SPEAKER_03 0:00

Did you know, David, that nowadays you can get osemic hormones all your lab tests without seeing a doctor in person?

SPEAKER_00 0:12

So I'm gonna be real here. Being a social media fitness influencer, this d it's so funny because this whole topic is something I've been dealing with for a decade in this space that most people, most doctors, I mean think know has been around.

SPEAKER_03 0:31

Wait, when you say dealing with it, what are you referring to?

SPEAKER_00 0:34

Online, online pharmacy type, like online systems to Okay, but I do not think a decade ago we were dealing with the same thing we're dealing with right now. It's bigger. That's a hundred percent true.

SPEAKER_03 0:48

What were you dealing with a decade ago?

SPEAKER_00 0:49

They were still selling this stuff on like the gray market.

SPEAKER_03 0:53

Okay, black market, sure. Yeah. But this is not the black market we're talking about. This is like legit companies.

SPEAKER_00 1:00

Yeah, it's true.

SPEAKER_03 1:01

So I see your point. But I feel like things have evolved.

SPEAKER_00 1:05

Very true.

SPEAKER_03 1:06

And now you can just, you know, pick up your phone, go online, give someone your credit card, fill out a questionnaire, and bam, you get what you want.

SPEAKER_00 1:14

It is kind of wild. And how many patients do you have doing that?

SPEAKER_03 1:20

Well, it's fascinating because I think this topic for a podcast, I think, came up because both myself and Jana over the last few weeks have had multiple new patients come in, or actually, they're not even all not even all new patients, but we had people coming in and they're like, Well, I'm getting this med from this online company, or I'm getting this med from this clinic over here. And it always kind of fascinates me because I'm like, why did you not, if they're in if they're not, if they're a new patient, this is not applied, but for our current patients, I'm like, why did you not come to me and ask me about this medication? Because it's often in a GLP1 or similar, um, or hormones, which we prescribe both of those things. So it becomes an interesting conversation. And typically we talk with these patients about whatever med, and they're like, Yeah, I'd rather get that from you. And I'm like, okay, great, let me prescribe this so that you can have your care kind of in a more comprehensive way. Because if you're going to an online company to get your GLP1 or an online company to get your hormones, they're probably not looking at the whole picture of your health. Could be wrong. I have not done these myself, but I just don't think so. I don't think that's how that uh it's gonna work. This model would work.

SPEAKER_00 2:38

Well, the big one there is like, and like here's here's the question is like, why number one, like break down like the like the landscape. What what pro what what companies are you kind of referring to in general?

SPEAKER_03 2:52

Well, so in to for full transparency, before we start the podcast, I have not used any of these companies. So I don't want people to think that I have personal experience with these. So I don't know all the details of how they do this, but from what I do know, there is several companies that are, I think, the biggest names out there. So there's a couple different companies I think that are big out there. I think one of the biggest ones is Him's and Hers, which had, I don't know, I keep reading about the Super Bowl ads that they had about all the medications that they prescribe, which is a big one is their GLP ones. And there is MIDI Health, which does a lot of women's health hormones. There's aloe, there's Rho. So there is a whole handful, and there's a lot more, but I think those are some of the biggest ones out there right now. And interestingly enough, um, the HIMS and hers, when I was looking things up for this, they actually were in, so they were in a court case with Novo Nordisk, who actually makes Wagovy, that GLP one, which is for weight loss. So they've been in a court case, court battle with them for the past several months. And just yesterday, I guess they figured this out. So what Hims and Hers was doing was they were using a bunch of different compounded versions of these GLP ones and not using the branded version.

SPEAKER_02 4:08

Yep.

SPEAKER_03 4:08

And so obviously the pharmaceutical company was not happy about this. And so they've been battling this. And just yesterday, they dropped the case, and Hims and Hers is going to be selling, guess what? Brand name Wagovy. And I don't know what the price is gonna be on that yet. It doesn't seem like that's out there yet, but it's just a fascinating landscape of what we have patients having access to outside of like what has been traditionally the healthcare system set up for how patients get medications.

SPEAKER_00 4:40

Yeah. I mean, it's it's it's super interesting because like I feel like some of this landscape has been getting created. And we were talking about this before the episode, where because of the general uh short-sighted, fast, not strongly communicated relational primary care lately, someone just feels shut up and and and bulldozed. They just find a new place to get access to it. And if you don't r have that relationship built where you can really talk out some of these things, you're just like it's it is crazy to me. I mean, a great example of this. Um I had a previous client, a good friend of mine, who became a nurse. He lost 300 pounds through marathon running, sociopath. Someone who's 500 plus pounds that loses a lot of their weight through marathon running, you're a greater person than I. Um and so he loses all this weight, he's doing great. He then decides to do a um an accelerated nursing program, okay? We were we were working together, and that stress and that anxiety of going through this accelerated nursing program got him back into some of those little habits. He was, he was using eat using food to cope with stress, and he wasn't getting his workouts in. And and so we were talking back and forth, and I was like, hey, losing any more weight not part of the mantra. Let's just try to not lose not because he's already kind of sliding. Uh-huh. And it was like, let's just change the mindset up to like, hey, just keep the status quo. Just don't gain weight. Like, don't think about you're gonna lose weight and still in the middle of your it's just not gonna happen. Like just just just focus on just maintaining. He kept spiraling. So I go to him, I'm like, yo, this was a couple years ago. And I think it was two years ago-ish. And um he goes to his primary. I told him, I'm like, yo, you're spinning. This is this is some of the obesity genetic environment and sick and the physiology behind obesity. It's not always your fault with these hunger cues and how this kind of works. You should really look into these medications, these GLP ones. He goes to his primary, he had just got through his nursing program now, and his primary says to him, You know, uh, you know, you're a nurse now. You should know better. And he's like, I'm not he goes literally, this primary looked at him and said, Because he's a nurse, he shouldn't need a GLP one. And like, so the reason why I bring that whole story up is how many people are getting bulldozed by their primary, whether they're bad primaries, they just don't have the time for it. Oh, there's a lot of to unpack there.

SPEAKER_03 7:24

Well, and I think that is important to say, yeah, like I think you were saying a few minutes ago, why do we have these companies out there? And like what is the landscape? And I think you're absolutely correct that I think some people either don't feel like they have a good primary cure they can talk to. Some people probably bring it up and don't feel like they're heard or what they're looking for, they're not given. Now, sometimes people want something that they maybe shouldn't even have, I would say. So they find a way to get it. So I think there's a lot of different reasons for it. Now, um, we were mentioning the hymns and hers, which that one was is doing a lot of these GLP ones and weight loss medications. Um, but then like there's MIDI Health, which is doing women's hormones. And it's interesting to look at these different companies because I think the hymns and hers has been all just about weight loss, give it to the people, do the compounded, you're gonna be happy with your weight loss. Great. Um, but it's funny how each of these programs has a different way of doing it. So some of them you meet with a real person virtually and you have a conversation. Some of them will do lab work, but not all of them. Some of them will do a questionnaire, and that's how they determine what you get. Um, the MIDI health one does do these hormones. They do the FDA approved. You do meet with an actual practitioner, and it seems like they're doing it pretty well. And I think it's interesting, at least from what I see. Again, not my personal experience. Um, but the uh at least with that, I with the changing landscape of menopause management, I think there are many women who know that there are options out there for their symptoms. And they're probably absolutely right that there are not enough practitioners that know how to manage those symptoms because we know that there is a lack of women's health, especially menopause management in healthcare, from a lot of historical reasons. But I think I saw the data of any, it's anywhere from like seven to twenty percent of physicians. Um, like that's it that feels comfortable managing menopause. And so that's a big deficit. And so people are fine have to find another way to get what they need.

SPEAKER_00 9:37

I will say on on this whole front, as we're kind of going through, because it's HRT, GLP ones is like a one-two punch that's huge in the fitness space, it's like in the social media space. I find it so interesting that all of these companies popping out of the woodwork for compounded GLP ones and all this kind of stuff on the this is tough because I have a lot of friends that are in it. Like I I this is my this is my two cents. Um one of the things I find like I I I won't go into all the social media people that I know that are getting paid deals, all that kind of stuff. It's whatever. It's just like selling a s there's an argument, it's just like selling any supplement of creatine, a supplement, whatever. But the one thing I do find so interesting is the other side, the actual compounded pharmacies. Because, okay. I just like so many people am s do feel that big pharma is pure pure profiteering focused. No one denies that. Do they do incredible things because of how they innovate and grow in health? Absolutely, they do. But there's no question, like they are in it to make as much put money as possible. And the ethics and morals behind healthcare and where is that line of doing something for the greater good of people's health versus I'm here to make money. And I'm not a huge fan of big pharma in general, in the sense of some of the at like how many times they've been caught in some billion-dollar lawsuits of unethical business like standards. They've gotten hit plenty of times for doing unethical, illegal things. Simultaneously, I'm sitting here going, what these compound pharmacies are doing is illegal. Like it's like they're they're going against the FDA and every big pharma company basically taking their proprietary blends, tweaking it a little bit for their own argument, saying they're not the same. They're the same, or usually they're the same. And like thinking that you're somehow gonna beat that giant is crazy to me.

SPEAKER_03 11:54

Aaron Powell Well, they did beat it for a few years.

SPEAKER_00 11:57

Well, they didn't beat it, they just got caught up in um all the legality of it.

SPEAKER_03 12:03

Well, but they because there was a shortage.

SPEAKER_00 12:05

Well, and so they were able to be beating it. That's just taking advantage of it. Yeah. They're taking advantage of a moment of scarcity of of access, which then puts them on a the limited opp the scarcity list, which then gives them the legal opportunity to manufacture. But as soon as that's done, they have to stop manufacturing, but they're seeing how much money they're making. And now big these compound pharmacies are like, oh, I don't want to stop doing this. I'm making a lot of money. This is great.

SPEAKER_03 12:31

So do you think these these compound pharmacies are just saying, we're just gonna hedge our bets that we can do this for a little longer without there becoming a legal issue with it? That's it. But they're still doing it.

SPEAKER_00 12:42

Well, so from my understanding of how the law works, is as soon as the FDA says these these specific drugs are no longer in scarcity, they have to stop manufacturing.

SPEAKER_03 12:54

But they can still sell what they have.

SPEAKER_00 12:56

So what they did, a lot of these compound pharmacies, they manufactured frickin' two years, five years, seven years of the active ingredients. And so, but they stopped. They stopped manufacturing them. Uh-huh. And now they're still selling, but they have so much back order because they kind of took advantage of the system. And so I just find this whole avenue of these compounded GLP ones and this whole world, I love the fact that they're cheaper than what Big Pharma's doing them for that has merit. I'm also the first one to say, as much as I loathe uh sometimes pharma's profiteering motives, they also have ruthlessly high uh levels of um protections that everything that's in the product is exactly what's in the product. There's always a concern in this compound pharmacy world like, is what you're taking actually what you think you're taking? This isn't a this is like sometimes there's pills, pills and potions and and and vitamins and mineral complexes, they're not always what you think they're they're not what you think they're, but they're not gonna hurt you.

SPEAKER_03 13:58

Oh, I see what you're saying.

SPEAKER_00 13:59

But like if you're if you're injecting yourself with what you think to be a GLP one and it's an amphetamine or whatever it's gonna be, like that's no joke. And so and obviously, is the like did they have clean practices when they uh there's there's just a lot to unpack there. Yeah.

SPEAKER_03 14:17

So well, and I think like you said, it's great that these are cheaper, but I have actually had some patients come to me getting GLP1, something compounded from California, and they're paying way more than what I can get them that med for, the FDA version. So it's not always cheaper. It's I don't understand, I don't know if people just don't do their research, or a lot of these companies are gonna say, well, you get the med, but you also get like access to, say, our you know, our nutritionist and this program and this support, which I mean, maybe some people are using that, but I am always a little bit skeptical that those are really fully utilized. Increasing your services like that sounds great, but like I don't know. I don't think they're probably as used as they make it seem.

SPEAKER_02 15:02

Agreed.

SPEAKER_03 15:03

So I I think you do patients do have to be careful just because it's a compounded version doesn't mean it's gonna be cheaper.

SPEAKER_02 15:09

Yep.

SPEAKER_03 15:10

And I think um also what's important to remember is what is the follow-up gonna be on these meds. So you start you start a hormone, you start a GLP one. Is anybody monitoring something? Is anybody making sure that you're not losing all your muscle mass? They're talking to you about your nutrition and your exercise. Are those things in place? Or are you just losing weight and seeing a number and the scale drop?

SPEAKER_00 15:33

Mm-hmm. And like, like, for example, um, there's there's the lack of oversight from that standpoint. Now, what's so funny to me, because I'll be I'll be the first one to say, like, it is crazy to me because I we I've we've had conversations on GLP ones and all this kind of stuff, and and in particular, it is interesting that since there hasn't been good systems and pharmaceuticals in place to actually help people lose a decent amount of weight and actually maintain it. It is I've seen it happen more than once where someone loses a lot of weight in a short amount of time. They go see their primary and the primary's like, great job.

SPEAKER_02 16:09

Uh-huh.

SPEAKER_00 16:10

And it's like, uh, this guy just lost 80 pounds in three months. That's not good. Like, I don't I don't know how to shake a stick at this, but probably because you see so little weight loss. Yeah, you're just so excited you see someone lose weight. But simultaneously, you got to be like a yellow flag going, uh, the only way they did that is they starve themselves.

SPEAKER_03 16:29

Uh-huh.

SPEAKER_00 16:30

And we got to be careful that that's not happening.

SPEAKER_03 16:32

But well, because I I remember when these I started to see patients getting GLP1s, and I remember a few people coming in and losing a significant amount of weight. And you're right, at the time, I was probably that doctor that said, that is amazing. I am so glad that you're losing weight. We're all excited about it. But it was so new, and we hadn't, I had not thought about all the details related to it. We're just excited to actually see a medication help people lose weight. And I think we're learning a lot more about how to do that in the most healthy way.

SPEAKER_00 17:03

Now, how does it work? Like, because actually this actually just popped in my head right off the off this whole conversation. Because obviously, in these online type systems, the lack of oversight, all the context and nuance. One of the side effects of GLP ones in particular, I I tend to lean towards that because obviously it's very no it's very buzzword right now. Um pancreatitis is real and it like in in GLP ones. It's not a huge statistic, but it happens. Like obviously, if they were seeing a primary, would it change that dynamic at all or probably not?

SPEAKER_03 17:39

Well, no, I mean if you get pancreatitis, you're gonna know.

SPEAKER_00 17:42

Yeah, you're gonna know and you're gonna go to the year. You're gonna be in the hospital. That's what I was just wondering.

SPEAKER_03 17:45

Like, but I think the question then is do people, and I don't know the answer to this, but are people getting or is it being discussed with them the potential risk? And I assume these companies would be doing that because this is not that difficult to understand what the side effect, potential side effects could be. And I think there's a lot of people out there, they don't really care how risky a GLP 1 is if they can get their weight loss. Because they want that weight loss, which I get. No, that was a good question. And uh the actual uh pancreatitis risk of a GLP one is actually very low, ranging from approximately 0.1 to 0.3%.

SPEAKER_00 18:23

Yeah, it's I knew it was super low, but obviously, just like anything, when you put a hundred million people on it.

SPEAKER_03 18:28

Right, you're gonna see statistics. You're gonna see statistics.

SPEAKER_00 18:31

Like it's I I people have such a a delusional expectation of any intervention, period.

SPEAKER_01 18:37

Uh-huh.

SPEAKER_00 18:37

Like, oh, guess what? If you put enough people on broccoli, there's gonna be a population that's allergic to broccoli.

SPEAKER_02 18:44

Right.

SPEAKER_00 18:44

Doesn't mean broccoli is bad for you. Right. But there is gonna be a population that is allergic to it. There's gonna be a population that gets these these really rare effects. Doesn't mean they're bad for you, uh-huh all in all, but they do happen.

SPEAKER_03 18:58

So and I think the whole conversation about an online company versus getting something from your primary or a specialist you're seeing is very interesting because I'm you know, with these online companies, a lot of them require a membership. So like you're getting the medication for maybe the same price I can give it, get it to you for, but there is this membership cost. And so in I know I'm concierge, so we do have a membership fee, but we do way more than just prescribe GLP ones. And so I think, I mean, hey, if you value what that online company is doing and they're doing it safely and you're getting the medication that you need, I don't know that that's a problem, but just know that there may be a better option for getting it.

SPEAKER_00 19:44

Well that's and that's always the classic, which is like I mean, what's what's it worth to you on it's it's tough because you sit there and go the Okay Okay, what? Statistically, yeah. How many doctors and I'm not gonna go into the assumption of why. Okay. How many doctors in the primary care system today do you think no matter they have for a multitude of reasons, they just stonewall their patients and don't even try anything that's in the gray, they're like no. And they just stonewall gaslight m not not gaslight is a strong term, but like just 10% of doctors, 30% of doctors, 50% of doctors.

SPEAKER_03 20:35

I don't think they're in the gray. I mean, if people meet certain if they're obese with these specific problems, the risk factors, the medications are indicated. So I don't know why there is so much of this gray talk. Now, if your BMI is 27 and you're perfectly healthy and you still have the medication, sure, maybe that's where this gray bit comes in. But for the people that are obese with health problems, there shouldn't be pushback.

SPEAKER_00 21:01

Yeah. And it's the same thing with I mean, we'll we'll kind of move it to the other one, which is TRT. Yeah. That's another one. Like obviously I'm on TRT now myself.

SPEAKER_03 21:09

At least go to a clinic that gives it to you. You have a relationship with somebody that's monitoring it.

SPEAKER_00 21:14

So I'm getting cons six week right now until I get my st like a good stable uh blood work. Like every six weeks I'm getting blood tests again. They're checking for uh my hematocrit, which is the thickness of my blood, they're checking for estrogen, they're checking for all this stuff every six weeks to make sure everything's on the up and up.

SPEAKER_03 21:35

Um I'm not and I'm not saying you can't do that online because that all could be monitored online. I think you just have to know what should be monitored. Yeah. So you hope that the online company is doing it.

SPEAKER_00 21:46

Is doing the right things. Yeah. It's and and and this is always the interesting one too, because like you and I both know we're not here to poke holes in any specific business, but there are plenty of doctors that see Dollar signs. And when push comes to shove, they don't care. Surgeons love to do surgery. Uh therapists love to do physical therapy. People that are financially incentivized to prescribe HRT or whatever drug, guess what? They're gonna do it. And so you always have to be concerning that at least a primary that you have direct uh this always goes a full cycle. Every online clinic, don't kid yourself, they're financially incentivized to put you on whatever product or service they have. The power of a primary care professional it is illegal. It is illegal. So we're clear, people. It is illegal for a primary care professional to get any type of kickback for what they're doing. So there is a difference. It is fascinating that you like people who love the and you see it a lot that people that love to play the conflict of interest in big pharma do tend to do these compound pharmacies online and stuff and get whatever they want.

SPEAKER_03 23:08

Yeah, because I mean I prescribe GLP once, I would say, quite frequently. It's a very common practice for our practice. And I am not doing it at all from any financial incentive, but because I think that no. All right, I'm not giving a financial incentive.

SPEAKER_00 23:25

So hear me out. You don't get anything financial, uh-huh, but the Zetbound and who's the other guy? It's Zetbound rep and who's the other rep?

SPEAKER_03 23:34

Wagobi.

SPEAKER_00 23:35

They always come in together, right?

SPEAKER_03 23:36

No, the Zetbound.

SPEAKER_00 23:37

Who's the combo?

SPEAKER_03 23:38

So it's Zetbound and Manjaro together.

SPEAKER_00 23:40

But they're like, but yeah, the Zetbound and Manjaro reps for you are hysterical.

SPEAKER_03 23:46

They're funny.

SPEAKER_00 23:47

I've I've experienced them multiple times coming in. They are a combo, like one two-punch comedian group. Like, obviously, you don't get any financial benefit from them, but they're pretty funny.

SPEAKER_03 23:59

They're fun people, I'll admit it. But okay, so they really wanted me to come to this dinner that they were hosting about Zetbound. They had to twist in my arm and drag me almost kicking and screaming to get to this dinner. So I didn't want to go to this thing. I did not have to go. I'm not saying that. But it's not like I'm like, this is amazing. I got a free dinner out of it. I want to do this all the time. I actually don't really have any interest in spending my evenings with drug reps.

SPEAKER_00 24:29

Yeah.

SPEAKER_03 24:30

Shocking, I know.

SPEAKER_00 24:31

I know. And well, and you sit there and go, you gotta be so careful with all these this this new momentum of all these online landscaped this service for this product. They want to put as many people on it as they can.

SPEAKER_03 24:46

Do you think how many people do you think go to this like online, either GLP1 or hormone, you know, online company and they say no to? It's gotta be a low number.

SPEAKER_00 24:54

It's gotta be, it's it's gotta be low.

SPEAKER_03 24:56

So, and then I know that there are holes in primary care and that not everyone has access to a good primary care doctor. I am fully aware of that. But if you can find one, you are gonna get so much better care experience, and your everything will be much more personalized to you and not financially driven. So that is my plug for good primary care.

SPEAKER_00 25:20

And it doesn't matter where it comes from. Like again, that that's the that's the whole thing. There's a lot of different models. There's obviously there's the concierge side of things, the DPC side of things, there's the traditional route. But I think that we we've the the pendulum does have to swing where you people have to realize that these online niche doctors, providers that are providing whatever niche part of someone's health, they are financially incentivized, usually through services, usually through having a membership model to that very specific like it's it that that's gray in and of itself when you start to really unpack it, because it's like, while they may not be getting kickback from the farm, but even then the compound pharmacy world is fascinating because what's considered legal on wholesale retail markup and who can make money on it, that's a whole gray area in and of itself, where like pharmaceuticals with doctors, you can't make any wholesale retail markup. But compounded pharmacy world is kind of different.

SPEAKER_03 26:22

Yeah, I don't know. I don't know all the details. I don't do compounded medication.

SPEAKER_00 26:26

I just I know people that they they make wholesale retail markups selling it. And like I'm like, okay, well, do you have physicians that do, or no, no, it's mostly uh it's just social media people. Influencers. Influencers.

SPEAKER_03 26:38

And that's fascinating too, that there are random people on TikTok. I know many that have no medical background and yet tell the rest of the world that they should do this.

SPEAKER_00 26:51

They're drug dealers. It's tough. I don't know. Like uh I'm not here to like tell people what they can and can't do. I'm like, I'm at the I just in my mind, in this circumstance, the biggest angle and concern I have about it, uh-huh, it's not gonna last. Like, you really think the FDA and big pharma are just gonna roll over while all these compound pharmacies take half their half their uh quote-unquote. Right. I mean I just don't buy it.

SPEAKER_03 27:18

That is not gonna last. But all the but the company is now like hims and hers, which is switching from compounded to now providing the exact same thing that I provide my patients.

SPEAKER_00 27:28

But they're getting a membership on top and they're actually paying more.

SPEAKER_03 27:31

Well, because okay, so people pay me a membership, but I have partners at my old practice here in town that are not membership based that prescribe these medications too, and they can get them to the same cost that I can get them for for my patients that this online company can get them for their patients. So it's not like the online way of doing this is the only way. But if you got the if you have a primary care, go see them and ask. That would be my recommendation. If you don't like your primary care doctor, try out somebody new.

SPEAKER_00 28:03

Yeah, like d like because at least from again, there's like we s like we said, there's absolute benefit to some of these different practices, especially if you're just you're running out of options. But simultaneously, and it depends, obviously, if someone has insurance or not. Because there that like how do you know what Okay, so at when your previous practice, if s did you have non-insured people can come in?

SPEAKER_03 28:30

Occasionally.

SPEAKER_00 28:31

What is what did they get charged?

SPEAKER_03 28:33

For like a visit? It depended on how complex the visit is, because that's how it's all billed. Is it based on complexity? But I think like a low complexity visit was like maybe 70 or 80 bucks.

SPEAKER_00 28:43

Okay, so low complexity is 70, 80 bucks.

SPEAKER_03 28:47

Probably.

SPEAKER_00 28:48

Okay. Um per visit. Okay. I'm just sitting there going like I mean, but when you actually start unpacking what the membership of some of these different online stuff it's worth.

SPEAKER_03 28:58

Oh yeah. I'm not saying that some people can't take advantage of these. I think that is that what you're saying?

SPEAKER_00 29:05

No, it's just the idea of like it's easy. I'm I'm trying to look from multiple lenses.

SPEAKER_02 29:10

Uh-huh.

SPEAKER_00 29:11

And so, well, it's easy for you to say to go to a doctor if you have insurance. I don't have insurance. So at least I can use this and know it's gonna work. And I'm like, yeah, so I'm like, yeah, that's that is a tough pill to swallow. But then it's like, okay, if you were to do cash with something in a more traditional sense, if you don't say like a DPC or you have a different model, yeah, like what does it cost? It's like, okay, so you're talking 75 to 150 bucks.

SPEAKER_03 29:36

I think ish. I didn't deal with that side of the state.

SPEAKER_00 29:39

It's so funny because it's like so many doctors have no idea what I'm saying.

SPEAKER_03 29:42

Well, I know they would occasionally occasionally a patient would come with no insurance, and then it was like they had to be given a sheet before they saw the provider about their estimated cost of the visit out of pocket, because I wasn't collecting the money. This wasn't going in right into my pocket, so it wasn't something that I really dwelled on.

SPEAKER_00 30:00

Yeah, I could see that.

SPEAKER_03 30:01

Sorry.

SPEAKER_00 30:03

I got 37 more patients. Yeah, exactly.

SPEAKER_03 30:06

I don't care what the price was. Uh so, anyways, um, any other topics that you wanted to add to this?

SPEAKER_00 30:12

No, I think it's just a really good, a really good conversation. I think it's it's super important, though. Um, number one, people that are uh promoting these compound pharmacy GLP1s on the internet, any friends and family that I know that are doing that, uh do you? Like I'm it has I I don't look at you any less for wanting to get a bag to do that kind of stuff. Um I would just say I don't think it's gonna last. I just don't I don't think FDA and big and big pharma are gonna just roll over and it's gonna be a quick bag and you're gonna get egg and out because I just don't see it lasting.

SPEAKER_03 30:46

But what about the non-compounded versions?

SPEAKER_00 30:49

What do you mean?

SPEAKER_03 30:50

Like the companies that are selling the non-compound like I get your point on the compounded again, but these companies are gonna still exist when they can't do compounded.

SPEAKER_00 30:58

Yeah, there's gonna be a population, but just know like you're paying more if you go through depending on if you're a primary or not.

SPEAKER_03 31:06

I know. And I think people also like to sit on their computer and do something as opposed to going into the doctor. I get that. I know it's inconvenient.

SPEAKER_00 31:14

Doctors are scary. They judge me for being fat. We do not. Yes, they do.

SPEAKER_03 31:20

No. Not the good ones.

SPEAKER_00 31:23

That's true. I still can't get over how my buddy had a a doctor, his primary, say that.

SPEAKER_03 31:28

That's ridiculous.

SPEAKER_00 31:28

Again, don't take the outlier and justify it to the majority. But gosh. Like when my buddy told me that story, I was like, I will get on a plane and absolute like let me come to this next next meeting, next uh visit. I will rip that dude apart till probably security comes in and has to rip me out. Because like I'll probably record the whole thing. They can sue me. I don't care because like I'm proving a point. Because that's so egregious and so ridiculous. Like that in my argument, that's like that's losing medical license worthy.

SPEAKER_03 31:58

If you are shamed for your weight, find a new doctor.

SPEAKER_00 32:01

Yeah, that's just wild to me.

SPEAKER_03 32:02

And again, I know it's not that easy for everyone, but still.

SPEAKER_00 32:05

But you can try.

SPEAKER_03 32:06

You can try.

SPEAKER_02 32:06

Yeah.

SPEAKER_03 32:07

All right. Well, uh, I think this is a great topic. I think it's very timely. A little spicy. I think it's spicy. I think we had a great conversation.

SPEAKER_00 32:15

Hopefully my my social media friends were not offended.

SPEAKER_03 32:18

I don't think you got too personal.

SPEAKER_00 32:20

No, I don't get personal.

SPEAKER_03 32:21

All right. Well, um, again, none of this is medical advice. Find a good primary care doctor if you can, and I think you will be happy and save money.

SPEAKER_00 32:29

Have a phenomenal day, and we'll talk to you all later.

SPEAKER_03 32:31

Bye.

SPEAKER_00 32:32

Bye.