What are some labs?

I would say that, hey, do you really need to be ordering a TPO antibody on a patient who doesn't have a TSH that's abnormal? Do you really need to be ordering a ferritin on a patient who's not anemic? So this happened last week.

I had a patient come to me In his 50s.

He came in.

He's like, hey, so I had this episode.

I was having a little bit of shakes, a little bit of sweats.

It was kind of weird.

For those providers who are now getting into DPC, longevity, concierge, but may not have that type of hospitalist or family medicine background, what are some tips that you can give them when it comes to critically thinking about how to best care for their patient? Whether it's lab work, maybe some loopholes, how to kind of think about insurance and super billing, whatever you think.

... not, not helpful, like I'm-

Like, the tension, the way that tension manifests for me has been, or what it makes me think about is specifically in trail running, and I got-- I was, like, really into trail racing between, like, twenty thirteen and twenty eighteen, nineteen.

Um, and I love-- I mean, I'm-- The running on the trails is like, it's the only reason to live where I live, and that's partly why I've, like, a little bummed I haven't been able to get up, like, on the trails here in the East Bay.

But, um, I remember, like, several instances, like, doing trail racing and, you know, I ran competitively in college and stuff.

Always like, I step up to a race, I really, I really wanna race.

But there were a few times where I remember just in that moment thinking, "I'm, like, working so hard to win or beat or place well in some arbitrary event, and I'm surrounded by, like, really beaut- I mean, this beauti- like, climbing up this, like, beautiful crest up above Stinson Beach at one point, and just, like, head down, just like spit all over my face, and just, like, not seeing anything but, like, this three feet ahead of my, of, uh, my, um, uh, ahead of my feet.

And, like, and it's, like, just surrounded by, like, the wonder [laughs] of creation and not noticing it, because I'm so focused on getting up this damn hill as fast as I can, and then back down and back up it again.

Yeah

Um, what, uh, what are people's perspective on that bailout, uh, and like, and Haley Stevens' role in it?

Well, I think it's important to point out that this is almost 20 years ago detail part of her campaign.

When I talk to people under 30, you know, a lot of people don't even know what the auto bailout was, frankly.

I mean, people in Detroit that are directly, you know, by family member, relative, uh, parent, grandparent, re- you know, tied to, uh, what happened in the 2008 financial crisis.

Detroit got hit really hard.

Uh, you know, neighborhood businesses, diners, um, no longer exist, right? You know, we had our, our neighborhoods kind of hollowed out.

And so younger people have no connection, and they roll their eyes and say, "Haley, why are you talking about things that happened 20 years ago?" And of course, you know, the, the older folks who...

But I, I'm wondering how much the UAW has sway here.

... on the ground largely?

You know, there's a generational divide in this race.

Uh, you know, I think the exit polls are gonna show that clearly.

Uh, you know, the, the talk of Black voters are all gonna vote for Haley Stevens is ridiculous.

The f- the ...

I mean, frankly, the talk of all Jewish voters, all Oakland County voters are gonna vote for Haley Stevens I think is a little bit ridiculous.

And, uh, when you go into those communities, you know, you'll really find, uh, all kinds of outliers, uh, older Black voters that are supporting Abdul El-Sayed that are, uh, frankly worried about the direction of the Democratic Party, uh, worried about, uh, their tax money going to foreign governments like Israel, uh, worried about, uh, cuts to Medicare, uh, voting rights.

Um, do you have any sense of, of the, the dynamics there, how, you know, if whether a strong showing for Abdul may help some other progressive candidates across the finish line, too?

I think people should remember the point you just made that while we who are kind of political addicts are following this race very closely, for a lot of normal people, they barely have any idea other than seeing YouTube ads and television ads that there's even a race going on.

Yeah.

And as you guys have seen, I mean, the ads have been absolutely effective.

People think that Barack Obama has endorsed Haley Stevens in this race.

He has not endorsed her in 18 and 20 against in a general election against Republicans.

You know, it's been kind of remarkable when you talk to people who are online versus those who are just sort of going about their lives.

They'll see the ads on the TV.

How is it possible that he's even in the race? Do you believe that, Paul? What's your assessment of this race, which the left sees as its next opportunity after Arizona Today to oust an incumbent?

But yeah, the ads, am I right that the ads don't really make it clear that that quote is from 2017, entirely different campaign cycle?

Well, it depends who you ask.

Of course, the El-Sayed supporters are going to say it's completely misleading and they're intentionally trying to dupe black voters in Detroit into believing that Obama endorsed her campaign.

Now, when you ask Haley Stevens supporters like Wayne County Commissioner, Chair of the 13th District, Jonathan Kinloch, you know, he says that none of these ads were meant to misinform people or mislead people.

They're just frankly doing what other candidates would do.

I mean, it is a pretty common thing.

And of course, even a guy like Bernie Sanders in 2020, I mean, he in an advertisement put himself next to Barack Obama, despite not having Barack Obama's endorsement in that race.

I just kind of wonder if there's much overlap between between people who may have an opinion on the Senate race and who's actually going to vote.

And I think that your approach is great in the way that, like, let's look at what really matters, let's look at what counts, let's try to measure it, and then let's give people a good plan, so...

Absolutely.

You're right.

There's a ton of stuff out there as far as what longevity is.

Longevity medicine, I say it's a gray area right now because when I first heard the term longevity medicine, I laughed and I said, well, that's just medicine.

That's just preventive health.

That's how we should be doing it.

and then be your own athlete in that way.

They wanna make sure they can feed their kids.

They're not.

I mean, I just, political game after political gamesmanship we watch over there.

And, you know, guys, it's, it really is, um, it's either side of the aisle that you stand on.

Uh, you know, th- there's things that lawmakers are going to deliver to their communities, because if they didn't, (laughs) they'd get voted right out.

'Cause their communities are, are, are expecting, um, them, them to do so.

You know, I, I, I, I really think that, uh, you saw this past election, um, you know, a, a culmination of a few different things on the Democratic side, a few different things on the Republican side.

Mm-hmm.