#2079 - Brigham Buhler

Hello. What's up, man?

And so to diagnose what the real issue is, we've got to dig a little deeper into the history and what's going on there. And it's a pretty insidious disease. And it's spread throughout all of the government. And that disease is private industry and its influence on the federal government and the decisions they make. And we're going to talk a little bit about large language models later in the future of what I think healthcare is.

But one of the critiques of large language models is it's only as good as the data you put in. And I would argue that humanity is no different. It is only as good as the data that you put in. And so if the federal government and the FDA is going to allow an open door policy with Big Pharma, they're going to come to conclusions and decisions and policies that benefit Big Pharma. And so if we take a little walk through history, you'll see time and time again how this has happened.

So I'm going to jump way back first, if you're good with this. So you go way back.

There was a small little company that reached out to the Third Reich and said, hey, we need 150 participants for our clinical trial. The Nazi regime shipped 150 healthy Jewish women to this pharmaceutical company to test its products. Literally within six months, there's letters back to the Third Reich from this pharmaceutical company saying, thank you so much for your cooperation. The women arrived in great health and working order. Unfortunately, none of them made it through the initial phases of our trial.

They killed 150 women. We kindly request that you send us another 150 women. That little company became Bayer, which is now a mega pharmaceutical company. And I say that because, right, that was the 50s. It would have changed by now.

That was forever ago, right? The world's a different place. We would never allow that today. Jump forward. post-World War II.

I talked about this on RFK's podcast. Eisenhower had that.

And it's continuing. And the reason I want to walk the public through this is because to understand what's going on, you've got to see the history of how it's happened. So now you jump forward to the 80s. Time and time again, when big pharma has had an opportunity to choose left or right. over and over again, they have chose profits over patient outcomes.

So 1980s, Bayer launches a hemophilia drug. They inadvertently contaminate thousands of specimens with HIV. They know that they've contaminated specimens with HIV, this drug with HIV virus. What do they do? They have a decision.

Destroy all of it or ship it to the public. anyway. They shipped it into third world countries, Africa and Asian markets, and infected 20,000 people with the HIV virus.

They infect all these people with HIV. OK. In the 80s, compounding pharmacies and specialty pharmacies and generic manufacturers attempted to create HIV treatment options that were affordable for third world countries, because at the time it was like fourteen thousand dollars a month for an HIV treatment to keep you alive. Nobody could afford that in those countries. So what happens?

This big pharma in a market they can't sell in a market they can't touch. in a market where they inadvertently infected, or I would say almost knowingly infected 20000 people with HIV. They then lobby with the US government, file and sue the shit out of all of these companies that were attempting to make cost effective generics. It caught it up in litigation for three years before finally they bent to the will of the American people and the feedback of the public. There was outrage over this.

And finally, after three years of litigation, big pharma said, basically, screw it. Go ahead and give them the HIV. Let them make these HIV meds in these countries that aren't buying our product anyway. And so I just say all this so you know the people we're dealing with. Right.

And then you jump forward to the opioid crisis, which was predicated by the volume crisis of the I think that was the 40s or 50s. And so time and time again. And so how does the FDA come to these conclusions? It's because a majority of their funding comes from private industry and a majority of their discussion, their talk track, their influence, their belief systems and their thought processes are being influenced by these companies. So when we talk about peptides today in specific, there's over 7000 peptides on the market.

OK, what peptides didn't get banned? That answers the question in itself. The GLP, one agonist insulin. Those aren't banned. Those are all patented peptides.

These are peptides. These are short chain amino acids found naturally in nature. They were patented for the dosage and delivery mechanism, because you cannot patent a molecule. You can only patent the delivery mechanism and the dosage. And so the FDA allows all those peptides.

But it's because big pharma is monetizing them, and big pharma has their ear. And so we talked a little bit about this on the last podcast. I didn't dig as deep because we didn't have as much time. We just burned so much time covering all of this crap. But one of the things I saw is it goes beyond the FDA.

This insidious virus that this disease state that we're seeing the symptoms of carries all the way into the DEA, the DOJ. When I owned my own pharmacies and labs that build insurance, that was one of the things I was talking about. I hired a former Department of Justice prosecutor to come in and help me build out my compliance program. And he told me, Brigham, when I was at the DOJ, we had an open meeting every month with the heads of the pharmacy benefit managers, where they would come with stacks of papers, books of papers of people that they wanted us to federally indict. And so, as I begin to layer this, you'll understand where this is going.

So if they can't indict someone, if they did, it's nothing wrong, right? That would be the lens that the average American has. So let me explain. You have a, let's say I build a blood lab, which I did. And I go out and I educate clinicians on the importance of running comprehensive blood work.

I go to the insurance companies and I say, I would like to be in network with you, United, Cigna, Aetna. Their response is go pound sand. We're not taking any more in network contracts. So my options at that point are to lay everyone off, shut down and go home, or bill them out of network. The issue with billing them out of network.

And so so the patients understand, or the listeners, you're paying for out of network benefits and you're paying these big companies, these big insurance companies, for the right to be able to choose where you get your blood work done, your blood work analysis, all of these things. What ends up happening is if you're out of network as a lab, as any of these, whether it's a blood lab, a genetic screening lab, like Gary talked about, the MTFHR test, the motherfucker test. We were doing that eight, nine years ago. That was one of the tests we offered. was this gene carrier test to identify the root cause of why people are having these issues.

Any of it? insurance said, no, we're not. We're not going to let you in network. So you're forced to bill out of network. What does that mean?

They pay me 30 percent of bill charges. So if it costs me three hundred dollars and I need to make three hundred fifty dollars, I now have to basically bill the insurance one thousand dollars to get paid my three hundred and fifty dollars. Are you following me? OK, now, what the insurance companies do is they wait till I've billed them millions and millions of dollars. Then they go sit down at a desk with the Department of Justice and they say, look at this.

This motherfucker billed us a thousand dollars a test on a test. that should have been three hundred and fifty dollars. Right. And I'm not blaming the Department of Justice. They are acting upon the information that they are given.

Right. They are being fed bad information by bad players. And that leads to bad decisions. And and at that point, if they bring forth a case on somebody, you're done. And so it's.

it's a terrifying space. And it's it's in every branch of the government. There's such a long reach of the ability to impress upon people how. So they're almost influencing decision making through enforcement rather than through legislation. Right.

So the checks and balances are being cut out from under the American people because there is no checks or balance. Does that make sense at all? And so this is what I explained again on RFK was. But if you're, if you didn't do anything wrong, you have nothing to worry about. When I started this, the head of the DOJ who I hired to help me with compliance, he told me there's two things that will get you in trouble with the Department of Justice.

A lot of money and bad facts. So if you're a successful entrepreneur, you're going to generate a lot of money. And if you get on the wrong side of a pharmacy, I mean, of not a pharmacy benefit of an insurance company, they're going to generate the bad facts. And now you're a target and now you're on the Department of Justice target list. So, doctors, it's beyond them being scared of getting kicked off contract to run these tests.

It's beyond them being scared of the insurance companies cutting their reimbursements or not allowing them to participate in their plans. They're scared for their liberties and their freedoms. If they get on the wrong side of an insurance carrier, they're going to use the justice system as an attack dog to take you out. And this is the honest, to God, truth. I saw people who were innocent, who did nothing wrong, get federally indicted.

And if you understand anything about that process, the more you know, the more fucking terrifying it is. It's terrifying, Joe, because as soon as they indict you, you're done in the court of public opinion. Right. They release something in a way that makes it look like you're this terrible human. They skew the facts through the lens of the of the insurance companies.

And so the insurance companies are essentially saying, hey, Department of Justice, we built the case for you. Here it is. Look, these guys build us three million dollars. They fraudulently build us and ran up the cost of health care. And that's the path they take.

And then, once you're on their radar, you don't get to present your half of the case. So to get an indictment, all it takes is a prosecutor presenting to a jury of your peers, which, in the state of Texas, has an eighth grade literacy level. And they say, hey, these guys build, you know, United, five million dollars last year on lab tests that United, say, should have been, you know, eight hundred thousand dollars. Do you think there's enough info to dig deeper? That's all.

an indictment is. Yeah, there's enough info to dig deeper. That sounds like bad facts and a lot of money. Right. But now it goes beyond that.

Ninety, 90 plus percent of the time, once they've indicted you, they file for an asset seizure. And so if you're an orthopedic surgeon and you were invested in one of these models with labs, all of a sudden you get indicted. They seize your ability to defend yourself. All your bank accounts are cleared. They, they can seize your cars.

They can take your assets. And it's. it's terrifying. And I'm not saying this to say the DOJ is bad. I'm not.

I don't think they're bad at all. I think they're given bad information and heretofore they act in accordance with the information they're given. And it's the same thing with the FDA. The FDA is acting in accordance with the Merck, is looking at over 200 peptides for patent. OK, they're actively investigating over 200..

Ibutamorin, which is on the ban list, just popped up. Phase two FDA trials with another pharmaceutical company. It's on the ban list, but it's in FDA trials now. so they can patent it and monetize it and have a monopoly on it. And what does it do?

Ibutamorin is the one that helps stimulate growth hormone. People use it for weight loss and growth hormone production. It's a precursor. And it's again, it's a safe drug, but it's not even a drug. Again, it's a peptide.

And so peptides are short chain amino acids. And the only reason I go down the path of the DOJ stuff is to just give the public the awareness of it's beyond the FDA. It's in all branches of the government and bad info in equals bad decisions out. And so I think that this is, you know, if you look at it from a different lens, I go, OK. When I try to sit in the seat of an FDA decision maker, I look at it and say to play devil's advocate.

You know, it's one of two things. Do you think the peptides dangerous? Do you think these short chain amino acids are dangerous? Because, if so, you're allowing big pharma to use them.

And there's no data that shows that any of these peptides that are on the ban list are dangerous. Like BPC 157.. And when I say ban list, let me step back on that. They didn't ban the peptides. They reclassified the peptides under a category of dangerous.

And through that, they indirectly have killed the market on those peptides, because most doctors in America are not going to write a drug that's on an FDA dangerous list because it opens them up to litigation and risk.

So then you go and say, OK, do you not think that FDA regulated compounding pharmacies are capable of compounding these peptides? The highest paid person in my building is my quality and compliance guy.

He literally worked for Abbott Laboratories for 15 years, working hand in hand with the FDA to make sure they follow all of their protocols and procedures. So just so the public knows, any product that comes into our pharmacy at Revive, our compounding pharmacy, we make sure it's an FDA approved ingredient with an independent third party verification of the ingredient itself. Right. Showing that it is 100 percent the ingredients they tell us it is. Then we compound it in an ISO 5 environment.

The law says we need to do ISO 7.. We go above and beyond and use an ISO 5 sterile facility. We have the two highest paid employees in our building, our regulatory compliance guys, that are over quality controls. OK, so then, from there, whenever we compound a product, we send every single batch off to be independently third party, verified by a independent lab, unaffiliated with us. And we file those records away.

Everything is documented. Every aspect, from the chain of custody of the ingredient to the chain of custody of the drug to the delivery to the patient. All of that is documented. So it's either one, you're saying the peptides dangerous, or two, you're saying compounding pharmacies are incapable of compounding drugs that aren't dangerous. And if that's the case, then why are you asking us to compound hundreds of drugs that are on FDA backorder lists?

Because your buddies at Big Pharma aren't going to compound them, because they don't make enough money. They don't generate enough revenue. So half the stuff that's on a crash cart used in the hospital system is made by mom and pop compounding pharmacies. It's like so. the safety is there.

The efficacy is there. The sterility is there. And the peptide itself is safe. So I just go back to. I have to believe that you're acting upon bad information and I want to give them the benefit of the doubt.

And, you know, my message is we've got to go meet with the FDA and we've got to start having conversations, and we've got to represent small compounding pharmacies and the average American. because right now they're only hearing half the story. and that half of the story is Big Pharma banging on the desk and saying, hey, we want to patent these peptides. We're going to go through clinical trials. We're going to do it the right way, you know, and we're going to do all these checks and balances.

But it's like we don't need you involved in supplements. Like, if you really look at it, it's, it's essential. I mean, again, I've said it. It's a short chain amino acid. It's not a drug.

The generic names are triseptide, triseptide and semaglutide, weight loss drugs, GLP, one agonist. Those are not on the ban list because FDA has our big pharma has patents on those, but they can't patent the molecule. Right. They can only patent the dosage in the brand name. So compounding pharmacies throughout the country are compounding those products for pennies on the dollar at a different dosage.

And then what happens is and that's because these products are on an FDA backorder list. OK, this is the whole cycle of the ludicrousness of this situation. there. The FDA is saying, hey, there's not enough of this product to meet the demand of the of the American people. And if we really look at what those drugs are, they're not a weight loss drug.

They're a diabetes medication. And we know that diabetes indirectly impact or directly impacts poverty stricken and minority communities disproportionately. And so. When we compound these medications to meet the needs of the people who can't get those medications or maybe can't afford those medications because they're on an FDA backorder list and they're asking us to compound them, big pharma then turns around and sues compounding pharmacies throughout the country, then uses their long reach of PR firms to put it in the news. Make it sound like you don't know what you're doing, like these compounding pharmacies are dangerous.

They're not regulated. It's the Wild West out there and compounding pharmacies. There's no oversight. These aren't FDA approved products. Bullshit.

Absolute bullshit. Do you know how many times the FDA has been in my pharmacy in 18 months? Twice. We've interacted with them four times in 18 months. Do you know that there are twenty five hundred manufacturing facilities owned by big pharma that have not been inspected in five or more years?

Five or more years. Furthermore, they've outsourced their manufacturing to third world countries in rural areas. And those products, when they come into the United States, do not go under FDA inspection. There is no validity testing like we do. There's no sterility testing.

There's none of that. And so why are GLP ones on backorder? You want to know why? Sure. Because the Eli Lilly, specifically with its product, got one of their facilities shut down because they failed FDA inspection with egregious actions.

We saw just a few weeks ago eyedrops that are from FDA approved sources got recalled. And when a whistleblower blew the whistle, they go in and there's people in their iso sterile rooms barefoot. Like. the level of egregiousness and manipulation is insane. But when you control the media and you have the ear of the government and you can move chess pieces, it makes it hard to be able to navigate that, compete with that and educate people.

And so if you didn't give me a platform, nobody would know this stuff. If it wasn't for people like you and Robert Kennedy and people who question things and challenge the system. I can't SEO optimize. I can't Google search engine optimize. I can't get these messages out.

I called a PR firm to say, hey, how do we combat this? and what can we do? And they were like, the best bet you have is long form media like podcasts. That's really the only way you're going to get it out there. It's not going to be something picked up by the media outlets.

It's lowest rating since 1991..

The last 40 years of the FDA, two heads of the FDA have not gone to work for industry.

I'm done. I'm not doing that test. I'm not doing a genetic test. Like, no way. And, and now insurance doesn't even cover any of those tests.

And so they're going to force anything out of the marketplace with time, but in the short term, they're going to run their offense. And that same level of spit that's being swapped at the FDA is being swapped at the DOJ. So the big insurance companies attempt to recruit away DOJ prosecutors. And once they've built their reputation in working as a steward for the people at the Department of Justice, and they put some big hides on the wall and build a name for themselves, they'll get recruited to private industry. And one of the big options for them is to go work for the insurance companies, including the FBI agents.

So most of the, and I say this because I don't think the average clinician in America even understands. When you have an insurance special investigative unit, show up at your practice, which happens. So if you run a lot of blood tests, or you do a lot of genetic tests, or you do anything that the insurance company thinks, man, this guy's doing these tests. I don't want him doing these tests anymore. There's a chance that they send an auditor and that auditor is a special investigative unit.

And that guy is typically a former FBI agent that worked for the federal government, who still has all those connections at the office. And so there's just so much cross-pollination. And again, it's not me saying the DOJ is bad or the FDA is bad. I'm saying when they're given bad information, just like AI, information in, information out.

When you go to a surgery center, there's a good chance that that surgeon owns into that surgery center. If you have a clinician, like somebody from the mothership, they could not get their GLP-1 semaglutide. So they reached out to me and said, hey, can you get my dad semaglutide? And I'm like, yeah, we make it at the pharmacy. The doctor wouldn't send to our pharmacy.

And it's most likely because he had a relationship with another pharmacy. And so that physician may have been invested in that pharmacy. And as crazy as that sounds, the law says they can. As long as you don't pay them on the value or volume of their referral, they're allowed to have a passive interest. So think of it as you're investing in a stock.

If I'm a doctor and I prescribe a drug from Pfizer, I'm still allowed to invest in Pfizer stock. What I'm not allowed to do is receive direct remuneration in accordance with the value or volume of my referral. It cannot be an arrangement where you say, I'm going to give you $100 per patient. That's a kickback. That's illegal.

That's a violation of federal and state law. However, if there is an investment, of a bona fide investment opportunity and a hundred clinicians buy into a hospital and then they operate at that hospital, the law says they're allowed to own into that hospital and own up to 40 percent of that hospital. And so, again, and two, I always like to give both sides of the story. And I said this on the last podcast. There are bad people doing bad things throughout every aspect of this.

It's not. insurance companies are all bad and clinicians are all good and lab owners are all good. There is egregious stuff happening at all levels. And there are indictments that the Department of Justice bring forth that are 100 percent justified. No arguments there.

But oftentimes the baby gets thrown out with the bathwater and oftentimes the insurance companies are able to skew facts in a way that put innocent people in bad positions. And that's all I'm trying to say. And so it's so deep and runs so deep. It'd take us seven podcasts to cover all this stuff. But, I mean, it's real.

It's not foo-foo stuff. It's real. It's happening every day.

But the side effect profiles safe on the peptides, like. there's the efficacy. like time and time again. I cannot tell you how many people, how many patients and clinicians who buy BPC for their patients throughout the United States have had phenomenal results with the healing factors. And I attached some links on the Waste to Well website about BPC and studies done with healing spine injuries, with healing joint injuries.

And there's even a study on safety. And it wasn't in humans, but the safety study was in mammals, dogs and mice. And yeah, there's. it literally talks about how there was zero side effects seen, regardless of dosage.

The full name. How do you say it? Penta Deca. Penta Deca peptide. Penta Deca peptide body protection compound, BPC, one by seven.

It's role in accelerating musculoskeletal soft tissue healing. Yeah, it works, man. It really does.

But as we look at it, go wild. As we look at it and we say, OK, what's going to happen? So one of two things, either. The FDA will hopefully meet with compounding pharmacies and have the discussion, and we can dive a little deeper and hopefully bring them to the light and bring awareness to this, or they ban these things. And what's going to happen is exactly what happened with the opioid pandemic epidemic.

People are going to turn to black market. Right. We had more opioid related deaths last year than ever in the history of the United States. More people have now died of opioids than the Vietnam War. It is killing young Americans, left and right.

It's because you allowed Purdue Pharma to push a product into the market that never had safety trials. Right. As far as addiction goes, they piggybacked onto a previous indication of their cotton system, get it into the marketplace. All these people get addicted. Boom.

Let's overregulate. Let's make it really hard to get opioids. Now everyone turns to black market. And that's exactly what's going to happen with peptides. People are already buying it off the Internet.

They're buying it from China. They're buying it from black market sources. They're buying it from non-human use sources. And that means that there is no oversight. They do not go through all the protocols and procedures that we go through at our pharmacy.

Like all of the safety nets, all of the checks and balances, all the things that I just went through about how we do it are gone. And so now, yeah, you do risk adverse events. You do risk issues, because who knows what contaminants in that. Right. Especially if you're getting it from some country and they're cutting corners and they're just selling you whatever they can.

And so the fallacy, though, the biggest fallacy, is that if it comes from a big pharmaceutical company and it's in the American market, that it's safe. Because time and time again, they've misrepresented the safety. They've misrepresented the efficacy. Right. And then you go beyond that.

They've also misrepresented their compliance and regulatory and their quality controls. Right. Where I was going earlier is they've outsourced 30 percent of their manufacturing to outside of the United States, to third world countries where it's cheaper to manufacture. In fact, a lot of them are manufacturing in rural areas of India where sometimes there's no running water at the hotels. So if I'm an FDA inspector and I can choose to go down the street and inspect a compounding pharmacy in Austin, Texas, or I've got to get on a plane and fly to a rural part of India, and now I have to give you three months heads up before I come.

Right. When the FDA shows up at my building, they show up and they say, we're coming in and you're going to let us look at everything you're doing and we're going to follow your employees around for the next three weeks and we're going to see if anything they've done is incorrect. That's the level of scrutiny we face. The level of scrutiny Big Pharma faces is we moved our facilities overseas. You got to give us a three month's notice to go into those facilities.

And then, when you get into those facilities, yeah, there's a book called Bottle of Lies. It's an investigative journalist. I mean, and it's it'll blow your mind. Like when the FDA showed up, they were burning records. That's with three months notice.

They were burning records. They made up their efficacy data. The data was all falsified. over and over and over again. These things have happened.

And I don't remember the author's name, but the book is called Bottle of Lies. And she dives deep into that. She was an investigative journalist.

My pharmacy, the last I saw was over 500,000 people have filled prescriptions. We're nationwide. We're working with some of the biggest telemedicine companies in the country, clinicians throughout the country. We're one of the bigger pharmacies providing these solutions for these practices, and the only adverse events we've seen is like an injection site inflammation response, an inflammatory response at the injection site. Sometimes it'll itch.

The worst is somebody's gotten cold sweats for a few minutes, and that's rare. Those are rare, rare reportings. Again, because you look at it, it occurs naturally in nature. It's a peptide. It's an amino acid.

It is a building block of life that your body becomes deficient in. as you age. Our body becomes less and less efficient, and so these peptides are a way to supplement. My buddy Ryan Humiston did a video on it. He's like a big YouTuber, and he called it Flintstone vitamins for grownups, and it's like it is.

The reason that supplements aren't regulated by the FDA is because Ronald Reagan said, I don't want the FDA telling me what vitamins I can and can't take, right? But because this is an injectable, and it's sterile for the most part, and there are pill forms too, but the FDA says, well, if it's an injectable, it's sterile, and it's made at a compounding pharmacy, then we have oversight. But I want to be clear. They didn't ban it. They just put it on a dangerous list, and this is one of the things that makes it difficult to navigate as an entrepreneur.

is you go, well, what are we supposed to do with that? Does that mean we're not allowed to make it? Does that mean we are allowed to make it? You're saying it's dangerous, but we're not having side effects, and we're having great efficacious results. It just makes it tough.

I stood in surgeries from dusk till dawn watching products that have never had human safety trials go into the body. time and time again. When people think that going into an orthopedic surgery or going into a general surgery or going into an OBGYN surgery, you make the assumption that all these products have been through human safety studies and all this stuff. And I talked about this on our last podcast too, but over 90% of the products that are in the operating room never went through human safety studies. The FDA created what's called the 510K approval process in the 70s.

They said, it's growing too fast. We're bogged down. We can't get to all this shit. Now you're bolting on all these extra products in addition to drugs. And now we're talking biologics.

and let's not even get into AI and large language models. You know, to their credit, they're doing their best to navigate a really tough space, with a lot of different stuff coming at them. And so they created a loophole and the premise was less than 10% of the products would come through this channel to get into the operating room. Jump forward to today, and 92% of the products in the operating room came in through the 510K approval process. And what is that process?

What it says is, if you can show something in like kind is already in the operating room, then you can do what's called a daisy chain. So imagine iPhone 1 versus the new iPhone, right? That's what we're talking about here. Imagine Henry Ford's car versus Elon Musk's Cybertruck. That's the difference, and it's moving at a breakneck speed.

And it's shocking that there's not more adverse events, but we also know that less than 2% of adverse events get reported. And so I can give you a real world example on that, too. When I was a rep, there were shavers that kept continually changing. Right. And it's a.

it's a blade that goes in the shoulder and they clean up your shoulder and cut out tissue. That tissue has to get sucked through a cannulated component of the shaver handpiece and pumped into a vacuum and disposed of and discarded of the bad tissue that, the tissue that you wanted to extrapolate.

As the technology changed and the shaver handpieces got smaller and smaller, a lot of these companies didn't update their packaging inserts, and so they didn't update their sterile processing procedures. And so what happened is tissue began to gunk up in handpieces. And this was not unique to one company. I'm not going to say the company's names and I'm not going to name the hospitals, but there's there's a company that took the fall for it. But in reality, I was the rep and I went in and helped that hospital figure out what was going on.

And I took a camera and I scoped every cannulated piece of equipment that I could find. All of it had tissue in it, gunked up tissue from previous surgeries in that. And so when you take this product from one surgery to the next surgery to the next surgery, we know that certain bacterias are extremophiles. They can handle, so they autoquave it and all that is, is it to purify it? It's called clean dirt, right?

The debate at the time was, is there such thing as clean dirt? If we run it through a sterile processing machine and we cook it at thousands and thousands of degrees, nothing can survive. that, right? No, bacteria is an extremophile. It can fucking make it from outer space on a meteorite and crash onto Earth.

You know, like these are some of the most resilient life forms in the history of existence.

And in the big medical, none of it. I was a device rep with shavers, pumps, equipment, implants in my trunk of my car in 110 degree weather. It wasn't just me. Every rep carries product called trunk stock. Drug reps carry product called trunk stock.

They put drugs in the trunk of their car and drive around and give them to clinicians to use for samples. But those products aren't being climate controlled in the way they're supposed to be. There's no chain of command. There's no chain of custody. They're not following any of those protocols.

And even the storage facilities that almost all of these implant companies are using and device companies, they're not paying for climate controlled storage. Typically, they're sticking them in a storage shed. And then, a month later, that product's going into surgery. And so I'll give you another craze. And I'm saying all this not to bash one company or bash anybody in particular.

It's just the truth, Joe. It's the fucking truth. And when the FDA says we're worried about safety on a peptide, that's a naturally occurring amino acid, I call bullshit. Because I go, then, where were you when all this other stuff was happening? I was in a surgery at the Houston Zoo, where I watched a shaver handpiece being used on a tiger.

And it had green tape wrapped around it. Okay? And I thought, oh, that's interesting. It had green tape. Jump forward, two months later.

I'm in a human surgery. And I see a shaver handpiece with green tape. And I thought, man, that's wild. It can't be. So I checked the serial number.

Same damn serial number that was in that tiger surgery.

Right? And so they ship out a loaner. And they would use that. And then they'd ship it back. But, okay, but they're going to process it, clean it, sterilize it.

You never should be doing that in the first place. But I've already told you now how the packaging inserts don't explain properly how to clean out these instruments. And it's not one company. It's not one product. It's thousands of products.

Like, let's go to the cellular options. Whether we get a biologic, whether cellular or acellular. Okay? When it ships out, they say what time it shipped. It ships on dry ice, stored at frigid temperatures.

When it arrives, we have to sign for it. And then we immediately unbox it and load it into a cryo-freezer and document each lot number, what time we put it in the freezer. And within 30 days, if we don't use that product, we discard it. Even though there's nothing that says it's not viable or it's not going to be as good. That's the protocol, because we're going to go above and beyond and follow the most rigid safety protocols.

And that does not happen in traditional medicine. The average American is assuming that if they go into surgery, that's safe. But these stem cells, man, ooh, who knows about that? That could be dangerous. And the truth is everything's risk reward.

It's all risk reward.

Jesus Christ.

Problem. There's an opioid epidemic. It killed my brother. Solution. Non-addictive, non-abusive treatment modalities to heal and help with pain.

So I start a pharmacy. Insurance says, no, we're not going to cover it. Right. We'll just put them on an opioid. Okay.

Problem. Now I have to figure out how to make these products cost effective enough to be able to sell them to the average American. The average Joe, you know, not the affluent. It's everybody needs to be able to afford these treatments. So I built a 503A serial pharmacy and we began to make products that were in the gaps.

Anything I saw that insurance didn't cover, wouldn't cover, was egregiously price gouging. patients on is what we would make at our compounding pharmacy. And so then we start Ways to Well.

Testosterone therapy. A lot of times when people say, hey, you know, if it worked, everyone would use it in traditional medicine. No. It took 75 years of dogma and confusion for testosterone to pull itself out of the doldrums of the dungeons, to be utilized daily as a go-to resource for aging men. And the only reason testosterone made it out was because one guy had the balls to test it.

No pun intended, but it was Dr. Morgan Tyler, a urologist, famous urologist, said this was prior to Viagra. He said, I've got to do something for these guys who have erectile dysfunction. I don't have an option. And he began using testosterone.

And then his colleague said, well, hold on a second. That's going to cause prostate cancer. And then he began to analyze his patient population and see that it wasn't increasing prostate cancer in his patient population. So then he went back and did a retrospective study all the way back to the 1930s, where we found out that the original study that created that dogma, that maintained its status for over 75 fucking years, was total bullshit. It was a patient population of three.

Two guys dropped out of the study. One guy had levels that went up and down on his prostate levels. And it was. it was all debunked. And now it's proven time and time again, if testosterone was increasing prostate cancer, we would have seen a huge spike in prostate cancer.

What we're seeing is about 14 percent of men develop prostate cancer. And so as we walk through...

Correct. And so the thought was, if we increase certain levels, that we would increase the risk of prostate cancer. And so the challenge becomes, if you really go back and you look at the study, the guy who stayed in the study was chemically castrated. He had a testosterone level of 50 nanograms per deciliter, which is considered chemically castrated. So nonexistent.

What Morgan Tyler discovered was, when we take you from 50, chemically castrated, to low, 250, we increase your risk of prostate cancer. Because your prostate cancer risk at zero, testosterone is basically zero. Right? But once we push past 250, the low number, we now reduce your risk of prostate cancer. In fact, we insulate you from various forms of cancer beyond prostate cancer.

So there's a therapeutic benefit if we get you into optimal ranges. And it's called the saturation model. So think of it like this. You can only water a plant. so much.

Right? Once that plant has water, it's not going to absorb any more water. The prostate can. only, the testosterone can only bind to a certain amount of receptors. Once those receptors are binded, then there's no continual upside risk.

And then you get to get the benefits of testosterone that begin to reduce those risks of cancer. But today, in primary care, you will still have doctors who quote a study that's been debunked 100 times. And there's this dogma that exists over and over again in healthcare, where it's like. the data's there, the research is there, the info's there. But the system itself isn't allowing for it.

And so when we look at that, I talked about this on the last. When we talk about insurance companies and pharmacy benefit managers, every drug on the market that is covered by insurance is controlled by a pharmacy benefit manager. And those pharmacy benefit managers prioritize drugs and their classifications not based off efficacy, based off profits. Right? And so they are monetizing those drugs through rebates with the big insurance companies.

So insulin's a prime example. The current Senate House Committee did a study on insulin where they found the price of insulin was $284 a vial. Do you know how much made it back to the pharmaceutical company that was making that insulin? Less than $40.. Where the hell did all that extra money go?

It went to the pharmacy benefit managers and the insurance companies through rebates.

And so this is the whole other area of healthcare that people aren't understanding. And I tried to explain it on the last podcast. I know we dove deep into it. But it is a crucial component for people to get their head around what's happening. So insurance companies, so many people say, well, I have health insurance.

Right? That drug isn't covered by my health insurance, so it must be bullshit. Or that test isn't covered by my health insurance, so it must be bullshit. No. You don't have health insurance.

What you have is managed care plan. They've renamed these plans. It isn't health insurance. It's a managed care plan. And what do I mean by that?

They're managing your medications, your treatment options, and they're monetizing your disease state. They make money on every step of the way. And since the last time we spoke, a new one came out, Ohio, the state of Ohio. They realized that over 200 pharmacies had gone out of business. The pharmacies were saying we're getting paid less and less.

But yet the government was paying more and more. Why? How? Where was that money coming from? Where was it going?

They used, I think, I can't remember, 30-something auditors at the state level. And what they found was $240 million in pharmacy benefit manager fraud.

$240 million in money that they extrapolated from the American people, from the people of the state of Ohio. Because taxpayer dollars are who's paying for this stuff. And these pharmacy benefit managers are making their money on the spread. So there's layer upon layer upon layer of how insurance companies can move dollars to maximize profits.

Optimists are usually successful, and pessimists are usually right. I am very optimistic about the future of medicine. I'm very optimistic through large language models, cash pay model. I didn't want to get into that without first setting the tone for the listeners on how we're here. Why did we go to cash pay?

Why is Ways to Well not in the insurance model? Why is Revive not in the insurance model? Because the insurance model no longer exists. That model is meant to monetize your disease, right? So Gary talked about this.

You come in. Let's say I come in, and I'm going to give you a perfect example. I'm a mom. I'm stressed. I have anxiety.

I'm not sleeping at night. I go to my primary care. That primary care has six minutes with me. It's not their fault. They're doing their best to navigate a shit system.

They write me an Ambien and an antidepressant or an anti-anxiety, and they push me out the door. And that's their go-to treatment, because that's the tool in their tool belt. The difference is if somebody were to come in the door of Ways to Well or any of these cash pay clinics, I don't even want to make it about Ways to Well. There are hundreds of phenomenal clinics across the country. Peter Atiyah is a prime example.

He's going to take the time to ask the question, to do the deep dive, to peel back the layers to the onion. Rather than treating the symptom, you're going to uncover the root cause. And so what did you do to assess that individual, right? If it was us, we would do a comprehensive blood panel. We would identify, is there a hormonal imbalance or any sort of imbalance in their biomarkers?

Not going to happen in the insurance model? because of what I was telling you. The doctors are scared. They're scared of getting kicked off the insurance. They're scared of ending up on a DOJ desk because the data's being skewed, the info's being skewed, all of it.

It's one half of the narrative. So that's one reason they won't do it. So that's the biomarker test, okay? Let's look at the other thing we would do. We would run an EEG to assess if you have insomnia, anxiety, depression, all of these things.

Another way to dig into the root cause, separate from biomarkers, is an EEG to run a brainwave test that tells us, is your brain neurons firing at the posterior of your brain to the prefrontal cortex of your brain? And if you're losing data from the posterior to the prefrontal cortex, what you find is people with depression, with anxiety, with all these things, they're losing 40% to 50% of that neuropathic firing from the rear of their brain to the front of their brain. And this is a simple $200 test, okay? Then you go to what Gary brought up. You can do a methylfolate detoxification test, MTFHR, the motherfucker test is what they call it.

And it's a gene carrier test. 40% of people in America suffer from that gene, right? There's four other genes that are part of that test that we do. Any one of those genes can change the way your body processes and detoxifies. They're never going to do that.

That isn't covered by insurance. You could do a pharmacogenetic test to see if that individual is even capable of metabolizing the treatment that you're writing them. Do they have a cytochrome P450 variant? Will this even work? How are they processing their food?

We can do a gut biome test. We can identify, do you have a food allergy? Is your gut biome in good working order? Not covered by insurance. Do you get where I'm going?

Yeah. There's seven or eight things we should be doing before we ever write you a fucking drug. For sure. Seven or eight easy things. And you're not talking about a million dollars.

Like, I bet all of those tests combined come out to less than a thousand bucks. And I know that's a lot. But, you know, how much do you spend on your car payment? How much do you spend on your house? You're spending a portion of your life in that.

You're spending 100% of this existence in this flesh vessel. And you only get one of them. What are you going to do with it? Are you going to put your hands, your life, in the hands of these fucking assholes that are here to extrapolate money from you and manage you into chronic disease? And I'm not saying the doctors are.

The doctors are just using the tools that are in their tool belt. They're using the data and the tools that are in their tool belt. And that's all. they know how to do. And they don't have the time.

And they're stressed. And they're overworked. And they're tired. And they're just trying to make it. And they're beat down.

These people are beat down.

Because they're just, again, trying to make it through the day. And so those were pathways to be able to educate a clinician and give them some insight into why they should be doing these tests clinically. But, yeah, even today, like if you talk about cellular therapies, if you talk about peptides, most primary care clinicians in this country have no idea about peptides. Or they'll say it's bullshit. Or they say they don't work.

And they'll say the same thing with cellular therapy. You can't get stem cells in the United States. You can't get that, you know, it's just this dogma that has created a misconception. Infrared, that's another example. You and I were talking about infrared beds and red light therapy.

It is viewed by a lot of the doctors in this healthcare system, and I say healthcare loosely, it's sick care, as pseudoscience, bullshit, chiropractic stuff. But if you look, infrared and these technologies, photo light therapy has been used since 1903, 1905.. The guy won a Nobel Prize. Huberman does a two-hour breakdown on this stuff. Infrared is not bullshit.

There are over 60 studies that show infrared works. There was a study done in Europe that showed infrared improved vision in people over the age of 40. Like using three minutes of infrared three days a week, returned vision and eyesight. There's nothing that has done that. And so infrared has done that.

And has helped people with degenerative eye disease, like as your eyes begin to degenerate. And how does it do it? We even know the science behind it. Like it literally, when you're taking NAD drips and you're doing all this stuff, you're doing it to try and get your cells to produce more ATP. Because as we age, our production of ATP decline.

And ATP is the energy source of a cell. And our eyes have a limited amount of ATP. But they require a massive amount of energy. And so as we age and our ATP declines, our cells are incapable of having the amount of energy required to maintain great eyesight. And so through infrared, through NAD treatments, through NMN, through all of these various modalities that are not being utilized in traditional medicine, you can make a difference.

Right? I've listened to some people in academia that told me they thought NAD was bullshit. And I can tell you, I have a friend who was diagnosed with MS, who's one of my best friends in the world. And he is on a treatment that costs $14,000 a month from the insurance companies and wasn't getting good results. And we started doing weekly NAD and BPC-157..

And he swears. And again, this is anecdotal. I'm not saying that this is going to cure MS. That's not at all. He has gotten better results and has felt better over the last eight months than he ever felt on that $14,000 a month medication.

Wow. So, for them to understand it, we would have—and that's why it's like, so to move, to be able to use these treatment modalities, you almost have to go cash pay. And then what I'm trying to figure out is how do we bring this to the masses? How do we bring longevity-based, predictive, proactive, personalized medicine to the masses? How do we bring this precision approach to everybody?

And that's where I think large language models are going to change the game. They're going to change the world. I sent you Alan the other day. Yeah. The little alien.

But that's—see, that feedback's amazing, because when I talk about personalizing—.

Or the clinician gets an inbox filled with questions. The future of medicine is large. language models will manage all of that. That large—Alan will be able to assess your medical record. He'll be able to read your MRI.

He'll be able to read your DEXA. He'll be able to read your VO2max. He'll be able to assess your all-cause mortality risk. He'll be able to tie into your wearables, tie into your REM sleep, monitor your heart rate variability. That's proactive, predictive medicine.

We're going to know what date you started testosterone, what date you started a peptide, what date we began to see improvement on all of your biomarkers. Or, if we don't see improvement, we're going to know in advance that this isn't a good medicine for you. This isn't a good treatment for you. And so traditional medicine is not going to do these things. It's never going to happen.

But again, this is all hearsay. I don't know. I don't have any line of sight into that. But my buddies in AI have told me that.

You're like, man, that's wild. An example is like with Alan. even when I was pressing him and asking different questions and cutting him off, he hesitated and was like, and held his hand up. And I'm like, that's weird. And the AI guys were saying this is an example of like things, that the large language model is kind of like improvving on its own.

that wouldn't be like a programmed behavior. So, I mean, the future is scary and exciting, right? And I look at that.

But what I see is, like everything, Alan and these AI models are a tool in the tool belt. And any tool can be used for good or for bad. And so my vision for the future of AI and large language models is using that to scale and bring predictive medicine to the masses. When I came on your podcast last time, we had thousands upon thousands of people register. In my model, a clinician spends 45 minutes with you reviewing your lab results, deep diving into every aspect of you at the biological level, deep diving into your gut, biome, whatever test it is we do, we're going to spend the time.

And we want to educate and empower patients and give them sovereignty over their health, because they're used to a system where they go in, they're given a drug and they're pushed out and they leave going, well, I don't know. I don't really understand. why am I taking this? What's wrong with me? Right.

I don't want that for them. I want patients to be educated and informed and make autonomous decisions that they drive. Right. And so the goal is to use large language models to give them a resource. Imagine if I can take the best and brightest minds in medicine and put them in your fucking pocket 24-7..

Imagine if you had Huberman and Atiyah in your pocket and it's 2 a.m. and you got a question about NAD. You just ask, ask Alan. The large language model is going to know all that. And he's going to be able to tie it to your medical records.

And he's going to be able to tie it to the pharmacy and know what date your prescription shipped. And the only reason I'll be able to do that when we go back to data in, data out. Right. And our LLM model, it will be a closed infrastructure. I'm not going to give him access to the AI, access to the Internet.

Right. The plan is we're going to peer review. We're going to look over anything that's loaded into that algorithm. And we're going to allow him to practice in the way that a ways to well clinician would practice and answer questions. He won't be there to provide medical care.

He'll be there to be a medical resource. And everything he does or the AI does will be monitored and approved by clinicians. And but what it does is it allows me to drive down the cost of health care. Right. Because today, how do I scale?

OK. I can tell you how a lot of my competitors scale. They hire a doctor by the hour. They outsource the clinician. And that's their way that they got into 50 states overnight.

So, so many people are like, why aren't you in 50 states? When are you going to be in all the states? I don't think that's health care. I think you're going back to sick care. I don't want an OBGYN who was pulling babies on a Tuesday, doing a testosterone call on a Thursday, with a disease state and a skill set and a knowledge base that she or he doesn't have the knowledge to do.

You know what I'm. you understand? I'm not saying that they're not a valid clinician at what they do. But, you know, it's it's like asking a jujitsu guy to teach you Muay Thai. I don't, I would rather put my faith in large language models that know jujitsu, that know Muay Thai, that know MMA, that know boxing, that know all of the history of those things in those modalities, that know every single product that we offer at Ways to Well, that immediately can recall your previous conversation, what happened, these large language models.

So in the demos, he'll literally chart everything that we discuss and put it in writing and load it into an EMR. You got to understand, like when we, when my clinicians, do a 45 minute call, they've got to spend 15 minutes reviewing everything, refreshing their memory, trying to go back over everything you talked about. What were your issues? Now they do the call for 45.. Now they've got to annotate all that on the back end.

AI and large language models will do that in real time, instantaneously. I can only see six patients per day, per clinician in my model, because I'm trying to provide them with great care. I'm trying to bring the Peter Atiyah, the, the, the high level care approach, but make it affordable for the average person. And so it's been this dance of like, how do we do that? And large language models and AI fix all these problems.

And we are on the cusp. It is right there. It is so close. I wanted to show it today, but we're not there yet. And I need to get kinks worked out, but I'm excited for what we're going to be able to do in the future.

I think there's going to be hundreds, if not thousands, of avatars in the marketplace within 12 months.

Elon has one. And it's a race. And there's a healthcare one. I can't remember the healthcare one that has access to all these medical records and data. The newest chat GPT outperformed clinicians at reading MRIs.

Like those kind of things. Where you're getting political or ideological influence. How do you keep that from happening?

And if everyone puts the same restrictions and requirements on these large language models, how will it differentiate? Where I'm going with this is ours would be a closed infrastructure. It wouldn't reach out to the internet to get an answer. Any data that we put into our large language model will be approved and peer reviewed by our team of clinicians. So today I have brilliant people on my team.

I have Dr. Grant, a board certified urologist. I have Dustin Loveland, an orthopedic surgeon, trained under Jimmy Andrews, one of the godfathers of orthopedic surgery. I have Ian White, a PhD from the Ansari Stem Cell Institute, 22 years at the bench. Right?

And I'm reaching out to thought leaders in their field and in academia throughout the country. And saying, hey, do you want to help me do something cool? Do you want to come change the game? We're here. Let's do it.

Let's get proactive and predictive, and let's help people drive their health journey. Let's give them this resource. And so this tool wouldn't be to talk about politics or to crack jokes with your friend. Our tool would be used to assess large amounts of data, which is what this thing is phenomenal at. It's going to, like I said before, tie into your electronic medical records, review your last consult, be able to read your blood report, because it's all analytics driven.

Everything is algorithm driven. And so almost all the reports and all of the decision trees that primary care clinicians and even a ways to well clinician makes are essentially algorithms. And the more data we can give the large language model, the better decisions it can make. And so I'm envisioning there's a day where large language models potentially, you know. Take over a lot of the heavy lifting that primary cares and internal medicine doctors do today.

And that's partially why I got out of the insurance model. I literally I described it this way. Joe is one of the worst years of my life, man. I lost my brother. I build this company.

I had 156 employees. We were days away from selling this thing, the previous company for over 30 million dollars. And I was the sole owner. And literally days before, insurance cut all of it out from under us. Quit reimbursing everything.

Got rid of all the genetics testing. All of the, any compounded medication, any of it. Gone. Overnight. I had to look 150 fucking people in the eye and say I came up short.

Right at Christmas time. Lay off all these people. I paid them all out. Three months severance. And this was four or five years ago.

And prior to Ways to Well, and I just thought I'm not ever doing this again. I can't put, I can't build a model that is in an ecosystem that is controlled by greed and corruption. And so my hope was to build a life raft with Ways to Well and revive. And I build it. And we get all this momentum.

Patients are ecstatic. You know, the average Ways to. Well person refers me one and a half patients. I mean, it's a cash model. These are people spending their hard earned money.

The way you know this works is, if it didn't work, I'd be fucking fired. They're not going to spend their paycheck for something that doesn't work. But look at all the people you've referred me. Everyone, for the most part, is ecstatic.

Yeah. It doesn't affect me at all anymore. I mean, stem cells, whether it's mesenchymal stem cells, BPC-157 peptides, all these different modalities, all these different tools that you use, they fucking work.

You know? Yeah. Middle-aged, what am I going to live to? 112?? I mean, some people, I guess, have done it, but it's pretty rare.

You've got to start thinking of your insurance, your health insurance, as managed care. They are there to manage chronic disease, maximize profits. Right. Okay. What do I mean by that?

Think of it like car insurance. Your car insurance is there when you wreck the car. Your car insurance is not there to rotate the tires, change the oil, and maintain the car. Dana White had an amazing quote. I will never go to a fucking primary care again in this country.

And he articulated it without even knowing he's articulating it. And he's not even a health care guy. And Dana saw it.

A guy won a Nobel Prize for using it to treat a disease state. I can't remember all of it. I'll butcher it, so I won't even try. But the gist of it is there was just a study done in orthopedics that red light therapy helped reduce osteoarthritis better than steroid injections and the other treatment options that they're using in the marketplace in orthopedics today. And it's not foo-foo pseudoscience.

Huberman breaks it down and explains it through using red lights. There's long wave and short wave, right? And the long wave pierces through the epidermis into all of the tissue in your body, all the way to the cellular level, all the way to your cells, spurring cellular turnover and increasing ATP, which is cellular energy. And so it gives your body the energy needed to heal itself. It reduces inflammation.

It helps with neuropathic pain. It helps with skin tone, skin complexion. It helps with eyesight. But, again, these are all things that typically aren't talked about in traditional medicine.

This hasn't been something on a large scale that human beings have participated in while they were going through this process of degeneration, the natural degeneration that most people experience as they get older.

You asked me about low testosterone and what could have caused it. And I look at that and I go, it's everything, right? Like there's another, when we get back to red light or not? red light, green and blue light can increase testosterone levels, right? Not only can, they, will.

You get it from sunlight. So what you found is, if you stand in the sun 30 minutes a day, it drastically improves testosterone levels. Again, Huberman goes into this, too, on a different podcast. How much? He breaks it down.

I don't remember the exact specifics, but the gist of it is if you have low testosterone, okay, are you inflamed? What is your diet? Are you working out? Are you lifting weights? Are you getting sleep?

Are you getting sunlight? Are you eating good protein sources? These are all just basic questions that we could ask and dive into to help patients optimize their hormone levels. But what happens if, like for me, I was up at 4 a.m. to go get into the operating room.

I stood in the operating room and would come out and it would be dark again. I didn't see the light of day for freaking like 13 years, like literally. And so I look back now and I'm like, well, of course. Because what happens is if you don't get sunlight, your body upregulates melatonin. And melatonin reduces testicular function and drives down testosterone.

And they believe it's because we evolved, like essentially being, when we were cave dwellers, we would, in the winters, in the cold time of the year, our rhythms would change with the environment and we would go and be more indoors. That wasn't the best time to breed or procreate. And so in the spring, in the summer, when there's more sunlight, you're in the sun more and your melatonin level deregulates, your testosterone level upregulates, and all of a sudden you're fertile. And same thing with women. Women are impacted by this as well.

Women have testosterone, too. So if they're not getting enough sunlight, it can kill their sex drive. It can mess up their hormone levels.

They use the tool that's in their tool belt. And if that's not a tool in my tool belt, then I'm not going to talk about it and I don't have time to do it. And that's where I see large language models in an evolving market, allowing patients to get that education on their own. They don't have to wait to talk to a doctor, right? I will have a team of academics right there at your fingertips, proactively analyzing everything about you.

And I would tell you another, I talked about predictive, proactive, personalized, all that. Another one would be private. Private. You do not want this data in the hands of insurance companies. Listen to what Gary Brekka was telling you.

He worked for the big insurance companies. He worked to assess your all-cause mortality, risk and the risk profile to the insurance company, right?

Let's just say, in a miracle world, all of a sudden, Blue Cross, Blue Shield rolls out a large language model to streamline your experience. And they want to tie into your wearables. The last person you want digging through your underwear drawer is the insurance company. Because they're going to use it to limit your care, to limit what they cover, and to kick you off a plan, right? They're going to know when the chronic disease is coming.

And they're going to charge you when they know they can monetize you. And then, as soon as you reach a state where they can't, and that's the dangerous side of these large language models. And that's the dangerous side of the tool. And so a sword in the right hands is, you know, one thing. And a sword in the wrong hands is a whole other thing.

Jesus.

OK. And they were put in place to negotiate the price of pharmaceutical drugs for the average American. because so many drugs were coming into the marketplace. The government couldn't get to and decipher what drugs make sense, what drugs don't make sense. What should we cover?

What should we not cover? So they allowed pharmacy benefit managers to do that. Within a decade, the big insurance companies went out and acquired pharmacy benefit managers. Within a decade from that date, the pharmacy benefit managers began to negotiate rebates to themselves, not discounts to the patient. OK.

So, yeah, that's where I was trying to go with this. When I talked about $244 million in fraud in the state of Ohio, how? Where's the fraud? And the answer is the margins are made in the mystery. The more confusing the insurance companies can make it and the more condoluted they can make it, the more profits they can make.

They have only a handful of levers they can pull to make money. So let's go over that. They can raise your copay. They can raise your deductible. They can raise your out-of-pocket expense.

That's one lever. They can drive down the price of a drug that they buy at a wholesale price point. They can mark up the coverage of your care for your employer. OK. And then they tier price all.

the pharmacy benefit manager gives a tier pricing. That tier pricing is not based on what drug is best for you. It is based on what drug is best for their financials. And so they prioritize drugs in a tier pricing, under the misnomer to the American people that a tier one drug is the best drug and a tier four drug is not as good. Right.

But the truth is a tier four drug is not as profitable. Because there's a lesser rebate. And so. So let's say, let's go back to the insulin example. The average price of this insulin is three hundred eighty one dollars.

is what the Senate Finance Committee found three hundred eighty one dollars on. I can't remember if it's Santa Fe. I think, was. there was their price. out of that.

The pharmaceutical company got less than forty dollars. So that remaining two hundred something dollars stayed at the pharmacy benefit manager. OK. Pharmacy benefit managers are making billions upon billions of dollars a year. They decide what gets covered.

What goes on your insurance plan. What your copay is what your deductible is. And they can move any lever at any time. So examples let's go back to GLP ones. Right.

The weight loss, diabetes medications. Those are showing up on insurance plans as tier four with a really high price tag. Well, you look at that and you go man, wouldn't insurance companies want to get rid of that because it's cost them a lot. No. Because they're showing that the price of a GLP one is thirteen hundred dollars.

They never paid thirteen hundred dollars. They paid a fraction of that. But then they go to the patient and they say hey, this is a tier four drug. You have a 50 percent copay on this drug. Five hundred dollars.

OK. So they made their money there. They made their money off the rebate from Big Pharma.

OK. Maybe the pharmacy benefit manager got it wrong. A drug entered the market. They didn't know it was going to be a blockbuster. They miscalculated how this was going to play out.

They have lever after lever, they can pull. OK. High margin drugs. They've gone out and bought pharmacies. So they own mail order pharmacies.

And they. So what they'll do. Like? when I owned a pharmacy. Blue Cross, Blue Shield.

They literally said they owed me over a million dollars. For one month of shipping out drugs. I'd already shipped all the drugs to their patient. I'd already done everything. They come in and say.

We're not going to pay you. We don't think you collected the co-pays or deductibles. OK. We did. Here's all the records.

I can show you. how soon can you get an auditor out. We want to cooperate. Like we're a small company. We need this money.

It's three months before we can get to you. OK. And then they begin to make it so hard for you to survive in their insurance model. And then you'll be sitting there and a couple months later. Knock on the door.

Hey man. I heard it's tough out there for these small pharmacies. You know. We're looking to acquire pharmacies just like you. Right.

They've gobbled up the lifeblood of America. They've put all these small pharmacies out of business. They now own most of these big juggernaut pharmacies. So, even if CVS says we only made $10 off that prescription. What did the pharmacy benefit manager make?

OK. Or what is the pharmacy, your mail order pharmacy, making? Lever after lever after lever. Then the last part of it is my buddy who has MS. He, his MS treatment, I think, is $14,000 a month.

We just met. I have 260 something employees across both organizations. We met with the insurance company. They're raising our rates because they claim they paid $14,000 a month for his drug. Right.

He had a huge out-of-pocket burden on that drug but was happy because he thought, well, hey, man, it was going to be 14 and I only had to pay X. And then they never paid the 14 because they negotiated a rebate on the back end. And then they turn around and they mark up my insurance plan for all my employees every year, year after year. It is a profit driven system, not a patient outcome driven system. And so that's that's all I'm trying to hammer home with patients.

When you say, why don't you take insurance? Because insurance is the crux of the problem. You cannot operate in that ecosystem and provide quality care. You can't. Everything's controlled.

Everything's dictated. It's, it's, it's terrible.

I go, oh, oh, God, that's why that was happening. OK, now I get it. Now I get the magic trick. I understand what you're doing here, how you're moving and shifting profits and monetizing disease states. So think about this.

If I can monetize your diabetes, why would I cure or prevent your diabetes? Right. And, and I know, if I'm a bigwig at United or Cigna, that you're going to switch jobs in three years. And by the time that diabetes leads to metabolic disease and a cascade effect that puts you in a hospital, that costs me more money, you're somebody else's problem. Or, if I can stall it long enough, you're the federal government's problem.

And so every aspect of health care is focused on that quarter, on that day, on that time frame. Another terrible example of surgery. And this is honest to God. I talked to my buddy, who's a president at an orthopedic company. He told me he was sitting down with a surgery center about joints and there's a new joint that they have and it's more expensive.

But the efficacy data of the long term benefits on it astronomically outperform the other joint that this hospital system was using. He sat down with the CEO of the hospital and he said, here's the data five years out. Here's what we're seeing. Da da da da da. The CEO said, I don't give a shit.

what happens five years out. Swear to God, this is a call I had yesterday. He said. he looked me in the eye, Brigham, and he said, if you told me that this joint will last at least 90 days and it's cheaper, that's all I care about. Because all of their data and records and accountability are only on the first 90 days.

Once you're out of that 90 day and you've done your little review and all that, you're off again and you're no longer a monetizable patient. And so, too, when we talk about primary cares and what's happened, the same thing with pharmacies, where they've been gobbled up by insurance companies, if they're in the insurance model, is the same thing that happened with primary care practices. The day of a primary care being independent and a free thinker is over. They're employed by hospital systems. Major conglomerates have gone out and bought up the primary care practice.

Why? Because now they have the patient population. If I can get you at the primary care level, then I can control the referral of where that primary care sends you as we profiteer off your disease state. Okay, so you go to a primary care. Let's say, let's just walk through the same example I gave earlier, a methylfolate test.

They never run that test, right? There's genetics. The methylfolate test tells me my genetics, but there's epigenetics. The choices I make every day impact which genes turn on and which genes turn off. If nobody ever has a conversation with me in my 30s about my hormone levels, about getting into the sun, about eating right, and you push me towards chronic disease because you wrote me a prescription to treat a symptom, and now I go through this system, and I get cancer.

That primary care is going to refer me to an oncologist, and that oncologist is part of that same system, right? And most people don't know this. 65% of an oncologist's income comes from chemotherapy, from the markup they're making off your chemotherapy. 65%, and I attached that link, Jamie, too, where it talks about this. So, all I'm getting at is, Russell Brand said this, and he was spot on, another guy who's not a clinician, but understood what's going on here.

If we make things about profits and quarterly earnings and big business and not patient outcomes, don't be shocked when we get phenomenal quarterly earnings and piss-poor patient outcomes.

Why would I go to Ways to? Well? Why would I go to a cash pay clinic? You will not get these treatment modalities and you will not have these conversations and you will not do that deep dive. So, in a dream world, what I'm envisioning, as we build this multidisciplinary institute here in Austin and we open these facilities across the country, is a lot of the care will be virtual and will be managed from the comfort of your own home.

Driven by large language models that are tying into your wearables and all those things we talked about earlier. But we first have to establish a baseline. What do I mean by that? If budget was no constraint and you could afford $1,200, I would say you come in, you do a DEXA, you do a VO2 max. Those two data sets alone allow us to calculate your all-cause mortality risk.

I know how much visceral fat you have. I know how much subcutaneous fat you have. I know how much lean muscle mass you have on your left quad versus your right quad. I know your bone mineral density. Then we add in a VO2 max test.

If you can be in the top 25% of VO2 max, you reduce all-cause mortality by 400%. Okay, so now you combine that with a DEXA. Now you combine that with a gut biome. Now you combine that with a gene test where we know what genes you have, what are your genetics. Now we can help guide you on how to prevent epigenetics.

How to prevent and use epigenetics to prevent disease states from chronically manifesting. And we can truly get proactive and predictive. We can truly prevent chronic disease. When you said living to be 106 or 112, whatever you said, Peter Attia talks about this too. The difference between somebody dying at the average human life expectancy and making it to be a centenarian, the only difference is the onset of chronic disease.

So today, can we stop or slow the progression of chronic disease and buy brilliant minds like David Sinclair, like Ian White, my stem cell buddy, who's our chief science officer. Can we buy them time to see if they can unlock the code? Because when Ian breaks it down, and I definitely want to get into stem cells, I don't know how far in we are. We're good. Keep going.

Because when Ian breaks down, when you start talking, and this isn't me talking. I'm trying to learn like a sponge from people who are way smarter than me. Like, I'm just, I'm a simpleton, just trying to make it and figure it out. But when Ian breaks down, that we share a common, his theory is this. In the world of biology, we share a common ancestor with species that live 400 years.

The Greenland shark lives 400 to 600 years with no cancer. We have a jellyfish that lives eternally in the ocean. It lives over 5,000 years. It can regenerate. We have salamanders that can regenerate limbs.

We have a Galapagos tortoise that lives over 200 years. We share a common ancestor with those species. And what that means is within our genetic makeup, within our code, we have the code to access those traits. How do we find those black boxes and activate them? Right?

And so, for me, when I talk about, you know, optimists are usually successful, pessimists are usually right. Like, I'm optimistic. The future is bright. The opportunity is there. We can do this.

Like, we, there's so much opportunity. But the first step is to get proactive, to take yourself out of the system, to do the data, because we can't improve what we don't measure. So, if you were to come in and establish that baseline that I was talking about earlier, we now have a full, comprehensive analysis of where you started the day you started treatment. The only test I hadn't got to yet is an EEG. So, for me, we do, Shane introduced me, Shane Dorian introduced me to Wave Neuroscience.

Super cool company. They're using artificial intelligence. Again, it's a tool. Right? Can be used for good or bad.

The example of where AI can be used for great things is they use artificial intelligence to analyze an EEG and to put it into a report that a layman, you know, Neanderthal like me can understand. So, they scanned my brain. I was able to look at this report and tell how my neurons are firing, where my neurons are misfiring, how my neurons are losing bandwidth from the posterior of my brain to the prefrontal cortex of my brain. Okay. Why is that important?

That woman we talked about earlier that may have anxiety or depression, that's another tool to assess that. We know that it has an 80, over an 80% success rate. Way more efficacious than any SSRI, which have been debunked and proven to be bullshit too. Way more than any of these antidepressants, anti-anxiety, meds, and it's a permanent fix. We scan your brain waves and then from there we can use a technology called MERT, which is a magnet, and the AI will give you a precision approach to rewiring your brain.

So, it uses a magnet to pull those firing neurons down the correct path. And so, let me quantify it and give you an example of how it works. For me, my brain, so the human brain has variances. Some brains are moving as slow as 6.5 hertz, you know, top tier is 13 hertz. And that's how fast you can analyze data.

And so, if there was a red dot and I flashed it up on a screen and I flash it once, everyone will see that. As long as they're above 6.5 hertz. If I flash it twice really fast, anyone below 9.5 hertz, they won't be able to make that signal connect to the prefrontal cortex to assess that it flashed twice. Does that make sense? Okay.

So, the posterior of my brain moves at 12.5 hertz. That's a really fast brain relative to the average population. But by the time it makes it to the front of my brain, I'm moving at 9.5 hertz. Why? It's years of sleepless nights, stress, anxiety, epigenetics, diet, nutrition, head trauma, these athletes with concussions.

So, they're using it mainly to treat athletes with depression from concussions and brain injuries. And we can't fix the anatomical issues of the brain, but we can help those neurons fire appropriately and maximize the delivery of the bandwidth of the signal. And so, through brain mapping, we're able to create a precision plan where that magnet is literally tuned to the frequency of my brain and is able to drive that 12.5 hertz all the way from the posterior to the prefrontal cortex.

I love helping people, but refining people who are already studs, that's fun. I immediately think, what about, they're using it a lot with high-level operators. They've already signed all these government Department of Defense contracts, and they're using it for Navy SEALs, for snipers, for people who have to make split-second decisions under high-pressure environments. You want that neuron firing all the way through.

And then I go to, okay, when we talk about the four horsemen, diabetes, atherosclerosis, cancer, and then the last one's neuropathic decline, Alzheimer's and neurodegeneration. When we begin to use these tools and allow AI to get ahead and get proactive instead of reactive, then we can start to assess your baseline. And now we've monitored not just your biomarkers, not just your gut health, not just your genetics and your epigenetics. We're now also monitoring your brain health and your neurowave health. And we can refine that with a precision approach.

And the traditional model uses a magnet as well, but it's only indicated if you, let's go back to the insurance. The only indication where you can use this technology and have insurance cover it is somebody who's failed two or more SSRIs. Okay, at that point, you've been taking drugs for over a year.

Not Rick. Doblin? No, Rick Doblin's friend, Dr. Bruce Dahmer. Sorry, Jesus.

Bruce. See that firing? Need to speed it up. Dr. Bruce Dahmer.

And so there is a sense of creativity that comes with that, but this gives us a quantifiable, measurable approach. to see did it change neuropathic response. Right. Using the EEG and using the wave neurosciences technology gives us just another tool in the tool belt, another assessment tool.

So back to it. Stem cells.

What we cannot do is clone or manipulate the cells. They have to be a minimally manipulated tissue. in the United States. These cells are mesenchymal signaling cells. Dr.

Kaplan, who discovered these, thought that they would differentiate. So he called them stem cells. But what he found is, when you put them in the human body, they actually do not differentiate. OK, so this is the biggest confusion. And that's, this is where I think, a lot of orthopedic surgeons, and there's a whole, there's a whole layer of why.

But one, it undercuts surgeries potentially. Right.

This was over 10 years ago.

When you take an old mouse, you combine it, you merge its organ system with a young mouse. The old mouse gets younger. OK, heterochronic parabiosis happens in a mother when she's pregnant. Dr. Ian White, again, my chief science officer, who has educated me on all of this.

This isn't me talking.

He, he released a a study where he talked about. this is occurring in a in a woman when she's pregnant with a child, and we can see it. How do we see it? The glow that the mother has. Right.

Her heart, increases its capacity in the third trimester by 50 percent. It is not just the mother supporting the baby. It is the baby and young genes and protein codes supporting the mother and helping optimize her health to create an environment that is synergistic for both the baby and the mother, that allows that baby to have an optimal environment. OK, so when we take those cells, right, an orthopedic surgeon say you have to use HSEs. You do.

You have to use HSEs if you need them to differentiate. HSEs will differentiate. They'll migrate.

You're in your 50s. You have 50, something year old HSEs. Right. We know, from the moment of birth, those HSEs viability begin to decline rapidly. And year after, year after year, I think it's like one in 10,000..

Once you're over the age of 30, you may be getting 10,000 HSEs, but only one of them is a viable HSE that will actually do anything. And so when we look at what's happening with these cellular treatment options that are placental derived or birth tissue derived, it's the same exact product that they're using over in Panama that they're using in all these other locations. You're just not allowed to expand them in a petri dish. And so there's an article that I listed on the Ways to Well website, because you asked me last time, is there a benefit to expanding the cells? And my answer was the optimal dosage is the minimal dosage required to elicit the desired response with the minimal side effect profile.

What does that mean? Does it work? And did I have side effects? If it works and you didn't have side effects, then there is no reason to add additional risk to a treatment or to manipulate something. And so there was a study where they put 200 million live cells versus 20 million live cells in a heart, and both made improvement.

and the improvement did not differentiate. It was comparable.

And so, and you're also, you're also historically like when an orthopedic surgeon says it's bullshit or it doesn't work, it's because they're misunderstanding the mechanism of action. Okay. They're, they're assuming if an MSC comes from an umbilical cord or from a birth derived tissue, it can't differentiate. And if it can't differentiate, it can't become something. And if it can't become something, then it can't heal something, because it's not going to become a tendon and or a tendon cell and heal that tendon.

You have to take a step back and go to the, the whole, uh, the whole analogy of the young rat and the old rat, right? Uh, and, and you look at that and you say, okay, when we put these young, vibrant cells in a body, it's not just the cells. Yes, you're getting mesenchymal signaling cells, which are going to go to that site of injury and trigger your body's own cells to come. Those cells transfer their mitochondria into your cells and their jobs done. They're out of your system in a few days.

Okay. From that point forward, the magic happens with all the other goodies that are included in that treatment. The extracellular vesicles, the exosomes, the cytokines, the scaffolding, the, uh, RNA, right? And so the example I can give is, with a facial treatment, right? We do a skin pen and we treat you with cellular treatment modalities and a cellular both.

But regardless, it will have RNA. RNA is a message, a messenger code that allows your cells to get a young, healthy message. Like I said, parabiosis, when the mother's pregnant, the baby's also improving her health. It's not just her improving the baby's health. Those same messages are in that tissue that we're putting in your body or on your skin.

And what they do is think of it like a construction site. If you're going to build a building, you not only need all the, uh, essential elements and, uh, essential ingredients or products to build that building, but you also need the blueprint. The RNA is the blueprint. It's the instructions. And all the extracellular vesicles and all these other items are the goodies and the materials of life that help with the healing process.

And so we're essentially attempting to create a perfect environment for healing. Where things have gone south is people have overpromised. They've said it'll cure all sorts of things, it won't. You know, now you've got orthopedists saying they don't work. And it's because of, one, people have overpromised.

Two, you know, they don't understand the mechanism of action. And I think they're kind of thinking, well, they're not differentiating, so it wouldn't work. Does that make sense?

You're not taking anything fringe. You're not doing anything outside the norm where another academic guy could question you. Right? So it's playing it safe. Right?

And the Hippocratic Oath is, first, do no harm, which is the dumbest thing. I mean, of course, do no harm. Like, the goal isn't to not fuck it up. The goal is to make this person better. Like, that oath makes no sense to me.

And so I've asked his permission to talk about this. We can talk about Aaron, Aaron Rodgers. I met Aaron prior to his injury via his bodywork guy, Aaron Alexander, who I think you've met. Crazy fitness guy. And he's helped Aaron with his preseason prep, getting ready for this season.

And when Aaron tore his Achilles, I reached out to Aaron Alexander and I said I would love to try and help Aaron and see if we can help him with this stuff. And that's why, when I was talking about the heterochronic parabiosis stuff, he had a great surgeon. He had a great surgery. He took a multidisciplinary approach to his healing. It went above and beyond just doing a surgery, to the point where he did cellular treatments.

Those cellular treatments are, for all the reasons I discussed earlier, creating the perfect environment for optimal healing. He used infrared. And I don't want to steal Aaron's thunder because he's got a documentary coming out about it. And I think he's been documenting this entire process. But even separate from Aaron, the truth of the matter is, I mean, dozens of NFL athletes that have had phenomenal results with this stuff.

I had one guy who was told he was going to be out for eight weeks. He was back practicing in four weeks. I said, did you tell the team doctor? And he was like, fuck? no, I didn't tell him.

I didn't want to hear it. I would never hear the end of it. And I just think a lot of it comes down to dogma, misunderstanding, frustrations with over-marketing and people promising people the world.

Same thing we talked about earlier. As we get older, we have less and less of these viable cells. We have less and less effective cells. And by giving your body all of these essential building blocks, plus the instructions on how to build via the RNA, now the body is getting young signaling cells, fresh, young, vibrant signaling cells. So back to what I was saying earlier about bone marrow.

Doctors, if you talk to an orthopedic surgeon in this country and you say, I want stem cells, they'll say the only FDA approved stem cell option is bone marrow aspirate. You're right. That's the only indicated option. That's the only option where you can make a claim. Right?

But there are other options in America that work, that are efficacious. Now, do they differentiate? No, they don't. But neither does the stuff you're getting in Panama. But the future of stem cells, and Dr.

White and I have talked about this, and this is another thing we're going to be doing at the new facility here in Austin, is we're building a state of the art lab. And we are going to do trials. And we are going to do the work at the bench. Because Dr. White is on the precipice of being able to use HSCs, the cells that do differentiate, but we will not pull them from bone marrow.

We will take them from the umbilical cord tissue, the youngest, healthiest, most vibrant cells, with all the extracellular vesicles and goodies. And if we can harness those cells and use those cells, they would be able to differentiate. Now, the reason you would want to do that is down the road, to be able to rebuild cartilage. or, you know, the critiques that guys have. Like, Jamie, could you pull up?

There's a study.

And he's been, that's why he and I were talking about it. Let's do it.

You know? Which is really kind of, it's a weird thing where you say, put something in my body that's permanent, but not really. Yeah. It's not really permanent.

Well, one of the biggest risk factors for knee issues is being obese. Right. Right? You've worn that joint out, carrying all that weight.