Transcript

[0:00] Every person has a unique story opinion approach that is worth knowing be curious.

[0:08] Music.

[0:13] Paging dr. cook paging dr. cook dr. cook you’re wanted in the o.r. dr. Koh.

[0:21] Music.

[0:43] Hello everyone and welcome to the prescription for Success podcast I’m dr. Randy cook and I’ll be your host.
Our podcast is a production of MD coaches providing leadership and Executive coaching for Physicians by physicians.
To overcome burnout transition your career.
Develop as a leader or whatever your goal might be visit MD coaches on the web at my MD coaches.com,
because you’re not in this alone my interview guest today is a board certified internist who has a very special interest in helping get better health care to the underserved.
By taking advantage of an often overlooked and highly valuable resource so let’s hear dr. Jill Einstein explain exactly how that works.

[1:38] Music.

[1:44] I’m really excited today to be talking with dr. Jill Einstein.
He has a really fascinating project to talk to us about Jill thank you so much for joining us.
It’s a pleasure to be here dr. cook how’s the weather out in California it’s been hot and fiery for a long time is it settling down out there,
it is been settling down today is actually very rainy in this past week we have had our first storms in a very very long time so we’ve been very thirsty out here for some a good drenching,
so you’re not so sorry to see the rank up,
not sorry at all Jill is you know we like to keep our show on a first-name basis and that’s what we’ll do here and I want to.
Begin with your origin story as we always do are you a California Native.

[2:30] I like to think of myself that way but I was actually born in Philadelphia Pennsylvania and my parents moved out to San Francisco when I was nine months old when my dad,
got a job working for a woman’s clothing manufacturing company so was.
Was there any influence within the family that led you toward medical school or did that come.
From someplace else it really came from someplace else my father although he was in,
the clothing manufacturing business everyone always thought of him as a doctor because of his demeanor in terms of I think what people thought in a stereotypical way but they would hope from their doctor of somebody being kind attentive,
and responsible and so I think,
have a lot of his characteristics and in addition obviously the training to be a doctor very interesting and,
when you started undergraduate school at Stanford which I guess would have been.

[3:26] Around 1988 you got to be a and American studies which doesn’t sound like the typical pre-med course of studies were you thinking medicine at that point.
Not when I was in college my interest in medicine actually began before then when I was in when I was in Middle School I was part of a doctor’s group called future doctors that was affiliated with my local hospital Marin General Hospital
and we would meet every month and get a chance to meet doctors from different Specialties I worked as a candy striper and I also got to Shadow some family friends who are doctors
and I was very interested in that when I was in high school I remember I had won an award in actually my,
history class and my teacher gave me a book called future doctors
women need not apply so I still have that interest my teachers,
recognized in me,
my passions and qualities that might be well suited to being a doctor and in addition I loved my
high school biology class I remember
in preparation for learning about insects I started my insect collection the summer before class and loved frog dissection I brought my frog home to do the debt section 2.

[4:53] Please do not too pleased but when I when I started college at Stanford the world of Academia was open to me and I remember thumbing through,
the course booklet and just looking and Department after department and seeing so many different kinds of classes that I wanted to explore.

[5:18] And so I decided to take my time at school to take classes in political science history and literature,
which all ended up under the umbrella of American studies and so throughout College I did not think I was going to become a doctor,
well that’s very interesting in that I am roughly a generation ahead of you and at the time that I was thinking about medical school the message that we got from all the medical schools was we want someone,
with a really well-rounded education will teach you all the science that you need to know,
when you get to medical school but we want you to go to Broad education but yet I can’t imagine that there were more than a half a dozen people,
in my freshman class that were anything other.
Then a science major so my next question to you is do you feel like that.

[6:13] Much more liberal arts education benefited you as a physician well I’d have to answer yes I think I think that there are.
Many more people nowadays who sometimes take a chance take a risk in,
having different backgrounds of a typical background before attending medical school so I didn’t feel alone when I started at the Medical College of Wisconsin
and even though I was took off three years in between college and medical school there were there were enough that’s when I that’s when I did all of my prerequisites if I went back to school
and I took all the required courses because I had not taken any of the sciences and college go back a little bit in talk a little bit about.

[7:05] How that.
Final inspiration came to you had a baccalaureate degree and I’m sure people were standing around saying well gee what are you going to do with your life what,
happened and how did it sort of sink in the medical school is where you wanted to go so immediately following
college graduation I ended up working in business
I’m ahead done an internship during my last quarter of college up in San Francisco working for an advertising agency which was some great real life experience
my first job outside of college was working for a company called The Sharper Image,
which sells all sorts of fancy gadgets they had an amazing catalog yeah so while I was having that first business experience.

[7:55] This little seed inside of me was growing.
And I one day had an epiphany that I wanted I did indeed want to become a doctor.
And I kind of came back around to what it was when I was in Middle School and High School that appealed to me about being a doctor.
And I really wanted to be able to have an impact on people on patients be able to work one-on-one with people.
To support them through times of need to be able to have a Hands-On approach.
And to help salt and to help problem solve.

[8:35] And it was really quite an amazing you know Evolution for me to be able to.
Try something and realize that wasn’t what I wanted to do and then go back and say yes this is what I want to do and now I’m going to go about achieving it.
Like that’s a great story.

[8:55] And I’m also curious that when you began to get into the medical school application process.
During those interviews could you get a feel for how that story was being received.
Did you find the interviewers saying well you’re just the kind of person we want or were you getting are you sure you’ve made up your mind what exactly was the reception.

[9:28] I think it was clear that I had made up my mind because of,
my commitment to spending and I think it ended up being about 18 months of taking all of my prerequisites at once and doing some research and,
Dermatology and doing volunteer work and I think that there are you know we’re medical schools that were more receptive to students having more of an alternative,
background in preparation sure but I didn’t get any obvious,
push back in those interviews and then the other thing that I want to get into and it’s.
Something that you sort of alluded to earlier and that is you started Medical School roughly a generation after I did,
there were I think perhaps 20.
Women in my class of 125 so upon your arrival I know that we’re were unquestionably.
More women in your class than there were in mind but.

[10:39] Did you feel that women had been fully accepted in that role when you got there so from my perspective at the Medical College of Wisconsin.

[10:49] I think at the time my class had about 40 percent women I may be incorrect with that but it was definitely a very high number.
And,
I did feel accepted I don’t know if it was the particular school or the professor’s the administration or just in numbers you know having that number of women and we were very lucky was a very large class we had 200 students.
And so I did feel comfortable confident and really enjoyed working with women I’m sure we did not have as many female role models in terms of our professors and doctors with whom we worked.

[11:28] But I did feel good and I remember at that time I became president of the American Medical women’s Association and that was a really great experience for me yeah but it was.
I’m glad that was overall a good experience for you I have actually had conversations with female Physicians even back in that era who were having.
More unpleasant experience and it’s nice to know that we’ve made some progress well any other thing that I would like to know is how did you happen to pick Wisconsin.
So it does seem
pretty far away from California distance and in culture so my father grew up in Omaha Nebraska,
and he had ties with Wisconsin he would go to summer camp up in northern Wisconsin so I was very comfortable and familiar with the Midwest,
and the Medical College of Wisconsin having a larger class they not only accepted students from Wisconsin but from all over the United States,
it’s a really great institution a little bit under the radar but they’ve got,
actually amazing research and commitment to Primary Care as well and that was really the primary care part was very appealing to me.

[12:49] But it was cold very cold for a California girl but apart from the climate it sounds like it was a really good experience and.
When it came time for postgraduate training it was time to go back to a more temperate.
So how did you happen to pick California Pacific Medical Center,
so I knew that I wanted to go back to the San Francisco Bay area where I was raised and where my family still lived.
And during my fourth year of medical school the college allowed us to do off-campus rotations so I did several rotations at California Pacific Medical Center and I really.
I liked working in this hospital and was one of the Premier it is one of the Premier hospitals in San Francisco and the location was great and they had a wonderful internal medicine program.
And so it just ended up being a great fit yeah and did you.
Feel early on in medical school that something in Primary Care was going to be your destiny or did you struggle with that at all.

[14:03] I think I came to it later on in medical school.
I was interested in surgery I happen to have a really great surgery rotation and I know that a lot of people are often intimidated by their surgery attendings but we just happen to have a.
I mean although he was intimidating he was just a really great guy and I’m sorry I don’t remember his name and we happen to have some great surgical residents and it was a and we had a great team
file of the teamwork aspect that we all work super well together and doing the wound care changes and our surgery residents invited us over to their houses so we could practice suturing on on fetal pigs and it was that was a positive experience.
So that was one area I was thinking about I also really like Dermatology as well.
But ultimately I decided that I wanted to be able to take care of a patient you know for a greater breadth of their life.

[14:59] And to establish an ongoing relationship with somebody,
and that’s the part that really appealed to me about Internal Medicine hi I’m Rhonda Crow founder and CEO for empty coaches here on RX for Success we interview a lot of great medical professionals on how they grew their careers
how they overcame challenges and how they handle day-to-day work I really hope you’re getting a lot of great information.
But if you’re looking for an answer to a specific problem management or Administration challenge,
or if you’re feeling just a bit burnt out like maybe you chose the wrong career,
well then there’s a faster way to get the help you need now it’s not counseling it’s coaching are expressed success is produced by MD coaches a team of Physicians who have been where you are,
I know you’re used to going it alone,
but you don’t have to get the support you need today visit us at my MD coaches.com to schedule your complimentary consultation,
again that’s my MD coaches.com because you’re not in this alone.

[16:08] We’ll get back to our interview in just a moment but right now I want to tell you a little bit about physician Outlook
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And now let’s get back to today’s interview.

[17:15] Music.

[17:20] That’s such a rare story in my experience as a surgeon I am a little bit embarrassed that
the surgeons are looked upon as not so friendly and I’m just delighted to know that that was not the experience that you had and that it had a good influence on you so.

[17:42] Getting back to residency training,
what was that like for you was it a lot of people get in there and they think oh my goodness how am I going to get all the work done was it was it
terrible was it intimidating or was it just a easy ride it was definitely not the latter it was intense it really is I mean you are a doctor.
Yeah acting like a doctor.
But you certainly haven’t had the experience you know at that point in your career I mean I loved I loved learning and I love learning from my patients I love learning from the nurses
and the rest of the staff at the hospital so.
And then watching that confidence built over the over the three years of the resident Residency program.
But there you know there were times of course you’re thinking I don’t know what I’m doing exactly and somehow you pull it all together and make the right decisions and.
And make it through but I think that always coming back to the patient and.
Not losing sight of the humanity part of it.
And you know supporting and caring for your patient in the best way possible you know through your knowledge through your skill but also through your care.

[19:09] I’m very impressed that you mentioned learning from the nurses.

[19:17] For me they are just the best and I feel like I learned.

[19:24] At least as much and maybe more from the nurses that I did from the attendings did you kind of have that same experience so I think so I mean they’re the ones that are
available there in the patient were there in the patient rooms they often know you know more of that day-to-day minute-to-minute of what was going on with the patients,
and and also they were often patient with me or with you know and with the other residents right and showing us how to do something.

[19:54] So now they’re I think they’re a guy mean they were a great a great resource.
I think what I learned from them I’ll be interested to hear from your experience but you know from.
The attendings from the from the Physicians around you you learn,
the pathophysiology in the natural history of the disease and what to expect on physical exam and how to interpret laboratory results and things of that nature but.
The signals and the subtle.
Information that you get from the patient’s I think the nurses are so much more in tune to and if you watch them you can learn so much when you are when you agree,
I would definitely just seeing how they spoke to them how they spoke to the patient’s how they treated them and then to solve a little kind of like tips and tricks at the bedside,
yeah you know whether it’s how to shift the patient in the bed
yeah so yeah I usually one of the most important parts if not the most important part of my medical education that sounds like it had a similar effect on you so.

[21:05] You make it through all the training you gotten yourself board certified in Internal Medicine.
And what was next for you at that point I knew that I wanted to go into private practice and of course.
Having done my residency at California Pacific Medical Center and having exposure to all the different attendings I knew that that I wanted to stay in that Community CPMC.

[21:34] The hospital itself is like a village and I think many medical centers were that way and it’s interesting that I feel like there’s been a little bit of a shift because of,
hospitalist medicine because the attendings you know often don’t come in to see their patients anymore,
because the hospital is Sir are there in the hospital not 24/7 but you know every day and can more efficiently and effectively take care of the patients,
but I did really like the knowing everybody from.
The attendings to the nurses to the janitors you know in my California Pacific Medical Center Village.
So I knew I wanted to stay in that community and I had a number of job opportunities to join different private practices and I ultimately decided to go with a multi specialty practice and I took over
the long-standing practice of an internist my,
bought her practice I owned my own practice but shared an office with four other doctors there were a couple of other internists and a rheumatologist and a gastroenterologist.

[22:45] That’s kind of nice,
you walk right in and the patient basis they’re so sounds like a good good decision on your part and it and it sounds like,
that you’re of your practice was a good fit for you the other thing and looking at your resume that.
Stands out to me is that at a relatively well almost from the beginning.
You seem to have an interest in looking after the underserved where did that come from.

[23:19] I

[23:22] I mean I think it came from I mean just the training from medical school and residency.
In medical school I remember the impact of doing rotations through the VA Hospital,
I remember during residency doing rotations through the public Hospital San Francisco General and working in their emergency room.
And even though my medical practice starting off was.
He was serving people who had insurance I think always in the back of you know in the back of my mind,
you know wanting to have some sort of impact on people who are who are underserved sure.

[24:08] And a little bit later on you decided to
sign up for a fellowship with the Wexner Heritage leadership program you want to tell us about that sure well I’ve always been
interested in leadership I had done a physician leadership program through my Hospital California Pacific Medical Center.

[24:29] And then I had the opportunity through the Jewish Community to be selected for the Wexner Heritage program,
which was for Jewish lay leaders in the San Francisco Bay area and actually there are different cohorts throughout the country that occurred simultaneously and it was an opportunity,
sort of receive an adult Jewish Education with fellow lay leaders and then also to be able to share.
Leadership issues you know amongst each other so it was a group of 20 of us.

[25:06] Who may be involved in their synagogue boards I Jewish philanthropic organization board the Jewish Community Center board and we met every week for two years
and then we also had several in person in person opportunities and it was at a time of my life when I wanted to learn,
more about Jewish history because I didn’t I wasn’t raised you know having a strong background in that sure and having the potential to learn with peers,
and enhance my leadership skills so it was a very profound,
experience because I met these incredible people that my husband and I continue to be friends with you know and to this day.
Yeah sounds like a really great experience and and I gather.
Had a significant impact on the remainder of your career and I don’t want to move ahead.

[26:13] To quickly and we can re track anything that you would like to but.
The thing that I would most like to learn,
some more about is the maven project for which you are now the is it the director of,
physician acquisition or physician engagement engagement so in any case.

[26:40] Why don’t you go ahead and tell us a little of the background of the maven project and where you fit in.
Wonderful I’m really excited to tell you about the maven project I have been the director of physician engagement for the past four years the maven project is a Telehealth nonprofit,
that connects physician volunteers with primary care providers that work in safety net clinics across the country.
And through our Telehealth platform our physician volunteers provide medical consoles medical education,
and one-on-one mentoring to the primary care providers.

[27:23] And the word Maven in Maven project we use as an acronym for medical alumni volunteer expert Network.
And Maven is an expert and Brilliant use of the word I might thank you it’s just perfect perfect for this group for this group,
so the maven project was founded probably about 7 years ago,
by dr. Lori Green she’s an actively practicing OB/GYN in San Francisco.
She’s an incredibly intelligent and inspiring.
An active person did you know her before you knew about the maven project or did one lead to the other,
so I did know Lori not closely but she also has her practice at California Pacific Medical Center
so we shared enough we shared a number of patients together and when I had made some transitions in my medical career.

[28:31] And I knew that I wanted to stay connected with medicine.
But use my business leadership and Community Building skills I reached out to her because I had heard that she had started this nonprofit,
and the job opportunity became available and everything ended up ended up working out,
so dr. Greene had been president of the Harvard Medical School alumni association,
and as she was leaving meetings she recognized that the Harvard Med School alums were in the Perry retirement phase of their lives and.
She saw how much passion and knowledge that they still had even though they weren’t working full-time or they had transitioned out of their practices.

[29:20] And then knowing what was happening in healthcare in America with more and more Americans losing their health insurance or becoming underinsured and more of them flocking to.
Federally qualified Health Centers and free and charitable clinics,
she thought how can I connect the expertise of these doctors with the needs of these clinics and so with the rapid growth of telemedicine and this is
pre covid that her idea was born you were way ahead of the curve on we were we were so I was you know,
we were positioned well obviously particularly in covid,
so she founded the founded this organization and it’s been really growing especially over the past couple of years.

[30:14] Seventeen States I understand,
actually 18 states as of today and and we have we have Partnerships with 73 Clinic operators,
and they represent 205 individual Clinic sites across the United States that’s amazing uh-huh so,
can you tell us a little bit more about the nuts and the bolts so you engage these Physicians who are actively retired or approaching retirement and you train them to do what,
exactly we have currently about 145 physician volunteers.
And they represent 55 different Specialties so adult and Pediatric Care primary care and Specialty Care.

[31:09] And to be a maven project volunteer you do not need to be retired but it’s especially appealing to our recently retired doctors
about 75% of our volunteers are retired and then the others are either in part-time practice full-time practice or work in the industry.
When we have a need for a volunteer in a certain specialty I either have a list of people who have.
Previously made inquiries about becoming a volunteer or I’ll reach out through different networks that I have to if I’m looking for somebody very specific.

[31:46] And they have to submit a lot of documentation we have a full control credentialing process they have an interview with me.
And once we bring them on they get trained on our Telehealth platform,
just to learn how to respond to email consults or how to accept a video console.

[32:08] And then they’re put on our Telehealth platform and then a primary care provider in one of our safety net clinics,
may have a question like for example let’s say there’s a family nurse practitioner in a rural clinic in Washington state and she may be seeing a patient with diabetes.

[32:28] And the nurse practitioner may be fresh out of her schooling and suddenly is thrown into seeing 20 or 25 patients a day.
And her more senior provider in her Clinic may not have time,
to be able to answer her questions there may be a barrier to getting her patient to see a specialist you know let’s say it’s a two-hour drive to Seattle to see an endocrinologist.
Or
It might take three or four months for the patient to get in to see an endocrinologist or might be sort of more of a simple question where you wouldn’t want to necessarily,
Force the patient to drive that distance to get that question answer here yeah so that nurse practitioner would log on to the maven project and see the list of 55 Specialties and click on endocrinology,
and then be able to submit a brief history of present illness and what her questions are,
to another chronologiste and then get a response back within two business days and our volunteers actually respond in less than,
eight hours which is pretty impressive all and is it a is it a written response or more like a zoom meeting or how do they actually communicate.

[33:45] So there are different options most of the providers submit through email on our platform so it’s called an e consult,
it’s about 75% of the consulates are done that way there is an option to do a video console but they pre-schedule for that video console,
so the volunteer I mean the provider will you know see that of volunteers open like on Tuesdays between.
Three and five and then I’ll book an appointment with them to be able to discuss via video and all the consulates are done,
from The Physician volunteer to the provider it does not include any interaction with the patient so it’s a really an advisory role.
Which means there’s.
None of the worry about Licensing in the state credentialing and things of that nature because it’s just provider to provider is all right exactly exactly.
What a brilliant idea and appears to be catching on obviously it’s growing fairly quickly,
I don’t know what else to say other than what a brilliant idea and it sounds like,
dr. Greene found exactly the right person to help recruit Physicians it’s been a great pleasure for me to be able to work with our physician volunteers and yeah I bet it has and.
That brings up another question and that is.

[35:15] What it what is the response like and and if if someone hearing this.

[35:23] Podcast is fascinated with the idea and wants to be a part of it how do they go about becoming a part of the network.
Sure well there are different ways to get involved with the maven project.
So there are physician volunteer opportunities and people can go to our website which is
Maven project.org and they can go to join Maven Tab and they’ll see a tab for volunteers and they fill out an inquiry form,
and they upload their CV at that time and then I’ll get back to them to let them know if there are any opportunities open in their particular specialty.

[36:07] So that’s the way to find out about volunteer opportunities if people have,
connections to free and charitable clinics or federally qualified Health Centers who might benefit from becoming a partner with us we always love those connections and introductions as well.
And there’s also on that same tab of,
join me even they can submit a connection for us in that way and lastly and probably very importantly is our funding opportunities,
so we’re always looking for different funding sources so,
we are funded through individual donations and family foundation’s corporate grants and government grants and so there are a lot of ways to to make contributions and connect in that way that’s a very.
Important part of it and.

[37:01] And so even though the project is only officially active in 18 states.
From what I understand a physician regardless of where they’re located can actually participate in the project is that right that’s correct so you could be a,
physician in Missouri with a Missouri State medical license and become a maven project volunteer and then you can provide medical consult so through our Telehealth platform to a.
Primary care provider who could be in New York or Illinois or Arizona because it’s provider to provider and you don’t have to have a state specific license what a great idea.

[37:48] And as I understand it your duties include Data Tracking credentialing for volunteers are you also a charge of the bi-monthly newsletter.

[37:57] Yes so we do a lot of a lot of communications and our youth are able to maintain your practice and do all that.
I am decided actually a while ago that I was not going to continue with clinical practice even though,
I loved taking care of my patients and it was really an honor and a privilege to do so I have.
Feel additional interests and skills but I wanted to pursue and so I don’t see patients anymore.
Sooner or later we all have to decide how much time we have to do the things that we want to do and it is a wise person who understands where to draw the line so congratulations to you on that thank you,
Jill this is really been fascinating and I’ve,
I particularly enjoyed the conversation about the maven project it sounds like such a brilliant idea and I know it must be a much welcomed resource to those,
people who are practicing in areas where it’s hard to get in touch with an expert so congratulations to you congratulations to dr. green and to everyone.
Who is associated with the maven project and I wish you much success with that.

[39:19] I have really enjoyed speaking with you but what I want to do at this point is.
What I think is the most important part of the show and that’s where I get out of the picture so I’m going to take a pause I’m going to close my Mike and dr. Jill Einstein will give us her personal prescriptions for success.

[39:38] Dr. cook thank you so much and I look forward to sharing my prescriptions for success.

[39:46] First is to learn the art of listening start with your friends and family expand to listening to your colleagues your patience.
Every person has a unique story opinion approach that is worth knowing.
Be curious you can learn so much from others and apply it to your own life.
Be an active listener by asking the right questions and engaging in the conversation it shows you care.

[40:14] Number to Seek mentors throughout your life and be a mentor.

[40:21] I’ve never had a mentor in a formal sense but I’m always on the lookout for people around me who have aspects that I admire.

[40:28] Every board of directors on which I’ve served I’ve learned from the people around me and they have served as role models.
I’ve observed their leadership communication and organizational Styles and Incorporated Parts into my own.
Even if you don’t have a formal mentoring relationship consider creating your own informal advisory Council like a kitchen cabinet even if you’re not in the same room there are people in your life,
who trusts his trust in Mayer and give good advice.
It could be a family a friend family member a friend therapist your work manager the president of your company or organization.

[41:07] And always be on the lookout for opportunities to Mentor others even if it’s not in a formal way people even though you may not know it often look to you.
For how you do things how you approach things third is create community.

[41:26] Be a part of or create communities in your life for me this has been a great source of satisfaction whether it be my to book clubs my work as a non-profit board member
sitting on the board of my synagogue and even in my work with the maven project I’ve gotten so much satisfaction in creating a community,
amongst all of the maven project physician volunteers be a part of making connections either as a member of an informal or formal organization,
and think about being the one to reach out to others to connect them to bring them in to bring them into the conversation to ask for their opinion.
And it’s really a joy being a part of a common cause or interest and then lastly I’ll leave you with have an understanding that you are always evolving.
And understand the skills and environments that make you flourish.

[42:22] Be versatile and open and recognize that you can reinvent yourself or at least pivot with the right support around you,
to accomplish the things that make you lead a good and happy life,
whether it is in your family and personal life or whether in your work life.
And I love this quotation from t.s. Eliot and I had actually used it in my medical school application it goes like this.
We shall not cease from exploration.
And the end of all our exploring will be to arrive where we began and to know the place for the first time.

[43:07] These are my prescriptions for success Jill you is certainly.

[43:14] Accumulated a good bit of wisdom along the way and we are grateful that you were able to join us today and share with us before we go I want to give you an opportunity to tell people where they can find you and what you do.

[43:28] Wonderful well you should all check out,
Maven project and you can find us online at www.steveadubato.org and please look to see how you can join maven,
either as a clinic partner being a safety net clinic or being a physician volunteer or being a donor we would love to have you involved
and you can also reach out to me personally my email address is Jay Einstein,
Maven project.org so it’s jei NST Ein at maven project.org,
well dr. Jill Einstein director of physician engagement for the maven project thank you so much for being with us today it has been a great pleasure,
dr. cook thank you so much I really enjoyed it.
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[44:50] As always we appreciate a review and a five-star rating as well as suggestions on future show.
And finally special thanks to Ryan Jones who created and performs our theme music for the show that’s all for now so be sure to fill your prescription for success with my next episode.

[45:10] Music.