Latest / CareTalk: Healthcare. Unfiltered. / Creating Health Content People Can Trust w/ Dr. Joseph Feuerstein

Transcript

Creating Health Content People Can Trust w/ Dr. Joseph Feuerstein · CareTalk: Healthcare. Unfiltered.

• 0:00
  David: Patients today are flooded with health information.
• 0:03
  David: Much of it inaccurate or misleading At the same time, trust in healthcare providers and institutions has eroded.
• 0:10
  David: So how can patient education cut through the noise and actually help?
• 0:21
  David: Hi everyone.
• 0:22
  David: I'm David Williams, president of Strategy consulting firm, health Business Group, and host of the Health Biz Podcast, where I interview top healthcare leaders about their lives and careers.
• 0:31
  David: My guest today is Dr. Joseph Feuerstein, integrative medicine physician and advisor to Caravan Wellness.
• 0:37
  David: We're talking about trust in patient education, why it matters, how it's built, and how digital health and AI are changing the landscape.
• 0:45
  David: If you enjoy the show, please remember to subscribe and leave a review.
• 0:49
  David: Dr. Feuerstein, welcome to the Health Biz Podcast.
• 0:52
  Dr. Joseph: Thank you so much for having me.
• 0:53
  Dr. Joseph: It's an honor.
• 0:55
  David: Well, we're gonna be talking about how healthcare professionals and content creators can better earn patients' trust, especially as misinformation spreads online.
• 1:04
  David: So let's start off by what does trust mean to you in the context of patient education?
• 1:11
  Dr. Joseph: So firstly, I'll tell you a secret, which is that, um, physicians are not infallible.
• 1:17
  Dr. Joseph: We do not know everything.
• 1:19
  Dr. Joseph: And so we will use online resources all the time.
• 1:24
  Dr. Joseph: Uh.
• 1:25
  Dr. Joseph: I, I, I don't wanna give you brands, but for example, generally a doctor's not gonna use chat, GPT because there is a, um, there is a better version, a medical version called open Evidence, and we'll use that all the time.
• 1:38
  Dr. Joseph: So, um, trust is that you have to know.
• 1:42
  Dr. Joseph: That the, the source is actually a legitimate source and that the quotes and the information you're getting is validated and evidence-based.
• 1:52
  Dr. Joseph: That's what I think of in terms of trust, and we do it as much as the, as the lay consumer does it.
• 1:57
  Dr. Joseph: Everyone's using this all the time, and you have to know where you're getting information form and inform specifically to my area of integrative medicine.
• 2:05
  Dr. Joseph: Uh, there aren't an enormous amount of, uh, Western resources.
• 2:12
  Dr. Joseph: You know, there's stuff from Mayo and there's some stuff from Harvard, but it's not the same as, you know, kidney stones.
• 2:18
  Dr. Joseph: You can just go to Harvard and they'll tell you everything you ever, you know about kidney stones, but if it's a botanical that you want to use, that gets a little bit more n nuanced and niche because where's the information?
• 2:30
  Dr. Joseph: And it can't be from some dude who wants to sell it to you.
• 2:33
  David: Exactly.
• 2:34
  David: So why is it, and I think you're already starting to put your finger on this, but why are patients struggling to trust health content and even frankly, their own providers today?
• 2:44
  David: Why?
• 2:44
  David: Why is it such a struggle?
• 2:47
  Dr. Joseph: What, what I would say is that, um.
• 2:50
  Dr. Joseph: There is an enormous amount of content.
• 2:53
  Dr. Joseph: The internet is limitless, and you don't know who is behind what you are reading.
• 3:00
  Dr. Joseph: You just don't know that.
• 3:02
  Dr. Joseph: And so that is suspect for anything medical.
• 3:06
  Dr. Joseph: Uh, because you know, the way these Google algorithms work is that if you've done this and that and that, then you're gonna be at the top.
• 3:12
  Dr. Joseph: And what you may be saying may be absolutely incorrect, but that.
• 3:16
  Dr. Joseph: It doesn't matter 'cause you're at the top and that's what they're reading.
• 3:18
  Dr. Joseph: Um, and the problem is that, uh, peace patients.
• 3:22
  Dr. Joseph: Now, I don't personally find this a problem, which is that I want my patients to be educated because I want my patients to be empowered.
• 3:29
  Dr. Joseph: But what they want in a therapeutic relationship with me is to tell 'em.
• 3:34
  Dr. Joseph: The wheat from the chaff, what part of what they've read is actually true and what part is probably not accurate.
• 3:42
  Dr. Joseph: So I'll give you an example.
• 3:43
  Dr. Joseph: Today I had a patient who wrote to me and said, what do you think of this new test?
• 3:47
  Dr. Joseph: And I know the test and I know that there isn't enough research behind it.
• 3:52
  Dr. Joseph: So they're asking me because they trust me to have done the research.
• 3:55
  Dr. Joseph: Um, but some physicians, uh, don't necessarily, uh, spend enough time.
• 4:02
  Dr. Joseph: Getting into the weeds of all of this, then it's there.
• 4:05
  Dr. Joseph: There areas that they perhaps don't have too much expertise with and that will disappoint their patient.
• 4:10
  Dr. Joseph: The patients are gonna go online.
• 4:13
  David: I wanna actually ask you how things have evolved, because I remember, I'm gonna say maybe it was even up to 15 years ago when patients started to use the internet for information and I used to hear physicians complain to me fairly frequently that a pa, a patient would come in with a bunch of stuff they'd printed out from the internet.
• 4:32
  David: The doctor had to use the whole appointment to sort of disabuse 'em of all the stuff they'd seen there, as opposed to kind of going through, uh, you know, whatever program they had planned.
• 4:41
  David: Now things have shifted and people are just much more online all the time.
• 4:44
  David: This trust is a factor and so on.
• 4:46
  David: How have you seen the evolution?
• 4:47
  David: What's different now?
• 4:49
  Dr. Joseph: Well, firstly, to go back to 15 years ago, it was Dr. Google.
• 4:53
  Dr. Joseph: 'cause that was literally what it was.
• 4:54
  Dr. Joseph: And the problem with Dr. Google, and I've said this countless times to patients, is that Dr. Google is an incredibly educated.
• 5:04
  Dr. Joseph: First day intern.
• 5:06
  Dr. Joseph: What do I mean by that?
• 5:07
  Dr. Joseph: So your interns, it's July.
• 5:09
  Dr. Joseph: July 1st in every hospital is when the interns just come.
• 5:13
  Dr. Joseph: How long have they been physicians for?
• 5:14
  Dr. Joseph: They've been physicians for exactly one day.
• 5:16
  Dr. Joseph: They've actually been practicing physicians on July 1st, so on July 1st.
• 5:21
  Dr. Joseph: What they have is a corpus, a body of information that they know.
• 5:26
  Dr. Joseph: They have no way to be able to put it into practice in terms of what is likely, what is not likely.
• 5:33
  Dr. Joseph: So what does that mean?
• 5:35
  Dr. Joseph: It means that when you don't know, everything is increasing, is, is, is, is increasingly, you know, they're all, the percentages of pro probabilities are all the same.
• 5:43
  Dr. Joseph: So if you sit there and say, I have chest pain.
• 5:47
  Dr. Joseph: Is the number one reason people have chest pain in America?
• 5:50
  Dr. Joseph: 'cause they're having a heart attack.
• 5:51
  Dr. Joseph: No, it's not.
• 5:52
  Dr. Joseph: It's gonna be re reflux or musculoskeletal.
• 5:54
  Dr. Joseph: There's lots of other reasons, but if you look at Google, it's not gonna rate that.
• 5:58
  Dr. Joseph: It's just gonna give you all of these reasons and you have no clinical experience, just like a first year intern.
• 6:04
  Dr. Joseph: No clinical experience whatsoever into being able to triage.
• 6:09
  Dr. Joseph: Okay.
• 6:09
  Dr. Joseph: What's most likely, what's most serious?
• 6:12
  Dr. Joseph: That comes with clinical, um, clinic with clinical experience.
• 6:15
  Dr. Joseph: So that's essentially what we were seeing 15 years ago.
• 6:19
  Dr. Joseph: People would just print it out and say, I think I have, and then they go to the bottom, you know, if we had a list of things, number 10 would be the one that they, I'm sure they have and they probably don't have that, but they don't know enough about it 'cause they have no.
• 6:30
  Dr. Joseph: Clinical experience.
• 6:31
  Dr. Joseph: They've never diagnosed this disease.
• 6:33
  Dr. Joseph: They've never seen this disease.
• 6:35
  Dr. Joseph: And they don't know, actually, it is literally like a first year intern and you wouldn't wanna, you know, you wanna hang your hat on the diagnosis of a first year intern.
• 6:44
  Dr. Joseph: 'cause they haven't seen anybody.
• 6:45
  Dr. Joseph: They're not doctors and doc and Google's not a doctor.
• 6:47
  Dr. Joseph: What, what's, what's happened over the last 15 years is, is really honestly through with AI and the elegance with which you can ask questions.
• 6:56
  Dr. Joseph: So it was, you know, 10 causes of chest pain would be what you could do 15 years ago.
• 7:00
  Dr. Joseph: Now you can sit there and say, I have this, this, and this, and this and this.
• 7:03
  Dr. Joseph: I'm 75 years old.
• 7:04
  Dr. Joseph: I have these risk factors.
• 7:05
  Dr. Joseph: What is my most likely diagnosis?
• 7:07
  Dr. Joseph: And AI will tell you.
• 7:09
  Dr. Joseph: And I, I work, I have a startup that uses ai.
• 7:12
  Dr. Joseph: So I use AI all the time for a specific purpose.
• 7:15
  Dr. Joseph: And the problem with AI is that it doesn't want to disappoint.
• 7:21
  Dr. Joseph: So if it doesn't know the answer.
• 7:24
  Dr. Joseph: It makes it up.
• 7:26
  Dr. Joseph: A good doctor who doesn't know the answer says the following, I don't know.
• 7:32
  Dr. Joseph: I'm gonna ask a friend who's a specialist, or I'm gonna go and research for you.
• 7:37
  Dr. Joseph: That is a good doctor.
• 7:38
  Dr. Joseph: AI will just make something up.
• 7:41
  Dr. Joseph: That's the problem.
• 7:44
  David: Great.
• 7:45
  David: I wanna talk about building trust now.
• 7:47
  David: I talked about the challenges of, uh, when we don't have it or the patients have trouble with it.
• 7:51
  David: Can you share a story maybe from your own practice where building trust had a real impact on patient care?
• 7:59
  Dr. Joseph: I mean, I have a kind of boutique concierge practice, so small it doesn't take insurance, and they know.
• 8:10
  Dr. Joseph: That I will go to war for every single one of them.
• 8:13
  Dr. Joseph: So I have the general impression from the nature of the relationship that I also go to the houses.
• 8:19
  Dr. Joseph: So I know these people intimately.
• 8:20
  Dr. Joseph: I know what they have for breakfast 'cause they see it.
• 8:22
  Dr. Joseph: I know their dogs and I have their wifi.
• 8:25
  Dr. Joseph: That is the ultimate in trust is that they just ask me because they, they.
• 8:31
  Dr. Joseph: No, I'm either going to tell them I know, or I'm going to find out the answer and they know they don't need to worry about it.
• 8:38
  Dr. Joseph: You know what I'm saying?
• 8:39
  Dr. Joseph: It takes time.
• 8:40
  Dr. Joseph: That's the point.
• 8:41
  Dr. Joseph: And you don't do that in a 15 minute or a 20, 30 minute once a year physical.
• 8:47
  Dr. Joseph: You're not building rapport, you're not building trust.
• 8:49
  Dr. Joseph: You're trying to get through a whole load of questionnaires that the United States Preventative Task Force thinks is are important, and it takes time to build that relationship.
• 8:59
  David: So you've, you've addressed one way that this can be solved, but it's not really scalable because it's expensive to have that.
• 9:06
  David: Right.
• 9:06
  David: So what's the, what's So how about in a more of a general practice, let's say with somebody who's got a panel of 1500 or more patients, what's their opportunity to build trust and what kind of a difference does it make if they can do it?
• 9:19
  Dr. Joseph: So you can't be an expert on everything.
• 9:22
  Dr. Joseph: And so, uh, generalists, I mean my, so my, my residency was in family medicine, but then I spent 15, 20 years after a fellowship in integrated medicine.
• 9:30
  Dr. Joseph: So that's my area of, uh, focus and my area, my niche area.
• 9:34
  Dr. Joseph: I do a lot of educating through podcasts, through webinars, through videos all the time.
• 9:41
  Dr. Joseph: I've written two books.
• 9:43
  Dr. Joseph: That is how you build.
• 9:45
  Dr. Joseph: Trust.
• 9:46
  Dr. Joseph: The fact is that over time, you know, you end up with people who trust what you say because they've listened to you say whatever it is.
• 9:55
  Dr. Joseph: Every time I do a video, I, I've done, I've done probably a 400 different, they call the MD minute.
• 9:59
  Dr. Joseph: They're once a week.
• 10:00
  Dr. Joseph: Every single one of them is based on research that was just published.
• 10:04
  Dr. Joseph: Literally just published, you know, um, what, whatever.
• 10:07
  Dr. Joseph: I'm, I'm gonna do one about beams.
• 10:09
  Dr. Joseph: It's gonna be all about the health benefits of beams, but it's coming from a published clinical trial that came out two weeks ago.
• 10:14
  Dr. Joseph: So people now at this point are used to the fact that.
• 10:19
  Dr. Joseph: They trust what you're gonna say because they know it's evidence-based and that can be done.
• 10:23
  Dr. Joseph: These videos take, I do 'em in 90 seconds.
• 10:26
  Dr. Joseph: Anybody can do them.
• 10:27
  Dr. Joseph: You just need to be reading medical journals, which is, uh, which is your responsibility if you want to keep up to date.
• 10:32
  Dr. Joseph: And that is the thing that you, that that's the, you know, you are going to disseminate to your patients.
• 10:38
  Dr. Joseph: That will build pro trust because now they real, they see that you have a level of expertise on whatever it is that they're, that they're interested in.
• 10:45
  Dr. Joseph: That's take, it takes years to do.
• 10:47
  Dr. Joseph: But the point is that that's another way, and that's to everybody.
• 10:50
  Dr. Joseph: That doesn't have to be to your little boutique concierge practice.
• 10:54
  David: So then let's took, take it from the patient perspective.
• 10:57
  David: So the patient that, uh, where, where you are their physician and you go to their home and you have all the, the information and the trust, like you said, that's pretty straightforward.
• 11:06
  David: Now, when I go on to the internet, I might find you, I. Pretty much right next to, I'm gonna find a lot of other things.
• 11:13
  David: So as a personal example, um, I, uh, had a hernia repair last year and I found actually fantastic physicians.
• 11:21
  David: They actually just do hernias.
• 11:23
  David: It's, I won't, I actually have a video on that if people wanna see that.
• 11:26
  David: Um, but you know, when I search for them.
• 11:28
  David: You should see the sort of stuff that comes up next to it.
• 11:31
  David: You know, how they, how someone cured their hernia with this, that, and the other.
• 11:33
  David: And it's, it's, it's 90% about that.
• 11:36
  David: So how does a patient get access to the same kind of information and find the trusted source?
• 11:41
  Dr. Joseph: So, um, before I went into private practice that did take insurance site, which the director of, uh, integrated medicine at one of the largest integrated medicine centers in the country.
• 11:52
  Dr. Joseph: And I took insurance for 15 years and I saw 45,000 patients.
• 11:55
  Dr. Joseph: So I know how that looks.
• 11:58
  Dr. Joseph: What I said to all the patients is, if you're going to go on a website, you want to go on a website that is known and is a recognized entity If you're looking for a Western medical condition.
• 12:11
  Dr. Joseph: You should be going to the Mayo Clinic.
• 12:12
  Dr. Joseph: You should be going to Harvard.
• 12:13
  Dr. Joseph: Should be going to Stanford.
• 12:15
  Dr. Joseph: Why?
• 12:15
  Dr. Joseph: Because they are going to have done the research and they will be evidence-based.
• 12:19
  Dr. Joseph: They're gonna steer you in the right condition.
• 12:21
  Dr. Joseph: You go to integrated medicine, that's a whole separate discussion.
• 12:24
  Dr. Joseph: Then it gets a little bit more complex.
• 12:27
  Dr. Joseph: And so then it depends on which disease and who's doing what.
• 12:31
  Dr. Joseph: And then there's more nuance.
• 12:32
  Dr. Joseph: But generally, if it's a hernia repair, you wanna know, how do I get hernia repair?
• 12:37
  Dr. Joseph: What happens in a hernia repair?
• 12:39
  Dr. Joseph: You, you, you, you, you go online and you are looking for the recognized brands because they are legitimate.
• 12:45
  Dr. Joseph: And then if you're looking for who's found a doctor, I'll just tell you that to find a doctor, you can find out names and then you need to find out these people.
• 12:52
  Dr. Joseph: You can look, you can read reviews, um, but most importantly, it's other people telling you whether they're good or bad.
• 12:58
  Dr. Joseph: It's very simple.
• 12:59
  Dr. Joseph: It's, it's really word of mouth.
• 13:01
  Dr. Joseph: We never advertised.
• 13:02
  Dr. Joseph: There's 45,000 patients.
• 13:04
  Dr. Joseph: I never advertised once it was word of mouth.
• 13:08
  David: So you mentioned a couple times that you, you can find things that are kind of like the standard, you know, western practice where there's a lot of clinical trials, peer-reviewed journals, et cetera, and you can go to Mayo, Harvard, Stanford.
• 13:19
  David: Now what about things like you mentioned botanicals or, or others?
• 13:22
  David: Are you suggesting that there are good.
• 13:26
  David: Data sources and trials, and it's just that they're covered by different brands, or what is the
• 13:31
  Dr. Joseph: brands, because they're more niche.
• 13:33
  Dr. Joseph: So for example, Memorial Sloan Kettering, which is obviously a cancer center, is gonna have a list of botanicals that might be used by someone who, uh, who is dealing with cancer.
• 13:45
  Dr. Joseph: That that's the type of, so in other words, it's more disease specific.
• 13:49
  Dr. Joseph: Um, there are a couple of well known, uh, uh, sites, uh.
• 13:55
  Dr. Joseph: Again, Mayo will have some of this stuff in terms of botanicals, but you are looking for a brand, you know, you know, it's not like, um, I just went out to lunch.
• 14:05
  Dr. Joseph: And you can have the local IPA or you can have, uh, something that, you know, you can have a stellar arch.
• 14:10
  Dr. Joseph: It's from Belgian, it's been around for 900 years.
• 14:13
  Dr. Joseph: That's what you're looking for when it comes to your medical care.
• 14:15
  Dr. Joseph: You wanna have something where you know, this brand, you've never heard of them.
• 14:19
  Dr. Joseph: That might be concerning.
• 14:21
  David: Got it.
• 14:22
  David: Now, one of the things that we hear about is, uh, challenges between, uh, let's say a provider and a patient is just the lack of, of empathy, which doesn't mean lack of sympathy, but it may mean they have, the physician may have trouble putting themself.
• 14:37
  David: In the patient's shoes.
• 14:39
  David: And I wonder how much of that do you still see as a, as a factor?
• 14:43
  David: And how much of it relates to things like, uh, you know, cultural relevance or just being able to connect with somebody based on their own experience?
• 14:53
  Dr. Joseph: I work twice a week at a hospital and I teach the residents.
• 14:57
  Dr. Joseph: It's a lovely hospital.
• 14:58
  Dr. Joseph: It's not relevant, which one it is, but let's just say part of one of the large, uh, medical systems tied to an a very well an academic medical system in, uh, uh, in Connecticut and in Massachusetts.
• 15:08
  Dr. Joseph: And, um.
• 15:10
  Dr. Joseph: When I first was a member of staff there, I had eight hours of how to be nice.
• 15:16
  Dr. Joseph: Literally, that is the culture of the place.
• 15:21
  Dr. Joseph: I've been to other hospitals in this place.
• 15:24
  Dr. Joseph: Every employee says hello to every employee in the morning.
• 15:29
  Dr. Joseph: When you finish the CEO of the hospital comes down to greet and shake hands with every employee.
• 15:36
  Dr. Joseph: It doesn't matter who they, they are, they're not all physicians.
• 15:38
  Dr. Joseph: They are a million different things.
• 15:40
  Dr. Joseph: It's the nature and the culture of that, and then that is how people are.
• 15:45
  Dr. Joseph: Uh, and that's how the residents are.
• 15:47
  Dr. Joseph: The residents are working in a system where they understand they have to be polite and respectful to everybody else, and friendly, and that translates into the patients.
• 15:56
  Dr. Joseph: So my hospital, uh, when I'm with there twice a week, has the top press gain awards.
• 16:01
  Dr. Joseph: Why?
• 16:01
  Dr. Joseph: Because patient satisfaction is supreme.
• 16:05
  Dr. Joseph: So empathy is part of that.
• 16:07
  Dr. Joseph: I, it's something that can be learned.
• 16:08
  Dr. Joseph: I have to be honest with you.
• 16:09
  Dr. Joseph: It's something that, that can be learned.
• 16:10
  Dr. Joseph: We're all humans and there are some cultural aspects to that, but the eight hours of how to learn empathy were very useful.
• 16:18
  Dr. Joseph: There's, there's techniques.
• 16:21
  David: Good.
• 16:21
  David: All right, good to know.
• 16:22
  David: And we'll do a different podcast on that perhaps.
• 16:24
  David: Um, I wanna talk about a little bit more about wellness and, you know, wellness platforms and content creators.
• 16:30
  David: As I mentioned, you can go on the internet, whether it's Google, TikTok, wherever, even LinkedIn, and find all sorts of stuff that's that's out there.
• 16:37
  David: That, and I think in general, the, you know, the consumers looking for things that are, that are accurate.
• 16:43
  David: To the extent that they can, they can find that and helpful and pertinent to their, to their situation.
• 16:48
  David: So I'm wondering where you see kind of a balance of, of responsibility between healthcare providers, wellness platforms, individual content creators to make sure that what's there is going to be accurate and useful.
• 17:04
  Dr. Joseph: So I think the people who police this are actually, it's not the clientele.
• 17:09
  Dr. Joseph: It's not the wellness providers and it's not the physicians.
• 17:12
  Dr. Joseph: It's actually the platform and the platform.
• 17:16
  Dr. Joseph: So for example, I was at a, I did my fellowship at the University of Arizona.
• 17:20
  Dr. Joseph: We had an alumni meeting.
• 17:21
  Dr. Joseph: We had the head of YouTube's.
• 17:24
  Dr. Joseph: I, I dunno, I dunno what she does.
• 17:26
  Dr. Joseph: She did for YouTube.
• 17:26
  Dr. Joseph: She did something for YouTube.
• 17:28
  Dr. Joseph: What she recommended straight out is that if you have a YouTube channel, which I do, it is had about 350,000 views send in.
• 17:39
  Dr. Joseph: Your medical license.
• 17:40
  Dr. Joseph: So you are verified as a licensed physician channel.
• 17:46
  Dr. Joseph: That doesn't mean I'm infallible, it doesn't mean what I say is true.
• 17:50
  Dr. Joseph: You can listen to what I'm saying.
• 17:52
  Dr. Joseph: What I personally say has be, has wrote, has has a, a clinical study behind every single, uh, statement I make every single one of them.
• 17:59
  Dr. Joseph: 'cause they're always the same.
• 18:00
  Dr. Joseph: 90 seconds.
• 18:00
  Dr. Joseph: This is a study from X, Y, and Z was just published.
• 18:03
  Dr. Joseph: This is the bottom line of the study.
• 18:05
  Dr. Joseph: Um.
• 18:06
  Dr. Joseph: That's what you're looking for in, in platforms like YouTube, you want to have someone who's actually, because they've done the work for you.
• 18:12
  Dr. Joseph: I don't think we can police ourselves.
• 18:14
  Dr. Joseph: 'cause I don't think, uh, there's a, there's a, there's a tendency wellness platforms.
• 18:19
  Dr. Joseph: It's too easy to turn that into a monetary.
• 18:23
  Dr. Joseph: Uh, you know, um, transactional situation where you're selling supplements, that happens all the time.
• 18:29
  Dr. Joseph: That is the pivot.
• 18:30
  Dr. Joseph: So it's difficult.
• 18:31
  Dr. Joseph: So that's why actually it's better regulated, I would say, in terms of wellness platforms by YouTube, by Facebook, et cetera.
• 18:37
  Dr. Joseph: And when I say things in, in, in, in, in CODI gave, uh, some research studies on this was right at the beginning of COVID on.
• 18:48
  Dr. Joseph: Basic research on things that might, natural supplements, like for example, elderberry extract that may have some small studies showing it might be useful in COVID.
• 18:56
  Dr. Joseph: And again, I was being very honest and saying, I'm not selling any, I don't just sell supplements this way.
• 19:00
  Dr. Joseph: That's not how I do it.
• 19:02
  Dr. Joseph: But the point was that.
• 19:04
  Dr. Joseph: Facebook immediately took me to task and said, you are now treating COVID.
• 19:09
  Dr. Joseph: And I said, fine, I won't say this anymore.
• 19:11
  Dr. Joseph: There was at least some clinical studies behind it.
• 19:13
  Dr. Joseph: I didn't just sit there and say, everyone should take, uh, God knows what, um, but the, if the policing actually comes from the platform.
• 19:21
  David: Now, let's say there's a healthcare organization that perhaps recognizes that it's, it's strong in, in certain areas, or may even refer people to Mayo or Harvard or Stanford, but they wanna provide some broader kind of wellness information.
• 19:33
  David: What is their, their role?
• 19:35
  David: How can they best go about vetting patient education content to figure out if it's going to be effective, useful, accurate?
• 19:46
  Dr. Joseph: I mean, I think that that's part of, for example, I'm the chief, chief, uh, health advisor for caravan.
• 19:53
  Dr. Joseph: If you look at through credentials, this is a completely, uh, unapologetic pivot and, uh, and, and a pitch about caravan.
• 20:01
  Dr. Joseph: But you look at the credentials that the people that are talking, these people have credentials.
• 20:05
  Dr. Joseph: They have gravitas.
• 20:06
  Dr. Joseph: They know what they're doing.
• 20:08
  Dr. Joseph: That is the way, if you're gonna sit there and you're gonna be Harvard.
• 20:10
  Dr. Joseph: So for example, in my startup, I didn't want to start doing 150 videos on stress management, yoga, et cetera, et cetera.
• 20:19
  Dr. Joseph: So what did I do?
• 20:20
  Dr. Joseph: I spoke to caravan and I used caravan videos.
• 20:22
  Dr. Joseph: Why?
• 20:23
  Dr. Joseph: Because I know the content is accurate and evidence-based, and the teachers are properly qualified, so it's not someone in a garage.
• 20:34
  David: Makes good sense.
• 20:35
  David: So you talked a little bit before about how you know the difference between Dr. Google and ai.
• 20:40
  David: So I'm wondering if you could expand a little bit and talk about some of the exciting things that may happen and maybe scary things in patient education, whether that's ai, personalized content, peer-to-peer platforms.
• 20:51
  David: What are, where are some of the innovation and excitement?
• 20:56
  Dr. Joseph: So I'm gonna pivot a little bit to tell you about a clinical study.
• 21:00
  Dr. Joseph: I'm literally just doing, um.
• 21:03
  Dr. Joseph: And not because it actually is relevant to patients, but I just want what I said previously, which is how physicians use ai, I think is interesting because I'm now showing you behind the curtain, I'm showing you under the skirt, if you will, um, of what actually physicians do as to how they get information.
• 21:22
  Dr. Joseph: Now, 20 years ago when I were as a resident, I'll tell you where we used to go.
• 21:26
  Dr. Joseph: We used to go to the library.
• 21:28
  Dr. Joseph: Literally you go to the library, you go get a journal, and you sit there and look it up.
• 21:32
  Dr. Joseph: I go to the library to, to, to, to, to write like bits of a book or something.
• 21:38
  Dr. Joseph: I'm not gonna the library to IE opening books in the library and looking at journals.
• 21:41
  Dr. Joseph: It's all done online.
• 21:42
  Dr. Joseph: What physicians do these days is they use, again, they're gonna use an ai, uh, an ai, uh, um, uh, tool such as open evidence.
• 21:51
  Dr. Joseph: So the clinical study we are doing is the following many times in a hospital.
• 21:58
  Dr. Joseph: You will have a specific question that you will ask a specialist.
• 22:03
  Dr. Joseph: The specialist is not gonna see the patient.
• 22:05
  Dr. Joseph: It is a sidebar, so you are gonna be like, oh, what's the best antibiotic for X, Y, and Z?
• 22:10
  Dr. Joseph: You're not, he's not gonna go to the trouble of seeing the patient.
• 22:12
  Dr. Joseph: You're just asking him for free medical advice.
• 22:16
  Dr. Joseph: What we're doing in our clinical study is we're having the three to five specialists from five different specialties, and they are going to set three questions that they are asked all the time.
• 22:29
  Dr. Joseph: We are going to put that in open evidence, which is the medical chat, GPT, and they are going to then rate according to a scale, how accurate, how empathetic, how evidence-based, how useful, how concise these are.
• 22:44
  Dr. Joseph: Why are we doing this Because.
• 22:46
  Dr. Joseph: Residents, especially the millennial residents who are the people now becoming doctors are using this all the time.
• 22:53
  Dr. Joseph: And as I said previously, your AI never tells you it doesn't know.
• 22:59
  Dr. Joseph: It just makes it up.
• 23:02
  Dr. Joseph: So we need to know that what we're actually taking is actually true.
• 23:06
  Dr. Joseph: And that's one way to validate.
• 23:07
  Dr. Joseph: So that from a medical point of view is an interesting thing.
• 23:10
  Dr. Joseph: 'cause doctors are gonna be using this more and more as a, uh, as a, as a, as a information tool.
• 23:17
  David: Yeah.
• 23:17
  David: One thing physicians have done.
• 23:19
  David: Uh, well, or in mass anyway, is using a tool like up to date in particular.
• 23:24
  David: So I'm thinking about the example of, you know, how was there such a wide uptake of it?
• 23:29
  David: And what happened was, you know, they'd go on grand rounds and somebody would ask a question and the resident would actually have a great answer 'cause they actually looked it up and up to date.
• 23:37
  David: And then it turns out, you know, the attendings have to go, they have to start using it as well.
• 23:40
  David: How is that, how is that involved?
• 23:42
  Dr. Joseph: So that's, so UpToDate was a great resource and Integr Integrative Medicine, we have this thing called natural standard, but it's the same principle.
• 23:49
  Dr. Joseph: It's monographs to tell you everything you need to know and if you want to know, if you don't know anything about the disease.
• 23:56
  Dr. Joseph: So if I see with a resident and we see something that there's one in 300 in the world that will be in my UpToDate because I'm not gonna know about this.
• 24:03
  Dr. Joseph: That is literally like opening a medical textbook.
• 24:05
  Dr. Joseph: I don't need to, it's on up to date.
• 24:06
  Dr. Joseph: I've got it literally on the app on my phone.
• 24:08
  Dr. Joseph: I pay 500 bucks and I have that.
• 24:10
  Dr. Joseph: But on a day to day practical thing where I know roughly what I'm gonna do, I wanna ask a specific piece of information.
• 24:19
  Dr. Joseph: I'm not spending 10 minutes looking up to date.
• 24:22
  Dr. Joseph: Like for example, randomly we're in Connecticut, uh, Massachusetts, there's people who get tick diseases or certain tick diseases associated with abnormalities in liver and function tests.
• 24:32
  Dr. Joseph: 'cause I'm looking, trying to work out what's wrong with the patient.
• 24:35
  Dr. Joseph: I'm not gonna spend 20 minutes looking at UpToDate to get to the point where it says elicia causes LFT abnormalities.
• 24:40
  Dr. Joseph: I'm gonna go on open evidence and I'm just gonna say.
• 24:44
  Dr. Joseph: Calls elevated, uh, abnormalities and, and, and liver function tests, and it's gonna tell me, and I got the, that's how we're using it now.
• 24:51
  Dr. Joseph: Up to date is a general thing.
• 24:53
  Dr. Joseph: This is very nuanced.
• 24:55
  Dr. Joseph: It's much more elegant.
• 24:57
  David: Got it.
• 24:57
  David: Alright, that's helpful.
• 24:59
  Dr. Joseph: You have, if you're doctor, you need to ask.
• 25:01
  Dr. Joseph: If you don't ask the right question, then you're not gonna get any information.
• 25:04
  Dr. Joseph: You know, the patient has this, this, and this.
• 25:06
  Dr. Joseph: What do you think is wrong with the patient?
• 25:07
  Dr. Joseph: You, you have no idea either.
• 25:09
  Dr. Joseph: So they're just gonna come up with whatever they come up with and it's say ai, it's gonna hallucinate if it doesn't know, you know?
• 25:15
  David: So for the last question, I wanna turn to a topic I always ask people, um, what are you reading these days?
• 25:21
  David: Anything you would recommend or anything you would recommend to avoid?
• 25:24
  Dr. Joseph: I, I have two books that I'm, I I, I read a lot of books at the same time in different, uh, areas.
• 25:29
  Dr. Joseph: Like there's, when I'm working in the hospital, I have a book, uh, I'm reading anyway, but the two books I want to recommend to you.
• 25:36
  Dr. Joseph: One of them is with a body of mine who was in the same fellowship.
• 25:39
  Dr. Joseph: Her name is Dr.
• 25:40
  Dr. Joseph: A Cohen, and she has written a book.
• 25:43
  Dr. Joseph: It's published by Simon Schuster and it's called Detoxify.
• 25:47
  Dr. Joseph: So let me tell you what this is.
• 25:48
  Dr. Joseph: She is an integrative rheumatologist.
• 25:51
  Dr. Joseph: She knows what she's talking about.
• 25:54
  Dr. Joseph: The amount of environmental load of toxins that we have in our bodies from.
• 26:02
  Dr. Joseph: Plastic, the air, the water, et cetera, and what it's doing and is really quite concerning.
• 26:10
  Dr. Joseph: You read what she's, what she recommends and she literally is reducing your pesticide load, your BPA load, your BPF load, S load, all of these things.
• 26:20
  Dr. Joseph: All of these different things that your body has to try and get out of its body, and it's helping to do that.
• 26:25
  Dr. Joseph: It's a really.
• 26:26
  Dr. Joseph: Very clever book that will open your eyes also to the complete real lack of regulation compared to Europe.
• 26:34
  Dr. Joseph: What goes on here is just ridiculous.
• 26:36
  Dr. Joseph: Uh, you can pretty much do what you like.
• 26:38
  Dr. Joseph: And, uh, in Europe they're actually trying to find out whether some of these chemicals are such a great idea and in America, you know, whoever it is, I can't remember.
• 26:47
  Dr. Joseph: Which government organization is supposed to be, was supposed to be, uh, uh, looking after this, I think they've investigated like nine of 700,000 or 70,000 chemicals.
• 26:56
  Dr. Joseph: We are woefully inadequate in that, in that capacity.
• 26:59
  Dr. Joseph: And it's having impact on a lot of, uh, medical, uh, systems in including, uh, in including, you know, causing diseases, which we know.
• 27:08
  Dr. Joseph: Um, the second book is one that a patient of mine, 'cause I have rapport my patients gave me, that actually has made me mad.
• 27:15
  Dr. Joseph: And it's called Blind Spots and it's by Marty McCarey.
• 27:20
  Dr. Joseph: So I listened to his podcast 'cause my patient gave me the podcast.
• 27:24
  Dr. Joseph: And the podcast was on COVID and it was on, I was in COVID actually, you know, I was, I'm, I'm a real doctor.
• 27:30
  Dr. Joseph: I was literally in the ICU working with COVID patients for a year.
• 27:34
  Dr. Joseph: So, you know, all the trauma of that.
• 27:36
  Dr. Joseph: I, so I, so the podcast was all about.
• 27:41
  Dr. Joseph: Where COVID really came from, and it's absolutely fascinating and it's evidence-based, but he's written this book that frankly makes me angry because it shows the complete arrogance of the medical establishment, uh, to orthodoxy of this is the way we do it and this is the way we do it.
• 28:02
  Dr. Joseph: And I'll just give you one example because it makes me absolutely furious.
• 28:08
  Dr. Joseph: Of pediatrics.
• 28:09
  Dr. Joseph: Do you know this story decided?
• 28:12
  Dr. Joseph: I, I just, I, I can't, I, it just makes me furious, decided because they are all holy, that no one should be having peanuts before the before, under the age of two.
• 28:22
  Dr. Joseph: And in other countries where they have peanuts, they do not have peanut allergies.
• 28:26
  Dr. Joseph: And we have a absolute epidemic of peanut allergies where kids die of this because they weren't exposed and there's no, and they don't get any tolerance to it.
• 28:34
  Dr. Joseph: And this was based on zero research.
• 28:37
  Dr. Joseph: It's based on expert opinion.
• 28:39
  Dr. Joseph: It is.
• 28:40
  Dr. Joseph: Criminal, and then they have the arrogance to not accept the fact that it was a bad idea.
• 28:45
  Dr. Joseph: Just it's not, you know, the, the, the house of medicine does some things that were based on zero evidence at all.
• 28:51
  Dr. Joseph: And God forbid, you should be, be, be iconoclastic and say, where's your evidence?
• 28:56
  Dr. Joseph: Your, your, uh, your, uh, your a troublemaker.
• 28:59
  Dr. Joseph: It's unbelievable this book.
• 29:03
  David: Well, we actually, uh, hosted Dr. Ari on, uh, this podcast, talking about that book, uh, last year before became, uh, FDA Commissioner.
• 29:09
  David: So, uh, you'll be able to, uh, take your, your request directly to him and see how they get, uh, implemented.
• 29:15
  David: But that's, uh, good.
• 29:16
  David: Good.
• 29:16
  David: That's right.
• 29:17
  Dr. Joseph: I'm pleased to then I'm in, then I'm in, I'm in, in illuminated circles.
• 29:22
  Dr. Joseph: 'cause he, I was very impressed with what he said, but it would it make, it makes you angry as a physician.
• 29:27
  Dr. Joseph: It makes you angry to see.
• 29:29
  Dr. Joseph: We are not supposed to be arrogant.
• 29:31
  Dr. Joseph: That's not what we are.
• 29:33
  Dr. Joseph: We are there to serve your patient.
• 29:36
  Dr. Joseph: If you're religious, it's to serve because that's what God wanted you to do or whatever you wanna want, do the reason you wanna do it.
• 29:42
  Dr. Joseph: But it has nothing to do with arrogance.
• 29:46
  David: Well, that's it for another episode of the Health Biz Podcast.
• 29:48
  David: My guest today has been Dr. Joseph Feuerstein, integrative Medicine physician and advisor to Caravan Wellness.
• 29:55
  David: I'm David Williams, president of Health Business Group.
• 29:57
  David: If you like what you heard, please subscribe on your favorite service.
• 30:01
  David: Thank you so much.