00:00:04:00 - 00:00:29:09 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. So, Leah, tell us so even up to you with your business venture. 00:00:29:09 - 00:00:45:13 Justin Nabity I know that's been something you've been working on. Not very many doctors that we speak with have this entrepreneurial background and interest of taking the bull by the horns and having an impact in their community. Tell us about what you've been up to lately. 00:00:45:15 - 00:01:02:21 Dr. Leah Houston So, you know, we all talk about the administrative burden and health care and, you know, all the extra stuff doctors have to do aside from patient care. And one of those things is credentialing. And so a few years back, I said, you know, I'm going to solve this for us. And that's what I've been working on. 00:01:02:21 - 00:01:31:08 Dr. Leah Houston So since then, you know, we hired a team, we shipped a mobile app on to the iOS and Google Play stores. We ramped up within the first month to about 700 users. And then, you know, as a first time founder, non-technical founder, you know, I learned later that we kind of built something too big, too early, because it started kind of breaking in, crashing. 00:01:31:08 - 00:01:49:00 Dr. Leah Houston So we've been working on fixing those things while also, you know, working on customer and competitive research and things like that. So we're not as far along as I would like, but we're in the growing pains stages that most companies often go through. 00:01:49:02 - 00:02:04:07 Justin Nabity Tell us about your your journey, getting to that stage with your practice. How did you get into medicine, and what was that kind of turning point where you saw, okay, I need to look outside of the four walls that I'm in that you were in before. 00:02:04:09 - 00:02:35:16 Dr. Leah Houston Well, you know, I actually believe that most physicians do have an entrepreneurial desire. I think most physicians would prefer to have a private practice. But, what's happened is the current system has made it so cumbersome and administratively burdensome that they can't. I personally wasn't really one of those doctors originally. I was an emergency doctor practicing, you know, in an emergency department, getting paid either by the hour or via RV years. 00:02:35:16 - 00:02:54:12 Dr. Leah Houston And I really, really enjoyed what I was doing, and I was happy, practicing. I never really, you know, a lot of people like you would do so good in private practice. And I'm like, nope, don't want to deal with that. However, something actually happened to me, in my practice that led me to want to make a change. 00:02:54:12 - 00:03:17:13 Dr. Leah Houston So, when I was working at a hospital, you know, when you first sign your contracts and your agreements, if you don't read the fine print, you wouldn't know this. But most agreements essentially say, okay, sign here on the dotted lines. We are going to bill under your name. Give us your credentials. Give us the rights to utilize your credentials. 00:03:17:15 - 00:03:34:06 Dr. Leah Houston Embedded in these contracts also are sometimes non-compete that are now potentially going to be illegal. You know, in other things that kind of, control how you practice, you know, you're not allowed to refer outside of the health systems. There's a little fine print like that that a lot of doctors don't notice. 00:03:34:08 - 00:03:34:23 Justin Nabity 00:03:35:00 - 00:03:58:20 Dr. Leah Houston But because of this fine print, I essentially was giving them a right to bill under my name under any circumstance for any reason. And I also assumed a liability, for whatever they, they were billing for. And so fast forward, I, I ended up leaving one of these positions, one of the many positions that I signed an agreement like this. 00:03:58:22 - 00:04:14:13 Dr. Leah Houston And, something happened administratively, either purposefully with intent and with malice, or accidentally as an administrative snafu. Either way, the outcome was the same, where they were billing under my name. For. 00:04:14:13 - 00:04:30:13 Justin Nabity What were they billing for? This is really interesting. I think doctors this is that underlining things that go on under the surface that really tell us about what was a billing issue. 00:04:30:15 - 00:04:34:04 Dr. Leah Houston I left and they were billing as if I was still there. 00:04:34:06 - 00:04:35:19 Neil Dougherty Oh my gosh. 00:04:35:21 - 00:05:03:23 Dr. Leah Houston There's you know, there's, you know, as an emergency doctor, especially now and increasingly and most professions and in medicine are experiencing this. We have non physician practitioners such as nurse practitioners, physicians assistants, working in the emergency department, taking care of some of the lower acuity patients. And, you know, the way that that is supposed to work is they see a lower acuity patient. 00:05:03:23 - 00:05:20:16 Dr. Leah Houston They come and report to me, I hear the story, I look at the vital signs and I decide, do I need to see them directly or can I, you know, give them some advice or allow them to to pursue their plan that they were presenting? And then at the end, I sign off on that chart as I supervise that case. 00:05:20:16 - 00:05:37:20 Dr. Leah Houston I was involved in the decision making. So what they were doing was they were having all these people see patients, and nobody was reporting to me because I was no longer working there. And then there were signing off my name. So that's how that happened. 00:05:37:22 - 00:05:39:11 Neil Dougherty Well, how long. 00:05:39:13 - 00:05:40:12 Dr. Leah Houston This year. 00:05:40:14 - 00:05:48:18 Neil Dougherty Is doing and how long is this going on? Before it was found out that they were using your name like that? 00:05:48:20 - 00:06:15:07 Dr. Leah Houston Well over a year. And there were only Medicare Medicaid claims that they revealed to me. But this was also insured patients and things like that. And there were, tens of thousands close to 100,000, dollars worth of Medicare and Medicaid fraud that was committed this way and unknown amount and insured patients. So, yeah, I mean, the health system claimed oops-a-daisy 00:06:15:07 - 00:06:23:18 Dr. Leah Houston I made a mistake, but I personally don't imagine how this could be done on accident. So yeah. 00:06:23:20 - 00:06:41:17 Neil Dougherty I you said snafu, right? Yeah. Perfect word for it. It's a great word, but, I was thinking I was like, I, I didn't even imagine this could happen in this type of way, but how prevalent do you think this is? 00:06:41:19 - 00:07:08:00 Dr. Leah Houston So this specific type where they're saying that the doctor was there and they weren't, and there was actually a patient being seen. I'm not really sure. I think it's much more common than people realize. And how would we know? You know, how did I find out? You know, how would I even know? The only reason I even found out was because my license lapsed in that state. 00:07:08:02 - 00:07:14:17 Dr. Leah Houston If I hadn't allowed my license to expire. Yeah, along with this, have gone on for without me ever knowing. 00:07:14:19 - 00:07:18:10 Justin Nabity I would have kept going. They would have continued on. 00:07:18:12 - 00:07:41:18 Dr. Leah Houston Right until there was potentially a lawsuit or a, malpractice claim or something like that. But, you know, even though it's rare enough that it might not have ever been noticed. Right. And so how much Medicare Medicaid fraud is happening? It's hard to say. You know, the false, you know, false claims Act, you can like kind of look up the cases that they've closed, you know, hundreds of millions of dollars by Sutter Health. 00:07:41:20 - 00:08:04:11 Dr. Leah Houston You know, there's there's been a lot of cases, they're cracking down on telemedicine practices because if the screen says you're seeing a practitioner and you're a telemedicine patient who, like, forgets their name and doesn't even remember, and then, you know, your insurance company is billed for a bunch of durable medical equipment that you never receive in the mail. 00:08:04:13 - 00:08:34:18 Dr. Leah Houston You know, that's a potential kickback Medicare Medicaid insurance fraud scheme. That's becoming more common. And telemedicine practices, you know, saying the patients are having more visits than they are documenting visits that never happened. Things like this. And so that's part of why they're starting to kind of crack down on telemedicine. They gave a lot of, you know, leeway, during the pandemic, but they're starting to kind of roll back some of those, some of those, privileges. 00:08:34:20 - 00:09:20:20 Justin Nabity You know, one of the things that you said, previous episode that we have, one of our guests was how we say the quiet part out loud and in every single conversation we have, there's always something like that that comes up and this experience that Leah has, has had it. It's like where is it that these administration teams, they just are so not on the same page with doctors because it if there's ten administrators for every one doctor nowadays, which is out of control, and you think about the star player on the team is the physician, they're the one that makes everything possible. 00:09:20:22 - 00:09:37:21 Justin Nabity They couldn't do anything without the doctor. The doctor is really king and queen here in the midst. Like there's there's nobody else that this can flow from. And, the disconnect is just so massive. 00:09:37:23 - 00:09:50:17 Dr. Leah Houston Well, the problem is they don't view it that way. You know, they don't view us as, highly competent, highly skilled workers that are, critical for the function of their health systems. 00:09:50:20 - 00:09:51:20 Justin Nabity How do they view you? 00:09:51:22 - 00:10:01:00 Dr. Leah Houston They view us as replaceable, you know, factory workers who, you know, are not producing enough widgets. 00:10:01:02 - 00:10:06:19 Neil Dougherty Wow. Well, well. So go ahead and say that. I won't say that out loud one more time. 00:10:06:21 - 00:10:18:04 Dr. Leah Houston I mean, this is the quiet part out loud also, right? Like doctor treating us like assembly line workers pushing out widgets. Those widgets are actually called RVUs and, you know, RVU based incentives. 00:10:18:09 - 00:10:18:21 Justin Nabity Yeah. 00:10:18:23 - 00:10:51:21 Dr. Leah Houston They're how we monetize and qualify, you know what our, the value of our work is. And so the doctors that are pushing out more reviews are going to get the better shifts. They're going to get the their weekends off and their holiday requests in, and they're going to get their bonuses and the doctors that are pushing out less widgets are going to get fired, or get the bad shifts or become not get, you know, promoted and not be given a letter of reference if they leave the, you know, abusive factory job and try to find another factory to work in the US. 00:10:51:23 - 00:11:19:21 Neil Dougherty I have to say, I have to say something here. That's because that's my for a second there I was, I was I kind of out of words here. What were what happened to your experience there? We've talked to doctors and we're trying to help them find the words or, stand up for yourself, make yourself aware and all these things and and you, you are aware of how you are being mistreated, mis viewed, and you remove yourself from the game. 00:11:19:23 - 00:11:33:00 Neil Dougherty And those people that are treating you like the assembly workers, they actually behind the the scenes. They know that your value is so much because they still have to use your name when you're going right. 00:11:33:02 - 00:11:34:23 Dr. Leah Houston That is so cognitive dissonance there. 00:11:34:23 - 00:11:38:22 Neil Dougherty Yeah, I'm I'm. 00:11:38:24 - 00:12:11:10 Dr. Leah Houston You know, and you know, it's really it's really scary because, you know, physicians have been, kind of put in a fear based submission standpoint and part of why you likely are encountering, other practitioners and physicians who aren't comfortable saying the quiet part out loud or they can't find the words is because there's this subconscious fear that they're going to be fired and they're going to lose their livelihood. 00:12:11:10 - 00:12:38:22 Dr. Leah Houston There's something in, medicine that very few people really understand or have even heard of called sham peer review. And sham peer review is essentially like, you know, like, let's just talk about it in a way that everybody in your audience can understand, this situation that's happening with the police departments and, you know, there's some cops behaving badly. 00:12:38:22 - 00:13:17:09 Dr. Leah Houston So, you know, some of these departments have mostly good cops who are doing the right thing and a couple of bad apples, but some departments are really run by crooked cops, you know? And so what happens when there's a good cop, you know, that enters that force? You know, what they might do is create a story about them, you know, over scrutinized things, use little, you know, lines in the bylaws that nobody really even knows or understands or pays attention to, to point out what they've done wrong, to essentially constructively discharge them or get them fired. 00:13:17:11 - 00:13:37:22 Dr. Leah Houston And the same thing is happening to good doctors and hospitals all over the US who are speaking up and, speaking up for patient safety issues. You know, they'll outwardly say, if you see something, say something. Have you see any patient safety concern, please report it to blah, blah, blah, blah blah. But in reality, they take your name down. 00:13:38:00 - 00:13:49:17 Dr. Leah Houston They bring you in to a quiet room. They ask you your story, and they essentially use Socratic questioning to get you to realize that if you don't shut your mouth, you're going to be fired. 00:13:49:19 - 00:13:50:11 Neil Dougherty Unreal. 00:13:50:13 - 00:14:13:24 Justin Nabity So the sham. So when I hear you talk about this way a sham peer review, that sounds like doctors are providing a bogus review of their colleagues. It's a joke or it's it's not a non credible. It's it's it's a a non warranted review that's really inaccurate. Is that what you're saying is that. 00:14:14:05 - 00:14:18:06 Dr. Leah Houston I don't think it's doctors. I think it's the administrators. Okay. I know it's the administrator. 00:14:18:06 - 00:14:28:19 Justin Nabity So when you say peer review I'm thinking I'm thinking now doctors reviewing doctors work or commenting, I was like expert witness kind of, sort of. So you're this review is for example. 00:14:28:19 - 00:15:03:10 Dr. Leah Houston So I was practicing in a very inner city emergency department with extremely high acuity patients, many of whom had, severe drug and alcohol addiction. Many who were experiencing homelessness had a lot of psychiatric problems. Look at where I've worked and make inferences on which hospital you think that might be. But in every other hospital that I had worked in with an acuity like this, with this patient demographic, there was always a psychiatrist on call. 00:15:03:12 - 00:15:27:12 Dr. Leah Houston There were social workers on call. We had security available to do 1 to 1 CIT or some, you know, medical or somebody to do 1 to 1 sits with patients who are unsafe. Okay. In this particular hospital, they had none of those things. No. No psychiatry on call, no security available, no availability for staff to do, 1 to 1 visits for patients who are dangerous, danger to themselves or others. 00:15:27:14 - 00:15:50:12 Dr. Leah Houston And I verbalize this concern. Within the first few weeks I worked in this hospital. And then I had an incident where a patient, attempted to, you know, grabbed me and pushed me against the wall, who was actually physically chained to a bed with but with handcuffs. The police officers brought this person in under arrest and left them with me. 00:15:50:14 - 00:16:11:19 Dr. Leah Houston And no security, no anything. And this is just it's just unheard of in every other emergency department in the country. And I've worked in a lot of places, and I've worked in a lot of high acuity, inner city places with this kind of demographic. So, I then that day I wrote an email, hi, doctor so-and-so. You know, this is the chairman of the department. 00:16:11:19 - 00:16:35:20 Dr. Leah Houston You know, I know that I brought this up before. I just wanted to let you know of an incident that actually was a safety concern. This is part of why I feel we, you know, it's really critical that we get this kind of staff in place and blah, blah, blah, blah, blah, blah, blah. One week later, I get, I get sign out by another physician on the team, and, this person happened to be next in line to become chairman. 00:16:35:20 - 00:17:02:10 Dr. Leah Houston He was like, chairman of that hospital system. So this is a large system with lots of different places. And, this person left their email open and I looked at the email and it was like reduced. So like I just opened it up and I saw my name. So of course I read it and it basically said it was basically saying, you know Doctor Houston is becoming a problem. 00:17:02:10 - 00:17:21:19 Dr. Leah Houston She's putting in writing these kinds of complaints. This doesn't look good for the department. You know, we're really concerned that this is going to become an issue. And then like a day or two later, I got an email that was basically like, you know, we've received some complaints from the staff that, you know, they feel that you might be unfit to practice. 00:17:21:20 - 00:17:44:17 Dr. Leah Houston You know, this might be too high of an acuity er for you, blah, blah, blah, blah, blah, blah, blah. And so I had known about this phenomenon. So the first thing I did was I immediately called, one of my mentors who is from residency, one of the attendings that trained me, and I told them what was going on, and they told me about this phenomenon of a sham peer review, and they told me to leave. 00:17:44:17 - 00:18:03:04 Dr. Leah Houston And I and I, put in my resignation for that job. But then going back to credentialing in my business now all of a sudden, I have no job and I have to look for a job, and then it's going to take 4 to 6 months to credential for a new one. So bringing it back full circle, you know, this is a big problem. 00:18:03:06 - 00:18:07:08 Dr. Leah Houston That's, that's that's affecting doctors who speak up. 00:18:07:10 - 00:18:31:24 Justin Nabity You know, the last thing that a doctor needs is to have some obstacle to be able to continue their profession and work with a system that has a 4 to 6 month wait on even being able to begin to take care of people. If you go back to the conveyor belt, the factory assembly line doctors have been reduced to factory workers. 00:18:32:01 - 00:19:00:04 Justin Nabity Where's the patient? In the factory. Tell me, because the thing that Neil is underscoring is that we are all about getting the doctors voice back. If every if if a small amount a doctor said, we're done with the B.S., we're done, everything would stop. It would. And doctors need courage. They need boldness. They need the support. And that's why we exist at DocNation to give that support. 00:19:00:06 - 00:19:25:17 Justin Nabity Anyone who has an employed situation or a business situation that we all have challenges. And so what are those issues? Bring those to us. We love to eat that stuff up and turn it into a better outcome. So and this isn't just for doctors. This is for doctors who want to impact their community, which is the patient. Where's the patient? 00:19:25:17 - 00:19:49:11 Justin Nabity In this factory. I'm trying to visualize this because I think patients need to understand how much. I mean, they know that they're getting less and less time with their doctor, and it's obvious it doesn't take a it's not complex to understand that outcomes are getting worse. Proper health care is not being given because there is no relationship in seven, 4 to 7 minutes. 00:19:49:11 - 00:19:56:09 Justin Nabity It's just not enough time. So where's the patient in this factory? Like where would you put that? 00:19:56:11 - 00:20:00:16 Dr. Leah Houston The patients are, on the conveyor belt. They're the widgets. 00:20:00:18 - 00:20:04:10 Justin Nabity Did you said the widget was the RVU? And I liked how you used to argue as a. 00:20:04:12 - 00:20:11:19 Dr. Leah Houston That's lot like the patient is, you know, I guess I don't know, it's I mean, I'm just using an analogy. 00:20:11:19 - 00:20:32:05 Justin Nabity I know, I know, I don't know where they are. And that's the problem I'm trying to picture where they are. And it's almost like they don't exist in this picture. It's all about the doctor just producing the review widget. It's like, where's the human aspect of what medicine is supposed to be? Yeah, that's what exists to help people. 00:20:32:07 - 00:20:37:16 Justin Nabity Yeah. And the one thing that it exists to do, it's not doing right. 00:20:37:16 - 00:21:04:18 Dr. Leah Houston And it's, it's and the sad thing is, is that, you know, and I don't want to sound like a conspiracy theorist, but like, the mainstream media has done a really good job of villainize and doctors, like this, for example, this Doctor Death podcast that's out, it's like, this is like one dude who's totally a sociopath who, you know, unfortunately, you know, we have sociopaths among us. 00:21:04:20 - 00:21:29:22 Dr. Leah Houston We have narcissistic people among us who are dangerous. Yeah, just like any profession has this. But unfortunately, you know, there's this villainized Asian. Oh, doctors are being bought off by pharma and they're trying to push drugs and, you know, that they, you know, look at this doctor Death person and, you know, let's talk about this weirdo who inseminated all of his patients with his own sperm. 00:21:29:22 - 00:21:51:23 Dr. Leah Houston And like this other guy who carved his name into some woman's uterus, like, yeah, there's freaking weirdos among us. However, most patients have had really good experiences with their doctors, and most patients genuinely feel like they're doctors care. They're just confused because, as you said, we're the main character. We're the ones that are, you know, the value creators in the system. 00:21:51:23 - 00:21:53:09 Justin Nabity It's the point of contact. 00:21:53:11 - 00:22:10:04 Dr. Leah Houston They think that because we're the boss and we have the M.D., that we have control over the system, and that we should be able to if it was really a problem that we had the ability to fix, we would have fixed it by now and that we don't care. And we we're just trying to also make money and all this crazy stuff. 00:22:10:04 - 00:22:30:06 Dr. Leah Houston So, and it's a hard narrative to push back on, especially when, you know, they've been really taking advantage of physicians altruism, you know, because in order to speak about this stuff, we have to talk about the abuse. We have to talk about the maligned incentives. We have to talk about money and why there's these incentives in place. 00:22:30:06 - 00:22:45:20 Dr. Leah Houston And this as soon as a doctor speaks anything about money, the administrators, and the medical industrial complex, the medical machine will say, you know, oh, don't you care about your patients? Why are you even discussing this? 00:22:45:22 - 00:22:47:10 Justin Nabity Right, I like yeah. 00:22:47:12 - 00:22:51:01 Dr. Leah Houston So. It's a bad situation. 00:22:51:06 - 00:23:17:19 Neil Dougherty Well, no, I love it. I love what you're doing, though, because we in DocNation, we we're trying to help doctors. We want them to stand up. We want to help doctor gain control. But you mentioned your your business focusing on credentialing and how, difficult and arduous that task may be. You said 4 to 6 months credentialing. 00:23:17:21 - 00:23:32:19 Dr. Leah Houston Yes. Sometimes longer. I mean, I've had a couple of people tell me that they waited 11 months, 12 months. One person was like, I ended up getting another job. But keeping this thing going, I didn't get credentialed for 17 months. Yeah. It's crazy. 00:23:32:21 - 00:23:52:15 Neil Dougherty Let's do that. Just and that's what it is like if we if we're saying, stand up for yourself and all the way up to the point and beyond of leaving and leaving a bad medicine. Yeah, we got to make it easier. Make it easier to leave. Make it easier to make it easier to get credentialed. I love thank you for doing what you're doing. 00:23:52:17 - 00:24:12:23 Dr. Leah Houston Yeah. I mean, it's it's it's kind of hard for people to understand why, credentialing is so critical, to solving the physician autonomy and freedom of mobility problem until they really think about it and acknowledge that this, this lengthy process is what's keeping us essentially tethered to the factory. 00:24:13:00 - 00:24:37:19 Justin Nabity Yep. That's your access card to get in. Yeah. Doctor patient. There's something in the middle that has broken that relationship, and it's the insurance company. And where does credentialing what do you need to do? It's the way the doctor gets connected to the insurance company. And I love what you said about patients. Think that. Well, geez, you're you're an M.D., you're a dog. 00:24:37:22 - 00:24:58:22 Justin Nabity Well, you if there was a problem, you probably would have done something about it. You wouldn't just let bad things happen. And so the perception that patients have is understandable. Like, if I was not in this industry helping doctors for 15 plus years, I wouldn't have a clue. This this would be totally foreign to me, I wouldn't understand, I would think the same thing. 00:24:58:22 - 00:25:23:05 Justin Nabity It's in the media. I think it's doing a great job. Pitting the bad experience that patients are having as if it's a doctor's fault when whose fault is it really? It's like the people who are at fault do such a good job of making it look like it's somebody else's fault, when they're actually the core reason why the issue exists in the first place. 00:25:23:07 - 00:25:29:15 Justin Nabity This this deception, this misinformation, this deception is the problem. 00:25:29:17 - 00:25:44:18 Dr. Leah Houston Well, it's really difficult. You know, it's it's it creates a lot of cognitive dissonance when you like, have to acknowledge that you are the problem in order to solve the problem. You know, you know. 00:25:44:22 - 00:25:47:20 Justin Nabity You're saying the humility that you have to have to recognize, 00:25:47:22 - 00:26:03:19 Dr. Leah Houston I mean, yeah, I forget what movie it was. I don't know if it was a Soylent Green movie, but it was like, you know, a woman that was like trying to fight against the machine. And, you know, her day job was like this working in this factory. And she had, like, risen to the ranks as manager and blah, blah, blah, blah, blah. 00:26:03:21 - 00:26:38:03 Dr. Leah Houston And then she finds out that her factory had been funding the very machine that she was spending all of her free time fighting. And if she acknowledged this and spoke about this publicly, her life would fall apart. Her friend group would disappear, her, you know, family would be impoverished, she'd have no home, blah, blah, blah. And it was like this kind of like crisis of conscience that she she had because she with this realization and I think that in most people, you know, the workers in these health systems and insurance companies, they genuinely believe they're doing the right thing. 00:26:38:07 - 00:27:02:24 Dr. Leah Houston You know, these prior authorizations are preventing doctors from over utilizing and, you know, over treating. And we're just trying to save our customers money that's not passed down to the to the patient. Number one. And number two, it's really just refusing to pay for services that have already been rendered oftentimes. But they don't know that, you know, because the, the, the rhetoric and the narrative within their system is, you know, we're here to help patients. 00:27:02:24 - 00:27:39:10 Dr. Leah Houston And we did it. And, and so there's a lot of confusion in general about what's, what's real and what's not. And so, I think that, you know, between this experience of sham peer review that I shared and this experience of identity theft and Medicare, Medicaid fraud that I shared, you know, there's a couple of other stories that I've personally had a lived experience around, you know, after talking to thousands of doctors, most people have 1 or 2 actual lived experiences that seem like one off weird things that only happened in that one place and wouldn't happen. 00:27:39:10 - 00:28:02:19 Dr. Leah Houston But the collective of all of these little things happening all the time, to all of us, is the pressure that's being put on the system that's driving doctors out of medicine, driving doctors to die by suicide. You know, you know, driving up the cost of health care, you know, worse outcomes. Now, when I started this company, our health care system was a $3.9 trillion system. 00:28:02:19 - 00:28:28:16 Dr. Leah Houston Now it's a $4.9 trillion system. In four years, it's gone up by $1 trillion. And, you know, less than 7% of that is actually going towards patient care, in the form of actual physician services. And the rest is a bunch of administrative crap, inflated pharmaceutical and device, costs and, you know, nonsense. 00:28:28:18 - 00:28:51:09 Justin Nabity Well, we appreciate you sharing your boldness, your courage to really underscore and unpack some things that people don't know about. And, we really appreciate you taking the time with us to get the word out and to not just talk it, but to actually do it. You've moved your with your feet. You're taking action to make a difference. 00:28:51:09 - 00:29:10:00 Justin Nabity And, we look forward to all the people that you're going to be helping get more autonomy, more freedom to be able to to do what they're passionate about. Rarely do, really do doctors get into medicine for money? I mean, there's a few, but that's just not it's too long of a road. It's too there's too much or too many requirements to get there. 00:29:10:00 - 00:29:28:21 Justin Nabity It's for the passion is the core and all these obstacles that exists to to make that passion. Like you said, why? Why are our doctors on day one of their career? They're like, I'm already thinking about my exit. What? 00:29:28:23 - 00:29:45:19 Dr. Leah Houston Well, no, there was actually a survey done. I think it was AMA and medical students and 30% of medical students say they don't plan to practice clinical medicine at all. That's outrageous. Yeah. 00:29:45:21 - 00:29:59:17 Neil Dougherty Doctor views. And it's more than appreciate more than just appreciation for you today. I'm a fan of yours. I'll be cheering for you. And, love what you love what you're doing. Thank you for coming on. 00:29:59:19 - 00:30:11:05 Dr. Leah Houston Thank you for giving us a voice and giving us an opportunity to share and for understanding that most physicians, when they really think about it, they they agree with a lot of what I've said. They just can't say it out loud. 00:30:11:07 - 00:30:12:04 Justin Nabity That's why we're here. 00:30:12:06 - 00:30:13:21 Dr. Leah Houston Yeah. 00:30:13:23 - 00:30:15:13 Justin Nabity All right. Thank you. 00:30:15:15 - 00:30:17:20 Dr. Leah Houston Thank you. 00:30:17:22 - 00:30:34:17 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. 00:30:34:23 - 00:30:42:07 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.