The DOC Podcast

In this episode, I sit down with Dr. Dave McCarty - board-certified in internal medicine and sleep medicine, Chief Medical Officer of Rebis, and the visionary behind the Empowered Sleep Apnea Project - for one of the richest conversations I've had on this show.

We go deep on why the AHI is far more limited than most providers and patients realize, trace the history of sleep apnea from Dickens' "Fat Joe" to the invention of CPAP, and unpack a landmark trial now questioning whether high-pressure CPAP may cause harm. Dave draws a compelling parallel between today's resistance to airway-focused thinking in dentistry and the tragic story of Ignaz Semmelweis, the physician who discovered handwashing saves lives and was institutionalized for it.

We also make the case for nasal breathing, tackle the real limits of evidence-based medicine, and Dave shares his vision for Rebis: an integrated sleep medicine ecosystem that puts the patient, not the algorithm, at the center.

Timestamps
0:00 – Introduction & Dr. Dave McCarty bio
2:40 – Dave's origin story: from primary care to sleep medicine ("I'm a recovering primary care doc")
12:32 – Cold-calling Tom Colquitt & the dental-airway connection
15:59 – Enthusiasm as a guiding force: Ralph Waldo Emerson, cold calls, and following fear
18:20 – Why insurance-driven medicine creates silos — and what the dental community can teach physicians about patient-centered care
21:37 – Unpacking the complexity of sleep apnea: obstructive vs. central, the "vanilla chocolate swirl," and why the AHI is a code that needs decoding
26:12 – The history of sleep apnea: from Osler and Dickens' "Fat Joe" to Pickwickian syndrome
29:21 – 1966: Henri Gastaut studies a Pickwickian patient and discovers sleep apnea as we know it
30:38 – Colin Sullivan and the invention of CPAP in 1981
40:40 – The five reasons to treat sleep apnea: risk, snoring, sleep experience, wake experience, and comorbidities
50:00 – Why nasal breathing matters: autonomic nervous system, nitric oxide, craniofacial development, and immune defense
56:07 – The Semmelweis parallel: dangerous truths, resistance to change, and the human cost of orthodontic practices we may need to revisit
1:12:43 – No randomized controlled trial proves CPAP prevents mortality — and new data suggests over-pressurization may cause harm
1:18:22 – Rebis: building an integrated, multidisciplinary sleep medicine ecosystem that democratizes complexity
1:27:40 – Closing thoughts & how to connect with Dr. McCarty

LINKS:
If this episode opened your eyes to how much more there is to sleep-disordered breathing than a number on a sleep study report, I encourage you to share it with a colleague in medicine, dentistry, or orthodontics who needs to hear this conversation. The siloes between our disciplines are costing patients, and it's going to take all of us working together to tear them down.

What is The DOC Podcast?

The DOC Podcast brings you unique educational content taught by Dr. Mike DeLuke, a Board Certified Orthodontist with over 20 years of clinical and academic experience. Dr. DeLuke built his orthodontic practice from scratch in the early 2000s and grew it into a multimillion-dollar enterprise in less than 10 years. He was able to retire from his private practice at the age of 46 years old, and now devotes his energy to teaching his colleagues how to succeed both personally and professionally. He also provides locum tenens coverage for colleagues in South Florida.

Dr. DeLuke has served as a faculty member at numerous hospitals and orthodontic residency programs around the country, including as the cleft craniofacial orthodontist at Albany Medical Center in New York, and as a clinical professor at The University of Connecticut in the Department of Orthodontics. He is presently an adjunct professor in the Department of Pediatric Dentistry at Healthcare Network and a Visiting Professor in the Department of Orthodontics at Montefiore Einstein Hospital in the Bronx.

The DOC Podcast will bring you in-depth discussions and interviews with industry leaders and experts on a variety of topics, including clinical excellence, practice management, finance and wealth creation, health and wellness, taxes and accounting, fitness, and much more!