COVID Tried To Kill It, But Here’s How We Can Save Primary Care

[Dr. Z] Hey everyone. Dr. Z. Welcome to The ZDoggMD show. I’m real happy today because I’m getting out of my bubble, the pandemic bubble. We’re finally getting in-studio guests, we’re social distanced, we have all this ventilation, there’s hand sanitizer everywhere, we’re paranoid, everybody’s got masks at the ready. But to actually be able to have a conversation with a longtime friend who is working hard to transform medicine, who was there with me at the beginning of Turntable Health, our direct primary care clinic in Las Vegas, helping us figure out how can we deliver care to patients in a way that actually preserves our sanity, gets insurance middlemen out of the picture in a very strategic way, and helps doctors do what they do best, which is take care of patients along with their wonderful staff, and Zak Holdsworth is that guy. Zak, welcome to the show. Forget it. No more intro.

[Zak] All right, man.

[Dr. Z] Because the more I talk, the less we get to talk to you. So Zak, just so people know, Zak’s history is like, he’s an engineer by training, and then a Stanford MBA, and an entrepreneur. Just tell us how you got to building a company like you run now. You’re the CEO and founder of Hint Health. How did you even get to that point? Like, ’cause healthcare sucks, dude.

[Zak] Yeah, I mean, listen, actually, I grew up on a farm in New Zealand.

[Dr. Z]Of course you did. How did I know you, look like a farm boy.

[Zak] Thank you. I think that’s a compliment.

[Dr. Z]It is, yeah, yeah, yeah, yeah.

[Zak] And my dad got the first computer in our town. So I grew up in a town of about 20,000 people.

[Dr. Z][Zubin] Wow.

[Zak] And I think ever since that moment, I wanted to go to Silicon Valley. So here I am. That’s the short version.

[Dr. Z]So was this in the eighties, nineties?

[Zak]Yeah, I think it was in, he got the computer in the eighties, I think. Yeah, and I was trying to program it and everything.

[Zubin] Okay, so what computer was it then?

[Zak] It was like a Commodore PET.

[Dr. Z]Oh dude, you had the Commodore. See, I had the Apple II E, and I was trying to program on that, but I was trying to learn assembly language, but I had no idea what that meant.

[Zak] I think maybe by learning to program, I think maybe I was just trying to play games.

[Dr. Z]Yeah, right. Yeah, exactly. Zork.

[Zak] Yeah, and so, I kind of, as an engineer, so I went to engineering school, electrical engineering, and I went kind of my first part of my career was in coding stuff, and sort of embedded electronics, actually for medical devices over in the UK. And well, prior to that, I did some stuff actually as well, but fast-forward to Stanford. So I got into Stanford, and my dream was to go to Silicon Valley, so I was like, “This is it.” So I jumped on a plane and came over here, and wanted to do something entrepreneurial, but wasn’t exactly sure what I wanted to do. So I went and joined a venture firm, and it was there that we invested in a healthcare company called WellnessFX which was, I think, one of the first direct-to-consumer-clinical diagnostics company.

[Dr. Z]WellnessFX, I remember that vaguely.

[Zak] Yeah, so it’s pretty cool. I mean, to be honest, I’d never thought I would want to work in healthcare ’cause it just, you know, partly cause I just wanted to build stuff, but also partly because I just thought it seems so broken and hard to fix. And I think WellnessFX was one of the first moments where I thought this is sort of something pretty cool happening. It combined my interest in, I was into pretty hardcore endurance races, and stuff like that. And so it kind of combined the human performance side with healthcare.

[Dr. Z]Ah, so you were interested in like, you know, ultra marathons and things like that?

[Zak] I was interested in them. I never got to that hardcore.

[Zubin] Oh, right. Right, right, right, but hard enough.

[Zak] Yeah, and so, yeah. And so then that was, but I was working at WellnessFX. So we invested, and I jumped ship. That’s where I really learned, you know, wow, the system is broken.

[Dr. Z]And so fast forward now, you and I meet in 2013, and we’re in Las Vegas, and you’re like, “Hey, I hear you’re starting this clinic. “We’re building this software that actually powers “exactly the kind of clinic you’re trying to run.” And I’m like, what do you mean? And he’s, “You’re trying to run a membership model, “direct primary care clinic.” And I was like, “How do you even know what that is?” Like, how random is that, right? This guy from New Zealand, all I can think of is “Flight of the Conchords” when we’re talking. I’m like, “Is he Jemaine, or is he Bret?” I can’t tell-

[Zak] Which one was it?

[Dr. Z]You know, it ended up, it’s a mix in my mind. You’re like a morphed version of both.

[Zak] Oh, okay.

[Dr. Z]Which is beautiful.

[Zak] Not as funny, though.

[Dr. Z]Have you seen “What We Do in the Shadows?”

[Zak] Yeah, yeah, amazing.

[Dr. Z]I mean the best movie of all time. Oh my God, it’s so good.

[Zak] Have you seen the series, though?

[Dr. Z]I have. I started watching it, but I was so disappointed that it wasn’t as true to the original, yeah. But what do you think? Is it better?

[Zak] It’s, I wouldn’t say it’s better, but as I, the humor’s, I mean, it’s the same type of humor. But it’s got, yeah, they’re both great, though.

[Dr. Z]If you haven’t seen it, you guys, vampire stuff. It’s really funny. So Zak, I meet him and he’s like, “This is what I’m doing.” And I’m like, “Well, I’m trying to start this clinic “where we take insurance out of the picture, “you pay me a flat fee just to take care of you.” So it’s a membership model, and a business could pay, an insurance company could pay, if they wanted to, an individual could pay. So it disintermediates what we have right now, which is this third-party insurance system where it’s like, oh, imagine you’re a car mechanic and you have to take your auto insurance to do your oil change. Imagine how painful it would be to do an oil change. It would cost like $500, you’d bill the insurance, like $1,000 dollars, they’d pay you $200. You’d haggle.

[Zak] Even better example is if you had to pay, if you had to call the cops to get a police report so you could submit an insurance claim to fill your car with gas. That would be the equivalent of a primary care visit.

[Dr. Z] That’s a great analogy because that’s the equivalent of a prior auth call. Call 911, get the cops there to comment on your fender bender when they have better things to do.

[Zak] No, but I’m talking about all, the example you’re talking about is a fender bender. I’m talking about fueling your car up. Like if you go, you know, that’s 80 bucks, 100 bucks. Like a lot of health care, a lot of health care can be delivered for less than $100.

[Dr. Z] [Zubin] Yeah.

[Zak] So, you know, obviously not all of it, but like the most extreme example for me is, and one of the reasons I think that the US healthcare system is sort of broken, I guess, is because of the fact that for the equivalent of filling your car with gas, you need to, like you’d be like submitting a claim for, you know. So that seems kind of perverted and broken.

[Dr. Z] And in primary care, where your goal is to keep the car running well, right? Typically it’s not broken. If it is, they can do minor repairs that don’t require insurance activation. So you and I immediately hit it off ’cause we’re like, “Wait,” you know, although we were mutually like, “Are either of our things gonna work, right?” Because we’re both starting up.

[Zak] I think the reality is with you is you’re one of the first people I was talking to, so I was actually pitching you vaporware.

[Dr. Z] Yeah, and I knew it too. I’m like, does this guy have a product? And I was talking to Josh, who was my partner at the time, and I was telling him, Josh pointed out, like, “These guys seem great. “They want to do exactly what we want, “which is build us a backend that allows us to bill patients “directly a flat membership fee, keep track of them, “do outreach at the minimum, right?” And to do that as a doctor meant I had to go to Salesforce.com, and build this complex thing, and basically learn how to code. I wasn’t gonna do it. And so you came up with the vaporware, and were just like ZDogg, like a New Zealand genie out of the bottle saying, “Hey, this is what we’re building, “and we’ll work with you to design it.” And so at first I was quite skeptical. And then the more you kept showing us what you would deliver as you built it, I was like, “This guy is like insane. “Like he actually does what he says.” So it was quite amazing, even those early days.

[Zak] Yeah, I mean, I think what’s interesting, if you go back to that point in time, or if you back it up a little bit, me and my co-founder Graham, what we were trying to figure out is, we worked at WellnessFX together, and I think one of the insights we had there was, you look at a lot of healthcare companies, or ideas, and if you just play sort of a simple role, like, okay, if we scaled this to 300 million people would there still be a trillion dollars of waste, and would there still be really unhappy providers? Quality, cost overruns. As you know, quality’s a problem. Would essentially the healthcare system still be broken? And, most ideas, I think if you give to everyone, it’s still broken. And so we were trying to figure out, okay, what’s something that, in theory, at scale, if everyone had this type of healthcare interaction, if everyone had this type of relationship with their doctor, if the third-party payer wasn’t in between everything, then would it fundamentally transform healthcare? And what you were doing at Turntable Health, and what we sort of discovered through just meeting similar type of people, doing some of the things in the direct primary care movement, we just thought, “Well, if everyone had this, “this could be sort of the seed, or the foundation “of kind of fundamentally transforming US healthcare.” And so at the time, you know, when we met you, I think you were crazy.

[Dr. Z] Yes.

[Zak] But we were crazy too, because there weren’t many people doing this. But for us it was like, if there were a lot of people doing this, it’d be awesome. And that was kind of the genesis. It was like, you know what? Let’s just do it. And so then we’re like, okay, we’ve got to go talk to all the people doing this ’cause there’s not a lot. We need to create value. And in order to do that, we have to build a business. So you have to build something that supports this community because we are technologists, not healthcare professionals.

[Dr. Z] So see, this is the perfect example of where technology, innovation, business training actually comes to support an idea that would make healthcare better instead of supporting the current legacy model, and tweaking the widgets we already have so that we can squeeze more money out of the current widget system. That’s what was different about this. Like you said, we’re both crazy because it’s an absolutely disruptive idea. It’s saying, “Here’s the old system, here’s us over here.” Now, that’s a terrifying place to be business-wise and emotionally, because you’re alone. Like you said, there were like a handful of people doing any, Erika Bliss out in Washington State, and-

[Zak] Dr. Rob.

[Dr. Z] Dr. Rob, right, right. These guys that are pioneers, right? And then I partnered with Iora that was doing it in a different version, a different spin on it, but same disruption, saying, “Listen, why is it that we can’t actualize “a human relationship in healthcare “that actually takes out middlemen, “that focuses on keeping you healthy, “that keeps the caregivers happy, and the patients happy “in a relationship that’s unfettered “by a lot of outside intrusion?” There’s no reason you can’t do that, except for the current system doesn’t pay you to do it. So step out of the current system. And what you said was, “Well, okay then, we got your back “on how you’re going to get paid. “Let us help you build this backend.” That’s COVID, a hundred percent. “Let us build this backend, and allow you then “to do what you do, which is taking care of patients.”

[Zak] Yep.

[Dr. Z] Yeah so smoke, and the fact that California’s burning aside-

[Zak] Yeah, it’s crazy.

[Dr. Z] It’s crazy, I mean.

[Zak] The world’s coming apart.

[Dr. Z] So, and that brings me to this point. So world’s coming apart, feels like medicine has fallen apart right when we needed it to be together. Now how does this disruption that you and I were envisioning in 2013 actually apply to this mess, because right now we’re talking about getting paid. So what you were building with Hint, and it’s Hint.com, if you guys wanna check out the website, what you were building was this infrastructure, the technological backend that allows doctors to spin up what we call a direct primary care practice, meaning don’t have to bill insurance, have a relationship directly with your patients, they pay you for your services as a membership, like a gym, and you provide services, and your goal is aligned with theirs, which is keep them healthy and well, and they see you when they need to, and they can call you any time. It’s like concierge for the masses.

[Zak] Right.

[Dr. Z] When we were doing that, we thought, “Okay, now this is a financial model that’s risky “because the current model of just billing insurance, “we know it works.”

[Zak] Well, we know it sort of works.

[Dr. Z] We know it works if you see a ton of patients, spend very little time with them, do things to them instead of for them, and maybe do a little Botox on the side. That will work in the current model if you’re a primary care physician and staff, and a nurse practitioner, whatever. So now we have a situation where that whole world imploded, because in order to keep that Botox machine and the electives thing machine going, you have to keep seeing patients. Well, it turns out no one’s coming to see you because there’s a pandemic, and we’re not paid to actually take care of the pandemic properly, so what ends up happening is physicians, small practices, start losing money, going out of business.

[Zak] Yeah. I mean, listen, when COVID hit, I was obviously concerned for obvious reasons, but for the business, I thought, “Gosh, this could really impact other businesses as well.” And so of course we see a lot of the kind of traditional fee-for-service groups, with large commercial books of business, seeing their revenues get cut by 50%, and I’m sitting there going, “Well, I hope “that doesn’t happen to our clients,” for obvious reasons. But of course what happens is, these providers have a awesome direct relationship with their members. At a time of need, they’re there for them. So we don’t fresh-start, we don’t see churn across our customer base, and their patients. In fact, what we see is a slight growth compared to same time last year, or net neutral, roughly. We think, gosh, ’cause a lot of our larger customers work with directly with employers where the employer’s paying for healthcare. And we thought, “Gosh, okay, “are the employees going to terminate all the contracts?” Actually the opposite. A lot of our clients are actually thriving right now ’cause they’re delivering an awesome value prop. And so not only is the business model more sound, but the care has actually been delivered. And of course, one of my pet peeves, I guess, is you see a lot of kind of innovation happening in telemedicine, but if you think about it, the innovation is not a, it’s not a clinical innovation. The doctors aren’t broken; the nurses aren’t broken. It’s not a clinical innovation. It’s really a business model innovation. And when you create the right incentives, then things like telemedicine is just, of course I’ll do telemedicine. You don’t need a special sort of reason to do it. So in this context, you just see folks, they’re already doing telemedicine and they just pivot more to that. So it’s more of a sort of natural flow state, which I think is really interesting. And so we saw a spike in lots of telemedicine happening, but the underlying business was just sound.

[Dr. Z] So I’m gonna translate that into simpleton’s terms that I can understand, and it’s basically this: when you’re paid simply to do the right things for patients at the right time, you will do whatever you need to do to care for that patient. That makes sense. And when a pandemic happens, telemedicine is the perfect fit, and direct primary care just says, “Fine, we’re gonna do telemedicine.” We don’t care how we get paid for it ’cause we’re already getting paid to do the right thing for you.

[Zak] And by the way we also have, because we’re not disincented to do telemedicine, we already have all the tech set up. So we’re good; no change.

[Dr. Z] That’s it. Now does Hint do any of the telemedicine stuff directly, or?

[Zak] We, so we have a number of partners that have telemedicine platforms like Spruce, for example, would be a good example there, integrated with our APIs. So we are, I’d say more focused on the administration layer, and then we have an ecosystem of technology companies that are integrated with us.

[Dr. Z] So what would a medical biller coder, right now, who works in the current system trying to get money out of insurance companies, how would they function in a Hint-based direct primary care ecosystem?

[Zak] Well, I mean, if you have a mostly direct-to-consumer panel, where people are paying out of pocket, then Hint would pretty much automate everything. You know, the monthly bills get automated, the invoicing. If you have, some things that fall outside your membership, you could bill those through Hint. So, there’s not a lot. I mean, Hint is designed to streamline that process. If you have employee contracts, then there’s a little bit more involved there, but at the end of the day, you’re just billing an employer, and our platform handles that, as well.

[Dr. Z] That makes a lot of sense that you’d end up taking the money that you would spend on those personnel, retrain them to do something else in a better economy where the pie’s growing. And you know, when we were using Hint with Turntable, it was a pretty seamless thing. So what would happen is, a patient would sign up for our platform online, it would, on the backend, seamless to them, it would take you to the Hint sort of database where you would enter your credit card and all that, and it would put them in a database, and then it would update everything and we’d be able to access it. And then if we wanted to give discounts, we could do that through you. And then it was a really robust way to take care of patients that was pretty seamless on our end. Now imagine how it is now. So you need a biller-

[Dr. Z] And it was vaporware, by the way.

[Zak] It was like me and Graham in the background doing it all manually.

[Dr. Z] You know what, I knew it. I knew it because I’d be like, okay, patients are signing up to the website, and it’s probably just paging Zak directly, and he’s manually typing in. And yet, by now it’s this massive.

[Zak] Yeah, I think the other thing that’s maybe changed since we were working together is we built this company on the back of this idea that this is a community we wanted to support, and we wanted to be part of this community, and sort of help us thrive. And so a lot of our focus actually as a company has been around building community. And one of the things, which you know about, is Hint Summit, which is coming up. So it’s a great kind of event we host. But the thing that we’ve also been doing is building kind of, I guess, a community of ecosystem partners that are some technology, some, you’re seeing really interesting models forming whereby the folks that are in our community are actually starting to interact with each other. So we’ve got technology vendors that are integrated, and they work with our clients as well, with our community. We have groups that are scaling direct primary care, and they work with, in sort of affiliate-type relationships with providers, groups like for example, Nextera Healthcare, or Strada, or we’ve got a number of sort of DPC networks that are forming where they’re actually kind of all running through our technology platform. And we’re just sort of seeing this really interesting, innovative, new things happening within the community. We’ve got groups that are starting to build direct primary care into their programs. So for example, Decent, if you sign up for Decent. At the heart of Decent, it’s essentially an insurance product designed for the individual market, but they’ve integrated direct primary care into their model. And so there’s really interesting things happening. We’re saying CTPAs and stuff. Anyway, so there’s-

[Dr. Z] So, I wanna dig into what you just said, because this is important. So when we talk about direct primary care, we’re thinking about stepping off the insurance grid and doing something different with primary care. So what happens if you get so sick you need a hospital, or a specialist, or a bunch of procedures, or labs, and all that. That’s where these other entities, too, can start to form an ecosystem where they step up direct-to-consumer as well, because right now everything’s overinflated in price. And so you can create an insurance product, and we did this at Turntable with Nevada Health CO-OP, where you carve out the primary care. So the insurance company says, “Okay, we’re gonna give you “your membership fee to take care of these patients, “and then we’re gonna provide “the wraparound catastrophic insurance. “If they need anything else, “we’re gonna do it for a flat fee, “and maybe even put it on the exchange.” And that way patient gets amazing care that’s curated well, because you’re not gonna send people to a subspecialist unless they need it. And you’re gonna do a lot more than a standard primary care can do cause you have the time, and the resources, and the tools to do it. And so you’re gonna keep them out of trouble, and the idea, then, that you create an ecosystem of like-minded people. That’s what didn’t exist when we were starting Turntable.

[Zak] Yeah, the thing that’s actually interesting is, I don’t think insurance is bad.

[Dr. Z] I agree with you.

[Zak] I just don’t think it should be used to pay for 80 to 90% of healthcare.

[Zubin] Right.

[Zak] I think when you kind of break it down, the sort of reason things are broken is because there’s no price transparency, there’s perverse incentives, or a lack of good incentives-

[Dr. Z] Do more to make more money.

[Zak] Yeah, yeah. And it’s everywhere. I mean, it’s, you know, it’s crazy. And then, oh, I’m having a brain… So there’s three, there’s always three.

[Zubin] You know what it is?

[Zak] Yeah, what’s it-

[Dr. Z] It’s COVID. It’s the COVID and the smoke. So it’s perverse incentives-

[Zak] Lack of price transparency, and crazy overheads.

[Zubin] Crazy overheads.

[Zak] There we go. So administrative burden. And so if you kind of think about, okay, if you had to redesign a system from first principles, which is kind of our vision really. Our stated vision is to redesign healthcare, to make it easy to get high-quality, affordable care. Then what you want to do is replace it with price transparent so you always know the cost of the goods you’re buying.

[Dr. Z] Heaven forbid in health care to know in advance what you’re paying.

[Zak] Yeah, you should eliminate perverse incentives, especially from healthcare. Like, you know, it’s-

[Dr. Z] It’s the worst place to have a perverse incentive. If your mechanic’s incentivized to give you a fake oil job, not a big deal. But you get an, you know you know, like, too many penis extension surgeries, I mean, again, I’m just saying it becomes garish after .

[Zak] Exactly.

[Dr. Z] But right, right, right.

[Zak] So, the thing that I think’s really interesting is direct primary care is really the foundation. Like the reason we gravitated towards direct primary care is because it was the first manifestation of a working model that stepped outside that traditional third-party payer infrastructure. But it was also fixing primary care. And so from there, then you start to think, “Okay, how do you start to evolve beyond primary care?” These same concepts apply. You wanna have price transparency, you wanna eliminate perverse incentives, and you wanna have, you don’t want 50 cents on the dollar going to insurance, or whatever it is, right? And so we’re starting to see really interesting things happening with specialists where you have a price-transparent, pre-negotiated rate for a service, or labs, or imaging. Seeing really interesting things happening with, we’ve got clients that literally dispense meds in-house at cost, and it’s a buck for a month, or something. Stuff like that. And so imaging, surgeries, if you start to apply these concepts kind of more broadly, then that’s the ecosystem that we’re trying to cultivate and curate. And but if you think about it, it all starts with primary care. So that’s why we started with primary care.

[Dr. Z] And that’s what I think differentiated you from a lot of people who are like, “We’re gonna try, and we’re going to disrupt .” They’re starting in parts of the system that are so downstream, that it doesn’t affect change. But when you’re starting with 80% of healthcare, which is primary care, probably more. Probably more like 90.

[Zak] It can be more.

[Dr. Z] It can be more. You fix that, and I used to say this in my talks, like if you fix primary care, you fix all of medicine because what happens is that ripples out. So then what you said, which I think people have asked about, like, well, okay, what about dermatology? What about radiology? What about labs? What about, well, yeah, you can, you can apply the principles of, like you said, price transparency, getting rid of unnecessary overhead, which involves like the billing of insurance, and the other things that don’t make any sense, And what was the other one you said? It was, now I’m having the brain fart. It’s like price transparency-

[Zak] Perverse incentives.

[Dr. Z] Perverse incentives.

[Zak] Overhead.

[Dr. Z] Overhead, right. Perverse incentives. That was the one, right? Yeah, man, I tell ya. I tell ya. And you know, both of us are dads, so it’s like, there are days that I’m just like, you know, before I became a dad, my mind was like a steel trap. Now it’s filled with like, “Avatar, the Last Bender.”

[Zak] Literally right now I’m singing Russian baby songs in my head, ’cause my wife’s Russian.

[Zubin] That’s amazing.

[Zak] Yeah, so we’re trying to teach, but they keep playing. I’m learning the Russian alphabet right now.

[Dr. Z] Dude, my wife, being Chinese, we had all these, like a Mandarin nanny when they were babies, because we were both working at Stanford as docs, and all day I was singing these Chinese nursery rhymes, and learning Mandarin. And to this day, now I know more Mandarin than my kids, ’cause they forgot it all and decided they’re just going to speak English. But yeah, it’s upsetting. So perverse incentives though, in medicine, for me, this was the primary structural problem. I get paid to do stuff to patients. Well, I’m going to do stuff to patients, and I’m going to rationalize in my mind that I’m a good person for doing it, which means unnecessary spine surgery, unnecessary imaging. But when you’re paid, like you said, okay, we have a pre-negotiated rate for a hernia repair, or something like that. Well, okay, I’m gonna make sure I optimize to take care of that hernia where I can still make a profit, do well by doing good for you. If you have a complication, that’s on me, I need to deal with it. Now there’s, of course, a lot of subtlety in the specialty space because you have patients that, if they’re non-adherent to the plan, they throw a wrench in it. So you have to figure out how to communicate with them and motivate change. It can be done.

[Zak] And I think it’s like, you know, the level of change we’re talking about, it takes time, right? So the vision we’re articulating, I think it’s a decade vision. But I think with COVID, it’s accelerating.

[Zubin] That’s what I think.

[Zak] And I think this change also is gonna be driven by employers, as well. They’re saying, “You know what.” You know, what’s interesting about healthcare is that all of the stakeholders are upset.

[Dr. Z] Yeah.

[Zak] It’s just that you’re in this complex, Dave Chase actually, he has a description. It’s a Rube Goldberg, I think it’s a combination of a Gordian knot, an untieable knot, and one of the Rube Goldberg machines.

[Dr. Z] Exactly, the Rube Goldberg, like the whole, like there’s a thing pouring. It’s like the beginning of “PeeWee’s Big Adventure.”

[Zak] So the healthcare providers are the ones that I think are getting crushed by it. But all of the stakeholders in the system are starting to have pain. So I think that something dressed, you know, employers are starting to move, as well. We’re seeing some of our more sophisticated clients that have very large, Proactive MD would be good example. Very large employer contracts. They’re growing really quickly right now because they’ve figured out how to actually save the employer money while also providing a better experience for the, if you think of an employee as a consumer, the consumer-grade experience where they provide access to a high-quality experience. And then the healthcare providers are also happy, as well, ’cause they’re now practicing in a model where they’re not, I think you talked about a lot, this sort of moral injury, right? Like you don’t want to, like, it’s not that you want to refer someone after four minutes because that’s the only thing you have time to do. So that is technically the medically correct thing to do ’cause it’s better than doing nothing. But actually, if you had 30 minutes with this patient, you could probably deal with the issues. So I think that, you know, I’m going on a bit, but I just think that there’s a wave of innovation that’s starting to happen where these principles are gonna take hold.

[Dr. Z] You know, I think the tipping point, I agree with what you’re saying. I think the tipping point is gonna be the employer, the big employers in this country that run 50% of healthcare and have these big levers-

[Zak] 800 billion.

[Dr. Z] 800 billion. Is big employers. So you’re talking about Apples, and Walmarts, and even smaller, you know-

[Zak] You know, it is the big ones, but what you have to remember, I think, in the US is I’m going to completely mess up the statistic, but a very large number of working Americans work for a small company.

[Zubin] Yeah, exactly.

[Zak] And so I think where we will see the kind of most rapid change is actually gonna be the hundreds to thousands of employee companies. They’re saying to move. The big, big ones it’s going to take longer.

[Zubin] Yeah.

[Zak] But, but it’s gonna happen.

[Dr. Z] And I’ve spoken to the organizations that serve those big companies, and all their HR people sit and listen to my story of Health 3.0, and they go

[Zak] How do I get that?

[Zak] How do I get that? Well, I have this stakeholder, and that stakeholder, and we have so many employees that if we make one change to benefits, they all freak out and they don’t understand. And it’s very much a challenge, but you’re right with the smaller company. So they could band together, be part of a network that then has a direct primary care core that is facilitated by companies-

[Dr. Z] They don’t even need to band together.

[Zubin] They can just do it independently.

[Zak] Yeah, there’s a lot of group provider, there’s lots of direct primary care groups that are local, that serve local employers. One of the things we’ve seen which is really interesting is if you have a group in, let’s say Clint at Nextera in Denver.

[Dr. Z] Clint Flanagan in Denver.

[Zak] Clint Flanagan, exactly, yeah. He owns some of his clinics, but a lot of them, he doesn’t own. He has affiliate relationships with other providers. One of the guys, Eric Crawley you had on the thing. He has a small network in-

[Zubin] In Florida.

[Zak] In Florida, yeah. So if a Clint has an employer in Denver, he can subcontract some of those employees to Eric’s network. And so he’s starting to see really interesting local, ’cause healthcare’s local. I think he’s seeing lots of interesting things happening with employees there, but then as it scales, then you are starting to see networks form. But it doesn’t need to, I don’t believe everyone needs to be part of one big network. You want to keep free market. You want to sort of allow the fluidity of the market to.

[Dr. Z] And this gets to another interesting point. So people talk about healthcare as if it’s an all-or-none thing. So either you have a single-payer, government-run conglomerate, or you have the current chaos. There’s no third way. And I keep telling people, since 2013, you said it’s a decade long thing. We’re seven years into it. COVID’s launching this into the stratosphere because people are realizing this doesn’t work. Really? Took you this long to figure it out? But the idea then, that there’s a third way, which is leverage what America’s really good at, which is innovation, competition, and free market when not bureaucratized by overhead, by a committee at Medicare that actually sets prices, which is almost like a Soviet Politburo in a way, because it’s setting prices from above based on input from specialists. They’re like, that’s why a hip pays you a ton of money, but me preventing you needing that hip by helping you lose weight, or whatever, don’t get paid at all. So that’s-

[Zak] In the traditional system, you’d lose money because you’d need to probably spend some time with that patient, and you’re gonna be unprofitable. And so that’s where I think if I was a doctor, I would be bankrupt. ‘Cause I’d be like, “No, I want to help this patient.” So then I would be depressed, and then what’s next?

[Dr. Z] That was my life story. So when I started my hospitalist gig, we had plenty of time per patients in a low census and a motivation that we worked in a group where our responsible, we were salaried, our responsibility was to, and this is interesting. This gets to the heart of what direct primary care is. It’s about doing well financially by doing the right thing for a patient. And that makes you feel good because you went into this, not for money, and the moral injury is solved. So when I started my career, I would spend an hour with each patient. I would go through the discharge. I would connect with the nurse, and the team, and the social worker, and there was this connection and sense that you’re a whole and part of a bigger whole. And then you had the capacity to do that because you were salaried and told by your group, which was a partnership of physicians, “Hey, we’re a bunch of multi-specialty people. “Your job is to take care of our patients “when they get in the hospital, “which means you’re accountable, not just to the patient “and your own conscience, but to us, “which means we want communication and all that.” So that’s what we did. And they were willing to sacrifice some of their specialty money that was made by fee-for-service, to pay us to do the right thing for their patients in the hospital and keep them safe. And that gave us a sense of worth that we then did it, and it was beautiful, man. And then we transitioned to a corporation, and then it became an RVU-based production machine where we had to see so many patients, and then Epic went live, and then all this other stuff. And the next thing you know, the moral injury is real, the time with patients has gone. You start rationalizing why you’re doing it, and then you’re broken. And I tell you, I think there’s probably 90% of my audience who feels that, who’s felt that. What you’re saying is, well, together we can actually create an alternative system that actually replaces-

[Zak] The movement, man.

[Dr. Z] It’s a movement. When you talk about the Hint Summit, which I spoke at a couple years back, it was like a highlight, man. Like these guys, these are docs, and nurses, and staff, that are just like activated; they’re like revolutionaries.

[Zak] It’s community. I mean, I think really, if I think back to like why I decided to start this business, I went to the first direct primary care conference. I think that was slightly before or after I met you, I can’t remember, but I think it was slightly before I met you. And just the energy, I think it was maybe like 70 people, or something there. It was a small conference, but it was high energy. And it wasn’t sort of a boring thing. It was like this really high energy. And I think that’s what Hint Summit is. It’s our vision of that. And we’d like to put on a show and try to create, we’re doing it virtually this year, but it’s going to be awesome.

[Dr. Z] I’m speaking for you guys, yeah. Me and Marty Makary.

[Zak] Yeah, you and Marty.

[Dr. Z] So Marty is awesome, and he’s with this, as well. Price transparency, disruption, remove perverse incentives, cut the overhead, he’s down with that.

[Zak] Yep.

[Dr. Z] Yeah.

[Zak] Yeah, so I don’t know what we were talking about, but yeah, yeah-

[Dr. Z] The community and the revolution.

[Zak] Yeah, yeah, yeah.

[Dr. Z] You know, this is again, getting to this idea. We’re in an election year, everybody’s politicizing everything. Ryan Neuhofel, who was at your Hint Summit when I spoke, and we became good buddies, and he’s just awesome, runs DPC in Kansas, and he was on my show. He proposed something on Medium, a healthcare plan that-

[Zak] I should read it, I haven’t-

[Dr. Z] Oh, dude, I’ll send it to you. It’s so amazingly simple, and yet no one will ever vote for it because there’s enough stakeholders that will oppose it, but this is how it works. And he says at the core of it, every American gets a health savings account. that’s funded either by the government if you’re poor, by your employer if you’re employed, or by yourself if you’re rich. And in that health insurance account, you can spend that on anything medical, but it’s preferred that you spend it on a direct primary care membership. So you sign up with a DPC clinic, you pay the membership fee out of that, and they keep you out of trouble. And when you need more care, once you’ve spent through that little bit, that’s when Medicare for all, which is a scaled-back, catastrophic Medicare, the government comes in, and if you’re rich, you pay a copay and a deductible, and if you’re not, the government covers you. Universal coverage, less government spend, competition at the level of the specialists and the direct primary care practices who are looking for that HSA money that you have and are competing for it on cost, quality, convenience, service. And it’s uniquely American while egalitarian, so nobody’s uncovered. You don’t have a homeless guy who can’t get care. And that would solve the problem.

[Zak] So then the question I have then is, okay, that’s a good plan. I think where my head goes to as an entrepreneur is okay, what can we do right now and how do we start? What actionable things we can do today to actually start moving in that direction. And I think at the end of the day, you know, those concepts, it’s really just about price transparency. You’re creating free-market competition, and you’re eliminating lots of the overhead. And so are there ways we can do that without needing it to be pushed through politically? One of the small little steps we can take that get us further along that path. And that’s kind of what maybe is the essence of what Hint Summit’s about. How do we push this movement forward. Like, what’s next?

[Dr. Z] And Hint Summit, that’s what I noticed last time when I was there, is people are brainstorming these ideas. And this is a diverse group of people. There’s a lot of libertarians who are like, they just wanna make something that works, that has nothing to do with the current system. And there’s a lot of people who are real bleeding hearts who are like, you know what? I get to spend time with my patients. It’s great because I can give my poor patients discounts on their memberships. I transfer all my savings on labs and drugs to them, by dealing directly with them. I don’t make a profit on it, but they get to get to. So it’s for everybody. And then the conservative wing, which is like, “Hey man, this is about competition. “I’m gonna deliver the best service. “I’m going to beat all these other guys. “And I’m going to do it in a way that makes me have “the autonomy to practice the way I want. “I don’t want an insurance company telling me what to do.” It is the perfect.

[Zak] Yeah, I think, maybe without going into politics, I think that, I can’t vote by the way.

[Dr. Z] Yeah, because you’re a illegal immigrant. I’m gonna build a wall with New Zealand.

[Zak] No, I’m a legal one.

[Dr. Z] Aw, shucks, I was gonna-

[Zak] And that’s because I married an American.

[Dr. Z] Oh, nice. But you’re singing Russian.

[Zak] She’s Ukrainian.

[Dr. Z] So she’s a spy, is what you’re telling me

[Zak] Yeah, exactly. She came over here. Honestly, I do believe she might be a spy. She, at least she knows all my passwords.

[Dr. Z] There you go. Well, now you know, so if you sign up for Hint, it’s like signing up for TikTok. You’re just giving the Chinese government.

[Zak] Well, unfortunately my team revoked all my access.

[Dr. Z] Oh, man.

[Zak] ‘Cause we are very compliant and everything. But yeah, so the thing, you know, the point I was gonna make is that if you, at the end of the day, I think these concepts are, I believe one of the few truly kind of bipartisan actually concepts. And so at the end of the day, it’s like, whoever gets in, it’s gonna be good, I think for this movement. And yeah, and so, and back to Hint Summit, I think the thing that we’ve been trying to do with Hint Summit is make it a high-energy, reach sort of restorative event versus one we sort of have to put energy in. So there’s like lots of, we had you with the entertainment a couple of events ago. But we try to create this sort of, almost like, it’s hard to explain, but we try to create this high-energy, sort of interactive, sort of networking. You can get to meet people. You get interesting content. We bring in speakers that are not even necessarily within healthcare. So last year we had Dr. Jennifer Aaker from Stanford doing a talk on the power of story.

[Dr. Z] Oh yeah.

[Zak] Which is really interesting, which is relevant. Because if you think about the end of the day, like this movement is about story, right?

[Dr. Z] This movement’s about story. Taking care of patients is about story. It’s all narrative where we’re storytelling creatures and story-receiving creatures.

[Zak] Yeah, so we try to bring different, interesting sort of thought vectors in. And then we also, of course-

[Dr. Z] Did you call them thought vectors?

[Zak] Yeah, yeah.

[Dr. Z] Dude, that’s awesome. I’ve never heard that. And they’re always like, “Oh, I have a bunch of thought leaders.” No, no, no. I’m calling myself a thought vector from now on.

[Zak] I just made that one up.

[Dr. Z] Did you really? It’s a viral kind of feeling, like a meme. How do thoughts spread? I love that. Keep going, sorry. Thought vector. I’m never going to forget that. You’re going to see it now in my ZDoggMD, healthcare’s leading thought vector. And then you’re gonna sue me.

[Zak] My team’s gonna give me shit when they hear.

[Dr. Z] Of course they are, yeah, yeah. That’s good. So you were saying, so you’re bringing in all these thought vectors, you create this community, this sense of energy. Everybody’s sharing ideas, outside speakers.

[Zak] The challenge this year is how do we take a, what was a physical event, and take it virtual. So we’re working with some cool technology. We’ve got lots of different ideas we’re brainstorming, but I think it’s gonna be cool. It’s gonna be awesome.

[Dr. Z] I’m excited. And again, it’s like the world is now in this virtual space, so we’re all getting the hang of this, but I think if anyone’s gonna do it good, it’s gonna be you guys, ’cause you guys are already telemed, technology enablement.

[Zak] The thing I’m trying to figure out is, I’m personally sick of being on Zoom all day.

[Zubin] I hate it.

[Zak] Right, but so then my challenge to my team is how can we make this not feel like you’re on another Zoom? I think we’ll pull it off.

[Dr. Z] Nudity helps. That’s what I’ve found.

[Zak] That’s why we’ve signed you up.

[Dr. Z] You know what, after the multiple penis extension surgeries, I think it kind of ties it in a circle. Yeah, it’s a challenge. And what I found is when I first started doing virtual talks, I realized I was like, “Oh, this is terrible.” I’m a in-person person for this kind of thing. And then I did a few, and I’m like, “No, this is like an extension of what we do on Facebook.” You can engage with people, make them feel like they’re the only person in the room watching, and it really is a beautiful feeling of flow state, both for audience and for speaker. So I’m excited for this thing, and you know, Marty and I are gonna do something crazy. You know it’s gonna be insane.

[Zak] It better be.

[Dr. Z] We may just come out saying, “Look, never use Hint; they suck.”

[Zak] Sounds awesome.

[Dr. Z] I mean, because then, that’s true disruption. Disrupt the disrupter. But the nice thing about those summits is, again, you get also like mind. So then you end up with a list of people that are there. You can network with them, share ideas-

[Zak] We’re doing speed dating. We’re gonna have such an interesting, you can sort of figure out the types of people we’re gonna meet and then we’re going to match you up in the sort of speed dating type thing.

[Zubin] Oh, nice.

[Zak] So there’s some cool stuff there. We’ve got lots of our sponsors, but all our sponsors are part of our community. So in order to sponsor Hint Summit, you need to somehow be part of our community, sort of like a little bit of a vetting process.

[Dr. Z] Right, so you’re not sponsored by Aetna.

[Zak] Uh, yeah, no. But yeah, so we’ve got, you know, but so then we challenge the sponsors to try to do more than what you, you wanna make sure you’re creating value for the people that are there. So it’s not a pitch, it’s like who can create the most value? Who can be the most interesting? How can share the most knowledge? Then whoever that person is is gonna get the most business. And so there’s sort of things we do like that. It just a little bit reminds me of some of the stuff you do where you’re really trying to make sure that you’re bringing in authentic guests to your people.

[Dr. Z] I mean, present company excepted. You’re just an Stanford MBA shill trying to sell me something, and I’m not buying it. That’s exactly right. That’s exactly right. So if it doesn’t add value for the tribe, then why do it, right? Including sponsors. So that’s awesome. And the thing is like-

[Zak] Summit.hint.com.

[Zubin] Summit-

[Zak] I got it in there!

[Zubin] You got it. You got your shill pitch in. I’ll put it in the description.

[Zak] But no one’s gonna understand anything I said, so you’d have to write it down for them.

[Dr. Z] It’s your New Zealand accent. They’re just going to be like, “What is this? “Summer at flint dot what?” No, I’ll put it in the description, and actually there’ll be a special link that we’ll put in that associates with me so that you guys can quantify how awesome my platform is.

[Zak] How awesome you are, that’s right.

[Dr. Z] Because it’s like, look at that, and I’m going to be there. So the pitch, guys, is, if you wanna see me speak, it’s like a super bargain, too. I mean, I won’t say the price cause you might change it, but it’s like-

[Zak] We’re not changing the price.

[Zubin] I thought you were going to lower it just for me, dude.

[Zak] Oh.

[Dr. Z] Awkward. Edit!

[Zak] Cheap!

[Dr. Z] No, it is.

[Zak] It’s not a profit, we’re not doing it for profit.

[Dr. Z] Yeah, you don’t make money on it, I know that.

[Zak] We might make a little bit, but it’s not much.

[Dr. Z] It goes right back into next year’s.

[Zak] We’ve been trying to get to the summit to the point where it’s profitable, but just so that we can fund more kickass things.

[Dr. Z] Yeah, exactly. Yeah, yeah, ’cause the original plan before COVID was like this massive thing in Colorado, right?

[Zak] We had Red Rocks rented, renting out an epic spot at Red Rocks, super cool parties.

[Dr. Z] I had backup dancers planned, like it was a whole thing.

[Zak] Fireworks.

[Dr. Z] Yeah, exactly. All the whole thing. Pyrotechnics. And then it was like wah, wah, wah, wah, COVID. But you know, again, I think COVID has been a mixed, you never let a good crisis go to waste. This is the turbocharge that this movement needs because these are the guys that aren’t going out of business during this time.

[Zak] They’re delivering value to people that need healthcare right now.

[Zubin] At the most vulnerable-

[Zak] Like the thing that kind of blows my mind, is like, I’ve heard stories about, ’cause we have some clients that are sort of in a transition phase where they’ve got their existing commercial insurance book of business, but they’re opening up a direct primary care business. And like, I’m on the call. I’m sort of calling, catching up with the client wherever they are. “Oh, we just had to lay off half our doctors.”

[Dr. Z] We had to lay off half our doctors?

[Zak] Something like that I’m like, “What?” Right now don’t we need doctors? So it’s just, but that was not from their direct primary care business. It was from their-

[Dr. Z] Commercial business where they’re billing fee for service and you need elective procedures to make money.

[Zak] Right. So to me, that’s just like the essence of this movement. It’s like this is a alternative to kind of the status quo that is working, that all stakeholders benefit. But it’s not easy necessarily, but it’s possible. And there are like, it’s getting easier as well.

[Dr. Z] Well, you know, so that brings me to an interesting thing ’cause people wonder what happened to Turntable Health? Like we started in 2013, we were your first client, you know, I’ll tell you guys what happened. Hint ruined us, okay? These guys were the worst. Like, if it wasn’t for this terrible software. No, but what actually happened was, the three things you talked about: perverse incentives, overhead, and price transparency. We had price transparency. We had wonderful incentives to do the right thing for patients. What we didn’t have was low overhead. So because we were venture-backed, part of a big thing in downtown Las Vegas as part of this thing, it’s not a great location for what we were trying to do. We had a ton of overhead in our rent space. We had a ton of overhead in the size of our team, and trying to catch up with patients. And we partnered with an insurance company that did the thing we were talking about, but then went out of business. So in that case, our overhead then exceeded our income, and we lost 3,000 patients overnight, and that was the end of us. That is not a scalable failure. In other words, that’s not a tale that says, “Oh, I’m not gonna start a direct primary care clinic Health 3.0 now, because look what happened to Turntable. No, Turntable screwed up that way. You could actually do it much better, much more efficiently, using something like Hint, using less overhead, being smarter about how you do it, having full control over what you’re doing, and thrive in a pandemic when everyone else is laying off half their doctors. So, I mean, I think that’s the punchline here is we need these out-of-the box ways to think about this stuff. Otherwise, ’cause the thing I’m concerned about is let’s say we have a political upheaval, and something changes. And then we go into a single-payer system, which, great, everybody’s covered. But now what you do is you codify, you solidify the current broken system by paying for it with government money. And I think it’s incumbent on us now to show, I don’t care who pays for it.

[Zak] Yeah, in a single-payer system which, you know, I personally don’t think it’s likely, but in a single-payer system, as a single payer, the way I’d think about it is, who would I want, like, do I want to pay something? Do I want to pay for cost-effective, awesome solution that’s working, or a expensive broken system?

[Zubin] That’s it.

[Zak] And so these concepts that would be relevant in that world, and I think that the provider organizations that would thrive in that type of situation would be ones that have figured out how to create value in a way that is sustainable.

[Dr. Z] And that’s what I keep saying, is like, why would you wanna pay for something that’s broken with common money? I have no problem with common money going towards things that actually work. So fix the model, which, that’s what you’re doing, and then you can actually pay for people who can’t afford it with government money. That’s fine. But until then, all you’re doing is you’re gonna solidify something. That’s why, look, the Europeans have better systems than us because I think, honestly, they do less to people. They focus a little more on prevention, and there’s less doing stuff to people and causing harm. But then they have the same problems we have, which is they don’t really, their primary care isn’t really preventing disease, their health IT isn’t great, their doctors are suffering, all this other stuff. Same problems. They ask us, they’re asking me, “So how did you solve this with this health 3.0 model?” And it’s like, “Well, we did this, and this, and this.” The key thing is how do you pay for it, right? So generating new, innovative business models to actually fund what actually works in a care system model is what initially got us together. And now we’re still friends after how many years, and we’re still working together in even these loose capacities, because it’s a movement. And I’m looking at the people who are part of this movement. It gets exciting. Like, you get goosebumps thinking you’re gonna be part of something that’s gonna transform something that affects people’s lives in a way that almost nothing else does.

[Zak] Basically, the quote’s something along the lines of you don’t innovate by fixing things within the system. You innovate by disrupt, by starting something new. Like by innovating from a clean slate, basically. That’s it sort of really.

[Dr. Z] That’s the nature of disruption, and healthcare needs its Wright brothers, its plane to kind of, and it’s not gonna be brothers anymore. It’s not gonna be an individual. It’s gonna be a movement of people. ‘Cause we’re too complex now for one brilliant inventor to come up with a solution, it’s gonna be a bunch of people going, “You know what, this works.” And that’s what I see in this direct primary care community. I saw it at Hint Summit, I’m gonna see it again at this virtual Hint Summit, virtually. Hopefully. Which I think it, you know, this is what our Facebook thing is. It’s like a bunch of people that are like, “Hey, we don’t even know, we don’t all agree on stuff, “but we agree where we want to be.” We’re like, I’d like to be here. Okay, so let’s figure out, like you said, all healthcare is local. It is. Figure out the right answer. That’s why I think all top-down, one-size-fits-all is not gonna work. Yeah, yeah. Well shoot.

[Zak] Awesome, man.

[Dr. Z] Man, this was like good times. Gosh, I mean, it’s a-

[Zak] You know, one other thing I wanna say is, I may not have started this business if it wasn’t for you.

[Zubin] Wait a minute.

[Zak] Because when you’re starting something, it’s like, one of the key hypothesis you need to test is will someone wanna buy this thing? And so when I talk about it was like mostly vaporware, What I mean by that is, really the hypothesis I was testing wasn’t can I build this? It’s can I sell it? And so there’s a few people that kind of leant in early that tipped us onto the let’s do this. ‘Cause in a way, what we were doing, purely from a business perspective, it’s a little bit irrational, because especially when you’re raising venture capital and stuff like that, because in order to build a venture scale business, you need some people to buy the things. And so, but there was a little bit of, you know what, this is the right thing to do. And if this works, it will help fundamentally transform US healthcare. So you’re sort of like early, you know what, let’s give the vaporware a shot. You know, that sort of was part of the journey.

[Dr. Z] That’s really great to hear, ’cause we-

[Zak] It wasn’t all vaporware.

[Dr. Z] Yeah, it was 70% vaporware, and then 30% BS. But at the time I remember we had, we really agonized over… It’s funny because you know, we had just met. You had some degrees in interesting things behind your name, which resonate with a guy who has degrees in interesting things. But we also know, kind of, that can be bullshit. And as imposters ourselves, we feel like imposters sometimes, right? It’s always like, well, is this real? Like, what are we doing? But then what it is is you back it up with actual action. So you get on a call, you start to hash out what’s going on. You realize that Zak is really open to the things we’re saying. We’re saying, “These are the things we need, “are you able to do that?” Well, yeah, we can make that work. It wouldn’t work for all our clients, but we can probably do that since you’re an early adopter. And we’re like, “Okay, cool. “This is great.” And in the end it turned out by taking that chance, by being open to something different, and not, ’cause we were using Salesforce.

[Zak] Yeah, you were customizing a implementation of Salesforce, which is like, you know, at the time probably the right call.

[Zubin] That’s right.

[Zak] Now I’d say if you’re doing that, you’re insane. And it’s not that Salesforce isn’t great, it’s just that we’ve built something specifically designed for it.

[Dr. Z] This is much better. And the minute we started using it, and customizing it-

[Zak] We actually have an integration with Salesforce now.

[Zubin] Oh, do you?

[Zak] Yeah.

[Dr. Z] Oh, that’s good-

[Zak] So if you want to use Salesforce as a CRM, you can integrate and we’ll real-time share data between your Hint instance and your Salesforce instance.

[Dr. Z] That’s customer relationship manager for those who don’t know. There’s like all these nurses right now that are like, “What the hell are they talking about?” But no, it’s true. And that’s nice because then people can actually do marketing integration and things like that. But yeah, so it was great. And then years later to see your success, and how you guys have helped so many doctors, and talk to the doctors on the front line and go, “Gah, you know, we were part of that beginning of it.” You know, some people are like, “Weren’t you really bummed when Turntable fell apart?” and all of this? And I’m like, “No, it was like one of the best days “of my life,” because I knew we’d done this thing, this huge burden of trying to make this thing work under very difficult circumstances was off. I knew that my staff were going to great places, and now I was free to go to the next level of evangelizing this, and without being muzzled. ‘Cause when you run a business, like, you know how it is. Like you can’t just go out and say all the things-

[Zak] That you wanna say.

[Dr. Z] That you wanna say, because someone on the board is sitting there going, “You know that time “you talked about penis enlargement surgery “on your show 25 times.”

[Zak] I know, right?

[Dr. Z] “And kept doubling down on it. “You know, that’s not really consistent with our brand.” And now I’m just like, “Well, it’s consistent with my brand.” But the idea that-

[Zak] You’re gonna have to have reductions coming on.

[Dr. Z] You know what, that’s the thing.

[Zak] You went too far.

[Dr. Z] My surgeons, they said, you know, “We’ve never seen anything like this now. “It’s time-”

[Zak] Is that actually a thing?

[Dr. Z] Enlargement or reduction?

[Zak] I don’t know. Now it to get ahead of the conversation.

[Dr. Z] The only thing I know about this space is from my email inbox, in my spam folder. And it’s usually a brick tied to a string, or something, right? Yeah, there’s actually a funny, Have you ever seen the movie “Waiting for Guffman”?

[Zak] No.

[Dr. Z] It’s like a old Christopher Guest movie, like “Best in Show”, the guy who does all that. But he, Fred Willard, who recently passed away, fantastic comedian, had this whole thing where he was like, “You know, most people, I had a minor surgical procedure. “Most people really would be envious of it. “It’s a penis reduction surgery. “It was botched.” And his wife is just sitting there like, uncomfortably next to him while they’re interviewing. It’s a very funny scene. But of course, no one has watched that movie except for me. Now that we’ve talked about penises for the last half of it, I think we should wrap up by saying, guys, Zak Holdsworth, transforming health care, direct primary care. I will link on my website, ZDoggMD.com/Zak. That’s what I’m gonna call it. Actually no, /Hint. How about that? Let’s do it that way.

[Zak] Might be a bit more relevant.

[Dr. Z] A little more relevant. And /Hint, on that site, and I’ll link to it in the description, we’ll have links to other direct primary care people we’ve talked to, like Eric Crall, links to the Hint Summit, so that you can sign up for this year in 2020, and other information that I’ve done on Health 3.0, Turntable, and other stuff like that so people can start going to your website, going to my website, learning about this because it’s a movement. And then, man, the next stage is getting those specialists wrapped in.

[Zak] Yeah.

[Dr. Z] Yeah. ‘Cause that’s going to be exciting.

[Zak] Yeah. No, and we’re seeing that start to happen organically. And so from a technology perspective, we’re fast following that. So Hint will is expanding into that as well, which is exciting. That’s fantastic. I’m real excited for you guys. Well, so guys, I mean, this is a thing now. We’ve done our-

[Zak] How do you say goodbye?

[Dr. Z] How do we even do it? We put our masks on like this, and we’re like, okay, we’ve done our show. We’re not gonna be able to socially distance when we go out there. So now we’re big, big, big dorks, which, masks are the great equalizer, right? So guys, thank you so much for watching the show. Thanks to Zak Holdsworth from Hint.com. Go to that website and check out what they’re doing. Check out the Hint Summit stuff, share this video. Thanks to everyone who follows and supports the show. I love you guys, stay well, and we out. Peace.