The Root Cause - Business of Medicine Podcast

This episode of The Root Cause - Business of Medicine features pediatrician Dr. Chris Magryta, who shares how he integrated functional medicine into a traditional pediatrics practice serving many Medicaid patients. He shifted focus after observing rising chronic illnesses in children and applied “five pillars of health” principles (stress, nutrition, movement, sleep/sun, toxins) in affordable, practical ways. Despite longer, less profitable visits, his egalitarian group model and Medicaid-funded care management make the approach sustainable. The episode highlights how culture, leadership, and a child-centered ethos enable better outcomes in underserved populations.

Creators and Guests

Host
Dr. Davin Lundquist
Dr. Davin Lundquist is a board-certified family physician, innovator, and healthcare leader with over 25 years of experience integrating medicine, technology, and holistic wellness. A graduate of the Keck School of Medicine of USC, he has held senior leadership roles at CommonSpirit Health, Dignity Health, and Augmedix, where he advanced the use of technology to enhance patient care. Driven by a passion to move beyond symptom management, Dr. Lundquist founded the Quantum Advantage Method™, a science-based, holistic framework designed to help individuals restore vitality and reverse dysfunction. His approach blends functional medicine, advanced diagnostics, and principles of quantum science to empower patients to achieve optimal health and lasting transformation.
Host
Dr. Erik Lundquist
Dr. Erik Lundquist, MD, ABFM, ABoIM, IFMCP Dr. Erik Lundquist is the founder and medical director of the Temecula Center for Integrative Medicine, where he blends conventional, holistic, and functional approaches to help patients achieve lasting wellness. Board-certified in Family and Integrative Medicine, he specializes in endocrine disorders, chronic fatigue, migraine management, cardiometabolic health, and chronic pain. A graduate of St. Louis University School of Medicine, Dr. Lundquist completed his Family Medicine residency at Naval Hospital Camp Pendleton, where he served as chief resident. He spent eight years on active duty with the U.S. Navy, including service as a battalion surgeon in Iraq and at the Naval Hospital in Naples, Italy. Certified by the Institute for Functional Medicine, Dr. Lundquist is passionate about empowering patients to take charge of their health and teaching fellow clinicians integrative approaches to chronic disease. Outside of medicine, he enjoys the outdoors, singing, dancing, acting, and spending time with his wife and three children.
Guest
Dr. Chris Magryta
Dr. Chris Magryta is a pediatrician specializing in integrative and functional medicine with a passion for disease prevention and optimal childhood development. A graduate of Dr. Andrew Weil’s Integrative Medicine program, he combines evidence-based science with holistic approaches to support both mothers’ and children’s health. As the host of the podcast “Dr. M’s Women and Children First” and author of the Salisbury Pediatrics Newsletter, Dr. Magryta empowers parents and clinicians with practical, science-driven insights to help families make informed, health-promoting decisions.

What is The Root Cause - Business of Medicine Podcast?

The U.S. healthcare system is at a breaking point—soaring costs, worsening outcomes, and widespread physician burnout. The Root Cause – Business of Medicine podcast, hosted by brothers Dr. Erik Lundquist and Dr. Davin Lundquist, charts a different path: one where healing, fulfillment, and business thrive together.

Each episode shares powerful stories of medical professionals who stepped away from the traditional grind to embrace integrative, functional, and alternative approaches to care. Through candid conversations with practitioners who have redefined success, listeners gain insight into navigating their own transitions, reclaiming a sense of purpose, and reshaping the way they practice medicine.

Erik
Welcome to the Root Cause Business of Medicine podcast, where we explore what's broken in healthcare And what we can do about it. I'm Dr. Erik Lundquist, and I've been practicing functional medicine for the past 15 to 20 years. I'm excited to co-host this podcast with my brother

Davin
Doctor Davenlunquist, who's just beginning his journey into functional medicine. We come from different points on the path. But we do share a common goal. D We want to rethink how medicine is practiced and help others do the same.

Erik
The U. S. healthcare system is in crisis, rising costs, declining outcomes, and physician burnout at an all-time high. Hi. But you know, we found a different way. Another way. A better way.

Davin
On this podcast, we dive into real stories from medical professionals who've stepped away from the traditional model, kinda like me. and have found a new purpose in integrative, functional, and alternative approaches to care.

Erik
These are authentic conversations with practitioners and friends who've redefined success not just for themselves but for their patients and communities.

Davin
Whether you're a clinician feeling stuck, a student seeking direction, or just curious about what is possible,

Erik
You're in the right place. This is the Root Cause Business of Medicine podcast. We're here for another episode of the Business of No, the Root Cause of Business of Medicine podcast. It's a mouthful. Uh, but we're super excited to have our guest here today, Chris Magrida. Um Chris has been yeah, Chris and I met doing functional medicine back I think like two thousand fourteen or something like that. We were at a conference. Uh and we uh totally hit it off. And Chris is a pediatrician, which varies from David and I, who are both family physicians Uh and we've we've gotten our fair share of pediatrics uh over the years, but we're super excited to have Chris on the podcast today. And one of the things that's really interesting about Chris's situation is that he um and we'll we'll let him talk a little bit more about this, but Uh Chris still works in a general pediatric office and uh actually works with a lot of Medicaid or underserved. uh individuals. So they don't have a lot of finances and yet he's still able to uh wiggle in some functional medicine and integrative medicine. and and help make some uh pretty significant changes with his patients uh who are willing to uh really uh get down to those five pillars of health of of lifestyle changes. So it's been it's been really fun to uh have conversations with you over the years, Chris, and see how successful you've been in your practice despite the limitations and challenges. So we're looking forward to hearing more about that journey today. This is the first time Davin's meeting him. And so we're we're we're happy to have you here. You know, that again, the purpose of this podcast is really to help open up uh this world of the business of medicine, particularly in the functional and integrative world. Uh we have uh, you know, those of us who have gone through training, we get super excited about what we're learning, but then we don't know exactly how to make money doing it. uh that that in lies uh there in lies the big challenge a lot of time. So today uh we're gonna be hearing about Chris's story and um and and kind of here Davin what questions do you have for Chris to get us started? Well, uh you know, I'm just really fascinated to hear kind of how your journey evolved.

Davin
You know, I I'm guessing that as a you know pediatrician they didn't have a functional medicine uh you know fellowship when you were when you were going through training. So I'd love to hear a little bit more about kind of your why and and and what it is that sort of drives you to to want to practice that way uh in a pediatric population.

Chris
Well, absolutely. Well first thanks for letting me be a part of this. I think this is super fun and and my world is a bit different than the average person in functional medicine, so I think this would be sort of a fun conversation because of the disparity compared to a lot of other folks that are doing this, especially in pediatrics. So my journey sort of began Phew I guess the simple answer is I went into medicine because my grandmother passed away from rheumatic heart disease. And she was one of the very early recipients of a heart valve transplant and was able to live a very good life until she unfortunately passed away at a relatively young age, uh, when I was around eight years old. And so it was sort of eye opening to me that, you know, somebody could lose their life to uh an infection. And so for the better part of the next bunch of years went to college um in the north and then I ended up going down south to Emory for med school And fell in love with medicine there and but it was the allopathic version. It was the treatment version. It was the pharmacological version. And at that time I drank all the Kool-Aid. It made sense to me and it was good and it was wonderful. And I remember taking the nutrition training that we had and it was 16 hours and we had access to the knowledge beforehand so nobody really studied and it was sort of a glossed over while thousands of hours of pharmacology was the baseline and So the you know at that time I was still naive to the fact that that was wrong. I was just like, hey, this is great. You know, went to UVA, practiced medicine in pediatrics, and Loved that too. Thought, wait, this is great. We're treating kids. We're doing great things. We're treating leukemia. We're dealing with these really intense diseases, and we're seeing a lot of amazing outcomes. And Somewhere between 1992 when I entered med school and or um yeah 92 when I entered med school and around 2000 everything started to change in the sense of the diseases we're seeing in kids. And so I'm sort of sitting there watching this continuum of what pediatrics used to be, which is primarily an infectious disease field, which was the most of the issues that we dealt with were primary infectious disease related and some cancer here and there, and it wasn't huge volumes, but still cancer was there. And some behavioral disease, but not much. And then, you know, life starts changing. I'm at UVA, I'm leaving. I think I I understand all this stuff. I come to Salisbury Pediatrics, where I'm at now in Salisbury, North Carolina And it's a large old school private pediatric practice. We've been in existence, I think, 67 years this year. And when I came in 99, I was one of the younger um junior partners. And so I came in again, eyes wide open to this is beautiful, this is perfect. But then over the next seven years until about 2006, I started to notice something didn't make sense. Kids were sicker. We're seeing more things in kids that I didn't understand, more ADHD, more autism. more just general behavioral problems. Oh by the way, kids are getting heavier. And does that matter? Well it probably we didn't understand at the time that that was actually the front end of the sword of metabolic syndrome that was coming. But at first we just thought, okay, kids are getting bigger. It's not the best thing in the world, but maybe not the worst thing in the world. Then all of a sudden we start seeing type 2 diabetes. And this was around the time we started seeing the high ALTs and all of a sudden, okay, wow, we got a lot of problems here, folks, and I didn't understand it. We weren't trained to understand what was happening. We were trained to throw drugs at this. Well, what kind of drugs do you have to throw at these kids? Nothing. Right? You know, they're sitting there with early signs of diabetes, but if they're not diabetic, nobody does anything. You know, you you you send them to a nutritionist and nothing changed. And so around this time, one of my partners, um, Kathy Russo, was like, hey, you ever heard of Dr. Weil? And I'm like, yeah, I know Dr. Weil. He's my wife loves him. I don't follow him at all. My wife gets his newsletter every week. She reads us So for full disclosure, my wife's the smarter one of the pair and she's the registered dietitian and we met at UVA and so she would she would take care of my kids when I was an intern. I would consult her and that's how we met and And lo and behold, she's asking me questions about nutrition, and I know absolutely nothing. I think I have the answer, because I'm confident enough to give an answer, and then I'm wrong, and I'm wrong, and I'm wrong, and like 30 freaking I'm wrongs in a row and I'm like, all right, maybe I'm missing something here. And so around that time when Kathy asked me to go and and look at this fellowship there, I'm like, well, tell me about it. So we looked at it. It's a two-year fellowship. Um most of it online, but you go there for a bunch of weeks.

Erik
And this was in in integrative medicine, right? This is an integrated medicine fellowship?

Chris
Yeah, so this was Arizona Center for Integrative Medicine under Andy Weil. Yeah. And so I'm like, yeah, let's do this. And so convince the partners to pay for the two of us to go because we're going to bring another whole set of thinking to the clinic and make the clinic better. And so I went out there. And then everything went crazy. Right? So all of a sudden, everything I thought I understood now was upside down. It was almost like I had a a psilocybin journey without taking psilocybin. It was like I had these connections in my brain that made sense and now Andy Wilde's like, well all those connections are wrong, and here are your new connections and you can't look back at the old connections anymore and like them because they're broken. And I'm like Oh my god, what am I gonna do with all this knowledge? And you know, here I am learning from Tironi Lodog, who's absolutely one of the best physicians training on herbal. You know, I have Andy Weil flooding my brain with everything related to mind-body medicine And I am, like I'll give you an example that I think is really sort of funny. So I was sitting in in a meditation class A and D led when we were in the in-person class, and it was three hours of meditation. Now, granted, the closest I had gotten to meditation was sitting in church and zoning out. So when I'm sitting there and and Andy's like, just don't worry, if you fall asleep it's good, I slept. I was like, I tried to meditate, I slept. As soon as I got out of there, I went straight to the gym. And I worked out, I'm like, I can't do this stuff. And so that was the implosion theory of me finally understanding there's a lot to this stuff. And it was actually super fascinating. So fast forward, we graduate in 2000 and uh seven. And now I have all this information in my head. What do I do with it? I'm in a traditional practice. At that time there were uh ten of us in the practice and we're a private practice so we weren't run by any overlord, weren't told what we were supposed to do, and we didn't have any Sense of we have to see this many patients a day in order to meet some metric with some MBA upstairs is telling me what to do. So my partners are gracious enough to say, hey, if it's going to make the kids' lives better, you can take a consult in the morning and consult in the afternoon for an hour each and start seeing what this does. And so I started to. So I would go, all right, give me that Crohn's kid, give me this patient, give me this patient, I'll start taking them on and looking at them. And at that time, North County Medicaid was pretty awesome because they would let us get Genova diagnostics testing. And so in the beginning, I was able to get microbiome testing, IgG food testing, nutrient evalves. And so I had a window into what was going on very early that allowed me to see. patterns of the five pillars played out in data. And so that was really interesting because then I'm starting to see, okay, this asthmatic kid has these things going wrong. This child who has type 1 diabetes has these things going wrong, and you can start to see signals that made sense for each disparate group. And so for the better part of the next five years, we were able to use that testing before North Carolina Medicaid decided no longer to pay for it. And I was able to effectively treat these kids with the five pillars. Now supplements were not easy to get and frankly weren't used often because my folks couldn't afford it. So the most we could get people to do is vitamin D, fish oil, and iron, because some of those were covered by Medicaid. Some of them folks would pay for the money, but anything more arbitrary than that was sort of a non-possibility. And fascinating enough, the signals changed enough that I was like, wow, we're putting diseases away. Right? And so what that taught me was is that we are one, taking teach taking care of a population that's less uh what I would call fibrosed at the cellular level than an adult might be. They haven't been on this train long enough to have cellular dysregulation so broken that we can't unwind it with the five pillars And so that was super fascinating to me. And then as time's gone on, now it's really just I leverage the amount of Medicaid lab core testing I can do. to get windows into what's going on. So a lot more in the like Erik and I are talking about our boot camp, a lot more into the world of metabolics that are testing that I'm allowed to do, fasting insulin, uric acids, GGT. Things that we're allowed to get, HSCRP, TGF beta, you know, IL6, IL17. So I can look into this stuff that Medicaid will pay for, that an immunologist might do, a rheumatologist might do. that's covered and now my window shifted from I can't do those tests, but I can do these tests. And how do we leverage those to give me a window into what's happening with the kids? And so the beauty of it is our practice has continued this now, 2025. What is that, 17 years? And from a business model, since this is a business podcast, it's not the smartest thing in the world. Because that one patient that I see for an hour, I could theoretically see four to six patients with simple sick visits or wealth checks. And from a monetary perspective, any MBA will tell you this is idiotic. But from a patient care perspective, it's fantastic. And so I've leveraged our group, and my group has agreed that this is worth giving back to the family. Almost like I look at this as like charity care. We're willing to lose money to make sure we're getting the best outcome for these kids. And and so that's sort of the lay of the land right now. And I can get deeper. We're doing a lot more stuff than that. But that's sort of the lay a lens so I can stop talking so otherwise I'll talk all day. Erik knows this, so you you'll have to interject me randomly.

Davin
No, I I this is fascinating to me because um the the last job that I had was part of a health system, dignity health. Um that, you know, was mission based. And so I had a lot of Medical and California Medicaid, you know, type patients. Um and even now, you know, in my current model, which is kind of more of a direct primary care concierge light model, there's still a fair number of people who are sort of, you know, budget sensitive, right? And I've noticed that um they're still kind of asking, well, what's that cheaper panel, right? And so I think this is a really interesting sort of side note to your really rich, interesting story. is that you've kind of it's it's almost like you had two phases to this to this journey, right? The one where you've kind of a little bit more freedom to just learn the the new way of medicine, and then the second was sort of adapting it to a lower uh socioeconomic uh patient population, uh which I think is really cool actually. Um An affordable way to do these, you know, to to accomplish essentially this.

Erik
Yeah, I agree. And I one one thing I do want you to to just cover, just in case our our listeners I'm guessing most of them are going to be aware of the five pillars, but just if you want to just review the five pillars, just so everybody's on the same page of what that is. And then we'll get back to Davin's question here.

Chris
So I'm gonna rank order it in the new way I rank order it. So I used to rank order it with nutrition first. And that might be a bias that my wife is nutritionist and I had a senior partner who we still have a senior partner, actually eighty six, he's brilliant, smartest man in our clinic. still worked three days a week, who kept pinging me saying it's not nutrition, it's stress. And it's predominantly mental stress is is the first pillar. And if you don't deal with the first pillar you're gonna have a hard time dealing with pillars two through five. And I balked that at nacamon. Food's the biggest thing. Food's the biggest thing. There's a recent paper actually in British Medical Journal that looked at 200,000 people. And the biggest outcome to longevity is actually SDN specifically related to poverty. And so it reinforced his belief. That that is true. So rank order number one is mental stress or what I would call a a mind-body connection that is in keeping with the yin and yang of peace. The second big play by far then to me is nutrition. And are you feeding your cells, your mitochondria, and your microbiome the appropriate inputs to help them functionally give you an immunometabolism that is that is right or or solvent with your DNA is what I'll basically say. Third to me is movement And so I say in the sense of what does movement mean? Anything that gets you up off the couch and moving against gravity. And that could be swimming, running, biking, walking, you know, uh, jumping in space. I don't care. That's movement. Um uh fourth is sleep, and so adequate sleep, and this is getting even so much more that I'm actually starting to think Sleep should actually be combined with sun. So I'm I'm now starting to call the fourth sleep and sun. Because circadian biology dictates sleep and sun now actually with near infrared light has huge effects on mitochondria through melatonin. So I'm now linking those two together, so sleep and sun, and then five is toxin exposure or hopefully the lack thereof. And so those are the five pillars.

Erik
Excellent. So it's interesting. So we so I use a different fifth from a five-pillar standpoint, and that is relationships and community, right? So these are Which I think you uh our community extends to our environmental exposure. So I think it kind of folds in. But i and the relationship aspect kind of falls into the stress component, right? Because if our home life, if our if we're feeling very isolated, that so I mean there's some there there's overlap in all of these pillars. But yeah, I th I I I that's great. And I think that that's an important thing to kind of keep in remembrance from a business model standpoint because there's a lot that can be done with just the five pillars of health in terms of moving the needle and you know I'm I I'm Curious to hear some more stories from you know what you've seen in an app applying this. But let's get back to what what Davin was saying. Um and I I'm I'm I'm curious to to hear if you were would one do things differently, like would you would you st if you going back now and looking at where you are now Would you go back and still join the practice again? Or would you have left the f after the fellowship said, you know what, I gotta, I'm gonna go on my own and I'm gonna set up my own private practice so I can just do this and not have the confines of a allopathic kind of you know insurance-based model where I'm I'm kind of being held back on some of the things that I want to be doing.

Chris
The answer is no, I would not do it again any other way. And I think this was meant to be for me Because how it's played out, if I had changed course anywhere along the way, I don't think I'd be in the position I am today, which is actually a really beautiful position. And let me back that up as to the why. So when I came out of Arizona, I had thought thoughts about really trying to just go the hang a shingle and and try and do it fee for service. And so we sort of had a hybrid model we started in a town about thirty minutes away from my current clinic where we had three integrative docs. Um one two pediatricians and one adult uh adult family medicine doc. And we did an area that was very well to do and we thought that would be perfect for it and it was still a non um concierge style. So we still used insurance, but we tried to do it in a way that was more frequent visits so they're paid for, but less time in big chunks. so that we could get the process done with insurance so patients could get the care without having to pay cash. And what happened over that four-year period was people never played by the rules. They would always expect more time from you, even though they're not paying for that time. And they would hold you accountable if you didn't and actually make you feel guilty. And so for after a very short period of time, I didn't like that clinic. And I actually, it was closer to my house, it was about seven minutes from my house, and my current clinic is 45 minutes from my house. I would get home earlier from my long distance clinic than I would from my local clinic because the amount of abuse I took from patients to want my time and monopolize my time. And my problem is some of that's my own fault because I'm willing to give it to people. And so I tried really hard to constrain that and people made me feel guilty, so I would invariably do that. And so we closed that clinic because that model just didn't make sense to us after a while. And so what we realized is that the process of figuring all this stuff out really had to be within the framework of a patient population who gets it, wants it, and believes in the structure of the model we've built. And that didn't bode well in that model. So we clock closed that model and went back to the big house where we have a huge group of providers. We're at 18 now. that are centrically located for all pediatrics and that spreads out all of the so if a patient comes in and they just need something simple And I'm backed up, they can hop over to another provider and get seen where that other click that was really difficult to do. And so it really took away some of that stress. Now Fast forward that over the years, as we've been modifying this model in the Medicaid system, the insurance system is starting to catch up with the knowledge that SDN matters big time. And North Carolina is one of the leading states that really cares a lot about trying to fix this, especially in the Medicaid world. So About five years ago, in their infinite wisdom, the State Assembly of North Carolina gave a bunch of money for private practices and hospital systems to build care management models. And so we started our own clinical underground network, which is called Children First of North Carolina, and it is now 55,000 kids strong. And what we're able to do now is take a care management member per month fee and translate that money directly into SDN help. So for example we have now embedded RN care managers, we have embedded care coordinators, we have embedded social workers, we have embedded therapists now. We have all of these things that deal with pillar number one that I could never have had access to in a private model, right? In the same vein. Unless it's supported by a huge amount of money, so i. e. people are paying 800 bucks an hour to come in, but now I have that set up in a traditional model that's paid for by the state government that allows these kids to get absolutely fantastic care. that they never could have gotten to this level before. They got great medical care, but they didn't have that wraparound care. And now they're getting the wraparound care that I could never have seen if I didn't stay in the traditional system and keep fighting it. And I think some of one of the gifts I've been given by God, I think, is persistence. I am a persistent person and I'll keep fighting for a cause that matters to me, and the cause that matters to me the most is the kid's health. And so I'll keep fighting for this stuff and and thankfully there's peep people fighting and giving and so this this system we're building is just continually growing. And I think what's gonna end up happening is it's gonna i i I think it's gonna be a shining model for the country to start thinking about in the traditional model where you can do functional integrative medicine and also meet the five pillars, sprinkling it on every kid every visit. And that's I think the other piece that I haven't even brought into the topic yet, but The business model we have started is all of our providers now understand basic five pillars. Everybody in our clinic is fully tuned to doing nutritional counseling. Everybody is fully tuned to doing um uh deep dives into what's going on with the social behavioral health to get into that. We are very keen uh uh keen on calling in our care managers, our social workers to come help this family out So pillars one and two are getting hit every single facet, every single day, all the time.

Erik
Is that something that you you instigated or was that something that just is I'm guessing you guys would have meetings as staff or as as as partners? And discuss how you wanted to continue to move the practice forward. So was this this was these were things that you and uh other providers were s were seeing benefit and wanted to get it across the board. Is that how that worked or How did you influence that?

Chris
Yeah. Yeah. And and it's it you know, I I think the simplest thing would be I came home guns blazing. I was ready to go. Two 2008. And so I'm printing handouts and articles and I'm just giving my partners everything I can give them on the five pillars and how they can start changing their practice model without learning the detailed understanding of the hard Functional medicine side of this, because it's a lot of work to do what we do. And so some of my partners love it, some of them don't. Doesn't matter, you don't have to. But we really want everybody to understand the basics of the five pillars and sprinkle them on every kid every visit. And everybody buys into that and and and really cares about that. And so for example, I'll do something super simple, like again, milk protein intolerance. In the average clinic, If you ask a provider if milk protein intolerance exists past six months of age, most pediatric providers will say no. Milk protein tolerance is sort of gone by then, even though they're still having ear infections, eczema, atopic derma uh asthma, allergic rhinitis, what is truly not allergic rhinitis, it's milk protein induced in And at our clinic, every single person knows that that's milk protein tolerance, you take them off dairy again, things settle out. And so That's sort of the the ethos of it's a top-down, but it's also a bottom-up. You know, the providers send signals down about what's happening, but we want all of our staff to bring it up if you see a case that's interesting. Everybody's involved in the finding the the issues that are out of kilter and sending it to the provider, sending it to the care management team, sending it to whoever, so you can alter the the what what You and I talked about all the time, the upstream reasons why things went sideways. And so we're trying to get on the glide path a lot faster. before the you know the train has left the station so far disease is hard to to to fix. So for example, this care management um clinical integrated network we have, now we are Aligned with five major Medicaid corporations, right? In North Carolina, there's five. There's Blue Cross, otherwise known as Healthy Blue, there's United Healthcare. There's um Wellcare, Centen, there's AmeriHealth Caritas and and something called CCH, Carolina Complete Health. And each one of these groups sort of follows a state model that's been laid out for care management, but each one has their own Pet projects they want to fund. And so one of the things I wanted to do recently, and this is going live now, actually, is I want to put CGMs on kids with obesity and asthma, but they're non-diabetic. Well If you asked the care CMO, they'll say, no, we can't do that for non-diabetic. I said, well, that's stupid. Like the CGM's gonna help me get the kid not to become diabetic, so let's do that. We know he's metabolically abnormal. And so one of the CMOs said, this makes complete sense. I've got a slush fund bucket. Let's do it. And so we're doing an asthma clinic starting this month where I've already got all the labs. I know what every kid's metabolic framework looks like. Medicaid covered. These are all Medicaid kids, underserved. And now I'm going to go buy 50 CGMs for a 30-day supply for all these kids. Um, we're actually gonna be 50 50-50, half get it, half don't, and now I'm gonna start seeing does the CGM alter the outcome in a better way than A traditional system one. That's something I could never have done in the other model. But I can now do it in this model because I stayed attached to a semi-broken system.

Davin
You know, I I didn't expect the conversation to go in this direction, although I should have anticipated it. So in my sort of former uh job as a back when I was a CMIO, Um, I was tagged with, you know, helping identify a value-based care technology system, you know, to to implement. And so I became somewhat familiar with some of the different value based care models, ACOs, et cetera. And and you know, the the Medicare, Medicaid world, right, is has been sort of ripe for that model for a bit, right? And but it's interesting because to your point, like, there's been money for these care management programs, but it was with the wrong philosophy, right? It it was it was the same broken philosophy of chasing disease, right? And trying to sort of manage disease, granted they s they saw a little bit of the light, maybe this would be pillar one of the social determinants of care, right? Where you're decreasing stress maybe by identifying the socio and economic stressors, right? That if you could sort of work on that, then maybe Pillar One gets better, right? But you know, it doesn't address all the other issues. And I think that's why I mean right now I'm sort of thinking that could be why those things haven't been successful. And now you're kind of proposing a model that um with the right doc doctrine, if you will I don't know if that's a doctrine sometimes has a negative connotation, but I think in this case, y you guys intentionally sort of indoctrinated your organization from the ground up with what I would call almost like a customer service type, you know, um approach, right? Where, you know, everybody's gonna get the same great customer service, which in this case is just learning about those pillars are being taught everywhere by everybody.

Chris
Yeah, and and and you know, the sky's sort of the limit. It's like one of the other things I love, I don't know if you ever read the book Extreme Ownership. Um by Jocko Willink. So Jocko's pretty famous now. He's been out everywhere. He's even got food and drinks in the grocery store now. But Jocko was a Navy SEAL and commander in the Armed Forces back in the Iraq War. He wrote a book, a business book actually, but it was the principles of the war, how you break those principles down, how you apply those to business. And one of the things that I found super fascinating Was the book is about extreme ownership and how if you're gonna lead, you have to take extreme ownership for anything that happens in your organization, which means no you're at fault no matter what at the end of the day. If the person below you isn't doing what you asked, that's your fault for not making sure they know what they need to do. It needs to be redundant. The person below you needs to know their extreme ownership position is they need to be sending issues up to you only as it's important. And therefore, you know when they ask, there's a good reason. And therefore you want to comply with that. And so our ethos here is that. So the the extreme ownership model When that book came out, I gave everyone a copy, read this, we're gonna talk about this, how we're gonna be. And I think that's the primer behind why our group really gets this philosophy of the kid matters only, right? So I have a I have a s uh uh a saying that all of our staff knows if the kid doesn't benefit, don't do it We're not talking about it. It's not in the game. It's not in the cards. Let's leave it at the table. And so when somebody brings something to me and the child is not at the center of that conversation, I don't even want to talk about it. It's it's it's a it's a waste of my time to fill some information over there that doesn't benefit the child. And so we fight back on that tooth and nail. So when I have somebody telling me they don't want to do X, I say, well Let's talk about why. Ethos-wise businesses need to have that model in place to to have everyone on the same page, the caring part, to have the five pillars. You have to have an ethos that says everybody should want to do the five pillars. And so I think if I'm going to give any reasoning to the why we're able to do it constructively, it's because the ethos permeates the the ecosphere here.

Erik
Yeah, so there's an element of of a of a culture, right, that you guys have established that everybody's bought into that allows you guys to be able to be on the same page. And collectively then you accomplish a lot more than if you were the only one continuing to see your one-hour consults a couple of times a day and you're taking on all the heavy difficult cases and trying to fix the problems. Everyone's just dumping all of their difficult cases on you, right? I mean, granted, you're still doing that, but Now there's a lot of other the the the everybody's doing a sense of the lifting, even though you maybe still be doing a little heavier lifting, but because everybody's lifting upwards, it's it's benefiting the whole population. Reminds me of the book Culture Code. Um for you know it's one that David and I have read. We'll be talking a little bit more about later on. The other one that that comes to mind is the uh 15 commitments of conscious leadership. And then they talk about that very thing where you have either above the line leadership or below the line, right? And the below the line is the one who's out trying to blame everybody else for the problems. And everybody else needs to just fix their stuff so that we can move forward. And above-the-line leadership is no, the buck stops with me. Um, let me find out how I can better support. How can I take ownership of what's happening? let me get in and help solve the problem versus it being somebody else's problem. So that's I I I think that's I think that's awesome. In terms of a the financial success of your clinic. It sounds like in in order, so I I know that there's going to be a certain number of our listeners. Certain number of the practitioners that we will get this out to who want to do more underserved medicine It it sounds like if you had said, well, I still want to s I still want to see the same patients, but I'm gonna go ahead and do my own clinic. You you tried some model where you were you were trying to increase the frequency of the visits and keep them to that 15 to 20 minute time slot. That didn't work out. It sounds like the the the the This model seems to work for an underserved population if you have kind of a collective where you can have one or two individuals within that collective who can kind of feed, you know, it makes it work because they can compensate for you financially to be able to expend the extra time. Would you say that like this you feel like this model does then work for the underserved population?

Chris
100%. And so two-fold answer there that needs to be looked at. So Medicaid's about a 66% pay rate compared to commercial So by definition you're getting underpaid compared to your best commercial payer, like Blue Cross Blue Shield of North Carolina. So you're already taking it on the chin if you live in a sir in a in a Medicaid highly um served area. And so you don't go into that area with the knowledge base that that you're going to make a ton of money um in in general because the the system is slated against you just from the get-go. So having that in the in the in the knowledge base makes it a little bit easier. Now, the other part of that argument is if you have enough providers that are doing the work of the whole collective, so again, 18 of us seeing a lot of kids Right. Everybody knows that the few patients that I see that we're losing money on saves a lot of headache from everybody else who might end up seeing that kid when something's not being helped taken care of adequately And and I sort of look at this as if we send another subspecialist, and the subspecialist, because the functional medicine stuff doesn't tend to lend itself as well to subspecialty care. they'll end up back on our books anyway because they haven't dealt with the problem, right? And so everybody sees as a win-win. The amount of time I'm spending, losing a little bit of money It comes back full circle because it's less headache for everybody. So everybody spreads the love around financially. And so it does work out very well. Now it only works in the sense because it's egalitarian. The partners, we just share the money across the board I don't make more money based on productivity than one of my other partners does. So that's also part of the part of the problem. Because if if the system was set up such that I would only get like what they call eat what you kill, then it'd be really hard to do that because then you then you'd you'd lose a fair amount of money. that, you know, puts food on the table at your house. And as pediatricians, you know, we're not sitting there like orthopedics with tons of money to throw around, you know, with reimbursement style. So Part of that's also the fundamentals of the practice makeup and the structure. And our practice again is an egalitarian group. I mean we're seven of us around a boardroom making decisions in a like a Supreme Court where if it's four to three, it's four to three. End of story. Nobody complains, nobody whines, we move on. And I've been here 25 years. We've had not one fight. And I can say that with the most hon you know complete honesty. Like we've never had a fight. We've got disagreements on which path it goes, but once four to seven happens, uh four to three happens, it's over. We move on. And and and I think that to me is why we've been so successful, because the end of the day, the ethos is the kid, and so we work always towards the kid. And so that means we suck it up and move on if we don't like it. And that may be unique to pediatrics in in in in some aspects.

Erik
Um I think that the at least the pediatricians that I know uh tend to uh have that more of that mindset than it seems like uh other other practices. I know we you know we we had a pediatrician in our practice for a little while and she was absolutely amazing. You know, our models uh different when with our model, a lot of the ancillary services and the supplement sales are what kind of buoy us up so that we can see a few less patients per day, but it's still because it's insurance based, it's volume based, right? We have to see a certain number of patients per day in order to be make our books uh stay in the black and the and not in the red. And it was a challenge for us to keep a pediatrician on staff because uh she you know from a financial standpoint we we were more of a you know we there was some sharing but there there was an element that that you know you you eat what you kill and She she was not able to bring in the same kind of revenue because the children weren't getting IV therapy. They weren't purchasing as much supplements. They weren't using the chiropractor. You know, so the the ancillary services that were buoying up the clinic were not being really utilized by the pediatric population. So We we we we we kept her as long as she was willing to stay, but it became clear that um you know her ambitions in terms of making more money than we could provide her uh or what finally drove her to open up her own private practice, uh, which now is a completely cash-based uh concierge practice. And because we don't have really a lot of integrated pediatricians in our neck of the woods, uh she's able to make it work, right? She's able to to to peel off enough of those who are willing to pay for her services that she's able to to do well. And she's And and and in her model, she's had to keep it completely lean. Uh it's just herself, an MA in literally like uh 1200 square feet foot you know office space And uh and that's it. So I you know I applaud you for sticking with it and being able to convince your partners the the the benefits of this. I think that's that's that's really awesome.

Chris
Yeah, time will show how it grows from here and I think for me, you know, if the if the state governments and the federal government thinks this process through, they will look more at funding primary care to prevent disease instead of spending all this money on treating disease. The the the vast majority of money spent in health care is is is wasted in the in the later part of the disease process, which is much more expensive. and the amount of money we could save if we poured money into continuous glucose monitors, into wearables, into supplements, into um, you know, healthy nutrition for kids. I mean, bloody hell, if we just fed 'em good food at school. what we could do. I mean, there's so many things that if I had my way, you know, if I ran for president, I I it'd be pretty simple. High quality school. Accountable. Teachers would be held accountable for poor activity. High quality nutrition no matter what. Everything the kids would be fed would be real. They'd have chefs in there. They'd feed them real food. And it wouldn't be The oh they won't eat vegetables, sorry, there's no other options. You're not getting, you know, garbage food. Yeah, we're not doing that, right? Like The If your parents won't do that home, that's okay. But in school, we're going to feed you nourishing food to help you be there. You know, three, every school would be clean, right? We'd have good air handlers. We'd get the air cleaned out every single day. We'd have non-toxic chemicals. We would make sure that these areas aren't filled with mold and garbage, right? And and you know, and clean water. You know, the fact that Detroit had lend the water in a country like ours with this much money. How is that even possible? And until we addressed everything that the kids need, the next generation that's going to grow up to be the doctors, the lawyers, the you know, the business people, until we address that, I don't want to hear another thing about spending money on some pet project for your No, we're fixing this first, then we'll talk about other projects to keep the government funded. That's that that would be me running for office and I'd probably get assassinated on day one.

Davin
No, I I love this idea though, which again will never will never fly in our country because, you know, our our political model is all about, you know, what you can give adults today, right? And but if you think about the whole insurance model, especially the government insurance model, right? If they they'd have to essentially recognized that all the money that they poured into those kids, right, would save them so much money in a in a in a few decades, right? Like in three or four decades. It would it would totally turn the whole system around, right? But no one No one looks at, you know, our politicians don't look twenty, thirty years out, right? They look at an election cycle and then and that's it, unfortunately. You know.

Chris
Well and and corporate capture is real. I mean, with the American Academy of Pediatrics and the American Medical Association are too big overlords watching over our patients and o us are promoting, you know, Ozempik and and Wagovy in lieu of changing sco kids' school food. We've got a huge problem. And I'm not saying the drugs don't work. It's apparent it's clear that in in Micro dosing, they're probably gonna work really darn well. I think they're dosing them wrong right now, but they'll probably work really well. But at that cost, you gotta be kidding me. I mean 15 grand a year per kid, I could feed him some really darn good food. and and probably not need the Wagovia and that stuff, but you know, the AAP doesn't seem to have any interest in in in chasing down for me what I consider to be preventative medicine. Instead, it's again Expensive drug treatment medicine.

Davin
Natural production of GLP one would be a a much better investment for sure.

Chris
Amen. Amen. I mean, let's go folks. But yeah, I mean we can go all day along on corporate capture.

Erik
I wanna make a comment and then I wanna bring up an an important point that you made um and then I have we I we have kind of a final question for you, but Um, I I you know it's interesting to think about not only feeding them the right food for the purposes of improving their bodily function and health. But from an education standpoint, right? Going you now then are providing them exposure to foods that they w they're not going to get at home. Right. A lot in a lot of these cases, uh, they don't the the parents aren't cooking well because they don't know any better. And so by providing good, healthy nutrition choices at school that they enjoy eating. all of a sudden now creates an educational component to the health that was that I think sometimes is lost in the conversation, right?

Chris
Let me tell you a story, because uh this is what's really cool about this clinically integrated network that we have. So part of that forced us to start a foundation. So we now have a foundation called Salisbury Pediatric Foundation in order to receive high quality food from places that want to donate it like a a food line or a Harris Teeter or a local grocer. And oh and beh lo and behold one of the MCOs said, oh by the way, you know, you want some fridges and freezers. Sure, that'd be great. So we have now three commercial grade humongous fridges and freezes in our office. So we are now giving out fresh fruits and vegetables with recipes and lean proteins and everything to impoverished patients every single day. The coolest thing about this is now providers like one of my partners, Jen Hudson, came and said, Oh yeah, by the way, I was in the grocery store the other day and One of my patients came up to me and she said, Look at my cart and she showed all the foods, all fresh fruits and vegetables. I'm making a green smoothie for my kid today. And and it's all because you pushed me to go this way and you're helping me and you're giving me access to good foods. O And so again, kudos to the North Carolina State government for providing the access for us to now take the reins and run with this. And and to me that's the thing is you have to have somebody who's willing to fund a project that says, I want these kids to live better lives. And then it's just to us, the group, that has the ability to now say, I'm touching these kids every damn day. Let's put our finger on the pulse of happiness and all this. So I'm super thrilled to see where this goes. Um we did a uh fill the fridge campaign for Easter. We've got thousands of dollars of of of uh donations. And we're just literally taking that to the grocery store and to the farmers markets and buying food, filling our fridges. Patients roll in, they take it. We had Foodline drop off a pallet of strawberries one day. We just send out through Facebook. Fresh strawberries, come get them. And all of our patients who can't afford stuff come by and pick up the strawberries. And so to me it's just it's just you have to dream, you have to wanna, you have to wanna build something better than yourself. And you have to have somebody who cares enough to back it. And thankfully, North Carolina's doing.

Erik
But I think that's great is as a collective that you guys are looking for those opportunities too, right? I mean you could it's I think one of the challenges to your point, David, what you were talking about is that there's so much downstream attention that as practitioners we're almost head down. Like we just we're so focused on trying to to put out the fire that we're not looking up to see w what's starting the fire, what's what else is going on around us. And I think it's leading to we've talked about this earlier on our show about the burnout, right? I mean the the the problem with family medicine and pediatrics, internal medicine, most primary care aspects is that We're tired. We're tired of dealing with these chronic disease issues and the tools that we have are inadequate. So we don't we don't there's not there's no satisfaction in what we're doing. But we're so busy we just have head down and we're just doing it day after day after day, right? All of this kind of the goal here is to back things up. And I love what you what your pediatric group has done to be able to incorporate you know, who whose ever great ideas are running through Congress, but you guys are tapping into that and utilizing it for the right reasons. And I think that's that's really, really impressive. David, any other thoughts or questions you want to ask about that?

Davin
Well, I I I just want to comment actually that um, you know, I think all of us that have read books on leadership There's a difference between, you know, people who are sort of out, like trying to light all the candles, right, for everybody versus just bringing enough light where you don't need candles anymore, right? And I think that's the inspiration model. And you've inspired me. I mean I I'm Like just hearing your story and having been in a system where, you know, I just saw over and over again one program after another that just didn't work in the Medicaid population, right? Especially in kids. the thought of some of the things you're doing, if we could implement that here, right? Recreate little versions of what you're doing across the country, you know. Um that that would be so exciting and so transformational for for families and for kids whose lives would be changed forever. So I'm inspired by you.

Chris
I appreciate I tell you this though, man, people want this. Like, I talk to people all the time. We just interviewed a young lady the other day to come join our care management team. And she works at the health department. And I asked her, so what's the issue? She goes, I'm constrained. There are so many rules about what I can and can't do. And how I can build or do this. I want to do a newsletter. And I'm like, what do you want to talk about? I want to give feedback to the school systems about things that are going on. I listen, I won't touch you, well, there has to be approved all this. So to me, I was like, well, if you come here, I'll you just right away and I'll look at it if I see nothing conflicting with what is okay in the world, we're gonna turn it loose and work with the school system. And so You start to see these people who all of a sudden they've been wanting to open it open up like a flower and they just need an environment to be in. And so I'm like. We're it. I'm gonna give you a whiteboard. You start drawing, and then we'll see what the drawing looks like. And the only thing we ask is that the kid's at the center of that drawing. And if you keep the kid at the center Nobody's gonna do anything nefarious. Like I it's the beauty, our our team down there, like they're coming to us constantly with ideas. And it's like, whoa, we can't do all these at once. Like we're doing a we're doing a back-to-school drive And we're it's like in three weeks, and they have 40 different groups showing up as vendors, and they're giving away like 400 backpacks filled with Everything these kids need for school. All donated. I just I just heard about it. I'm like, this is great. And and they're just turned loose and they're It's again, it's this to your point, it's this the micro microsphere is here, the macrosphere is here, and each person inside that is building something that they believe in. And so it's about their passions.

Davin
And I'm just enjoying the ride now. Well, I I think one other point that uh I was thinking about throughout this is there's there's no sort of moral complexity to helping kids. You know what I mean? I think like when you look at like adults, and I don't think we should do this, but I think we do, right? As a society, judge adults for their lack of health, right? And I think you could probably go back to their childhood or whatever and it's just programming. But with kids, i all that goes away, all the moral ambig ambiguity goes away because Who doesn't want to see a child succeed? Who doesn't want to help a child? And so this idea of put the child's health first, I love it. It's beautiful.

Chris
Well, at the end of the day, that's what we should always be doing for every human, right?

Davin
I mean that's the essence of functional medicine. Yeah. Yeah. You're right. It is easier to get on board with kids, right? With adults, there's that you know, judgment factor, unfortunately sometimes, right? But you're right, it shouldn't be that way.

Chris
But Yeah, but again, I think that's something that we can change as a society. And I I used to look at moms who were narcotically uh abusing and pregnant and delivering I used to really despise these women. And then somebody looked at me one day and it was a very great statement. And they were like, I wonder how hard it has to be. In your life that you're willing to take drugs at that level and then have a baby, the amount of death, disparity, you know, pain And I was like, wow, that's really the way we should be looking at this. And so every single mom I see now, I have so much compassion for her. Like, what happened to you? How much abuse did you suffer? what happened in your life that it's so bad. And I try and sit with that. And and I think if we as a society go more in that direction, yeah man. I'm with you. We'll we'll change the world one one person at a time.

Erik
Well we're coming up on the uh end of our time, but I want to I want to throw two questions out to you. Um the the first question is tell us a little bit about some of the other things that you now are involved with that are generating some revenue, right? Because it's your soul Your sole focus isn't just seeing patients in the pediatric clinic. You're you're utilizing your integrative and functional medicine knowledge to help you do some other things. So I'd like you to tell us about that. And then why don't you close with Um, you know, what w what do you kind of see as the the future of the business of functional medicine? And if you could i i i i if you could continue to change how medicine is being practiced from a business standpoint, what what do you what do you think would be the key component to continue to move things forward in that in that world.

Chris
So let me take it backwards first. So I think moving forward Functional medicine and especially integrated functional medicine pediatricians need to be more comfortable with charging appropriate fees for their services. And I think one of the biggest mistakes that my colleagues make who are not in my position where they can survive in a fee for service insurance-based market need to be quite comfortable with the fact that you have an incredible skill set You're atop of your game and you should feel comfortable charging the appropriate amount of money in order to get reimbursed at a level that is comfortable Right. That that to me I think is the biggest struggle I see with people because they're by nature we're very good hearted in medicine. We want to heal others. And so when somebody comes to us and says they can't afford that, don't want to pay it, we feel bad and we reduce our prices. There's nowhere else in the world that that happens. Your lawyer won't do that in general. The the you know Walmart's not going to let you buy the widget for anything. And so I think we need to get more comfortable with that that very difficult part of life, which is I am worthy of being paid X. Right. And and I don't think X is exorbitant. Right? Whatever that is for your services. That would be the the first piece. If you can build ancillary funds from other things that you do, I think that's great. You know, if it's Um and again, there's the there has to be the moral compass of if you are selling supplements, they are necessary 1000%. And if that are necessary 1,000% and you make a little bit of extra money on that, I think that's okay. Where I wonder with some folks that the supplement game can be a piece of ways to earn money and I think that's morally a dangerous slippery slope that you have to be careful of. But I think if your morally your moral compass is super strong there, I think that's okay too. Fundamentally, I think your knowledge is what you should be trying to use as a way to earn more money if you're really good at what you do sharing your knowledge so for example Erik and what you and I are doing lately doing these boot camps right being paid appropriately to teach others how to successfully be in functional medicine looking at labs. I think that's excellent and something that we should again be compensated for because you and I spent a long time learning all this information. I'm almost almost coming up on my 20th year, s deep diving into every article I can find. So I feel very comfortable being paid appropriately for giving away that knowledge. And I think that's something that that people should do um if they if they feel comfortable in that. Where does it go from here? I think prevention's the key. So I think AI and wearables are going to be part of my game moving forward. I think we're going to be sitting in a world where um CGMs are going to be the new thing. Once the the powers that be get that, that's actually going to save them way more money down the road. and and it it literally having AI ping the patient about what you eat. Or shoot shoot me a picture of what you just ate and the A goes, oop, dude, this is what why this is why that spiked Or tell me what's been going on and and that real-time feedback is going to change the lives of these kids and we'll be a part of that experience. So I think that is the future. I'm already using AI tremendously in diagnostic skills um awareness. Like, you know, if I see a patient that I'm not sure of, even today at a kid with inability to sleep, I've done a bunch of work with him in autism. So I pulled up AI and said, what am I missing? And the only thing that I was missing that I couldn't find after a deep dive was something I'm not willing to do that I'm going to send psychiatry or neurology for. But I I think that leveraging AI is going to be huge in the future. And again, there is skepticism around it because it does make mistakes, but in general, I'm not going to prescribe or do anything without vetting it further. I just want the window into maybe something I'm not thinking of, sort of like an up-to-date So I think leveraging AI is going to be huge and how that plays out in monetary. I think it's going to make us more efficient. So I think at the end of the day we're going to see more patients, which means we're not going to potentially have to charge as much. So maybe the democratization of our skill sets will allow us to make more money there. That's my hope and dream. Who knows? Maybe not. So I'm sorta looking at it with very eyes wide open and very thrilled AI is here. I don't see AI as a bad thing. I see AI as totally gonna be like in in some ways it's like juicing in baseball. I'll be able to hit that ball out of the park now. And if you don't establish a relationship with AI, well you're gonna be the guy sitting on the on the on the dugout bench going, wow that ball went out of the park, how come I can't do that And and so I think everybody in functional medicine should start learning how to use AI in an appropriate way. So to me, I think those would be the biggest pieces of where the financial side of this is going to grow. I I You know, again, my moral compass is very clear. I think the most important thing to do is keep the kid at the center. If I can enjoy a good living with the child at the center, I'm great with it. If not, then I I really would be fine with less money

Erik
That's awesome. Well, thank you so much, Chris. It's been an absolute pleasure to have you on. And look at it, uh, Business of Medicine. uh from a root cause analysis in a different perspective. And we really appreciate that perspective that you uh have brought with us today. Davin, you want to give us any final thoughts or words?

Davin
Uh, Chris, if if you ever get approached about, you know, some value based care uh initiatives or projects, like I would love to just learn about it or be involved in some way. I think that's the future of like Medicaid, right? And and even Medicare in general, these, you know, ACOs and value-based care models, I think if we just injected the functional medicine philosophy into those, they could actually work because it's all about outcomes, right? And I think Um, there's no better way to to get outcomes than you know getting to the root cause and and prevention through those lifestyle pillars. We're doing that now already.

Chris
The problem is assignment and attribution. The systems are not very good at assigning and attributing patients appropriately. And so by definition, value-based care is dead in the water until they fix that.

Davin
No, it's been the that's been the challenge all along. I mean we you know, I looked at so many technologies that would we're hoping to solve that and it's just so it's such a difficult Such a difficult problem for people.

Chris
Well the the solve is actually I don't think the solve is that hard. For me personally, I think what's where they could do this now, even if they just want to do it off claims, which isn't even real time Right? They could just say, hey, you know, if you've seen this provider out of the six months of the year plus one day, you're attributed to that provider. If you saw this other provider six months and one day out of that year, you go to that provider. Because what they're doing now is if they attribute it to me and they've never seen me, but they know they saw the clinic down the road. I'm getting dinged for it. And so when we looked at our actual, like recently we did a deep dive on our highest some of our highest paying kids, and like the first 15, five of them were in our patients. One of them was 37. You know, like you want me to get into value-based care when when that's my panel?

Davin
No, come on. Well, Erik, maybe uh I didn't mean to go down a rabbit hole, but maybe for the next uh podcast we'll bring Chris back and uh I think this would be an interesting topic. uh that that is a challenge to our country and and uh sounds like Chris has some.

Erik
Yeah, we've talked about on the the podcast doing you know we have interviews and then we would do just topics where we just talk about topics within the business of medicine where we're not so much talking about the journey, but we're actually talking about a critical piece that is from the root cause of the problem of the business of medicine, right? And that's I think one of the things that we are trying to Just bring some awareness and exposure to I we don't pretend to have the answers, but we may be able to find some answers as we have these discussions. And we talk to a bunch of really smart and and ingenious people and entrepreneurs who are doing some great things and we we start collecting these little nuggets we may find over time that we we have some good solutions. So really appreciate you the time that you took to be with us today. We're excited. Uh we're just getting this uh podcast launched and we're we're also grateful that uh we're gonna be able to to have this piggyback on your channel and uh utilize that and uh for as long as we can and and we We appreciate it. So thank you. And we we're excited for our next guest. It's uh a a bit of a mystery to who that's gonna be yet, but we'll let you know as soon as we find out.

Chris
On times, gentlemen. Always a pleasure.

Erik
Thanks, Chris. Thanks, Davin.