Ep. 67: The Future Patient - Trends We're Already Seeing

Part 10:00

This is Beyond the Arches, where full-arch dentistry meets real talk. Let's get into it. Hello, welcome to Beyond the Arches. I am your host, Dr. Daniel Noorthoek, and I am joined today by the lovely Dr. Laks. Hello, hello. Welcome back. It's been a little while. It's been. It's been a little bit, yeah. Last time we spoke was about the refresh and about how we take cases and take old parts and pieces and kind of update them and turn them into our own digital process, which is always a fun topic.

And today we're going to talk a little bit about how the patient has changed over time. And so I thought you'd be a good one to bring in. And we didn't do a lot of prep because I wanted to kind of get your off-the-cuff reaction. And then I've got a little bit, I spend a little bit more time in the numbers and the data than you do, so I'll kind of throw in a few things here and there.

▶But just off of the cuff, if you look back at the last two and a half years that you have now worked with us, we're only, actually we're pretty much like on the day, two and a half years. Wow. Right? April 1st, right? Yeah. Yeah, so it's almost October 1st. April 1st, yeah, yeah. So we're right at the date of two and a half years. And so in that time, as we know that because we looked at it the other day, you've done, was it 572 consults?

Something like that. 570 something? Yeah, I saw the number and it's all a blur. With a great close rate. So in that, how have you, from the beginning to now, started to see? Have you seen any changes to patients' profiles you have? I think I have, now that I'm thinking about it. It's, I mean, we get to talk to and meet like so many different types of people. So every consult is different. But looking at it kind of like as a whole, taking a step back, I can definitely say that more people these days are more aware of things, right?

So with the information era that we're in, with AI. And all these different, you know, modes of like data, you know, information. I feel like people love getting all of that, like all the detail. So there's more questions, more in-depth questions, I would say, that get asked. The age of the patients, I feel like these days when it comes to full arch, the age is getting lower and lower. Like more younger people are looking into this, which is a great thing, you know.

And so when it comes to that, I would say like age and the amount of information that people want to know. So let's harp into the AI age and the access to information, which is plentiful. Yeah, it's a blessing and a curse. It's a blessing and a curse. That's where I was going to go with it is, do you, how often, let's say out of 10 people that are well-researched and ask you a lot of questions, what percent of those 10 are a good informed and which ones are you spend the majority correcting?

Oh, my gosh. I feel like it's... 50-50 or more? Maybe 60-40. I don't know. Like AI is amazing. It's accurate. But sometimes it's just like a little bit off and there's not as much nuance in the responses. And it could get a little, you know, iffy. So there's a lot of clarification. There's a lot of weight, you know, that only applies to this scenario. So, yeah, half and half. You know, some people do their research and they, you know, they check and they edit and they really make sure that what the information they're getting is true.

But it is hard. There's so many different opinions out there. So it's nice for them to come in with that sometimes. And then we'll go through it and we'll clarify step by step and we'll kind of sift out all the misinformation. Yeah. Yeah. The AI. The AI is good. It provides us with information. There's stuff that I do on a daily basis that actually gets done now because I can figure out, not figure out, but it can figure out how to do something.

It's a tool. Exactly. For instance, there was a couple of projects that I had to hand over control to Nick this week. And I can tell you beyond the shadow of a doubt, handing over that control would have been something that I just... Ignored for three to four weeks or waited until I was in front of a computer with him or had to call somebody, any of those number of things. And instead I was able to get it done in two minutes.

It was exactly what he needed. It even told me how to clean up my back, back trace, my steps so that it was cleaned up behind me. So the point being is that, you know, it's a wonderful tool. Yep. And anyone that's interacted with it knows that. It can mess up in a lot of the nuance. It's getting better and better where it used to just flat out not understand, you know, like, should I buy a convertible?

Since you live in Florida and it never rains there, like, no, it rains here. Oh, yeah, I just checked. It rains all the time there. So you're right. It's doing less of that. But there's still that nitty gritty nuance that's still human that it can't ascertain.

Part 25:44

Especially with dental related things. And it's funny. I feel like people should look into this more because sometimes, you know, the amount of teeth will get, you know, a little bit thrown off or, you know, the little things like that. It's funny to see the, like, mistakes and errors. But, yeah, you take that and then you make sure that what you're seeing is actually true. Would you say that the majority of that change has been bringing in a list of, hey, here's what I found.

Just to be transparent, this is what I'm working through. Help me work through this. Is that the type of presentation you get? Yeah. Or is it like, well, what about this? And they're trying to catch you. Less so that. It's more so the first. It's really just them being curious, wanting to do their own background checking and information research. So it's, you know, they're coming into this with an open mind for the most part. A lot of people do know that, you know, it's not the end all be all.

You've got to look into it and make sure that, you know, it's right. But this also goes for mock-ups of, you know, aesthetic inspiration, like the smile goal and what things are going to look like. People are now starting to do that on their own, which I feel like even a couple years ago was something you had to book a consult, go in, you know, do a whole mock-up, see what, you know, the final results are going to be.

So now people have a lot more control over that. And so that also brings a lot of. It's more collaborative, I would say, these days because people come into this kind of knowing or having like an idea of what they want to look like because they, you know, ask chat to create a smile. Absolutely. Sure. So it kind of becomes fun. You know, we collaborate and for the most part, it's good. Yeah. When we used to get workups from patients and I'm saying used to and we're talking like three years ago.

I can remember the last. The last guy that gave me like a guide of what he wanted and it was a very in-depth 10 to 15 page example after example. It was quite impressive what he had drawn up and he did it all, drew it all up on his iPad or whatnot. And those, the only time you would ever see that was it was going to get in your way. Yeah. Because it's very hard to recapture what that person is thinking.

It may or may not. It may or may not be right. It may not, may or may not be true. May not, may or may not have the intended effect. But I would imagine that for the average person, I could see it being a little bit more collaborative. Yeah. And sometimes it inspires them because then they see it. They see their face and it looks real and it's a nice, ideal, beautiful smile. And it kind of helps them a little bit come into this because they know that, okay, maybe that's achievable.

Obviously, we talk through it during the consult, confirming that if it is achievable or not doesn't make sense. But sometimes it helps us when they begin. I can see for the most part it being a positive thing. Yeah. If what you're saying is correct, which is where people are coming to the table with more, hey, I've done a bunch of research. Not 100% true. I'm sure if it's true, but do you mind if we work through this?

Yeah. So that's a whole different thing than like, well, you know, I do know that it's supposed to be, you're supposed to be using this material. Right. That can really get in the way of anything productive. So that's good to hear that that's better. Yeah. Another thing also I would say is like social media, right? People are very open these days with sharing their stories and bringing us through, you know, their journey. And so it's, I feel like just the whole online data, kind of all the information out there.

It's, it's just a bombardment of information. So it's, it's in their right to take all of this and then come to us and say, all right, let's lay it out. Let's, you know, go through it together and see what, what's next. It's fun to see how in grow, in building this done in one from the very beginning, how it morphed into, like we've talked about several times. It morphed into this personality business and this. Friendship based business more than a relationship based business rather than it was the technology.

The technology is just what enables us to maintain that relationship. But it's kind of cool to hear what you're saying there, because a lot of what you're saying is enhancing that experience. Yeah. And it does stress the relationship and the working through together. Yeah. Right. The whole point is to make it a smooth process. Knowing the steps, already having that down pat dialed in so that we have the time to go through these questions, to go through all the data and human to human.

Right. Just talking now. A lot of it is just talking. Yeah. So, yeah, it makes it, I guess, a lot easier in a way. Sometimes it gets a little overwhelming and there's too much information is not good. You can drive yourself crazy. Right. But for the most part, I think it's been it's been cool to experience. It's been helpful. I would say. Yeah. And you've seen it just change in your 30 months. Yeah. Yeah. Right. With all.

I feel like there's been a lot of changes recently the last couple of years. And I'm sure other full arch, you know, places feel it, too. I would think there's a lot of changes. The whole dental industry probably feels it. And so I don't think it's specific to just us. But I do feel like a slight change, like new chapter, a new era. So. Most of it good. Most of it good. Yeah. One part that we're starting to see just a little bit.

I was just talking to a friend who's in dental supplies and he has a less expensive alternative. And they're really busy right now, which is sort of a sign that there's pressure because that's when people look for deals. They don't really look for deals until traditionally that helps done in one itself. ▶Because we have always been. In that less expensive competitive market. But it also when people are doing more research to find the best deal that causes them to leave their private practice dentist locally and start to think about traveling, et cetera.

Yeah. So we haven't really seen that. We haven't seen a negative or anything. It's very hard to tell how the economy is doing with our numbers. It depends on the economy. It's all. Everything. Yeah. It's a trend. It's all related. Let's talk about age. So tell me what you see with it being younger and why it's sort of trending towards a younger based group.

Part 312:59

So in my opinion, and I thought about this, I really think it's just because people know that it's not like what it used to be. You know, people have maybe a view about full arch and this type of procedure. And, you know, they look at it and they think it's just really intense. It's for old people, you know, things like that. It makes sense. And so now I feel like because of this information that's available, they're able to see really in depth how it works, the process.

And they realize, all right, it's doable, you know, and it's available to me. Why would I wait? You know, if it's something that I really need now and there, I don't know, maybe it's not being brave. It's just knowing the information and knowing that it's not going to be as intense as it used to be. And they can get through it. And I would say that's probably the main thing that's affecting the age. Yeah, I see in that light.

I see it very much the person that a group of younger people is a group that we know is dropping drinking and smoking in record numbers. They're focused on a healthier lifestyle. So this is something that they're thinking about more. And maybe have more dollars to put towards it since they're not smoking and drinking. Certainly see that in the groups that I golf with. The younger guys that will, you know, are starting to show up in groups as I get older.

They don't drink on the course. They don't, you know, they're definitely not smoking. Like they're definitely more health conscious. Yeah. So you've got that as a little bit of a push. They probably grew up. They grew up in more process. I wanted to ask how you, what you thought was the effect of diet. Yeah. And, and carries, you know, cavities. Because it certainly seems like there's a lot of younger people with a lot of high carries rates.

For sure. You know, I feel like it's, it's a big problem. It depends on socioeconomic, you know, things like that. And knowledge. And being introduced to these things at a young age. Sometimes it's genetics and they're just doomed, you know, from the start. But I think diet, health, people that, you know, are aware of these things. It's all related. And these days I do agree. I think people are becoming more aware of their overall health. And they know that their diet is directly related to the health of their teeth.

You know, cavities, all these things are related to all these processed foods and sugars and all that. And so. So people are becoming more aware. I think, I think it's going to take time. One thing I was just thinking of as we're walking through that is when I started to do Full Arch, a younger person that definitely needed it, maybe you could, maybe you could fix it. Let's say you could fix it with half their teeth needed root canals and crowns.

And half of them needed some sort of major filling, you know, something severe enough that they end up in your chair. There was a 50-50 that you would be able to educate them enough that they should save it and should put the effort into. Yeah. Or 50% would sort of say, I see that it's not really worth the effort that I want to go, that you want me to go through. I still want the Full Arch. It was like a 50-50, I would say.

I would tell you that in the consults that I do as of, let's say recent. One major shift that I'm seeing is that, and it might have to do with a more educated person. They're coming in and it's almost a zero percent. And if they've come into our office, they are going to get this done. That's, it's almost a hundred percent. It's not, there's no, like, let's, let's run a little quick thought experiment. ▶So if you had somebody that was 35 years old.

50% of their teeth needed root canals and crowns and some other restorative work. What do you think is the percent that you would be able to convince them to not do it? Very, very low. Very close to zero, right? Yeah, I know that you brought that up. I do agree. People come into this more really knowing what route they're going to take. It's not so much a discussion anymore. And I, I still do that sometimes. And it's, you know, talking them through it, kind of laying out each path and what the options are.

And sometimes that's needed. And sometimes it is, you know, avoidable and they can go down the other restorative route. But people are more sure coming into it these days. It was, I was, it's funny that we're talking about it now because I was thinking about it yesterday. The case that I did, one of the cases that I did yesterday, the guy had moderate to severe periodontal disease. But we'll just classify it as sort of moderate. And I was thinking, like.

Back in school, I would have spent an hour convincing this guy that he should go through periodontal surgery. And I would have done periodontal surgery on him. And he would have hated the look and the experience and the whole thing. And there's not a chance that I could have convinced this man to do periodontal surgery. Zero chance. And that's a, that's a big change. Yeah. You have to be careful that you don't just make that assumption. So you still have to say it.

But there's still, I. ▶I would say that's probably like the biggest change as we're working through this. That's one of the biggest changes is people come in more educated and more convinced of what they want. If it's going to hurt them, we need to prevent them from hurting themselves. But the majority of them are like, if there was somebody that you want to mention, they're already 50-50 on the line. It's not like people come in with pristine.

You don't go to a car dealership looking for a brand new car with a. Brand new, perfect car. Right. And that's the thing, right? These people that are sure, you look into it. And I know you've said this before, like during surgery, you take the teeth out, you can feel. A lot of times. Right. And so a lot of times they know and they're coming into this knowing. And so usually I'm, I'm in agreement, you know, after we discuss and I'm like, yeah, I agree with you.

You're right. This is a great option for you. But I don't know what it is. I think maybe it's the fear of, of the pain and the longer road, you know, taking. The other route, maybe it's just wanting something done and a solution and they just don't have to worry about anything. And it's fast. I'm not sure what it is. There's probably, it's multifactorial. Yeah. It's a product of the environment we live in now because you've got resources and, and dispersed knowledge.

We have longer running track on the fact that it actually works.

Part 420:09

And it's not that if you get it, the surgery done once and it. Goes bad that you're absolutely screwed for life, which is what we thought long time ago. And it's also probably some of the expense that's still tied to regular traditional dentistry and all the visits that are tied in. People are busy. They want to move on with their life. Yeah. People don't want to be at the dentist. And they're on the, you know, another thing, this is a whole nother episode could be on the effect of social media on people's looks.

Your teeth are a massive part of your looks. Yeah. And there's a lot of motivation there to not be hidden. Yeah. Hey, we're in Boca Raton, Florida. People want to look good. So there's a huge aspect, you know, it's definitely related. We did surgery on a guy who was embarrassed and didn't love his smile at all. And he probably had six on the top and six on the bottom with partials and such. ▶Teeth were really easy to take out because they were being loosened by partials for years.

It was an amazing case. It was so fun. I don't have a lot of fun doing these cases anymore, but when they're fun, they're fun. But interestingly, one of the most difficult things of his case was that he's been sort of hiding his smile for so long that naturally his jaw is always closed. And it was really hard to get him to stay open at all because his natural rest when he's around humans is closed. Wow. It's like his instinct.

You could feel it, that it was just like, we're talking to him, he wants to be closed. Yeah. It was pretty wild. Well, just wait a couple days. Yeah. You've got to unlearn all that. All I thought to myself as I was doing the case was, you're going to not be able, we're not going to be able to shut you up. Exactly. They can't stop smiling. Yeah. And it's just knowing that you come into the office, there's no judgment.

You know, I think people also appreciate that. Like just today, I did a consult. You know, the patient came in with a mask. You know, hiding. And then by the end of the consult, she walked out, you know, with no mask. She felt, you know, more comfortable around all of us. So it makes a difference. You know, just being transparent, real, open. Like people appreciate that. I, we can all kind of relate a little bit in some random ways.

I had a, I have a classic car and when I bought it, the tires looked nice and they went bye-bye really quickly. Um, within the matter of like a hundred miles because it was dry rotted. They were old tires. They were ready to go. And just by me using it, it just blasted through them. And just in that stupid little example, I was so embarrassed to bring the car in with the tires that it had on it.

Yeah. It feels like it's your fault. Yeah. You did something wrong. Don't look, just change the tires. Yeah. And the consult today was like, don't like yell at me. I'm like, I would never, you know, judge you. Like, it's not your fault. At the end of the day, you're here, you're here. And so, yeah.

Part 523:17

▶We're, we're our worst, we're our own worst critics. I always say that. I say that when I'm like weekly. I said that cause I know you say that all the time. Um, what else? What, um, besides age and, uh, in information, do you think that, um, let's just stick on the social media topic. Do you think that patients in general are more apt to be picky? Because they're seeing themselves more and, and in a, in a good or bad way.

Yeah, for sure. Yeah. With social media, you know, people release all aspects of their life, right? They want to be looked at a certain way. So yeah, I would say that, you know, these days we're in a very, um, superficial, you know, era. And so I think people do or are more picky about their looks and how they come across. And they know that people are judgmental. And so a lot of people have plans, uh, put their photos out and, you know, start whatever it is, podcasting and they want a nice smile.

So I think it does matter. It does make a difference. It matters in a big way for sure. And we all, to go back to it, we all look at our own pictures that we have eight bazillion of and see, see what we like and don't like of it. And, um, sometimes that can be motivation to get it done. Yeah. But, uh. But in our scenario, it's going to be more of a comparison, which I think is it also, that helps us quite a bit because there is that psychology of wrapping up the case quickly and being done with the zirconia.

Um, because whatever pushback you get about, well, you know, it was great after surgery and now I want to change it because I don't like the look. It was that times. Pro I would not. Even kidding times 20 minimum back in the day because you had such a long time in temporaries that they hated and they wanted to get it perfect. And you were limited by the capabilities of the materials a lot more. And, um, that was tough to come, to come across the finish line with a patient back in the day was really tough.

Yeah. I would say it's a lot easier now because we're also able to see it in real time. So we know what we're getting, you know, with the final results. We know what the final result is going to be. Um, but also when the patients know that they're not stuck, and I also say this a lot, I never want someone to feel locked in or stuck, right, because a lot of times the most little adjustment, right, even a chair side, you know, adjustment, zirconia, we adjust it, right, it could be modified.

And so knowing that, you know, having the patient know that, um, and we are able to provide that, that also helps, right? Knowing that. All right. You're healing, you're adapting, sit with this, you're going to come back. You're not, you know, done with us. We're going to be, you know, seeing you back at the three month that, you know, one year mark and things like that. ▶We can always modify, we can always fine tune and create little imperfections here and there.

So we kind of add that character if we want to eventually. So it's, that's a huge, a huge part of it because you don't always, the re the, the base of what you're saying is that. The, it doesn't have to be completely redone. Sometimes it's just renovating one bathroom in a house. Yeah, exactly. And, um, I, I can see that for sure. Another thing is with the advent of digital, it's created things to make it so that it's so temporary and prototypy to begin with, or even through the process.

If you have a problem, if you break the teeth and whatnot, it's. It's a big change that there isn't a lot of stress or work in the office apart from switching out material, you know, switching out for a temporary again, pro re prototyping, adding a new implant to the new, to the old design. Those kinds of things are wild transformations that just like anything else kind of get faded into the background. I know we don't appreciate it.

Yeah. You can't remember when you couldn't Google something. You can't remember when. You didn't map quest something. You can't remember. You lost all that file and you can't get to it. Like it's. It corrupted. Yeah. It's, um, that's a big change. Yeah. ▶That's just always in the background, but it supports what we're able to do and what we're able to perform and exceed on.

Part 627:58

So while none of us realize it on the day to day, because we just kind of get lopped into it, patients as well. Um, it prevents a lot of strife and issue. Yeah. Yeah. Knowing that. It's probably achievable. It's not really a big deal. We can get it done. A little tweak here and there and it makes a big difference. It's great. So, uh, another thing that I was thinking of as we went through this is, um, when we looked at your numbers for the consult.

And by the way, it wasn't because I was evaluating Dr. Logs. She wasn't on the, she wasn't in the hot seat or anything. Report card. You were the one that asked the question. Oh, that's true. Um, but when we were looking through that, your virtual. Um, so, um, so, um, so, um, so, um, so, um, so, um, so, um, so, um, so, um, so, um, so, um, so, um, so, um. The number of people to in-person consults was pretty much the same.

It was almost 50, 50. Which I was surprised about, I think. Very. Because I thought, you know, something gets lost in translation doing it virtually. But I guess with, you know, the tech these days and the way that we are able to, you know, FaceTime or, you know, Zoom or whatever it is. Um, it, yeah, I guess it doesn't really make a difference, which is great. So there's more opportunity for people to call in, even if they're across the country.

It's been a really powerful tool because it allows people to sort of be in that protected zone while they're getting, they're looking into the fix. True, right. So they can kind of be in their comfort, in their comfort zone. So when that sort of became a thing in 2020, 2021, I would have told you that it's definitely a trend, but we're going to go back to full-on, full-scale in-persons. And that's been something that's interesting is it spiked.

But then kind of came to a normalized and it's really 50-50. Um, but it hasn't gone, it doesn't waver very much. ▶If you just take, even if we change up the strategy of our marketing, I bet you it'll, it would stay 50-50 now. Probably. Yeah. And we get people calling from like all different types of places, from their beds, from a car, from everywhere. So, yeah, it's true. They're in their comfort zone. They're doing their research in their little dark room, you know, about all this.

Yeah. Yeah. Yeah. I think it does help, you know. The amount of variety of locations that we see on a virtual consult is pretty wild. Yeah. We should get the stats on that. Yeah. I'm sure we can get that. All over the place. And it's actually pretty much constant. Even, we have a high focus obviously for travel, but Jacksonville does not. Tampa does not. And their consultations are pretty much 50-50 as well. Yeah. Yeah. Yeah. Yeah. Yeah.

Yeah. Yeah. They have in-person and virtual. Mm-hmm. That's nice. About 50-50. Right. Which is good. What about the type of patient? Has that changed over time? The type of patient? Mm-hmm. I mean, everyone is so different. I don't know if there's, if I noticed one certain type of patient to begin with. I think it's like a whole range, but like we said before, the age, you know, younger, older patients coming in, older patients coming in also, like really old, which is also I think related to the fact that it's an easier process.

It's going to be done quickly and they're, you know, back to normal. And so that's an interesting, you know, thing to see also. I think our oldest patient is like a hundred maybe. Yeah. Close. He turns a hundred soon, doesn't he? That's right. Yeah. Yeah. Yeah. Yeah. ▶I think he's like a ten year old before age, but I don't really notice any difference in the type of person. I think it's just, we see everyone. Yeah.

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There is no classification for a full large patient. They can be rich, destitute, old, young. Everything. Medically compromised. Yes. Medically healthy. Yeah. It's bananas. And I'm sure, what even 10 years ago, it looked different. Maybe. um 10 years ago it was and i'll tell you why i think it was different it was because of access to the information and the channels with which you would use to advertise so it used to be the only way to get to a patient was say television and let's say that you advertise on the local television well that might cater to your less uh rich clientele because they are demographic that's not paying for tv necessarily but if you're in cable maybe you can search out in your clientele is going to be a higher income group because they paid for cable tv in a world where that's all streaming and mixed and mumbo-jumboed and you're not really putting as much of a percent of your budget in a specific class it's way more variety varied rather it's instagram and tiktok and google and some television but not a ton you know not this and is what we do right yeah it's everywhere right so i think that's why yeah i don't see any difference a good thing it's a good sign i guess it used to be way more marked right because you were getting and you you you would make a decision based on that a little bit too you'd say well the patients we've been getting us recently are stinky and horrible let's change this up yeah um so it has changed the whole thing there isn't one thing that's untouched by the last 10 years in terms of progress and change pretty crazy which is why this is an important conversation and you know the take-home like why would you have this conversation um like what does that do for patient education and awareness well it can it's it's there as a um uh comfort that you're not alone there isn't it isn't just people with curly hair that are 40 years old it's not just for fat people that are 80 years old or more that's it's really for everybody that is appropriate and needs it and um you know in whatever way you want to digest that information we're here to try and help and walk you through yeah available to all and i i personally find the trends to be fascinating it is they are very interesting to look into because once you see it you think oh my god i'm gonna die i'm gonna die back and it all kind of makes sense you know so it is cool it's it's ever-changing and um it has sort of stabilized in the last like two or three years i would say like our patient base is pretty dialed in to be very varied for sure it's high variety but also very steady eddie in that variety

Part 834:56

yeah you know every three months you know for a fact you're gonna get somebody with a ton of tattoos yeah every month you're gonna get somebody with a really big beard like what yeah just so it's very yeah yeah it's you're right though it's just a sliver of the demographics from the country and you know those are coming you know exactly but at the end of the day every once in a while you get the folder guy always the drawings and you know the drawn out and all that and then you get the the wife that's making the decision for her husband of course you know i was just thinking as we were talking about um the speed with the age um i will say that i don't have any stats but the amount of because of the speed now the amount of patients that we have and this is sad but the amount of patients that we've seen in the past that are terminally ill that want a chance at this is wildly different than it used to be yeah we actually we have many patients that are currently going through health issues you know really big medical things and they they get this done knowing that it's not as hard and you know it'll be a little bit more smooth of a process and it's going to help them systemically you know beat whatever they're dealing with so we do have a lot of those people which is nice yeah it's um it's it sucks because it brings a gravity to the to the world that you get to blissfully ignore for a lot yeah but they also don't have to think about their teeth but there's happiness in the result yeah being able to achieve that little sliver that they really wanted to there's like a very deep satisfaction with that and that has changed they feel good they don't have to deal with you know whatever infection or what was going on so they feel a little better a little bit more energy so it's a little boost yeah that's a heavy one but that's a big change yeah well doc i appreciate you going through that stuff with me it's always fun to get your insight i like to use you for the more boots on the ground clinical um and uh you've always got a really good temperament as always um and so we appreciate your insight and appreciate your time thank you fun to be here thanks doc and uh for you guys at home uh we hope that this is somewhat uh reassuring that uh at some level you're not alone that there's uh somebody in this world that is just like you and we've treated them and um we'd like to be a part of your journey and a part of your being able to feel like you're a part of your life and uh wherever you may fall on this this timeline give us a call like subscribe listen to the podcast there's plenty of episodes to get whatever information you want and uh run it through chat gbt run it through claude we're here if you're a weirdo run it through gemini grok grok if you're a weirdo run it through grok yeah um just kidding we don't consider anyone a weirdo but we might judge you if you use gemini uh at any rate thanks for listening to this podcast i'll see you next time