An Army of Normal Folks - A Family's Commitment to the City That Saved Their Son (Pt 2)

Episode Date: October 22, 2024

Pedro Velasquez Jr was diagnosed with leukemia when was 5 years old. His dad Dr. Pedro Sr. pleaded to God that if St. Jude saved his life, he would dedicate his life to the Memphis community that was there for them. He founded Lifedoc Heath, which has helped 1,100 patients a week improve their health outcomes so much that their cost of care has plummeted by 27%! Support the show: https://www.normalfolks.us/premiumSee omnystudio.com/listener for privacy information.

Hey everybody, it's Bill Courtney with An Army of Normal Folks and we continue now with part two of our conversation with Pedro Velezquez, senior and junior, right after these brief messages from our generous sponsors. Do you ever wonder where your favorite foods come from? Like what's the history behind bacon wrapped hot dogs? Hi, I'm Eva Longoria. Hi, I'm Maite Gomez-Rajon. Our podcast, Hungry for History, is back.

Season two, season two. Are we recording? Are we good? Oh, we pushed record, right? Okay. And this season, we're taking an even bigger bite out of the most delicious food and its history. Seeing that the most popular cocktail is the Margarita,

followed by the Mojito from Cuba, and the Pinyucolada from Puerto Rico. So all of these things. We thank Latin culture. There's a mention of blood sausage in Homer's Odyssey that dates back to the ninth century BC. BC? I didn't realize how old the hot dog was.

Listen to Hungry for History as part of the MyCultura podcast network network available on the iHeart radio app, Apple podcasts, or wherever you get your podcasts. I'm Malcolm Gladwell. 25 years ago I wrote my first book called The Tipping Point. All about the moments when an idea or trend crosses a certain threshold and spreads like wildfire. I've had a lot of time to think about that book, and the way I thought about Tipping Points changed. So now I'm releasing the sequel, Revenge of the Tipping Point,

where I return to the subjects of social epidemics and the dark side of contagious phenomena. You can hear a sneak peek of the audiobook on my podcast, Revisionist History. Plus, we'll dive into a duo of narrative episodes about my favorite trial in American history and a reevaluation of the broken windows theory I explored in my first book. Find Revenge of the Tipping Point wherever you get your audio books and listen to Revisionist History on the iHeartRadio app, Apple Podcasts, or wherever you listen to podcasts.

Muhammad Ali, George Foreman, James Brown, BB King, Miriam Makeba. I shook up the world. James Brown said, said love. And the kid said, I'm black and I'm proud. Black boxing stars and black music royalty together in the heart of Zaire, Africa. Three days of music and then the boxing event.

What was going on in the world at the time made this fight as important that anything else is going on on the planet. My grandfather laid on the ropes and let George Foreman basically just punch himself out. Welcome to Rumble, the story of a world in transformation. The 60s and prior to that, you couldn't call a person black. And how we arrived at this peak moment. I don't have to be what you want me to be.

We all came from the continent of Africa. Listen to Rumble, Ali, Foreman, and the soul of 74 on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Hey everyone, it's Katie Couric. Well, the election is in the home stretch and I'm exhausted. But turns out the end is near, right in time for a new season of my podcast, Next Question. This podcast is for people like me who need a little perspective and insight.

I'm bringing in some FOKs, friends of Katie's to help me out like Ezra Klein, Van Jones, Jen Psaki, Ested Herndon, but we're also going to have some fun, even though these days fun and politics seems like an ox Herndon. But we're also gonna have some fun, even though these days fun and politics seems like an oxymoron. But we'll do that thanks to some of my friends like Samantha Bee, Roy Wood Jr., and Charlemagne the God.

We're gonna take some viewer questions as well. I mean, isn't that what democracy is all about? Power to the podcast for the people. So whether you're obsessed with the news or just trying to figure out what's going on, this season of Next Question is for you. Check out our new season of Next Question with me, Katie Couric, on the iHeart radio app, Apple Podcasts, or wherever you get your podcasts.

What's up, y'all? This is Questlove, and I'm here to tell you about a new podcast I've been working on with the Story Pirates and John Glickman called Historical Records. It's a family-friendly podcast. Yeah, you heard that right. A podcast for all ages. One you can listen to and enjoy with your kids starting on September 27th. I'm going to toss it over to the host of Historical Records, Nymonee, to tell you all about it. Make sure you check it out. Hey, y'all. Nimini here.

I'm the host of a brand new history podcast for kids and families called Historical Records. Historical Records brings history to life through hip hop. -♪ Flash slam, another one gone. Fast bam, another one gone. The cracker, the bat, and another one gone. The tit, but a cap, cause another one gone. Each episode is about a different inspiring figure BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, BAM, Check it! Get the kids in your life excited about history by tuning in to Historical Records because in order to make history, you have to make some noise! Listen to Historical Records on the iHeartRadio app, Apple podcasts, or wherever you get your podcasts.

First of all, thank you so much for sharing all of that very personal experience, but you get to get through that to understand your commitment to this community. And the commitment to this community is a deal that you made with God to spare your son. And I hear you, Pedro Jr., use the word commitment. And I think that comes very naturally from your parents because they are clearly committed. And the whole family is committed. Committed. And you made a commitment and you intended to make good on it. So here's the deal. You made the deal, your son saved, you ain't going back to Venezuela.

And you decide, well, I've got this background in endocrinology. I understand my emphasis was on diabetes. And I read a thing that says, I read a demographic that says the national average for diabetes is 9% and Memphis is almost double that. So there's a huge need. It's like a 30 something percent higher. 30% higher. It's 9.6 is the prevalence of diabetes in America. Here it's 15%. So the Lord works in mysterious ways.

Not only did you make a deal with God, but little did you know you were making a deal where your talents and expertise and education were actually really, really needed. So the thing is though, you don't go to work in the diabetes world to just go make a bunch of money, you say the reason diabetes is so much more prevalent in Memphis is because you find it in the poverty stricken, underserved areas and you decide that's where we're going to work. It came from, I'm being a researcher. I analyze, I create models of hair. So I didn't want to create life doc as my practice.

We tried to become with something that actually let's do a little bit what's going on in Memphis. I realized that Memphis, what I was seeing in my older folks, I'm an internal medicine by training at all endocrinology. So when I came here to work for a pediatric hospital, it got my attention to see that kids, they were having the same risk factor that we see

in our adult patients. Actually, it's totally different, the level of illness and sickness that I found in those kids that I didn't see in Boston. You saw sickness in kids in Memphis that you did not see in Boston. No, I didn't see that. Why?

The severity of obesity, the complication of obesity, sleep apnea, and ground disease. Sleep apnea in children? Very frequent. Really? Hypertension. In children? Very frequent. Really? Hypertension. In children? In children. We have, I mean, at some point, I hope that we can talk because this is part of Life.Talks measure, how we can communicate where are we heading.

Oh yeah, we're getting to that. But first, I want to, you know, your beginnings. I got my attention and then I was funded at that time, interested in diabetes by NIH and what is called translational research. It's benched practice. So I worked very closely with the University of Tennessee College of Nursing and I developed like an incubator. So I was preceptor, I was designing different studies to characterize what's going on in Memphis. And this is how Live.Model comes. So we develop a model that

works for Memphis. And this is what makes the difference with any other practice that come out, this is what I'm going to do and this is what I know how to do. No, we come out what this is what is needed and this is how we're going to approach base and result for many years. We have been not only characterizing what is affecting Memphis the most, but also what are the interventions that best impact and we've been testing this for many years. Also we've been...

So not only are you treating pediatric diabetes, hypertension, sleep apnea, all the things that are affecting children that shouldn't be, you're also collecting data and the research to try to understand not how to effectively treat it, but the why. The why. The why. And this has been probably the biggest driver of what we do. So interestingly, as I hear this, I can't imagine that Jackson, Mississippi, Little Rock, many other cities, Oklahoma City. If this exists in Memphis, it has to exist in other cities the exact same way.

It is. I mean, it's impressive. And I'm going to leave something for you to see the evolution. And this is the reason that we become No, it's generation We become what an evidence generation center because of the say that again a what evidence generation center and evidence generation center Break that down for a guy that's a football coach because those are big it's easy we

What you were saying? It's a guy that's a football coach, because those are big words. It's easy. What you were saying, it's a center that map characterize the impact of obesity and chronic conditions across the generation. Okay, we've jumped too far ahead. We're getting to that. That is phenomenal, and I cannot wait to explore that. But we gotta, our listeners have to explain.

Okay. You made this deal, you start. I think I read the first year you were seeing 19 patients a month. We is. 19 patients a month for the first, they opened the clinic on Valentine's Day 2005 was the first day that.

And what was the clinic? Just a, a pediatric? Initially was a primary care. It was? Initially it was a primary care. It was just one doctor. A primary care. A primary care because we wanna. But serving the unserved. I focus exclusively on minorities underserved.

Okay, and where was this thing? Mount Moriah and 385, Mount Moriah and Ridgeway. Okay, for those listening, that is not really inner city, but it's southeast inner city. It is, I wouldn't say it's the hood or the projects, but it is certainly a lower moderately income area. And at that time in 2005, it was also one of the areas with the most uninsured populations.

It was one of the places that, you know, there was a vast, uh, health disparity in that area, um, back then. Okay. So that's where you open and you're seeing 19 people a month and you start going to work. But as you go to work, you start to collect this data. I still working for the university. Oh, as well. Yes, I work for the university. I couldn't practice there.

And I choose to invest in developing the model. So I hired more physicians that were able to track the patient, implement the patient, but it was gathered in the data. So I paid. Initially, we pay, we developed the insurance process and we were not necessarily making money. But I couldn't work as a physician there because of my commitment with the university.

So what I was doing, it was what I was calling the incubator process because I make all the nurses, the PhD to analyze the data. Let's see, let's explore what we can do. Combining the data of this underserved community with the data that we see at Labona and come out with difference, disparities. If you see most of the paper that we have published has been in disparities, difference in diseases, challenging the guidelines, and trying to understand why these people die more, why these people get sicker. Because it is true. People that live in poverty have, I think it's a 14-year discrepancy in life expectancy.

And it sounds like it starts in childhood. They die. They represent what is called early mortality. Before 30, they represent a significant percentage. Before 30. And there is another definition of early mortality, early death before 55, they represent the majority of the people that died earlier. And we're going to go deeper in that. But it's exactly where Life.Doc is heading. Try to

understand the design of Life.Doc is trying to understand because it doesn't start when you become 21. It has to be something that you carry from childhood and this is why we choose to move to understand better the diseases in younger people. But one of the things that's worth also highlighting is the fact of why it's an effective thing is because there's different ways of doing research, right? You can study what other people are doing and come up with answers. And what how Life.doc started was just get in there and start doing the work and see what you learn. You know, you get in there, you start seeing the patients, not just reading about the patients,

not just collecting data from other places, but one-on-one with patients getting to do the work every day to see what does the data show, what does the people show, and then where do we go from there. I've got to believe early on the first thing you saw had to have been diet as much as anything. I mean, it's beyond that because neither the... That is of course that there is something there and we're going to go deeper in that. But what I saw is that we were addressing things in a uniform way and I believe that race environment imposes different challenges that require different approaches.

And this is what today- Okay, hold on. You're saying what you observed early on was that race and environment required a different medical approach. I agree with you. Please explain that. So, for instance- Because honestly, we're not supposed to say that.

You know, I mean, let's be honest. We're not supposed to talk about race as a different approach. I mean, that's, ooh, we gotta be careful saying things like that. Please don't misunderstand me. I'm being facetious. Of course we should talk about that.

If those are the facts, we should talk about it. But that almost seems taboo. Let me give you word I'm heading, okay? If I get you, him, and I that are overweight, we have three different, totally different mechanisms why we become overweight. And also if we are exposed to different environment, and we'll talk about what is usually called today social determinant of health, used to call barriers of healthcare in the past. So we get access to food that is not healthy, but also the genetic predisposition. There are people that have a genetic predisposition. We human beings are exactly the same

like any other animal in the world. We have predisposition in the same way that people- Genetic predispositions. Do genetic predispositions sometimes have to do with race? It has to do with race. They do have to do with race. They have to do with race. But hold it. Political correctness says we don't need to talk about those things. But one thing is race... But you're saying that political correctness then...

One thing is racism and another is race. In my country, I learned what was my race when I came to America. The first time that I came to America, I was 15. I came to New Orleans and when I was in the custom, they asked me, what is your race? My mother is Indian with, Indian with German. My father is Spanish with black. So what race am I?

So I didn't, it doesn't, I mean, what does it, so I said, I have no idea. And in many countries, race is a character. It's something that defines something in the same way that you choose a horse, a horse that is good, a race horse. The pedigree defines the quality of the horse or whether or not the horse, you know, it runs. The pedigree define the quality of the hoard or whether or not the... You know, it runs. The pedigree, yeah. And also the genetic makeup.

And the genetic makeup is also exposed and modified by environment. So people that have never been in this level of poverty, and for generations, not necessarily will understand that, but it modify, make a different makeup. And we have a full line of research in that. Okay, so, and this is something, and today, Bill, the best way to do medicine is what is called precision medicine. It's called what?

Precision medicine. Precision medicine. It's called what? Precision medicine. Precision medicine. So meaning that the more specific I target your condition, I will have more chance of success. This is what St. Jude did with Pedro. They did genetic mapping, the way that he respond to the medication is different than the way that other people respond to the medication, the way that they metabolize the medication is different than the way that other people respond to the medication.

The way that they metabolize the chemotherapy is different. So this is where medicine go. Pharmacoh. Difference in the way that people respond to treatment has been defined by genetic predisposition. People in the way that they metabolize, how fast. You may take a blood pressure medication that probably is metabolized faster and you don't respond well, and you may need another that will require... So when you have your clinic and you're starting to treat kids, you're mapping their reaction to your treatment to start to better understand how certain people from certain environments and certain genetic makeup respond to treatment.

Well, and they created a series, an algorithm while they were doing the NIH-funded research. My father and the team back then in 2005, him and Dr. Nero. What were they doing? They created an algorithm to predict who was going to be at a high risk of developing diabetes, pre-diabetes and cardiometabolic conditions. Based on? Based on lab results, history, social history,

family history, medical history, and just a bunch of different factors, because that lets you zone in on what is the root cause of the diabetes. For example, for me, I'm also a patient at Life.doc. I'm diabetic. You're a patient of Life.doc that your father started. Crazy. I'm a patient. But what he was referring to earlier is that most people, even in the early 2000ss were saying diabetes, throw insulin at it. And that's a band-aid on a problem that isn't really a great band-aid because it has its

own complications. But by understanding root causes, we can see what other treatments exist. I'm not on insulin. I've been diabetic for 12 years now and I was on insulin for a while. I've been, you know, because of everything that we can learn along the way, you know, I've been off of insulin now for like seven or eight years. With other medications and lifestyle and everything, but it's not type one, it's not type two, it's chemo-induced diabetes, and it's got a different cause and treatment option.

The causes are different. The model that we try to embrace is that initially the initial approach was, let's find out what are the risk factors, and from those risk factors, what are the predictors? And then based on those risk factors and predictors, we stratify, actually in 2005, we published one of the papers that say,

to teach physician what kids is gonna become with diabetes, wanna become obese, and to become with heart disease before they develop. Okay, so they, and this is what I try to see. We haven't done a good job stopping the progression of obesity and diabetes, not only in Memphis, in the whole country. This map, when you have a chance, take a look 2004, and you will see that we haven't done anything in prevention because we choose to treat.

Once you are obese, I'm going to approach you. Once you develop the heart disease, once you develop the diabetes. Even though NIH, CDC, invested 250 million dollars to prove that diabetes is a predictable and preventable disease, we choose to treat, not to prevent. So Life.Dog is reusing all this data and adapted to the Memphis in order to see what are the risks, how can we intervene earlier in the risk instead of wait for you to develop, David. We'll be right back.

We'll be right back. Season two, season two. Are we recording? Are we good? Oh, we push record, right? And this season, we're taking a bigger bite out of the most delicious food and its history. Saying that the most popular cocktail is the Margarita, followed by the Mojito from Cuba, and the Piñu Colada from Puerto Rico. So all of these things, we thank Latin culture. There's a mention of blood sausage in Homer's Odyssey that dates back to the ninth century BC.

BC? I didn't realize how old the hot dog was. Listen to Hungry for History as part of the My Kultura podcast network, available on the iHeart radio app, Apple podcasts, or wherever you get your podcasts. I'm Malcolm Gladwell. 25 years ago, I wrote my first book called The Tipping Point, all about the moments when an idea or trend crosses a certain threshold and spreads like wildfire.

I've had a lot of time to think about that book and the way I thought about Tipping Point's changed. So now I'm releasing the sequel, Revenge of the Tipping Point, where I return to the subjects of social epidemics and the dark side of contagious phenomena. You can hear a sneak peek of the audiobook on my podcast, Revisionist History. Plus, we'll dive into a duo of narrative episodes about my favorite trial in American history and a reevaluation of the broken windows theory I explored in my first book. Find Revenge of the Tipping Point wherever you get your audiobooks and listen to Revisionist History on the iHeartRadio app, Apple Podcasts or wherever you listen

to podcasts. Muhammad Ali, George Foreman, James Brown, BB King, Miriam Makeba. I shook up the world! James Brown said, said love. And the kid said, I'm black and I'm proud. Black boxing stars and black music royalty together in the heart of Zaire, Africa. Three days of music and then the boxing event.

What was going on in the world at the time made this fight as important as anything else is going on on the planet. My grandfather laid on the ropes and let George Foreman basically just punch himself out. Welcome to Rumble, the story of a world in transformation. The 60s and prior to that, you couldn't call a person black. And how we arrived at this peak moment. I don't have to be what you want me to be.

We all came from the continent of Africa. Listen to Rumble, Ali, Foreman, and the Soul of 74 on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Hey everyone, it's Katie Couric. Well, the election is in the home stretch and I'm exhausted. But turns out the end is near, right in time for a new season of my podcast, Next Question. This podcast is for people like me who need a little perspective and insight. I'm bringing in some FOKs, friends of Katie's, to help me out like Ezra Klein, Van Jones,

Jen Psaki, Ested Herndon. But we're also going to have some fun, even though these days fun and politics seems like an oxymoron. But we'll do that thanks to some of my friends like Samantha Bee, Roy Wood Jr. and Charlamagne the God. We're going to take some viewer questions as well. I mean, isn't that what democracy is all about? Power to the podcast for the people. So whether you're obsessed with the news or just trying to figure out what's going on,

this season of Next Question is for you. Check out our new season of Next Question with me, Katie Couric, on the iHeart Radio app, Apple Podcasts, or wherever you get your podcasts. Sup, y'all. This is Questlove, and I'm here to tell you about a new podcast I've been working on with the Story Pirates and John Glickman called Historical Records. It's a family-friendly podcast. Yeah, you heard that right. A podcast for all ages. One you can listen to and enjoy with your kids starting on September 27th. I'm gonna toss it over to the host of Historical Records,

Nimini, to tell you all about it. Make sure you check it out. Hey, y'all, Nimini here. I'm the host of a brand new history podcast for kids and families called Historical Records. Historical Records brings history to life through hip hop. Flash slam, another one gone. Bash bam, another one gone.

The cracker, the bat, and another one gone. A tit for the cap, there's another one gone. Each episode is about a different inspiring figure from history, like this one about Claudette Colvin, a 15-year-old girl in Alabama who refused to give up her seat on the city bus nine whole months before Rosa Parks did the same thing. Check it!

Get the kids in your life excited about history by tuning in to Historical Records because in order to make history, you have to make some noise. Listen to Historical Records on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. In bold letters, our mission is to build healthier communities by preventing diabetes and obesity through healthcare and research. All while serving underserved communities. With equity. Started just only 19 years ago.

So tell me what LifeDoc has grown to from 19 patients a month in Mount Mara area to now. So, you know, since it is a data driven approach, we never really believe in a if you build it, they will come it's got to be more intentional. It's got to be based on you know, what do people need? And how do we make a solution that works, right? So it started as primary care and over the years that it developed into endocrinology, diet and exercise, optometry, cardiology, behavioral health, pharmacy, and all these services get added over the... Intentional exercise.

All right. So cardiology, pharmacy, endocrinology, diabetes and obesity, optometry, and behavioral health. And pediatrics. And pediatrics. And pediatrics and family practice. And all of these are now folded into Life.docs treating for the underserved communities in Memphis. And right now we see anywhere from 900 to 1,100 patients a week. Holy crow!

Oh my gosh! And how many facilities? So we have three clinics and we're also in four schools in Memphis. And all the while still collecting the data, still doing the research. The main thing is systemic change, right? We're not going to really change the world on our own the same way that St. Jude couldn't change the world on their own. They have to find out what works and share it and try to instigate systemic changes to make it more doable. And when you're talking about healthcare, that talks more than just access to care. That's the things that my father was talking about earlier, you know, access to healthy food, lifestyle, safety, jobs, income, all these things are connected. And so the way that we see this is providing a roadmap for people to make better decisions

who are in the positions to make those decisions. So your father just gave me a map that I that I will show for those who can see it on film. This is 2004 and for those listening in 2004 it's just a map that is age-adjusted prevalence of diagnosed diabetes and obesity among adults by county in the United States and as you the a little bit. And then there's kind of a band starting in Oklahoma going down through Mississippi, Alabama, Georgia, and up to the Carolinas that has a little bit and in Alaska. The rest of it is very light in 2004. In 2019, 15 years later, the map is just dark. Perfect. It's purple. The whole map. I mean, there's a really smart area of white somewhere in the mountains of Colorado, and

I don't even think anybody lives there while that's why. But if you look in the south, it's purple. It is, it is, it is stark how you go from white to purple. And so this is your point, Pedro Senior, that you circle this area, it's just deep purple. But your point is the CDC in the country has spent $250 million in research. And in the last 15 years, we've gone from not that bad to horrific. Because we're not working on prevention, we're working on treatment. That's it. You put it in black and white, the white away. And the reason that we are moving, if you choose to analyze our population,

is 60%, 65% is younger than 21, because we can't prevent in this population. Even though if you go, most of the people that pay better, more insurance in Medicaid than other people, but we won't be able to prevent. So, our mission is to be sure that we prevent. So, we are working with people at risk. And the more life-dark model is focusing in managing the risk.

The risk to become sick, but if you are sick, how can I prevent you to develop complications? So, you're seeing about 12,000 patients a year now. You provide, I don't know, 50 to 55,000 visits. You're in schools. You're collecting the data. You're treating people, but you're also working on prevention with your... Identifying, mapping the population. Mapping the population. So the thing that I found phenomenal is from your experience as St. Jude, I gotta believe your experience as St. Jude had a part in this process. Your goal is yes, to absolutely do everything you can to prevent and treat the most underserved communities in Memphis to make good on your commitment because your son lived.

That's it. But further, is you are trying to get this data mapped and understand through these things that you've learned and your goal is to share it with the country. To say this is what we can do to be better that you've learned and your goal is to share with the country. To say this is what we can do to be better despite the 250 million the government spent, we have a better way. And also not only show what we can do, but also what we can do with our own resources.

Because all the research program that life has been self-financed. We reinvest part of our earning in understanding better the community. And the budget has been growing significantly, but initially LifeDog was not recognized by any insurance. So- It was not recognized by insurance. No, for the first two, three years,

they didn't like the model that we proposed. Now we are in every single. And because... Yeah, because unlike a lot of places like you, I know you receive some donations, but the vast majority of your revenue comes from Medicaid, right? Medicaid. From patient care, you know, about 70% of the patients we see are Medicaid. About 15 is uninsured.

So 85% is what we would consider medically underserved. And then the rest is Medicare and commercial insurances. And so the makeup of what we do is the gist of self-sustainability means that we don't want what we do to be dependent on a donation or a grant. And if we don't get that donation that year, that we can't provide the care. So it's been very intentionally designed so that the care that's provided is self-sustainable and long-term.

You could have made a hell of a lot more money going into private practice. By far. But that wasn't your commitment, was it? It wasn't my commitment. I know I've been on that. You've started to really dig this commitment thing inside your family ethos.

That's a beautiful thing. So Pedro Jr., you're not a doctor. I'm not a doctor. What are you? I've been whatever I needed to be since I was a kid. I've read where you said it was free child labor for a while. Yeah. And it sounds like your dad would have smacked you

if you didn't go to work. You know, it was after high school, after wrestling practice at CBHS, we'd go to the clinic. Christian Brothers High School. At Christian Brothers High School. We'd head down to the clinic until it was time to go home. Which was when? Seven, eight o'clock, you know.

The idea was that we'd be doing our volunteer hours there and all those things, so you sort of grow up around it. And then during college, I would do my summer internships there. Where'd you go to school? I went to Florida International University down in Miami. Got it. And so during those summer internships, I'd come back.

We'd see what was going on. One of my first projects was back in 2011 for the uninsured population, creating a membership model so that they could get access to everything that we do at the clinics for 90% off. How do you do that? Just projections, data and trying to tie what has to happen medically to how can you make it happen operationally. Like once the doctors sort of identify what works, we can try to make sure that it can be implemented, right? And sometimes it's the other way around. Hold it, you say that, yes, right, I get it, but that's not the reality in most places

across the country. No, usually it's the financial people that will say what needs to happen and the doctors have to try to make it work. And that's one of the biggest things that is why there's so much purple on that map, right? Is that it's not really with the health. A lot of decisions weren't necessarily made for the health benefit.

They're made financially rather than the health decisions. Which is normal for any country, right? It's just that, and this is again why we are so intentional about the work that we do is that we have to provide an avenue for people to be successful and make money by keeping people healthy and not necessarily by treating diseases. So you go to Florida International, you do your thing,

and then after you graduate? It was actually my junior year. My father and the business were going through some pretty difficult times. So I was there here this summer. I was hoping on a mean difficult so it was 2012 back then and I was here for my summer internship. There was a Difficult situation with his partner at the time and so

My father being a businessman, he, sorry, a medical person, he wasn't really business, he had a partner that handled the business side of things. And some things were happening that shouldn't have been happening. And he had to end that partnership and was sort of left with the clinic in a state of I'm a doctor, not the business. And so during that summer, I was trying to help with as much as I could. And when it was time for me to go back to school and register for classes, when I asked him if, you know, it'd be better if I stayed my senior year. And so I registered for online classes and stayed in Memphis to see what I could do to help my senior year. And that's when I sort of got into this mode

of going into different departments, learning what they do, helping fix something, and going on to the next thing, whether that was the front office, the billing, the accounting and all these things. As a senior in college. As a senior in college. I had one day a week where I had to go to Miami.

It was a Tuesday. Tuesdays was my in-person days. And so I'd fly down on Monday, come back on Wednesdays. And I got to know a bar at the Charleston airport very well that my coconut rum with coconut shrimp would be a bi-weekly thing every Monday and Wednesday. Ah, it's hilarious. And so when I graduated, I ended up seeing a path for me in healthcare,

which was sort of serendipitous. That's sort of what my upbringing was. I swear to you, I was just about to say serendipity, really. And so that's when I decided that I was probably going to dedicate my career in healthcare in different ways. I didn't know exactly what that meant. So what I like doing and what I have done since is just identifying problems and finding solutions to them. From a business perspective.

From a medical implementation perspective. There's a lot of journals, there's a lot of things out there that exist that tell people what they should be doing, but don't really provide a path on how to do it. How can you operate a clinic? How can you do these things? How can you implement these things in your community,

in your neighborhood, in your organization without having to be a nonprofit or a hospital? Pedro Seniors, are you not so proud? I am. You should be. I am. I am. A kid that's a senior in college is supposed to be going to keg parties and chasing girls around and acting like an idiot. And he is flying to school for one day, flying back and basically running the operations of your clinic for you.

He learned every aspect of the clinic. He also partied a lot. He did have fun. Good. But he knows every single aspect of the clinic in the way that people should know. So you are now what? My role is executive director of Life.doc. He was the operational director. He's been the operational director for a long time. He's been more than 12 years working in We, uh, we- As a 33 year old. Mm-hmm.

We'll be right back. Do you ever wonder where your favorite foods come from? Like what's the history behind bacon wrapped hot dogs? Hi, I'm Eva Longoria. Hi, I'm Maite Gomez-Rajon. Our podcast Hungry for History is back. Season two, season two. Are we recording? Are we good?

Oh, we push record, right? Okay. And this season we're taking an even bigger bite out of the most delicious food and its history. Saying that the most popular cocktail is the Margarita, followed by the Mojito from Cuba and the piñuculada from Puerto Rico. So all of these we have, we thank Latin culture. There's a mention of blood sausage in Homer's Odyssey that dates back to the 9th century BC.

BC? I didn't realize how old the hot dog was. Listen to Hungry for History as part of the My Cultura podcast network available on the iHeart radio app, Apple podcasts, or wherever you get your podcasts. I'm Malcolm Gladwell. 25 years ago, I wrote my first book called The Tipping Point, all about the moments when an idea or trend crosses a certain threshold and spreads like wildfire. I've had a lot of time to think about that book and the way I thought about Tipping Points changed.

So now I'm releasing the sequel, Revenge of the Tipping Point, where I return to the subjects of social epidemics and the dark side of contagious phenomena. You can hear a sneak peek of the audio book on my podcast, Revisionist History. Plus, we'll dive into a duo of narrative episodes about my favorite trial in American history and a reevaluation of the broken windows theory I explored in my first book. Find Revenge

of the Tipping Point wherever you get your audiobooks and listen to Revisionist History on the iHeartRadio app, Apple Podcasts, or wherever and listen to revisionist history on the iHeart Radio app, Apple Podcasts or wherever you listen to podcasts. Muhammad Ali, George Foreman, James Brown, BB King, Miriam Makeba. I shook up the world. James Brown said, said love. And the kid said, I'm black and I'm proud. Black boxing stars and black music royalty together in the heart of Zaire, Africa.

Three days of music and then the boxing event. What was going on in the world at the time made this fight as important that anything else is going on on the planet. My grandfather laid on the ropes and let George Foreman basically just punch himself out. Welcome to Rumble, the story of a world in transformation. The 60s and prior to that, you couldn't call a person black.

And how we arrived at this peak moment. I don't have to be what you want me to be. We all came from the continent of Africa. Listen to Rumble, Ali, Foreman, and the soul of 74 on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Hey everyone, it's Katie Couric. Well, the election is in the home stretch and I'm exhausted.

But turns out the end is near, right in time for a new season of my podcast, Next Question. This podcast is for people like me who need a little perspective and insight. I'm bringing in some FOKs, friends of Katie's, to help me out, like Ezra Klein, Van Jones, Jen Psaki, Ested Herndon. But we're also gonna have some fun,

even though these days fun and politics seems like an oxymoron. But we'll do that thanks to some of my friends like Samantha Bee, Roy Wood Jr., and Charlamagne the God. We're going to take some viewer questions as well. I mean, isn't that what democracy is all about? Power to the podcast for the people. So whether you're obsessed with the news or just

trying to figure out what's going on, this season of Next Question is for you. Check out our new season of Next Question with me, Katie Couric, on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. What's up, y'all? This is Questlove, and I'm here to tell you about a new podcast I've been working on with the Story Pirates and John Glickman called Historical Records. It's a family-friendly podcast. Yeah, you heard that right. A podcast for all ages. One you can listen to and enjoy with your kids starting on September 27th. I'm going to toss it over to the host of Historical Records, Nimini, to tell you all about it. Make sure you check it out.

Hey y'all, Nymonee here. I'm the host of a brand new history podcast for kids and families called Historical Records. Historical Records brings history to life through hip hop. Another one gone. Bash bam. Another one gone. The cracker, the bat, and another one gone. The tip of the cap is another one gone. Each episode is about a different inspiring figure

from history, like this one about Claudette Colvin, a 15-year-old girl in Alabama who refused to give up her seat on the city bus nine whole months before Rosa Parks did the same thing. Check it. And it began with me. Did you know, did you know I wouldn't give up my seat

Nine months before Rosa He was Claudette Goldman Get the kids in your life excited about history by tuning in to Historical Records because in order to make history, you have to make some noise! Listen to Historical Records on the iHeart Radio app, Apple podcasts, or wherever you get your podcasts. We became a nonprofit in 2021. Okay. And that was a two year process that we started just because I don't know.

It's not easy to get a 501 C3, especially in the medical world. It's not. And you know, we thought it was the best move for the longevity because you know, the alternatives when my father decides to stop practicing is that it can either shut down or sell the clinics. And so as a nonprofit, the organization is going to continue to live until you know, diabetes and obesity is no longer a problem. That is so weird to hear you say because that's St. Jude's that St. Jude's goal. St. Jude wants to work itself out of ever being needed. And LifeDoc wants to work itself out of every

goal of every nonprofit, right? Is that you know, eventually they don't have to exist, whether you're fighting a lack of education, lack of economic or income development, lack of food. The end goal of every nonprofit should be that they can close shop one day. But the reality is that, you know, it's gonna take a lot. So when we developed the board, when we developed everything,

we started shopping around for an executive director. And after a few months is when they asked me if I could step into that role. And that's where I'm... Oh, Pedro, it was not me. It was the board. It was not nepotism. I don't think that you really... And it shouldn't be. And I said, when I said that my family is committed is that every child has been supported in different way who we are now, what we, the organization that we are. So everybody raised by merit. So it doesn't matter whether they are my children or whoever, they have to compete. And Pedro actually, at some point he said, I'm the working the most and getting

the less pain. So it's because this is what make people... So nepotism tends to go the other way in our family. You know, the closer you are, the harder you have to work. So few demographics. 9.6% of the US population has diabetes. Shelby County, Memphis is 15. You guys have been cited in 80 publications based on the work that you've done. Your research has impacted 73 practices in Tennessee.

You do not depend on charity. You use insurance, Medicaid, and Medicare, which many doctors' offices says you can't operate on because it doesn't pay enough, but you have spoken amazingly to how you've managed that. Less than 10% of your revenue is from donations, although you can always use donations for the work you do. It's still less than 10%. And Slingshot, who has been a guest on our show, who they do through analytics,

really go into philanthropic endeavors, 501c3 organizations, and they really measure endevours 501c3 organizations and they really measure the success of those organizations and do it in a very analytical way. Slingshot found that for every dollar invested in to Life.doc, there's $2.7 in poverty fighting impact by what you do. Last year we spent $8 million running the organization more or less. So using what Impact saw, which they analyzed 2023, that means that those $8 million we spent generated over $20 million in economic benefit for the communities that we serve. 50% of the impact come from our nation, diabetes and obesity prevention and early management. This is – I brought also the summary of the slingshot report. So –

This is our – and – So say what you just said again, 50%. So they analyzed a few things, right? They looked at our medical model, they looked at our school-based health system, and then they looked at our community health worker initiative. And each one of these three parts of what we do was analyzed to understand what was the impact that it had on the patients. And most investments that, well, any investment that gives a 270% return in a year would be considered a good investment.

That's a home run. Yeah. So the interesting thing about this third party analysis was trying to tie the knot of, why should people care? Nobody? You know, nobody wants Memphis to not progress economically. And this, what this shows is that, you know, a healthy Memphis is a more prosperous Memphis. And so being able to use data to paint that picture for people is going to be extremely important, especially as we have to start having more and more conversations around what has to happen systemically for these things to be more realistic, more doable,

and that it doesn't take people as committed as my father and I and my family for it to be possible. It should be the status, the standard of care. What you said by extension, a healthier Memphis is a more prosperous Memphis. A healthier Little Rock is a more prosperous Little Rock. A healthier Louisville is a more prosperous Louisville. A healthier US is a more prosperous US,

but I would even go as far to say, a healthier Memphis is a more prosperous Memphis, thus a more prosperous Memphis is a safer Memphis, is a less crime-ridden Memphis, is a less blighted Memphis. It all flows downhill, so when we talk about the things that are plaguing our culture and our society, it follows them that a healthier public generates a healthier culture, not just from a physical health, but a cultural health, a societal health, a safety health. And there is plenty of research supporting what you... There's plenty of research that says what I'm saying is right.

Well, why did you do all the research? I just said it. I had it all wrapped up. But tell me about that. That's interesting. It is. I'm hearing you and I'm repeating what I'm hearing from you. This is nothing I'm saying.

But this is the way. There is plenty of research showing that, for instance, there is a different model of healthcare. One of the healthcare is called behavioral and different model of healthcare. One of the healthcare is called behavioral and ecological model of healthcare. It's been published by Harvard, by anything. So they show that the belief of the people, the access to healthcare, the perception of diseases,

the way that the physician treat them, the way that they feel they trust in the primary care, define the outcome of the society. They associated with less crime, there is association with less depression, there is association with less expenditure and unnecessary ER, less hospitalization. Most of the research or whatever you said. So health care will impact the whole economy to the point. To the point.

Since the state of Tennessee start to measure quality metrics, Life Dog have achieved 100% of the quality metric. You're kidding. However, even more, since 2017 that we start to measure financial impact, patients that are seeing life doc have had 27% lower total cost of care. Total cost of care means that they get less admission in ER, less admission in the hospital, less

pharmacy, less radiology, less surgery. Twenty-seven percent reduction in the cost of healthcare for patients. The patients from life. And this is data that can be seen in 10 care. Okay, this is part of the patient center medical home that has been polished by 10 care based in our patients. So why can't this be scaled in every city in the country? That's one of the things that has to happen, right,

is that, you know, it's doable, it works, but the systems aren't necessarily in place to support it, right? A lot of the work that we do around creating models of care, models of reimbursement, creating these things so that it is more scalable, so that people can do it in their own backyards. We don't wanna be the clinic across the US trying to tell New Orleans how to treat New Orleans.

We do wanna create around, we wanna provide the path to where people can do this on their side. We've been able to treat the underserved community and drive our organization. We've been able to use the patient that we see most practice doesn't accept those patients. Most practices won't accept the patients that you see because they don't have private insurance. They don't have private insurance. And the doctors want to make more money than what Medicare or Medicaid will pay.

Well and it's hard, you know, because these patients do have definitely a lot of challenges in their lives that make it difficult for them to remain compliant. And that's a very frustrating sentiment to have when you know you are a doctor seeing a patient and it seems like they just don't really care and you want to focus on the people that do care. Right. That's a very... You mean care about their own health. Around their health.

And so understand... But the whole time you know from the data, as a physician, your patient doesn't really understand this, but you're thinking, if I could get this person to care about their health and listen to me and I could help prevent their cure, I'm going to save them money and I'm going to better my community. Actually, you're right, because the first step

that we put in the school system, when we saved a significant amount of money to one of the HMO insurance, we didn't ask for higher reimbursement. Can you help us to impact the community? Can we finance the first school program? Today, we support five school programs from our own resources. We spend more than $300,000 providing care to close to 2,200 kids at the school. We see about more than 4,000 visits, and most of the visits are not reversible by insurance.

It's our decision to... You're just doing this? We have been doing this since 2019. So when we talk about research and innovation, you know, we've built a model of self sustainability, however, self sustainable medical model doesn't really promote innovation, so we have to continue to invest in sort of new models of care, new ways of making sure that people in these communities that where the parents can't take off work enough times to get the kids to miss a lot of

school, to get them to to miss a lot of school, to get them to the doctor's office, you know. Instead of that, you're actually meeting them where they are in their school. In the schools, again, to try to make sure that we can generate the evidence so that this can become the norm, so other people can do this.

We're not trying to be in every school. We invest in this, Pedro companies working with tank care, why don't we, and the University of Tennessee, why don't we approve this type of code and reimbursement so any doctor, no life doctor, they can go and serve to the community. So there is progress. The state is very eager to make some changes that eventually, not Life. Life. Dog will develop the model, but any other... Which you're going to give it to all the doctors in the state.

That's it. This is the way. That's again the state's your model. The way that the epidemic is growing. Life. Dog become nonprofit, not because of the operations budget. Like that become because we need to expand the model faster if we wanna target the obesity

and diabetes epidemic in the country. It says, one of the things I've read is your research has impacted 73 practices in Tennessee. I said that earlier. How? So when we talk about developing different models of reimbursement, different models, the way that we would do that is by working with the key stakeholders, right? The insurance companies, the state, and trying to see what models of care can help others

replicate this. So, in 2017, we were part of a pilot in Tennessee that was launched to try to support, implement a reimbursement model that would let practices provide the type of care that we do at Life.doc and, you know, focused on the patient and everything that we need to coordinate for them. And so that's been rolled out to now over 80 practices since we spoke about it last and that they treat over half a million people in Tennessee. It's an example, I guess, of what we mean when we say that we're trying to use what we do to sort of help guide the decision makers.

Again, it's really important that our listeners get that 50% of the benefits created come from prevention and treatment of chronic illnesses like hypertension, diabetes, and obesity. It is phenomenal that by treating early on, gathering the data, studying the data and putting together plans based on that data, you have then gone into how to best treat and prevent these diseases specific to this region, but you can use the same model for a region in New Orleans or Albuquerque? That's the way that we are doing it.

The data that we've been collecting has been analyzed and in conjunction with the University of Memphis has been published. So any other physician can use our model, validate the model, but also can use our results. So this is the reason, most of the most recent, most of our publications are in conjunction with either University of Tennessee or University of Memphis. So most of what we are heading now, how can other people can replicate what we do? If the state is happy because we are producing savings, because we are 51% less hospital admissions, 48% less ER utilization.

Not only we are making the patient healthier, but also something that anybody can replicate and produce similar outcomes. So this is where we are heading now. This is where our expansion is going. How we can develop a more humanistic, patient-centered healthcare model that focuses on what is killing Memphis.

We'll be right back. Like, what's the history behind bacon-wrapped hot dogs? Hi, I'm Eva Longoria. Hi, I'm Maite Gomez-Rejón. Our podcast, Hungry for History, is back. Season two, season two. Are we recording? Are we good? Oh, we pushed record, right? And this season, we're taking an even bigger bite out of the most delicious food and its history.

Seeing that the most popular cocktail is the Margarita, followed by the Mojito from Cuba, and the Pinyucolada from Puerto Rico. So all of these... We thank Latin culture. There's a mention of blood sausage in Homer's Odyssey that dates back to the 9th century BC. BC?

I didn't realize how old the hot dog was. Listen to Hungry for History as part of the MyCultura podcast network available on the iHeart radio app, Apple podcasts, or wherever you get your podcasts. I'm Malcolm Gladwell. 25 years ago, I wrote my first book called The Tipping Point, all about the moments when an idea or trend crosses a certain threshold and spreads like wildfire. I've had a lot of time to think about that book,

and the way I thought about Tipping Points changed. So now I'm releasing the sequel, Revenge of the Tipping Point, where I return to the subjects of social epidemics and the dark side of contagious phenomena. You can hear a sneak peek of the audiobook on my podcast, Revisionist History. Plus we'll dive into a duo of narrative episodes about my favorite trial in American history and a reevaluation of the broken windows theory I explored in my first book. Find Revenge of the Tipping Point,

wherever you get your audio books and listen to Revisionist History on the iHeart Radio app, Apple podcasts, or wherever you listen to podcasts. black music royalty together in the heart of Zaire, Africa. Three days of music and then the boxing event. What was going on in the world at the time made this fight as important that anything else is going on on the planet. My grandfather laid on the ropes

and let George Foreman basically just punch himself out. Welcome to Rumble, the story of a world in transformation. The 60s and prior to that, you couldn't call a person black. And how we arrived at this peak moment. I don't have to be what you want me to be. We all came from the continent of Africa. Listen to Rumble, Ali, Foreman, and the Soul of 74 on the iHeartRadio app, Apple Podcasts,

or wherever you get your podcasts. Hey everyone, it's Katie Couric. Well, the election is in the home stretch and I'm exhausted, but turns out the end is near, right in time for a new season of my podcast, Next Question. This podcast is for people like me who need a little perspective and insight. I'm bringing in some FOKs, friends of Katie's, to help me out like Ezra Klein, Van Jones, Jen Psaki, Ested Herndon. But we're also going to have some fun, even though these days fun and politics seems like an oxymoron. But we'll do that thanks to some of my friends like Samantha Bee, Roy Wood Jr., and Charlamagne

the God. We're going to take some viewer questions as well. I mean, isn't that what democracy is all about? Power to the podcast for the people. So whether you're obsessed with the news or just trying to figure out what's going on, this season of Next Question is for you. Check out our new season of Next Question with me, Katie Couric, on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Sup, y'all. This is Questlove, and I'm here to tell you about a new podcast I've

been working on with the Story Pirates and John Glickman called Historical Records. It's a family-friendly podcast. Yeah, you heard that right. A podcast for all ages. One you can listen to and enjoy with your kids starting on September 27th. I'm gonna toss it over to the host of Historical Records, Nimini, to tell you all about it.

Make sure you check it out. Hey, y'all. Nimmini here. I'm the host of a brand new history podcast for kids and families called Historical Records. Historical Records brings history to life through hip hop. Flash slam, another one gone. Bash bam, another one gone.

The cracker, the bat, and another one gone. The tip of the cap, there's another one gone. Each episodeer, the bat, and another one gone. The tip of the cap is another one gone. Each episode is about a different inspiring figure from history, like this one about Claudette Colvin, a 15-year-old girl in Alabama who refused to give up her seat on the city bus nine whole months before Rosa Parks did the same thing. Check it.

And it began with me. Did you know, did you know? I wouldn't give up my seat And I am a before-roader It was Claudette Goldman Get the kids in your life excited about history by tuning in to Historical Records because in order to make history

you have to make some noise Listen to Historical Records on the iHeart Radio app, Apple Podcasts, or wherever you get your podcasts. I think it's worth noting that the reason that people need to sort of start caring about that, like why do why should they care if we produce savings, right? Is because research has also shown that the your health is 15% of your health is determined by the care you get. Only 15% is determined by the quality of the care that you get.

25% is genetics and other non-modifiable factors and 60% is about your lifestyle and where you live, work and play. Which means three out of five things that determine our health we can control if we just know how. And you made an analogy earlier where healthier Memphis is more prosperous and safer but the way that health care works that's sort of the other way around. For Memphis to get healthy we have to have a safer community so health care dollars need to be starting to get spent in different ways than just treating people. Our approach you know America has like an $8 trillion a year healthcare budget. There's no other budget, you know,

maybe the defense budget, but the food industry, the education, nobody has as much of a budget as the healthcare industry does. And that money is being spent in a way that it's not really producing a healthier US. So what our goal is, is that, you know, can we produce safer communities with better access to food, with better education, with all these things that will lead to healthier Memphians, more prosperous Memphians?

Because, you know, you've had a lot of speakers in this podcast, right, that have a lot of really great work in different industries. And there's always a sort of a competition around who has access to the resources to support their work. And we need the healthcare industry to sort of start lining up with these organizations and seeing that that's really the way that you're going to build healthier communities. What we try to prove to the industry is that the saving can be reinvested in the community

to prevent diseases, not to treat more illness. So wait until you need the bypass or the leg amputation. We can prevent this earlier. And this is where we are heading with the saving. This is the conversation that we are moving forward with the state. Actually, we probably have one of the uniqueness in developing a new reimbursement model that we choose to become at risk. We want to prove actually the patient, the membership that he developed, the patient doesn't sign any contract.

They stay in the membership as long they see value. The mean stay of the patient in the membership is three to five years. But also with the state, we are willing to take full risk for what we do. We are willing to prove that we can produce safe and patient health care. The more you invest in early and in managing the risk of diseases, there is more money for the companies and there is more money for the community. One of my guests said this a few months ago and I've used it since a couple of times, but it's appropriate here.

You can stand by the river and be heroic and pull drowning babies out of the water all day long, but eventually you need to go upstream and find out how they're getting in the water in the first place. That's the solution. Looking for the solution. And this is what we try to understand, what is predicting that we become so sick. For instance, if you analyze Memphis data, Memphis, this is Shelby County data,

67% of the people that die from diabetes is black. It's telling us that we are missing something. It's telling us that it's not because they are black, it's because we probably have not been measuring the disease in the way that they need to be measured. We are implementing approach, there are general approach to the population, but we probably have not been targeting their risk. So it's amazing how you see that Memphis today is probably the city with the highest percentage of black.

Seven of every ten Memphians are overweight or obese. Thirty-three percent are severely obese or severely obese. And there is not necessarily something that we are trying to do as a community to organize and move in that way. And this is what we try to do. I mean, we want to be part of something. The way that we operate is based on results. I can spend most of our resources if we see that we are helping.

The model that Life.doc developed is based in three primacy. Are we helping? We measure by outcomes. Can we escalate? Is measure how we become from 19 patients to the amount of patients that we see now. And second, can we be self-sustained?

So we won't be able to go to Orange Mound and tell a physician, you can help this community if we don't develop a self-sustained. So we won't be able to go to Orange Mountain and tell a physician, you can help this community if we don't develop a self-sustained model that allows this physician to grow the practice in a decent way. We won't develop something that will help if I need to become an FQAC or a 501c3 to help people. No. or a 501-C3 to help people. No, and LifeDAC is the proof that we can work with it. Lowest reimbursement insurance

for the most undeserved community, and we are still driving, and we are still impacted. That's the way to end it. LifeDAC has proven you can work with the sickest, poorest people, receive the littlest amount of reimbursement and create the best results. That is a phenomenal legacy to our city and all from a deal you made with God because you wanted to make sure your son survived. What a phenomenal story. Pedro Velazquez and

Pedro Velazquez, somehow yours has a dash on it. I don't understand what that is. Is that right? It's probably because there was Rodriguez after it. I got it. He's hyphening. So we've got Dr. Pedro Valesquez and Director Pedro Valesquez Jr. in Memphis, changing the way medicine is thought about and focusing on treatment and summed up the best way possible, treating the most difficult patients to treat, receiving the least reimbursement and being the most successful

because of a data-driven approach toward understanding the demographic of the group you're trying to serve and fitting medicine to their needs. And now, having created a scalable model, if somebody wants to reach out and hear more, maybe there's a doctor in Oklahoma City right now that says, I wanna know more.

How do they find you guys? You know, email, phone number. Well, email you, how do they email you? Do you want me to just say it or do you want me to give it to you? Yeah, give me your email. It's P-A Velasquez. Okay, you got it actually Velasquez

P a V e l a s q u e z at life doc health org at life doc health org and I want to put this up there if I gotta believe if If somebody reached out If somebody reached out, you would be more than happy to share with them anything because the other cool part of the story is from the hospital that saved you, you've adopted their beliefs that what we learn we share and when we share we make a better world. And we're only here because we were the people that used to make calls to see how can we and what do we do. Well, because we were the people that used to make calls to see how can we and what do we do.

Well, we are still the people. We knock on doors. And one of the cool things about Memphis is that it doesn't really matter whose door you knock on. Everyone's always willing to talk and lend a helping hand or point you in the right direction. So yeah, if people call or email, we're going to answer the same that people have answered our calls and emails. If there is also more medical provider interested, they can go to PubMed and search Life.Doc.Model. We publish and even the code that we use, the model what we do, our outcomes has been

published by the University of Memphis. So our research to impact the epidemic also has been published in the University of Memphis. So our research to impact the epidemic also has been published in major journals. Okay, so we want to be approached. We want, something that we are interested in is how we can attract talented physicians to Memphis. How we can attract people that is interested in serving the community,

and be sure that we are helping people. So I hope that this podcast can help us to spread the message that Memphis is great to drive. Regardless what we hear about Memphis, Memphis have a uniqueness that they tend to adopt you if they know that you are helping them. Okay, it's a relatively easy city to love it. And we are the proof.

We are first generation and every single child of my child has been impacted Memphis in their business and they are committed to this. From Venezuela to Boston, back to Venezuela, who found Memphis with a sick child back to Venezuela who found Memphis with a sick child and who found an amazing purpose with a healed child now changing lives in our city and data points in a plan that can change lives across our country. Pedro Pedro amazing story thank you so much for joining us and I can't wait to see what you guys do

over the next five or 10 years, because it doesn't look like you're gonna sleep on what you've done because of a particular word that your family seems to hold dear and dear, commitment. We seem to be passionate. Everybody is interesting because sometimes when we get together, it's like a board meeting. What are we going to do? At some point he said, we need to talk

in another thing that won't be business because everybody is passionate about what aspect of the health. Passionately committed. Guys, thanks for joining me. Thank you. Thank you. Appreciate it, Bill. And thank you for joining us this week. If the two Pedro's or other guests have inspired you in general, or better yet, by reaching out to Life.doc Health about their research, seeking to create something like it

in your own community, donating to them, or something else entirely, please let me know. I'd love to hear about it. If you write me at bill at normalfolks.us, I will respond. And if you enjoyed this episode, please do me a favor, share it with friends. Each of you share this episode, please do me a favor, share it with friends. Each of you share this story with three friends, share it on social, subscribe to the podcast, rate it, review it, join the army at normalfolks.us.

Consider becoming a premium member there. Any and all of these things that can help us grow. An army of normal folks. Thanks to our producer Ironlight Labs, I'm Bill Courtney. I will see you next week. What does the heartbreaking fate of the cheetah tell us about the way we raise our children? Why was Los Angeles the bank robbery capital of the world? What exactly happened in the Marriott Hotel in downtown Boston in March of 2020? I'm Malcolm Gladwell. In my new audiobook, Revenge of the Tipping Point, I'm looking at these questions and exploring the dark side of contagious phenomenon.

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