Dr. Franchell Hamilton

She recognized that many of her patients needed a more personalized plan to help them maintain their weight loss goals. By addressing the mental, behavioral, medical, and environmental factors that kept them from a meaningful transformation, her patients began to regain control in these areas.

Ari Gronich: Hey everyone, welcome back to another episode of create a new tomorrow I am your host or Ari Gronich and today I have with me Dr. Franchell Hamilton. She is a bariatric surgeon with not only several years of medical and surgical training, but chemistry psychology as well, who's now kind of grown a little tired of the system, as it is, and is looking to help support patients in a more holistic way. So I want I wanted to have her on here because she truly is part of who's making medicine, good for tomorrow, helping them activate their vision for a better world through medicine. So wanted to bring her on Dr. Franchell, thank you so much for coming on.

Franchell Hamilton: Thank you. Thank you for having me.

Ari Gronich: Absolutely. Why don't you tell us a little bit about your background? And what made you go from traditional medicine towards some more holistic approach?

Franchell Hamilton: Sure. So I was traditionally trained MD, medicine, went through residency, general surgery, and then I did extra training and bariatric or weight loss surgery, and was in private practice for about 10 years. And it wasn't until I was in private practice, actually, kind of with my own patients doing the things the way I want it. To do that I started realizing the system that I've been trained all this time wasn't really effective. And I have three clinics, right. So we had a pretty large practice. We're in a big Metropolitan Dallas Fort Worth area. And I was probably one of the top geriatric surgeons as far as volume, what I started noticing probably about seven years in actually, that I was doing a lot more revision surgeries, which means they've already had a bariatric surgery, gastric bypass, sleeve, lap band, whatever it is, and they were coming back to get a revision surgery. And I noticed that several years in the practice changed from doing predominantly first time, weight loss, whatever, surgery, medication wellness, I do a lot of things in my clinic that I saw a lot of repeat customers that regained. And I had to ask myself, what am I doing here, like I did all the checkboxes that I was taught to do. All the patients had to go see a nutritionist, they had to go see a psychologist, they had to get their heart checked out. They did all the checkboxes that was required by insurance. And that was required from my training. But patients weren't getting better. They were requiring revisions. And even the ones that were doing just the medical weight loss, they just weren't progressing the way I thought they should be. And I didn't go into medicine just to be busy. Just to be a busy surgeon, I actually wanted to make a difference. I have a heart for people with a lot of medical problems and complicated obesity. And I really wanted them to not just treat their medical problems, but to resolve them. I wanted them to go away. And I felt like in that moment, we I wasn't doing the right thing for them. So I really had to kind of rethink what I was doing revamp and I actually got more education and almost like what we call Eastern medicine or holistic medicine during those years because I was getting burned out with traditional medicine because I felt like I was not helping my patients because they didn't get better. Like I was trained bariatric surgery will not only help them lose weight, but their diabetes and hypertension, cholesterol, all this stuff will resolve. Right. And it did for a brief moment in time. And then the majority of patients were regaining. So that was my turning point for me.

Ari Gronich: Awesome. Thank you so much for that and your dedication in general to wanting to find the best results for your patients. Because we all know that that's not happening so much in the industry right now. And one of the questions I wanted to ask you is what's been your, you know, the pushback from the system or from your colleagues, and so forth? Or what's been the adaptation from them where they've said, Oh, yeah, I've seen this too. And I also want to do what's best. So how can I get on board with what you're doing? So how have you seen on both sides of that?

Franchell Hamilton: So, believe it or not, I felt like and still feel like I'm almost like a sore thumb in my industry because I will tell you, especially in the surgical industry, a lot of us are them. They're not there yet. Like they just they operate the and to be honest, I don't even know if it's their fault, like we were trained as a surgeon, we see a problem, we fix the problem or take out the problem. And then we move on to the next thing before I started my own private practice, I was with a group that was very much like that I was employed. And I immediately got out of that, because I was like, this is definitely not the way I want to practice medicine. And the only way that I felt like I can even come close was by starting my own practice. So that's kind of how I ended up in my own private practice. But I will tell you, in my own private practice, it was a struggle, like, I felt like I got pushback from all sides, I got pushback from the insurance companies, I got pushback from a lot of my own colleagues, when I surgical colleagues, when I brought up the idea that patients have to do other things to help them with their weight, diabetes, when I talked about positive affirmations, or maybe including meditation or yoga, I got pushed back all the way around to the point where I had said, almost like leave those I'm not a part of a lot of those organizations. And from the insurance standpoint, they did not pay for any of the more holistic things that I wanted to do that I saw worked, I saw this work. And I even wrote a letter saying this is medical necessity, I think they need this, this and this. And it was denied left and right. And I often found patients were almost mad at me or my office because we couldn't get this approved. And I'm like insurance companies will pay for their blood pressure medication. But if I want it to treat their blood pressure in another way that I know would actually benefit them by helping them reduce stress, change their environment, whatever the case, I got pushback, I wasn't paid, the insurance company didn't pay. And a lot of my surgical colleagues thought I was actually kind of crazy. So I literally had to shut everything down and almost start over the way I felt like with my own vision, the way I felt like things that should be it almost gave me an aha moment. On the way healthcare was practice, like everything it was it was almost like a brief down moment for me, because I've been in this system for so long. And I didn't even recognize this was happening until my patients weren't progressing. And then if I was in fight with the insurance to get stuff covered, I felt like my voice really wasn't being heard. On the other side, some of my medical colleagues, medical non-surgical, were very open to that idea. So I had to shift almost to the more holistic or integrative community, where they got it, lifestyle medicine, doctors, integrative medicine, functional medicine, meditation therapist, yoga therapist, so I almost shifted into that community. And that's kind of where I felt more welcomed, because in my traditionally trained community, a lot of us, some of us are jumping over, but a lot of us are still with the typical mindset when it comes to how we should treat health care.

Ari Gronich: Right. So, you know, part of this show has always been a lot about the health care industry, because that's where I started. And, you know, I know from my own medical history, having a brain tumor that I was told, I'd be basically gaining weight until I was dead. And I was 342 pounds at one point where I'm just going okay, so I went on to a cleanse, I went on to another cleanse after that I did a 40 day fast, and I did a 10-day water fast. I mean, it was like one after another of just Something's got to give. And but, you know, misdiagnosed and mistreated my entire childhood. It's kind of why I'm in the business to begin with. What I what I saw was that results never seemed to matter. It was procedures and the incentive system is to do more procedures rather than to actually get the good results for the patients. And so, one of this is like the audience here. A lot of them obviously hear me a lot, but to the people that are in what they would say mainstream, I'm considered maybe woo woo because I don't have a doctor degree other than my doctor of metaphysics, right. So, I would be discredited, you know, because of that. So, you're a medical doctor who's in this industry, right? And so how do we get that system to start shifting itself to more of a results-oriented system?

Franchell Hamilton: Yeah, and I'm glad you mentioned that because one of the reasons I got into, particularly obesity medicine was because of the labels like I was labeled as a kid, I didn't have the best childhood. And I had all this kind of like negative labels slapped on me. And so, when I got into medicine, I knew I wanted to be in a field, where people felt like either they were defeated, or they’re, you know what I'm saying they just have this negative connotation. So that's what drew me to obesity medicine in general, because there's all this negativity around it, that most of it is not true, which a lot of it I also felt growing up. And so I want it to be that kind of voice for my patients and be that advocate truly be that advocate. And that's one of the things when I got into medicine, where over time, I felt like I'm not advocating for them, kind of like what you were saying. It's a procedural driven society. I mean, we can talk about what happened in COVID, when elective surgeries got shut down, like there's so much stuff in the hospitals that got shut down, I think the way to change it is to do stuff like what you're already doing, talking to more people getting the word out what me and you are both doing try to promote, I still have my practice, it's completely changed now. But a lot of my work now is to get the word out on the way this healthcare system is having practiced in it for a decade before my eyes were open. And realizing like this is not the way it needs to be practiced. There are actually several communities of physicians now who also believe this, which is helpful, we are partnering with a lot of people like you like yoga therapists, like other people who years ago, they're just like, oh, they don't know what they're talking about. Yes, they do, because they're also seeing results. So it's a matter of like getting the word out there that these other modalities exist. And I think it has to be a combination of patients, patients now are also getting frustrated with their results, they're getting frustrated, for paying these high insurance premiums, and not having anything covered, and not getting the treatments that they feel like are going to resolve their medical problems. So I think it took everybody being frustrated and wanting to make a change in the system it's starting. And I think it's just the combination of us getting the word out joining together and getting a change in this area.

Ari Gronich: Yeah, so one of my questions, then is being that you're in the unique position that you're in, of being in that medical side, and now bridging the gaps. You know, to the western side, my question would be, how do we get some of those organizations that are individual like IFM, FMU, a forum, right? Those are all individual organizations to kind of come together and literally create the next kind of healthcare system. Because, you know, the way I look at it, the battle that we've been having has been about who pays the insurance company bills, right? Whether it's the government paying or whether it's the insurance paying, it's still who's paying, but there's been no talk about how do we make the system more effective so that people are healthier so that it costs us less money in general? And so that's kind of one of the conversations I like to have is, how do we come together in a way that honors and respects all aspects of medicine, minus, of course, the fraud and deceit and all that shit. But that honors the risk and respects all the good that medicine is mixed with all the good that the holistic side has to offer, and come and create a new system that just is outperforming the old system.

Franchell Hamilton: I agree. And that's a loaded question. Because as you and I both know, that's going to take a lot. That's going to take a lot of manpower. On all ends, physicians, support staff like you other health care workers like you and patients to kind of come in and say we want this change, I can tell you, I have stayed one of the reasons I've stayed with my foot in medicine, like clinical practice is so I can help dictate and start being the change. There's so many other opportunities, I've had to completely leave medicine and kind of and maybe at some point, I will do that. But right now, I am trying to bridge the gap. There are several people that are trying to bridge the gap with their patients and these organizations. So I sit on a lot of committees on a lot of these organizations that do not see it this way. yet. One of the reasons I started They'll stay on these committees. So I can almost be a voice inside that committee to help create the change that I think is needed. I'm, I still sit on my Council Committee for American College of Surgeons and so I'm over all of North Texas as a bariatric surgeon, I represent that one of the reasons I still stay there is so I can voice some of the changes that need to be made, I think it's going to take people higher up honestly, in these organizations to say something, and then to start kind of weaving, which we already had, we met each other. I've met several people who are on the same playing field, but I would have never met until I kind of started this whole thing. I think there needs to be a movement. That's what I'm talking about on my podcast and shows. That's what you're talking about. There's a lot a lot of us that are talking about it and we need to all come together, believe it or not, we are making some headwing. CMS which is Medicare, Medicaid, they the government insurance is considering at least looking at functional and integrative medicine, as far as coverage, which is huge. I know, it doesn't seem like a lot. But that is a huge thing that in general, we've been trying to push just like coverage for bariatric surgery, right? Like there's a lot of issues with that. There's a lot of these like grass roots going on in these organizations. I'm part of AMA, which is an American Medical Association. We're trying to in these organizations, I know there are several of them. And yes, we need to come together more, but we're trying to get stuff passed. So integrative and functional medicine has gotten a bill to Congress saying this is what needs to happen in order to help treat patients better, they've actually looked at it and are considering approving it. Once Medicare and Medicaid approves the coverage of functional and integrative medicine, which is currently not approved, that will be a ripple effect, and all other insurances will follow. So I think it's steps like that that's like big, it's hard for like the lay person to see it who's not working. And it takes years, it takes years. Like it took about six years for even that to get to Congress, you know what I'm saying? It just takes a long time for this stuff to happen.

Ari Gronich: So because it takes a long time, when it's us industry, people that are not lobbyists? What is the thing that we can do with our patients? Like what are what are the things that patients can do to accelerate it within their groups? Because I'll tell you, I look at all of the Facebook groups and you know, people, some complaining and some promoting and some other things, but all of them is like it's disconnected. And it's what I would consider to be frantic, complaining or gathering to complain instead of collaborating to succeed. So, my question is both for the patients and the physicians who are starting to work with their holistic counterparts, right? How can they combine together to create more power in that movement.

Franchell Hamilton: So I think in kind of what we're doing, and this has also already started, where we're forming networks, right, and networks among our area, or region. And I think from a patient standpoint, they need to complain to their insurance company for coverage, which a lot of my patients when I was accepting insurance and alert or accept it, but when I was accepting insurance, I was like, you need to talk to your insurance and ask to get a coverage, believe it or not, when you're an insurance physician or practitioner of any sort, there are several people that's not a physician that takes insurance, there's only so much that we can do, believe it or not, insurance don't want to pay us but as the patient and I'm a patient too, you're paying into the system. So the patient has more power when it comes to their insurance than the physician or the provider does. So those complaints need to be directed towards their insurance companies demanding coverage or demand to leave. There's so many other options out there. If everybody pulled away from the insurance companies and just decided to that that's not that's not working from them, they have to make changes, right. This is what happened and financial infant structures. You almost like wherever the money is going. So in my community, we've formed networks with everybody massage therapist, physical therapist, nutritionist where you can either do like a subscription, which a lot of people are doing now, and you pay into this network, a subscription and it will cover whatever visits almost like an insurance But you're cutting out the insurance, you're cutting out the middleman, this is getting provided directly to whatever group that you're with, or you because a lot of us physicians, we just want to treat the patient, most providers just want to treat the patient. And so we will make something that's reasonable, and that they can afford a lot. And I can speak on physicians, and a lot of these holistic practices are no longer or don't accept insurance, and they're doing their own models, but we have to network and collaborate. Because if I can't offer something, I need to be able to refer that patient to other services that are in our cash pay, holistic integrative network that they can go see. And a lot of patients, believe it or not, are leaving insurance companies and only getting what they need in the event of traumatic or event. Yeah, exactly. And they're paying the doctors and the providers that are providing care for a lot cheaper than paying these high premiums in these high deductibles. So I think that's what needs to be done all over. And that movement has already started.

Ari Gronich: That's awesome to hear. I'm so glad to hear that that is going on. And we'll have to make sure that people know how to connect into networks like that, when they listen to the show, so we'll have links and stuff for that as well. So here is a, an off the cuff. Right? So let's say you're not taking insurance, right? I'm taking insurance, you're not taking insurance, you're getting results, I'm not getting results. Alright, so we're just taking a scenario that I think happens quite a lot. So we're going in for weight loss, counseling, weight loss care, right? How much is the difference in cost for say, bariatric surgery compared to a functional medicine approach? And, you know, an average cost, right? So a bariatric surgery costs, how much and then the average approach for functional medicine costs How much?

Franchell Hamilton: Well, in the other question, I guess we have to ask is the results, right? So okay. So the first part, so average bariatric surgery probably costs about 20 grand between the hospital and the doctor. And usually the doctor’s offices provide all the pre care and a lot of the post care. So about $20,000 functional medicine, typical subscription cost, cost about 100 and 100 to 150 a month. And so let's say 13,000, right? Are there I'm sorry, yeah, sorry, 13 100 a month. So 1300 for the year versus $20,000, for bariatric surgery. So that's a huge cost difference.

Ari Gronich: Okay, so now we're going to go to vote who results on both sides. Since you were talking earlier about how many people come back, let's just do that how many people come back after bariatric surgery versus how many people do average, see come back, meeting more care or knowledge or whatever, after going through a functional medicine program.

Franchell Hamilton: So with the functional medicine program, it's kind of ongoing, which it's a lot of support. And so people may not come back because they have recurrence of their disease, it's more just maintenance, right? So that's a little so we're not adding money into the system, because we're not treating anything per se anymore. We're just maintenance, right? So that taking into account, my bariatric patient population. For me, I felt like it was at least 50% that needed a revision, which is high considering the cost of a bariatric surgery. So I felt like there was a piece missing there.

Ari Gronich: So, is the cost of the revision about the same as the cost of the original?

Franchell Hamilton: No, it's significantly higher, significantly higher, because it's more complicated. Anytime you have to go and this is not this is all surgery. Anytime you have to do a revision, your complications increase dramatically. And so the length of stay in the hospital increases dramatically. Like your postdoc, potential complications are higher, like everything is more expensive in a revision surgery.

Ari Gronich: Okay. Cost of ongoing care for functional medicine since there really isn't any revisions. But what's the ongoing cost? Oh, it's just the 13.

Franchell Hamilton: Yes, your monthly fee. Yeah.

Ari Gronich: So on top of the monthly fee, for instance, whatever that is, so they're, you know, they're all programs are different costs, right. So then there's obviously supplement costs, food cost, so people are freaking out. Let's gonna cost me so much money to get healthy. So let's talk about those costs a little bit, how they go high and how they go low, comparatively to what other people are doing. So in bariatric surgery, typically there's medicine medications that they're taking, which have a cost, right? What's the average cost of the medications of maintenance for somebody who's going through the surgical route.

Franchell Hamilton: So bariatric surgery, you have to have supplements, they all have to have supplements. And there are specific variadic supplements that most bariatric surgeons or nutritionist, or baria-nutritions provide in the office because that's what the ASMBS, the people kind of write the rules say they need this supplement. And so there's an approval process. And so those supplements are usually about $60 a month for your basic supplements, let alone if you actually have some deficiencies, and then you start adding on and those supplements can range up to 60 to $100 additional a month, not to mention before surgery, there's protein drinks and supplements that you have to do. And after surgery for the first six to eight weeks, there's also protein supplements that people have to stay on to make sure they're getting all the protein that they need. And let me also mention to stay healthy. There are certain foods the bariatric patients have to eat, they eat less, but almost the same healthy foods to stay healthy that people in a maintenance program will need. So that's the bariatric cost, functional medicine cost. They don't have some way, if you don't have bariatric surgery, you don't necessarily have some of the deficiencies that bariatric patients get. So you don't necessarily need all of the supplements. Some people do, right? But very extra patients require us because of the way we rerouted you, you are 100% going to have these deficiencies because of the way the surgery was made. Other functional medicine patients that didn't have the surgery may or may not have those deficiencies, but everybody should be on a basic supplemental regimen that could cost anywhere from 40 to $60 a month.

Ari Gronich: So what's the cost of obesity without any intervention at all? Do you know about those what those numbers are the statistics for those numbers.

Franchell Hamilton: So because obesity, so let me tell you what obesity cost big picture, because they've looked at different sectors. So obesity caused, apparently 40% of less workdays, obesity in general, because you're obese, you have all of these other chronic problems that come about that people don't even realize that they will get you're sicker. So COVID, for example. I mean, there's so many studies showing obesity alone is reason why there was high death and high hospitalizations with a ventilator. Okay, so outside of that, though, people your immune system is down, you have more missed workdays, or missed work days, which is costing the economy money, you have a higher propensity for diabetes, and all of those medications, hypertension, high cholesterol, depression, anxiety, we don't even care enough to get into the emotional and mental side of what obesity can cause. So overall, they were in this was probably several years ago, when that I saw these numbers, the cost of obesity was taking up about 56% of our total healthcare, that's just for obesity, because of all of the other sub-quella that it has with obesity and this, I use that number because that's the number I used back in the day to try to get bariatric surgery covered because it wasn't covered as readily. It's better, but we still have coverage issues.

Ari Gronich: Alright, so, I want to do the numbers because I want people to kind of grasp the gravity, not just of the obesity, just of the cost of bad results, right? You think that it's costing you a lot to go into a physician, a doctor who actually gets the job done? Who is not taking maybe insurance, but is really about caring for you and your patients? Right? And then you go, but I can't afford you. I have to go to where the insurances and then you have to go to 15 people, you have streamlet high expenses. I find it fascinating that somebody can go in for an MRI without insurance and it costs $200 and they go in with insurance and it costs 1600 or 2000, or however much they decide to charge because the whole idea of insurance at the very beginning is we all pay into it. Cool, so that they negotiate better rates for us, right so that they are taking care of those kinds of things. And I think that people are in such a cognitive dissonance about what is really happening in the world around them like, well, they wouldn't, you know, choose money over, over my health, right? They wouldn't allow the system of medicine to be about that. And so there's this disbelief, even though we see after we see after we see the evidence that something is shifty is going on, right.

Franchell Hamilton: Yeah, yeah, I agree. And just to kind of piggyback on that, a lot of people think that they're there, it's almost like insurance for them as a security blanket of some sort, when it's actually not doing anything for you. I mean, I get it, I was in that boat too, for a while, like, Oh, we have to have just in case just in case, in, we're pouring 1000s of dollars a month into insurance. And over time, it's changed right now, everybody not only has their high monthly premiums, but they have this huge deductible that they have to pay out. So they're paying high monthly premiums. And then when you come see me or whatever, Doctor, you owe me your deductible, so your insurance is not even covering that they don't kick in until after your deductible is met. Even when I had insurance, I got rid of it myself. You're right, that same scenario happened to me, I needed an MRI, because of my neck. And so I was gonna go and pay insurance. And I had to pay my deductible. They're like, Oh, you need to pay a $2500 deductible. And I was like, pin. And then my therapist, my chiropractor, he ordered it. He was like, you know, I just I know a cash place, go pay cash, and don't tell him you have insurance. And I went there those 350. And I'm like, why when I had insurance, I was gonna have to pay $2500 out of pocket with insurance. I go to another place and say no, I don't have insurance. And I paid 350. Like, what is wrong with this picture, we're actually paying more into the system with insurance than without insurance the same way with physicians, my rate to see me is the same rate that insurance charged for a deductible plan. And so they're not only paying me that, that they're paying, they're also paying their monthly fee, you know, so it's, it's crazy.

Ari Gronich: Yeah, it's, it's intriguing to me, but it also intrigues me to the level at which I guess our industry just doesn't even pay attention or explain it or talk about it. Because to me, it's so obvious, right? If the only thing you did, as a scientist, as a medical scientist was look at the numbers of diabetes, of rates of autism, of rates of obesity, of rates of heart disease, right? You would say, Well, shit, we have all this new technology. But the results that we're getting are like 10 times worse than we were getting before we had all this technology. So you'd think that there'd be some cognitive awareness of this? So my question is, how do we bring back the cognitive awareness to people in their own profession? I mean, in their own world, so that it's not incumbent on the patients alone, to have to fight for their right to feel good?

Franchell Hamilton: Yeah, yeah, I agree. And that was the problem. And I was a part of this, where I was completely clueless. I was completely clueless, because they didn't teach this to me in school. And I don't know if they taught it at the school you went to but believe it or not, in most healthcare, professional fools, they're not talking about this. And why would they talk about this, because, you know, this could potentially bring down insurance companies or whatever, I was just looking while you were talking, the gross domestic product for our first quarter was $22 trillion. And that's for to 2020. It has gone up, but it's gone up every year. And this was my kind of aha moment. So when I was giving you those numbers, this was probably back in 2018, or 19, when it was a little bit less, but it was still in the trillions. And so if you think 56% of OB takes 56% of that obesity takes up this $18 trillion number, how much we are spending because of obesity, and we're not doing anything. I mean, that was kind of my big thing. Like this person just paid $20,000 for the bariatric surgery, and they're back in here two years later, and now it's going to cost them 35 you know, because they have to have an extra hospital stay because now it's more complicated and the insurance are willing to dish this out. But when I requested that they see counseling or therapy or food addicts? You know, they denied that like, this does not make sense to me why as a country are we willing to spend money on stuff that may only band aid the problem, but we're not willing to spend money on things that will actually resolve the problem? I can't answer that, because I was blind to it also, because I didn't see it. And I don't even know what kind of the only reason why it was brought is because I want it better for my patients. Not everybody is like that some people are just happy going to work collecting, they're checking going home. And if that's the mentality, that they we will always have that system where our head is kind of down. And our blinders are on, because they're going to work the collecting their check, regardless of the healthcare profession. And they're not seeing this bigger picture. I think what helped me is because I was in private practice, I wasn't employed. But a lot of this, if you're in a hospital setting, or an employed setting, honestly, in the defensive providers, it's hard to see, because you have a patient who comes in with diabetes, you have 30 minutes to talk about their nutrition, prescribe some type of medication, and your hospital, or your clinic has already scheduled the next patient for you. So they've got to go. And that's all you see. And so awareness has to come from the people that are doing this, but only if they want to, like me and you talking about it can only help hopefully that helps people kind of think twice, especially providers that have been there in those employees conditions where their employer doesn't see this, they may not see this, you know,

Ari Gronich: Right, I just, you know, I look back on this last year, and I go, what an amazing amount of opportunity got lost, because we weren't allowed to talk about building your immune system versus treating a disease, right, we weren't allowed to talk about the ways in which we develop a system that is immune to these kinds of things, because we're so healthy, and our healthy immune system takes care of this stuff like, Good, right. And so I'd like what a missed opportunity we had this last year. The positive, I think is that we've gotten the opportunity a little bit to recognize and to start building the numbers for what you were saying a little earlier, which is look at all the medical intervention that did not happen this year. And the deaths by medicine toll, how much that's dropped. And we'll we might if somebody is actually interested in doing this be able to figure out what really is the cost and the toll death toll wise and cost toll of medical intervention that's unnecessary. what's the overages of what we're doing that we should not be doing? And, and so I'm looking forward to seeing if that gets any play in the community, you know?

Franchell Hamilton: Yeah, and I think it will. So I and that's one of the things like in my practice, I never did research. And I'm getting physicians, because I'm like, we need the data, the only way that we're going to be able to beat this thing is the data like in bariatric surgery, which is where I was for so many years, we have data on how bariatric surgery causes a decrease in diabetes, a decrease in hypertension, and how this is saving money, how much obesity is costing America and how we treat this right. So we have those numbers. But then that's it, it drops off, it doesn't talk about or show the aftermath, right? We hadn't even and I think part of it is because people don't want to, we did so much to kind of get it approved. And even my own community is not showing the data afterwards. Because once they get the surgery, that's it. There's no prevention, there's no once their diabetes has resolved. And that's what we're missing the boat. And part of that, believe it or not, is insurance, you're healthy, wanna pay for your one wellness visit a year in your lab work, and that's it. And then patients are left having to what do I do now as they're like medical problems and everything else is slowly increasing. We need data on what prevention does in the big picture. But what we do have data on and this is kind of what I'm trying to educate other physicians about is that every medical disease has increased since the beginning of time since 2000. Diabetes has increased, hypertension and cardiovascular disease has increased obesity has increased, yet, we're supposed to have some of the best health care in America. And we have all these technologies and all these great meds that have come out right these $1,000 meds that are treating epilepsy in cancer and heart disease. But yet the incidence is not going down. The incidence is not going down people because we're not doing prevention, because the focus is not on prevention. This is why the incidence is not going down. And I don't understand why anybody else is not seeing this. They do offer grants, which mean one of the companies that I'm working with digital health company, to increase access to kind of ask these questions, I will tell you what the pandemic I think, like you were alluding to help with open eyes, we had way more deaths than we should have, because of the pandemic because people were not healthy. And if we have the best expensive meds that everybody's paying for in the best health care of all these technologies, why do we have so many deaths, we have more deaths than some other underserved countries. So what, like what's going on there? So we need to start focusing on prevention. And I think, as the whole people are starting to see that now, I've seen more of a shift, kind of towards the end of this pandemic than I've seen before. So I think all of us like you like me, all of us who are like advocates of prevention, now is our time to try to make changes, policy changes come together, educate our other so I'm educating as many physicians as I can I host webinars, you know, conferences, I'm speaking at conferences, in order to cut these to get the word out conferences where it normally wasn't spoken about before. I think at this point, we as a medical society, all providers have to look at this and look at what happened this past year, and start