2019 2020, 2021, 2022, 2024. But well, they just taken the 24 off and they put 25 on it. So what they're basically going to do is they're going to they're going to try to just stop the cuts. Is the bill itself was originally you know, it was originally introduced, you know, it's from the health, the health, the Ways and Means energy and, committee in the Commerce Committee on. 00:02:51:22 - 00:03:17:07 Dr. Brian Rich And that's, that's who overtakes this. That's who sees this. We talked about this Ways and Means. Health and Energy, Subcommittee on Ways and Means, is is who's oversees this, who does oversight and what makes this particular bill more special this year is, Panetta out of California is Democrat, which I've always said many, many, many times, this is a bipartisan thing. 00:03:17:07 - 00:03:41:06 Dr. Brian Rich This a bill was initially introduced by Republican, Murphy out of, North Carolina, I believe, and then Panetta co-sponsored it. But when Panetta co-sponsored it, he wanted to roll back the, some of the it put more in the inflation, cost of living on to this as well to actually increase this to, to, to help with inflation. 00:03:41:06 - 00:04:02:12 Dr. Brian Rich So now we're actually not only stopping the cuts, we're actually going back up, to try to, to try to help with inflation. So it's not it's it's great. It's a great thing. But what it basically does is it's going to roll back to pre 2023 and and basically give you really the rate at pre 2023 which is higher and stop the cuts. 00:04:02:12 - 00:04:30:00 Dr. Brian Rich So it's really kind of a double hit. So it's important. And so they've attached that to this particular bill. Typically what makes this positive is is that this this generally passes. So that's why that's the like I said, that's why I was looking at the actions. It it's since... It's when it first was introduced, in October of 28, October 28th. 00:04:30:02 - 00:04:43:03 Dr. Brian Rich As of right after the election, they added about, I think 7 or 8 more co-sponsors since then. Now it has 28 co-sponsors, which is a big deal. So and so now how. 00:04:43:03 - 00:04:46:02 Justin Nabity Many do we need to have, you think, is this enough people? Or do we need more? 00:04:46:24 - 00:05:02:04 Dr. Brian Rich That's enough to get the groundswell going. Going. So it then has to be scored by the CBO, which is probably what's delaying it once it's scored by the CBO, which is kind of get it score. They're going to, you know, they're they're going to look at it. And then that's where the debate is going to come. 00:05:02:06 - 00:05:22:24 Dr. Brian Rich But it's bipartisan. And I mean, you know, both sides really agree on it. So once it gets scored by the CBO and starts and then they start taking it up in committee, because bear in mind, remember H.R. 2474, which is the Medicare, equality, you know, act, still has no actions on it, no more new co-sponsors, no actions. 00:05:22:24 - 00:05:49:04 Dr. Brian Rich And it has sat in committee for almost two years. This particular bill has got a lot of energy, no pun intended, because it's that... anyway. And so, and there's, you know, there's a lot of change coming really at HHS large in part because of a new election and that sort of thing. The most important thing to keep pounding away is that is that this particular one is it has a bipartisan support, significant amount of bipartisan support. 00:05:49:04 - 00:06:13:02 Dr. Brian Rich It's about equal equal on on both sides. This is also a really good example of how, organizations like this one and like, DocNation just constantly pounding the drum. Eventually, slowly but surely, that pound and they get tired of it and they actually do something about it. Congress and the government, especially Congress, they always work under stress of failure. 00:06:13:02 - 00:06:28:04 Dr. Brian Rich So when and what I mean by that is, is they weren't really if something could be put off, they'll put it off. If something can't be put off, which we're on a timetable because we've got to get this done before the end of the year, then that's when they that's when they really start working. So that's really a good thing. 00:06:28:06 - 00:06:49:02 Dr. Brian Rich So I have a lot of I have a lot of hope. I've a little bit more hope on this particular one that that we're going to get some movement on it. And, and more importantly, that we're actually starting to get our voices heard about really the cost of inflation because they're losing they're losing providers. They're losing people are, you know, unenrolling in Medicare, if I can use that word. 00:06:49:04 - 00:07:15:08 Dr. Brian Rich And, and they're losing providers and so they understand. Wait a minute. We've gone is we've gone too far. And so and because it you can't keep cutting physicians reimbursement and increase and doing the cost of living increases are the associated rates of inflation with hospitals and facilities like that and not give it to physicians? And I think that is where it's coming out. 00:07:15:08 - 00:07:28:19 Dr. Brian Rich So the more is the more exposure you have, the more you get this out, the better it is. State medical societies... so far, almost every single state in the country supported this bill. Medical society, 00:07:28:21 - 00:07:29:11 Justin Nabity How could they not? 00:07:29:13 - 00:07:56:19 Dr. Brian Rich Actually Texas Medical Association and California medical Association, all the medical Associations support it. And that's and the reason for that is, is finally we got help from the AMA. The AMA is strongly supporting it and actually showing, on their website, if you go if you if you look that you just Google this bill, you'll probably see the AMA website and it'll show you a really nice graph where that's where where the cost where it's been going down. 00:07:56:19 - 00:08:17:18 Dr. Brian Rich And now it's leveled out and going back up a little bit. And that's on physician reimbursement if this particular thing goes through. So it's H.R. 10073. If you just Google that, you can pull up the AMA. AMA. They got a really slick graph on there, which they do really good. And whoever does their graphics does a great job because, I mean, they they it's real easy to see. 00:08:17:20 - 00:08:29:04 Dr. Brian Rich So that's really helpful. That's a really positive thing to say. I think probably one of the first times I've done this with you guys, I've actually had something positive to say that I think I feel like is going to have some positive response. 00:08:29:04 - 00:08:30:18 Justin Nabity It's been two years plus. 00:08:30:21 - 00:08:34:10 Dr. Brian Rich Yeah, the glass has kind of become half full and half empty here, but that's. 00:08:34:10 - 00:08:48:03 Justin Nabity What you said along that drumbeat. And I think it's hard for doctors to look at the situation and say, what can I do? I'm just a little old me and my voice. I'm too busy. I got so much going on, how can I actually make a difference? 00:08:48:03 - 00:09:13:18 Dr. Brian Rich And I so that's, that's there's two issues. I was really going to talk about today. That was one big one. So, all I what I would say to everyone and anyone is listening is really one of the talking that, you know, it's it's H.R. 10073 call that congressman. Let your Congressman know we support this bill and let them know this is a good thing and that those little things like that go a long, long way. 00:09:13:19 - 00:09:17:19 Dr. Brian Rich When those phone calls happen, I don't think people, appreciate that enough. 00:09:17:19 - 00:09:41:22 Justin Nabity So let's talk about that real logistically. You call your congressman, they have a staff person that answers or nobody answers. You leave a voicemail. What do you say. What do you do. Because some of us may only just have time to do that piece of it somewhere else farther. But what what's practically can we do that way? 00:09:41:24 - 00:09:47:10 Justin Nabity It's all of us doing a little bit and that a little bit that everybody does. It turns into a massive. 00:09:47:12 - 00:10:02:11 Dr. Brian Rich So the best way to do that, and that's a great question because a lot of people don't really know how to do it that way. But the best way to do that is to call is, is a call, whether the district office or whether the DC office, it doesn't matter. Probably easier just calling the district office. Ask to speak to the legislative aide. 00:10:02:11 - 00:10:27:11 Dr. Brian Rich I want to I want to, talk to them about a bill that's, in Ways and means. It's in committee right now. And I want to explain to them, you know, my support of that bill within probably 10 or 15 seconds, they're probably going to put somebody on the phone. You may even get the legislative aide what you call, and you just tell them that strong support of H.R. 10073, that's in ways and means right now. 00:10:27:13 - 00:10:50:14 Dr. Brian Rich I will be this is this, this is a one issue voter issue for me. So you know, I'm watching and I want to watch and see how my member of Congress votes for it, and it's bipartisan. So it's it's well supported, has several co-sponsors. You can go into that much detail, but I given you like 2 or 3 different things that you could say. 00:10:50:14 - 00:11:09:21 Dr. Brian Rich But the biggest thing is within, you know, a 35 second blurb of I'm in high support of this, I strongly support this. You know, I, I think this is something that should happen. I think, I think as we move on and, you know, in the societies, you know, right now, the AMA supporting it. 00:11:09:23 - 00:11:26:22 Dr. Brian Rich So it's going to be really easy for the medical societies to support it. I think it's going to continue to swell. And that's a lot. That's a lot. That's a lot how how these, you know, eventually they got to do something about it. So it'll start getting more energy. And I'm going to I'll keep following the actions. 00:11:27:03 - 00:11:44:00 Dr. Brian Rich You can also, you can go to congress.gov and type in the bill and you can get notified on the bill. I think you can get there from Google as well. Typically that's how I do. I was going through Google, I punch it in and then I go to congress.gov through Google and I keep up with all this stuff. 00:11:44:00 - 00:11:47:16 Dr. Brian Rich So it notifies me when there's any action that's been taken on the bill. 00:11:47:18 - 00:11:49:21 Neil Dougherty I mean, I'm literally doing this as we speak. 00:11:49:22 - 00:11:52:10 Reid Lancaster I know we're supposed to be doing a podcast. 00:11:52:12 - 00:11:57:14 Dr. Anthony Giuffrida I mean, H.R., H.R. 6371, maybe. 00:11:57:16 - 00:11:58:07 Dr. Brian Rich What about it? 00:11:58:07 - 00:11:59:19 Dr. Anthony Giuffrida That’s what the AMA has. 00:11:59:21 - 00:12:03:22 Dr. Brian Rich No it's H.R. 10073. It's, 00:12:03:24 - 00:12:06:06 Dr. Anthony Giuffrida 10073. Okay. 00:12:06:08 - 00:12:14:20 Justin Nabity Dr. Rich, when you say, call the office. The district office, that's for your state. So your district office for your state. 00:12:14:22 - 00:12:37:08 Dr. Brian Rich Yeah. Any time. Yeah. Just for for clarification, anytime I say district office, I'm talking every time you hear a member of Congress say in district or district office, that's their constituency. That's their office where, you know, they have to reside in order to be able to, to run. To run for it. I was looking so, just checking the actions that finally came out. 00:12:37:10 - 00:13:07:14 Dr. Brian Rich No action yet. Which means it's probably still at CBO, Congressional Budget Office. They'll score it. And then, the, they. So, yeah. So the actual name of the bill is the Medicare Patient Access and Practice Stabilization Act. The the stabilization part is the is sort of the the cost of living increase for us is what they're talking about there. 00:13:07:16 - 00:13:24:15 Dr. Brian Rich Medicare has a really good write up on it. I'm sorry. AMA has a really good write up on it on their website. You can go Google that and pull up the AMA art, and see if there's any medical association in the state. Probably there's a lot of medical association in the state of I made a statement on it. 00:13:24:15 - 00:13:35:20 Dr. Brian Rich So that helps. You can read that too, to kind of get more educated on the bill if you want to speak to an LA before, legislative aide, before that. But. 00:13:35:20 - 00:13:45:04 Justin Nabity What do you think would be a good goal for Doc Nation if we got just throwing out just something simple here. 20 doctors per district to make those calls. 00:13:45:06 - 00:13:45:17 Dr. Brian Rich That's a good number. 00:13:45:17 - 00:13:46:20 Justin Nabity Leave those voicemails. Is 20... 00:13:49:05 - 00:14:04:16 Dr. Anthony Giuffrida We have contacts that all signed the petition. I would send an email to all the docs that signed the petition and just kind of give a five step process of how to call their their congressman. I mean, how many signatures do we have on that petition to stop Medicare cuts? Probably over 500. Over a thousand even. 00:14:04:20 - 00:14:22:07 Dr. Brian Rich Yeah, it's it's not I haven't looked at it lately, but it's quite a bit I mean, you know. Yeah, I think we can we I think when you get AMA support like this, you know, just so just a little background information, this is maybe knowing the inner workings of what's going on in that committee right now. They're going after CMS right now. 00:14:22:09 - 00:14:47:00 Dr. Brian Rich They're going after CMS hard. Yeah. They're they're they're just going after CMS. And so, you know, when you have the when you have this much support and there's much bipartisan support and there's many co-sponsors, right? It's like the thing when you think of when you look at a bill or when you look at an act that's that's on its way to becoming a bill, that's in committee. 00:14:47:02 - 00:15:08:22 Dr. Brian Rich It's like showing up when you show up for a fight and, you know, you're only going to fight one person. When you look at co-sponsors and you show for a fight and you’re gonne ave to fight like 28 people, you're not really interested in fighting that fight. So because, you know, they're gonna think, okay, this is I mean, when you when you have a bill that only has 1 or 2 co-sponsors, which is not a lot of political capital that people are going to try to expand to really fight for that bill. 00:15:08:22 - 00:15:16:05 Dr. Brian Rich But when you have 28 co-sponsors in this bill, especially bipartisan, it's it's going to it's going to be tough to slow down that momentum. 00:15:16:07 - 00:15:16:17 Neil Dougherty Yeah. 00:15:16:23 - 00:15:19:08 Justin Nabity We've almost got 2000 people even look up. 00:15:19:10 - 00:15:31:17 Dr. Anthony Giuffrida You can look up the co-sponsors and see if they're in your state and give them a call to yeah yeah. Congress.gov. If you just type in H.R. 10073, it comes up as the first hit on Google. 00:15:31:19 - 00:15:36:11 Justin Nabity Well, the co-sponsors’ already in though. We need to talk to the people who are not co-sponsoring, really 00:15:36:12 - 00:15:37:07 Dr. Brian Rich Well, well. 00:15:37:07 - 00:15:51:19 Dr. Brian Rich Yeah, anybody that co-sponsors for it and stuff like that. So you just have to, you know, you you are where you live, right? So if you're one of your representatives is in support of it, you know, that's fine. Now, you know, if you want to do more due diligence, you know, you can look and see who hasn’t sponsored. 00:15:51:19 - 00:16:09:12 Dr. Brian Rich You can look, well, first of all, what you can really do. you can look on the committee, get the members of the committee and you can look at, you know, member it just really any member on that committee right there. It's got to come out of committee first. Right. So you can you really want it. The biggest part is is the members on the committee. 00:16:09:14 - 00:16:37:17 Dr. Brian Rich And so you can if you can't get through the members on the committee or the members on committee is already a co-sponsor. And you're, your member of Congress, is not a co-sponsor. That's a really good one to call. Yeah. You know, and those types of things, but, you know, I mean, it it's, I mean, it jumped in co-sponsors in the last week by almost 26 people, 26 members of Congress. 00:16:37:17 - 00:16:39:00 Dr. Brian Rich That's quite a bit. 00:16:39:02 - 00:16:43:12 Dr. Anthony Giuffrida Yeah. It says, I mean, two people co-sponsored yesterday. This is good. 00:16:43:14 - 00:16:43:23 Dr. Brian Rich Yeah. 00:16:43:23 - 00:17:01:16 Dr. Anthony Giuffrida And as DocNation, I think we should make some graphics that we can share around social media and LinkedIn that just says, hey, look at this bill. Call your local person just to get get the word out there about this bill. Yeah. We could do that. I think we could all share it too 00:17:01:18 - 00:17:08:17 Dr. Brian Rich Right. And when they're supporting you, you're on your side. The best place to get some of those graphics is with the AMA. 00:17:08:19 - 00:17:09:10 Dr. Anthony Giuffrida Yeah. 00:17:09:12 - 00:17:32:05 Dr. Brian Rich Yeah, they do great graphics. And so they have a they they did they put a graph up that showed a little bit about how the reimbursement was going to go back up and really, really more which it it's, it's going to go back, it's going to go back to eventually to where it should be. And then and then it's, you know, that's hopefully it continues to, to follow that trend, which I bet it would. 00:17:32:07 - 00:17:33:10 Dr. Anthony Giuffrida This is great news. 00:17:33:12 - 00:17:40:12 Justin Nabity You know, how much time do we have got, Dr. Rich, on this in terms of getting the word out and getting people to contact their representative? 00:17:40:12 - 00:18:12:01 Dr. Brian Rich Well, they'll they'll come back, you know, they'll, they'll come back, you know, and they'll be while they're still in session, they haven’t recessed, but they'll really come back to work, probably next week. So between next week until really the last second or third week in December, but those things start moving pretty quick. What's interesting is, is that the end of it at the end of a Congress is the Congress is get will adjourn, and then a new Congress will come in at the end of a Congress is when so much work gets done. 00:18:12:01 - 00:18:19:08 Dr. Brian Rich And it almost makes you wonder what it is. Everyone always asked the question, why couldn't we been doing this in the first place? 00:18:19:08 - 00:18:22:02 Dr. Anthony Giuffrida You know, you wait. You wait till the book report is due, right? 00:18:22:05 - 00:18:32:13 Dr. Brian Rich We have to wait. That's right. They are there. They've already joined the night. It's like they cram for a test the night before. It's done. But that's like their pattern. But, so there. 00:18:32:15 - 00:18:38:05 Neil Dougherty You know, there's there's you the there's the message right now is to call now, but. 00:18:38:05 - 00:18:38:13 Dr. Brian Rich Correct. 00:18:38:17 - 00:18:42:18 Neil Dougherty What what is what what is too late. Can you say, can you say, well. 00:18:42:18 - 00:18:44:04 Dr. Brian Rich I mean, you know, obviously, 00:18:44:06 - 00:18:44:14 Reid Lancaster The end of the 00:18:44:14 - 00:18:45:08 Reid Lancaster year. 00:18:45:10 - 00:19:06:12 Dr. Brian Rich You know, the end of the year, and I can be, you know, I'll be following the bill and I can keep you posted as to where it is. I mean, once it gets its CBO cost estimate, once it gets its CBO budget estimate, once that's accomplished and once that's happened, then it's going to start cranking. Then it'll start cranking, then it'll start rolling through. 00:19:06:12 - 00:19:24:00 Dr. Brian Rich It'll go. It'll get through the house. They'll, they'll they'll get it out of committee right away. They'll attach it to they'll do a bunch of, you know, the speaker will call roll call votes and, people will have this in front of it on this will pass pretty fast. It'll probably pass with little fanfare. The house go over to the Senate. 00:19:24:02 - 00:19:51:22 Dr. Brian Rich Again, you know, anyone that generally has, has it has any kind of Democratic co-sponsor on a bill than the leader? They're typically will shuttle it through pretty fast. And this definitely does. And it will it will most likely. It will most likely if it moves at the pace, it will move, I think it'll probably hit the president's desk within the second or third week in December. 00:19:51:24 - 00:19:53:13 Justin Nabity Second or third week of what? 00:19:53:13 - 00:19:55:18 Dr. Brian Rich Then he just has to remember to sign it. 00:19:55:20 - 00:19:56:20 Reid Lancaster December.. 00:19:56:22 - 00:19:58:19 Dr. Brian Rich Yeah. So yeah, December. 00:19:58:21 - 00:20:03:01 Neil Dougherty You're joking about that. But, is there what do you mean? He has to remember to sign it. 00:20:03:03 - 00:20:04:10 Dr. Brian Rich Well I'm joking. 00:20:04:13 - 00:20:04:23 Reid Lancaster Okay. 00:20:05:02 - 00:20:07:05 Reid Lancaster I was like... 2020. 00:20:07:05 - 00:20:08:17 Reid Lancaster Can he not just sign it. I mean, 00:20:08:17 - 00:20:12:04 Dr. Brian Rich well, I mean, I mean, yeah, well, you can always do what presidents can do, you know 00:20:12:09 - 00:20:13:11 Reid Lancaster That’s what I'm saying. 00:20:13:13 - 00:20:23:04 Dr. Brian Rich I'm just a bill, you know? But, I mean, he can veto it. Which he won't, he can pocket veto it which he won't, he'll sign it if it comes to if it passes both houses. 00:20:23:04 - 00:20:28:12 Dr. Brian Rich I mean, especially this particular president who's trying to get accomplishments before he leaves office. He'll sign it. 00:20:28:14 - 00:20:29:05 Reid Lancaster Yeah. Okay. 00:20:29:07 - 00:20:30:16 Dr. Brian Rich I'm pretty sure he'll sign it. 00:20:30:18 - 00:20:41:00 Dr. Anthony Giuffrida So we need to call a call. You know, a call to arms here with all the docs out there that we follow and tell them, hey, in the next week, call it, call your congressman, and let's get this going. Yeah. 00:20:41:02 - 00:20:43:21 Neil Dougherty Even the med grads need to be doing it too, right? 00:20:43:23 - 00:20:44:12 Justin Nabity Absolutely. 00:20:44:12 - 00:20:47:03 Dr. Anthony Giuffrida Everyone! Patients, patients should be calling. 00:20:47:05 - 00:21:03:06 Reid Lancaster Okay. So let's just take responsibility for DocNation right now. We had 2000 plus people sign our last one, we need to get this going again so we can talk after this to, to, to get the message out to everybody, because, I mean, how many physicians do you think even know that this is happening? 00:21:03:08 - 00:21:05:21 Dr. Anthony Giuffrida None. Zero. We're not good at this. 00:21:05:21 - 00:21:06:11 Dr. Brian Rich Not a lot. 00:21:06:14 - 00:21:07:20 Dr. Brian Rich But the more you send more. 00:21:08:01 - 00:21:09:09 Dr. Anthony Giuffrida Brian Rich. One. 00:21:09:11 - 00:21:10:09 Dr. Brian Rich Yeah, me. 00:21:10:11 - 00:21:12:13 Reid Lancaster it's crazy, but anybody that lies. 00:21:12:13 - 00:21:13:16 Reid Lancaster Therein lies the problem. 00:21:13:16 - 00:21:34:12 Dr. Brian Rich We now, you know, so, so, I mean, the, the other thing that kind of dovetails, dovetails on this that's important to really talk about is one of the biggest reasons why these cuts are happening is because, you know, CMS has to be deficit neutral. Well, CMS is losing money in areas where they shouldn't be losing money. 00:21:34:12 - 00:22:04:02 Dr. Brian Rich And there was a there was a lawsuit that just, that's that's in the process of working its way through the court. It's in district court in California. That's a San Francisco court. It was the Kaiser Foundation. I'm sure most of you’ve heard of the Kaiser Foundation in California is a big, big, big, big, big entity. They're seeing their suing HHS for this lack of reimbursement and not getting the reimbursement that they're getting and what they have determined in their lawsuit. 00:22:04:04 - 00:22:30:19 Dr. Brian Rich This is separate from the bill. But, there's a reason why I'm explaining this to you. They determine in their lawsuit that the advantage plans cost the federal government an extra $591 billion with their advantage plans through Kaiser. So the reason why I'm telling you this is, is because this, a lot of times is how change happens. You you have a lawsuit or a lawsuit in a district court, in a federal court. 00:22:30:21 - 00:22:52:15 Dr. Brian Rich And the government looks at it as a net negative, which this is definitely a net negative. Because these you knowing that hese advantage plans were supposed to be saving the federal government money where Medicare did not have to, you know, draw down their, their reimbursement somewhere. They're actually showing a significant amount of minutes, over a half trillion dollars, you know, that is that it's caused CMS. 00:22:52:17 - 00:23:25:01 Dr. Brian Rich So that's an interesting lawsuit to follow, because what that will do is that that will then start to turn the tide on advantage plans. And advantage plans are the reason why Medicare reductions are happening, because they're costing Medicare more money than it should. So, again, the drumbeat of the advantage plans and what's happening to advantage plans, we also need to be talking about you cannot you cannot talk about the, the what's called the Medicare disadvantage plans, right, that everybody calls it. 00:23:25:03 - 00:23:52:20 Dr. Brian Rich You also cannot talk about that enough because now here's good concrete information is where they did their research and showed, you know, how much how much they lost. And if they win this suit and there's a really good chance that they win. They'll win it on a summary judgment and they'll have to pay back almost a have got to pay back about $500 billion in claims to to Kaiser because Medicare was supposed to pay these anyway and these advantage plans didn't pay it. 00:23:52:22 - 00:24:13:17 Dr. Brian Rich That's going to cause that's going to cause a lot of strain on these advantage plans, which ultimately might also turn the tide and help us. And, you know, really in 2025. So those are those are things that are always interesting to follow, that any time HHS gets sued, what are they getting sued on. And what and how can that affect. 00:24:13:17 - 00:24:32:01 Dr. Brian Rich You can kind of get a it's a little bit of foreshadowing of what is potentially to happen. So if we're sitting here six, eight, nine months, you know, next year, and all of a sudden we're seeing this significant amount of legislation that's going against advantage plans. It generally started in a lawsuit like that. 00:24:32:03 - 00:24:34:08 Neil Dougherty Very interesting. Thank you. 00:24:34:10 - 00:24:50:22 Dr. Brian Rich And the reason why I mentioned this is, is, is to get you to understand kind of a little bit and get their listeners to understand a little bit as to how the how the, how the federal government works. I mean, it's like, you know, like I said, about 2 or 3 years ago, I jumped down that rabbit hole and I still feel like I'm in Wonderland. 00:24:50:22 - 00:25:16:06 Dr. Brian Rich Like, I don't know, it's just crazy how it works. And when you really understand how it works and understand how that how things happen, then you then it's it's the best example is it's like spinal cord stimulation. You know, now that we know how it works, we're better at it. Well, you understand how government works. You're going to be better at knowing how to attack members of Congress or people that, or even just talk about it. 00:25:16:08 - 00:25:28:14 Dr. Brian Rich Just have conversations about it and get it out there in the public space even more, in like in venues like this, you know, that's what's really important. And, and seeing these types of lawsuits. 00:25:28:16 - 00:25:47:05 Neil Dougherty I have a I have a compliment for you because you come on here and you do a great job of telling us how things work. Why we should care and then exactly how we can help. And that's, that is gold for our, our angle and these kind of podcasts. 00:25:47:11 - 00:26:06:21 Dr. Brian Rich Yeah. It does matter. I mean I've seen a lot of the things that you know, that you guys have put out there. And this was back, if you remember when y'all asked me that question about how the effects of them kind of halting what they did, this is the result of it, you know, this is the result of because they had more time to look at it and make and make deeper considerations. 00:26:06:21 - 00:26:31:05 Dr. Brian Rich And not only do they go back and stop the cuts, now I'm back talking about H.R. 10073. The, they went back and realized, hey, we got to stop these cuts, but we also need to kick back in for cost of living. So that little pause gives us a little bit of time to, you know, give them a little bit of time to understand kind of what's happened or what's been happening. 00:26:31:05 - 00:26:35:24 Dr. Brian Rich And it actually ended up turning it to being a double net positive for physicians. 00:26:36:01 - 00:26:48:00 Dr. Anthony Giuffrida That's great. I just in that two minutes there, I just sent a message to my representative. If you're able to find it in two seconds, then send a short message. I think everyone needs to do that. But everyone, that's what they need to do that. 00:26:48:02 - 00:26:48:17 Dr. Brian Rich 100%. 00:26:48:18 - 00:26:51:01 Reid Lancaster How do you do it? Anthony? 00:26:51:03 - 00:26:56:06 Dr. Anthony Giuffrida You go and find your physician. I sent, Betsy the email, the way we put it on your. 00:26:56:06 - 00:26:58:18 Justin Nabity Physician? 00:26:58:20 - 00:27:26:12 Dr. Anthony Giuffrida Representative. Sorry. And, it comes up to, house.gov. You put in your address, it gives you who the person is, you click on their name, it goes to their personal, webpage. There's a contact me button and then you just enter, I put in I put the subject line as H.R. 10073. And the thing I said, as a physician, I would, please support HR 10073 and become a co-sponsor. 00:27:26:18 - 00:27:30:19 Dr. Anthony Giuffrida It'll help a physician not go bankrupt and, treat patients better. 00:27:30:21 - 00:27:33:16 Reid Lancaster That's not oall you said. But there was some other stuff in there. 00:27:33:18 - 00:27:35:21 Dr. Anthony Giuffrida No, no, I didn't know. I'm not sure that's really. 00:27:35:21 - 00:27:36:16 Dr. Brian Rich You know that right there’s effective. 00:27:36:21 - 00:27:38:02 Dr. Anthony Giuffrida That's all you got to say I. 00:27:38:03 - 00:27:57:18 Dr. Brian Rich That's that right. There's effective. If you draw their attention to so so what happens is I'll, I'll give you the I'll give you the flip side of how that happens on the back end. So what happens is the the LA or the legislative aide gets that, you know, they go and they, they look at you know, they you know, they have they have essentially sections of bills that they know that are, you know, in front of a committee. 00:27:57:18 - 00:28:12:08 Dr. Brian Rich Now, if it's not on their committee, it's not something that they're going to be talking about a whole lot. But what will happen is, is that when they go to vote on the floor, they're going to go to vote on the floor. And when they go to vote on the floor, they're going to ask their legislative aide is like, do we have any constituents that have talked about this? 00:28:12:08 - 00:28:27:01 Dr. Brian Rich Do we have anything to consider? Can I come back and look at that and this is where this is where a lot of it happens, because a lot of times they go to vote on the floor, and no one in their district has even talked about it. So now they've got to truly make their decision based on what they think is the right decision. 00:28:27:01 - 00:28:40:01 Dr. Brian Rich And that's a lot of times where representatives kind of get a bad, bad break there. Sometimes where they say they go to Washington, they don't they don't, you know, they don't represent us. Well, if they don't hear from you, it's also hard to represent you right? 00:28:40:03 - 00:28:45:02 Dr. Anthony Giuffrida I've never done this for anything. So and it's a fault of most of the American people. 00:28:45:04 - 00:28:45:23 Dr. Brian Rich A lot of people do. 00:28:45:23 - 00:28:47:12 Dr. Anthony Giuffrida But it's very easy. It's very easy. 00:28:47:22 - 00:28:50:22 Justin Nabity Did you go to the the Congress website with. 00:28:50:22 - 00:28:54:11 Reid Lancaster Where did you start? What website did you start on or did you just google? 00:28:54:13 - 00:28:58:18 Dr. Anthony Giuffrida I started at Google. I started at Google and said how to find out who my representative. 00:28:58:23 - 00:29:03:13 Dr. Brian Rich Yeah, you just Google who on it. And if it was my US rep. 00:29:03:15 - 00:29:10:24 Justin Nabity And then are you doing it through their website? Are you filling out the contact us form or are you sending a separate email. How are you doing that? 00:29:10:24 - 00:29:33:01 Dr. Anthony Giuffrida Well then then this house.gov, representative look up came up. I put in my zip code. Yeah. I said it's 1 or 2 people, and it says, put in your address. I put in my address in this guy Jared Moskowitz came up. And then. And then it goes to his Moskowitz that house.gov/contact. So his direct contact to the big contact me button. 00:29:33:03 - 00:29:47:05 Dr. Anthony Giuffrida And then you just put in your address again you have to verify that you're in his district. And then it says what would you like to say. And it says would you like a response. And I said, yes, I think we can. We should we can make a quick video or something for people to, to help out with how to do that. 00:29:47:05 - 00:29:53:07 Dr. Anthony Giuffrida But it took me, I was doing it while I was still speaking with you guys. Took me two minutes. 00:29:53:09 - 00:29:54:01 Neil Dougherty I yeah. 00:29:54:01 - 00:30:12:24 Dr. Brian Rich So that's a good one. He's, I know, I know who that is. I know that rep. I know who he is. Again, he's going to be one that's going to look at, he's going to be one that's that's going to look at, you know, on what, you know, the fact that is bipartisan and that would help. 00:30:13:01 - 00:30:30:19 Dr. Brian Rich I'm just trying to look real quick and see what, committees he's on. But, you can look that up too, the, I mean, he's, you know, he's pretty popular in his district. I mean, you know, he just actually just won reelection. He, you know, we. 00:30:30:19 - 00:30:31:18 Dr. Anthony Giuffrida Just we just won. 00:30:31:18 - 00:30:36:17 Dr. Brian Rich Yeah, yeah, he just won reelection. He got 52% of the vote in a state. That's heavy red. So it was. 00:30:36:18 - 00:30:44:23 Dr. Anthony Giuffrida Incredible. Yeah. Broward County is a little a little more blue. But yeah he's he's been here a while. And I know most people like him. 00:30:45:00 - 00:31:01:01 Dr. Brian Rich Yeah I mean you're not going to keep going if you're not in that kind of district. So you know those types of things. You know, if you if those types of things go a long way, just exactly what you know, Anthony did is they just do that. That's huge. Right. And this is big because he's not he's not on it. 00:31:01:01 - 00:31:20:24 Dr. Brian Rich He's not on ways and Means. So now there's somebody who's not co-sponsored it either. So, you know, so that's a what they'll do is when they go to the floor to vote on it, he's going to go, you know, he's going to sit here and they're going to his legislative aide is going, oh, hey, by the way, you know, you got, you know, several physicians in your district that said, we want you to support this. 00:31:21:01 - 00:31:25:19 Dr. Brian Rich He's got a he's got a he's got a green, green light it just off of the high. He's going okay, okay. Support for this. 00:31:25:22 - 00:31:26:13 Reid Lancaster Wow. 00:31:26:13 - 00:31:26:23 Dr. Brian Rich We're going. 00:31:26:23 - 00:31:29:23 Reid Lancaster That's the power that something like that two minutes has. 00:31:30:00 - 00:31:31:05 Reid Lancaster Holy cow. 00:31:31:05 - 00:31:53:01 Dr. Brian Rich It’s important to. So organized petitions are great because you get a lot of you can get a lot of signatures on an organized petition. But just someone just doing what what. Anthony just did carries, in some ways almost the same amount of weight. Because what happens is when people are looking at organized petitions, they think, oh, well, that was really easy. 00:31:53:01 - 00:32:20:07 Dr. Brian Rich They just kind of log rolled, you know, log rolled them into that. They just went and got a whole coalescence of people pulling together, had them sign this petition. This person actually took the effort to email our office, to tell our office that I'm a physician, that I support, that that carries more weight. And so and if you get 20, 30, 40, 50 people in a one congressional district, which doesn't seem like a lot, but is a lot supporting it, then it's a no brainer for that, for that rep. 00:32:20:07 - 00:32:37:21 Dr. Brian Rich So what you do is, is you can you can also when you call or if you call the office, you can ask them, hey, you know, H.R. 10073... is my rep supportive of that of that bill? They'll have to give you that answer. They know that may not be able to give it to you right away. 00:32:38:01 - 00:32:57:10 Dr. Brian Rich Then it comes back. Yep. He's voting for it. Well problem solved. If it's not, then you can say, well, let me explain to you why you need to vote for it. And so that change that will change that process. Again, I don't think when this comes out of committee, it's they're going to have any issues moving because it's got strong bipartisan support. 00:32:57:12 - 00:33:00:11 Dr. Anthony Giuffrida I think it'll be good for physicians to jump on it too, 00:33:00:13 - 00:33:00:21 Dr. Brian Rich of course, 00:33:00:22 - 00:33:04:22 Dr. Anthony Giuffrida and to really wake up and say, hey, now we're a part of this, you know? 00:33:04:24 - 00:33:19:21 Dr. Brian Rich Well, right now, right now is a good time to make those calls and get those and get those efforts done with your member of Congress, because then they're going to, you know, they say, have you members of Congress, you know, let's get this out of committee so we can vote on, you know, this when. 00:33:19:23 - 00:33:23:21 Neil Dougherty I just I just did the exact same thing that you did. Dr. G. 00:33:23:24 - 00:33:25:20 Dr. Brian Rich What what district are you in? 00:33:25:22 - 00:33:27:16 Neil Dougherty 12. 00:33:27:18 - 00:33:28:10 Dr. Brian Rich All right. 00:33:28:12 - 00:33:29:14 Neil Dougherty Kay Granger. 00:33:29:16 - 00:33:31:20 Dr. Brian Rich Ah okay. Yeah. Former mayor. 00:33:31:20 - 00:33:33:16 Dr. Anthony Giuffrida What, it took five minutes, right Neil? 00:33:33:18 - 00:33:37:23 Neil Dougherty Less. I did it as you said. Yeah. 00:33:38:00 - 00:33:41:19 Reid Lancaster So? So is a better to call or is it better to submit via the way they're doing it. 00:33:41:22 - 00:33:42:16 Justin Nabity I just submitted mine, too. 00:33:42:18 - 00:33:49:09 Dr. Brian Rich look, I mean, submitting it is just as good in some ways. It's actually easier for the office. 00:33:49:09 - 00:33:50:07 Reid Lancaster Yeah, I would say. 00:33:50:07 - 00:33:52:06 Dr. Brian Rich Because they can get it in, but. 00:33:52:08 - 00:33:53:17 Justin Nabity And have a record of it, too. 00:33:53:19 - 00:34:15:12 Dr. Brian Rich If you know. But but if you're just one of those people like pick up the phone and call and and let them know about it, get some information on where where they stand on it, then, that's good too. But getting sending that information in is, is good because what they'll now what they're going to do is that's going to come into, you know, district contact, form. 00:34:15:14 - 00:34:36:00 Dr. Brian Rich They're just going to print that off and put that in that file. And when it goes, if it makes it to the floor, then when they go to vote, they're going to open up that file. They're going to look at you all got, you know, all these people that are for it and this sort of thing. And, you know, the only time you're ever really going to be in trouble is when it's a heavily unique party, one party bill that doesn't have a lot of co-sponsor support. 00:34:36:02 - 00:34:53:06 Dr. Brian Rich And your district and in your district your member of Congress is in the other party, you know, that's when you're going to have some work to do. Some real work to do. Now, it doesn't mean you don't have work to do now. It just means you're going to have some real work to do. You're going to have to going to do some things, donate to the campaign or something. 00:34:53:07 - 00:35:11:18 Dr. Brian Rich You're going to have to get their attention, you know, to, to get them to do it. But, you know, my member of Congress who I actually, advise, you know, sits on this committee. So, that's how sometimes I'm, you know, I needled her and needled her and needled her for the last 2 or 3 days to ask her. 00:35:11:18 - 00:35:21:21 Dr. Brian Rich It's like, hey, what are we going to do? What are we going to work on this? And, you know, and she's she's like, we're getting ready to get, you know, we're getting ready, get back to work. We're going to or we'll start seeing that. We got to get CBO scoring first. 00:35:21:23 - 00:35:23:02 Dr. Brian Rich But 00:35:23:04 - 00:35:40:20 Dr. Brian Rich Follow it. When you go to Congress, dot gov and you put it in that bill, you can get notifications on that bill, you can follow it. So it'll send you text message updates and let you know if something happens to it. That's another good thing you can do. I think all physicians should be following all health care bills. 00:35:40:22 - 00:36:01:18 Dr. Brian Rich And I think probably when we do another one of these, I'll probably show up with all the health care bills that that they and we just have a whole list of the health care bills. These are all the health care bills that you should be following. Right now it's obviously dominant payer Medicare CMS types like that. 00:36:01:20 - 00:36:27:22 Dr. Brian Rich But we've got we're going to be in that same committee. So you can almost if you want to, you know, if you want to jump ahead, you want to find it on your own. You can got a ways and means, in a, in the, in the Health and Energy Commerce subcommittee and just look and see all the bills in front of them and you'll see, quite a few of those are, are, you know, physician friendly. 00:36:27:22 - 00:36:56:08 Dr. Brian Rich Now, really the last thing that I would probably comment about if you remember, and I'll kind of jump back again to that lawsuit in California, if you remember when I said that lot, the difficulty that a lot of physicians are up against is because the the hospital and the, insurance lobby, you know, they spend a lot of money each year lobbying, again, you know, for their cause, which in some ways is against physicians. 00:36:56:10 - 00:36:56:19 Justin Nabity Yeah. 00:36:56:19 - 00:37:10:02 Dr. Brian Rich And that's a lot of money that they put up. Well, it's not going to be hard to fight that now when you can point to a case where you could say, you got this problem in California that cost CMS almost $600 billion. 00:37:10:04 - 00:37:10:21 Dr. Anthony Giuffrida Um hmm. 00:37:10:23 - 00:37:35:13 Dr. Brian Rich How the little guy can fight for against these larger companies that are spending, because United's an advantage plan. Aetna's an advantage plan. Humana's an advantage plan. So all that, you know, when that stuff happens, you can point to that and that that and a lot of ways that gives that negates a lot of the lobbying that some of these large entities are doing. 00:37:35:13 - 00:37:52:21 Dr. Brian Rich Because we're not going to win that war. We're not going to win that money lobbying war. But what we're going to win is we're going to win lawsuits and things like this happening that cost CMS so much money, and you'll be able to use that to your advantage whenever you're you're trying to argue your case or when you're trying to talk to your member of Congress. 00:37:52:23 - 00:38:18:09 Dr. Brian Rich I think one of the things that, ACIP does that they do, you know reasonably well is when they go to, when they go to, to the hill and then walk around and see members and talk to them about it. Those things are those things are great. And, you know, obviously the members, you know, are going to give you a they're going to give you their attention because if they're a bunch of physicians or a group of physicians are coming in, they're going to give you your attention. 00:38:18:11 - 00:38:29:23 Dr. Brian Rich The grassroots is where all this is, calling, you know, you know, sending sending the message to your member of Congress in your district is, is really what really moves the needle on a lot of this. 00:38:30:00 - 00:38:33:23 Neil Dougherty It felt, it felt good. It felit like really get to do something. 00:38:34:00 - 00:38:55:14 Dr. Brian Rich And then and then you can even like, you know, like. And I, I know your I know you already sent it, but you can even let them know that you're, you're getting updates on the bill. You're getting your you're subscribed to updates on the bill, you will be following the bill. So now you're like, okay, we got to really, you know, now we got to go do something about it, you know, and I'll put it on it to go do something about it. 00:38:55:18 - 00:38:58:13 Justin Nabity How many Cosigners or other are sponsors on this, you say? 00:38:58:13 - 00:39:02:18 Dr. Brian Rich There was I think the last time I left it was like 28. 00:39:02:20 - 00:39:05:16 Reid Lancaster What constitute's a cosigner who is a co-sponsor? 00:39:05:16 - 00:39:27:04 Dr. Brian Rich It's a co-sponsor. So what happens? Oh, that's a great question. So so I think, Murphy out of North Carolina introduced the bill, Panetta joined the bill. But when Panetta joined the bill, he wanted to make the adjustment for inflation. So, you know, I mean, Murphy's our friend. So is Panetta, right? So definitely we we like we love them both. 00:39:27:06 - 00:39:46:12 Dr. Brian Rich Well, so they introduced the bill. The speaker designate is that to go whatever committee is supposed to go to what yours goes the ways and means, and then once is there, then some. Anyone else can just attach their name to and become a co-sponsor. And what and and when they do do that, then they're a co-sponsor. 00:39:46:14 - 00:39:48:07 Dr. Brian Rich It just bolsters the bill. 00:39:48:09 - 00:39:48:10 Justin Nabity For. 00:39:48:12 - 00:39:49:15 Justin Nabity An endorsement. 00:39:49:17 - 00:39:59:12 Dr. Brian Rich And I can't remember the breakdown. I think a few jumped on on the seventh after the election, but a lot, a lot of people are still getting on. I think even as as, Dr. Giuffrida said today. 00:39:59:14 - 00:40:01:00 Dr. Anthony Giuffrida 3 got on yesterday yeah. 00:40:01:00 - 00:40:18:14 Dr. Brian Rich Yeah, yeah. And so, you just, you can co-sponsor, you can be a co-sponsor of any bill. You can, you can. It's like cosigning. You know, it's like signing a petition, right. But what it what it does is, is that it helps the bill get more energy to start moving. 00:40:18:16 - 00:40:34:00 Justin Nabity Is it realistic to assume that, just like you are connecting with your Congressman and you're communicating that each of these other 28 have somebody like you, that's also encouraging them as a physician that's actively being the. 00:40:34:02 - 00:40:36:05 Dr. Brian Rich That yeah, you can assume that. 00:40:36:07 - 00:40:49:09 Justin Nabity So essentially we need to get the other 400 and slightly over 400 representatives to have a doctor that's kind of becoming the captain for their district to say, hey, this is serious. We need help with this. 00:40:49:14 - 00:41:20:17 Dr. Brian Rich Yeah. You know, I mean, you know, do you get 28 co-sponsors? That's really good. You're not, you know, I mean, I've seen bills that have had 100 co-sponsors. The bill, the bill itself, the co-sponsors, was actually longer than the bill. It was crazy. I mean, and of course, obviously that that goes through. But the biggest part about this, and then, you know, it's, it some people, you know, it it's there are enough people on both sides of the aisle that will vote for this bill that will make it pass. 00:41:20:17 - 00:41:37:09 Dr. Brian Rich Remember, you got a Republican and Democrat and Republican majority, a Democratic minority. But, you know, if you get if you, you know, it's like you don't need you don't need a whole lot of of Republicans or Democrats on each side because you're going to have enough on both sides of the aisle voting for it, for it to pass. 00:41:37:09 - 00:41:57:09 Dr. Brian Rich So it should it should pass fairly well when it comes out of committee. Saying the same thing with the Senate, it's going to be it'll be really easy for the Senate to vote on it because of the bipartisan support. And I think you can't emphasize that enough when you're arguing for it. It has significant bipartisan support. 00:41:57:11 - 00:41:58:12 Dr. Anthony Giuffrida This is great. 00:41:58:12 - 00:42:09:01 Reid Lancaster And now you. Yeah. And now, you know, with Doctor Brian Rich, we need to have an A now, you know, like once a month like the education piece of this is is is key. 00:42:09:02 - 00:42:28:20 Dr. Brian Rich Well it's you know I mean everything gets bogged down because of the election, you know, and it's all everything. It's like, you know, it's it's, the best way I can explain it is it's like, you know, you, you know, two people that are playing on competitive teams or playing opposing sports. They hate each other. They hate their mothers. 00:42:28:20 - 00:42:45:03 Dr. Brian Rich They hate when they grew up games over, like, hey, man, let's go have dinner sometime. Let's go. That's what we are now, back in Congress. Now the drama, the other drama. The election's over. Now. People are going to try to people, especially members that are leaving, are really going to try to do something before they leave or before this Congress ends. 00:42:45:03 - 00:42:57:05 Dr. Brian Rich And so now they're going to come back and actually start to work together a little bit. And it's just a different it's a much it's much different environment on the hill when it's like this than when it is when they're all hating each other. 00:42:57:07 - 00:42:58:17 Dr. Anthony Giuffrida Good. 00:42:58:19 - 00:43:02:13 Reid Lancaster And and that date is December 31st. 00:43:02:15 - 00:43:09:06 Dr. Brian Rich Yeah. I mean, you know, they'll have to do something before then. It'll be before that week. I mean, you know, but I mean, you know, I mean, but those. 00:43:09:06 - 00:43:13:00 Reid Lancaster Exiting the exiting representatives December 31st is their last. 00:43:13:02 - 00:43:24:16 Dr. Brian Rich What's the when when they adjourn, when the speaker adjourns the the when speaker adjourns that Congress you know, every two, every two years you have a new Congress. And when the speaker adjourns that Congress, that's when it's over. 00:43:24:21 - 00:43:26:18 Reid Lancaster Okay. 00:43:26:20 - 00:43:30:21 Dr. Brian Rich A new House of Representatives speaker has a new House of Representatives, not a new Congress. 00:43:30:21 - 00:43:41:09 Neil Dougherty But Brian I can't think of a more valuable, supporter of DocNation than you. We are truly thankful for you. So thank you so much for the time you spent with us today. 00:43:41:11 - 00:44:04:15 Justin Nabity Well, I one second before we wrap up read, you often say that DocNation shouldn't have to exist. We should not be a thing. We should not be having these conversations like things should be so much better than they are right now. But because things have gotten so bad, we have to exist. And. And in the two plus years that we've been having these kinds of discussions, this has been in the making for years before that. 00:44:04:17 - 00:44:26:23 Justin Nabity But Dr. Rich, you're talking about really this conversation that has that began a few years ago, is starting to hit the point in time where the flywheel is turning. So thank you for for being with us at the very beginning, continuing with us. And this is it. We're going to start to see some real change here. 00:44:26:23 - 00:44:35:08 Dr. Brian Rich I think I think you I think you will I think you'll see something positive. I mean, you know, I think I think this is a big positive and it's a big it's a good trend. 00:44:35:10 - 00:44:35:23 Dr. Anthony Giuffrida It’s really great. 00:44:35:24 - 00:44:55:23 Reid Lancaster It's been a long time. We've got the, we've got the DocNation group together and had something that was positive. And that's the truth. DocNation shouldn't have to exist. But we do and we do for a very, very important reason. And typically we're fighting and fighting and yes, we're fighting right now, but but it feels like we're close to winning a nice battle. 00:44:56:00 - 00:44:57:06 Justin Nabity Huge. 00:44:57:08 - 00:44:58:23 Reid Lancaster Brian, thanks for your time and your leadership. 00:44:59:04 - 00:45:01:11 Dr. Brian Rich You're welcome, it was good seeing you guys. y'all have a good one 00:45:01:11 - 00:49:49:11 Reid Lancaster You, too. 00:49:49:13 - 00:50:06:09 Justin Nabity This has been the Doc Nation podcast. If you like what you heard, be sure to subscribe, rate, and leave us a review on Apple Podcasts, Spotify, or wherever you are listening to us. Your feedback really helps us reach more listeners like you. We'd also love to hear your thoughts and any topics you'd like us to cover in future episodes. 00:50:06:15 - 00:50:13:23 Justin Nabity Don't forget to follow us on Facebook, Instagram, and LinkedIn for updates, behind the scenes content, and join the conversation. Thanks for listening.