A Family's Commitment to the City That Saved Their Son (Pt 2)

Published Oct 22, 2024, 4:00 AM

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

Hey, everybody, it's Bill Courtney with an army of normal folks. And we continue now with part two of our conversation with Pedro Velesquez Senior and Junior, right after these brief messages from our general sponsors. First of all, thank you so much for sharing all of that very personal experience. But you get to get through that to understand your commitment to this community. And the commitment to this community is a deal that you made with God to spare your son. And I hear you, Pedro Junior, use the word commitment, and I think that comes very naturally from your parents because they are clearly committed.

And the whole family is committed.

Committed, and you made a commitment and you intended to make good on it. So here's the deal. You made, the deal your son saved. You ain't going back to Venezuela. And you decide, well, I've got this background in indo chronology, I understand. My emphasis was on diabetes, and I read a thing that says I read a demographic that says the national average for diabetes is nine percent and memphisis almost double that. So there's a huge needs. It's like a thirty percent higher thirty percent higher.

It's nine point six is the prevalence of diabetes in America. He had his fifteen percent.

So the war that the Lord works in mysterious ways. Not only did you make a deal with God, but little did you know you were making a deal where your talents and expertise and education were actually really really needed.

Yeah.

So the thing is, though you don't go to work in the diabetes world to just go make a bunch of money. You say, the reason diabetes is so more, so much more prevalent Memphis is because you find it in the poverty stricken, underserved areas and you decide that's where we're going to work.

It came from amberin researcher, I analyze, I create models I've heard, so I didn't want to create lifeloc as my practice. We tried to become with something that, actually, let's do a little bit what's going on in Memphis. I realized that Memphis what I was seeing in my older folk. I'm an internal medicine by training and add al in doctrinology. So when it came here to work for the pediatric hospital, I got my attention to see that kids, we're having the same risk factor that we see and our adult person. Actually in it's totally different. The level of illness and sickness that I found in those kids that I didn't see in Boston.

We saw. You saw sickness in kids and Memphis that you did not see in Boston.

I didn't see the severity of obesity, the complications of obesity, sleep, apny and blundish sleep, and children very frequently really hypertension and children and children we have. I mean, at some point I hope that we can talk, because this is part of life doc measure how we can communicate. Where are we heading?

Oh yeah, we're getting to that, But first I want to you know, your beginnings.

I got my attention and then I was funded at that time interested in diabetes by Nahe And what is cultural research is bench to practice. So I worked very closely with the University of Tennessee College if Nursing, and I developed like an incubator, So I was preceptor. I was the designing different studies to characterize what's going on Memphis. And this is how life dog model come. So we develop a model that work for Memphis. And this is what makes the difference with any other practice. That come out this is what I'm gonna do, and this is what I know how to do. No, we come out what this is what is needed and this is how we're going to approach based results. For many years, we have been no only characterizing what is affecting Memphield the most, but also whether or not what are the intervention the best impact. And we've been testing this for many years.

Also, we've been there only are you treating p theatric diabetes, hypertension, sleep apnea, all the things that are affecting children that shouldn't be, you're also collecting data and the research to try to understand not how to effectively treat it, but the why, the.

Why, the why, And this has been probably the biggest driver of what we do.

So interestingly, as I hear this, I can't imagine that Jackson, Mississippi, Little Rock, many other city, Oklahoma City. Now, if this exists Memphis, it has to exist in other cities the exact same way it is.

I mean, it's impressive and I'm going to leave something for you to see. The evolution and this is the reason that we become.

Generation We become what an evidence generation center because of the again, what Evidence Generation center.

An evidence generation center. All right, break that down for a guy that's a football coach, because those are.

It's easy what you were saying. It's a center that map characterized the impact of obesity and chronic conditions across the generation.

Okay, we've jumped too far ahead. We're getting to that. That is phenomenal and I cannot wait to explore that. But we got to our listeners have to exchange. You made this deal. You start. I think I read the first year you were seeing nineteen patients a month.

Is nineteen patients a month for the first they opened the clinic. On Valentine's Day two thousand and five was the first day that.

And what was the clinic just a It itially was a primary care. It was just a primary care. Because we want.

To but serving the unserved.

I focus exclusively on minorities underserved.

Okay, And where was this thing at.

Mount Moriah and three eighty five Mount Marian.

Okay, for those listening, that is not really inner city, but it's southeast inner City. It is. I wouldn't say it's the hood or the projects, but it is certainly a lower moderately income area.

And at that time in two thousand and five. It was also one of the areas with the most uninsured populations. It was one of the places that you know, there was a vast health disparity in that area back then.

Okay, so that's where you open and you're seeing nineteen people a month, and you start going to work. But as you go to work, you start to collect this date I work.

I still working for the university. Oh as well, Yes, I worked for the university. I couldn't practice there, and I choose to invest and developing the model. So I hired more physicians that were able to track the patient, implement the patient. But I was gathered in the data, so I pay initially, we pay, We developed the insurance process, and it wasn't we were not necessarily making money. But I couldn't work as a physician there because of my commitment with the university. But I was doing it was what I was calling the incubator process because I make all the nurses the PhD to analyze the data. Let's see, let's explore what we can do combining the data of this on the serve community with the data that we see a labona and come up with different disparities and if you see, most of the paper that we have published has been in this party this difference and diseases, challenging the guideline and trying to understand why these people die more, why these people get sicker, and.

Because it is true people that live in poverty have I think it's a fourteen year discrepancy and life expectancy, and it sounds like it starts.

They what it's called early mortality before thirty. They represent a significant percentage.

Of four thirty.

And there is another definition of early mortality or early dead before fifty five. They represent the majority of the people that die earlier. And we're going to go deeper than that, but it is exactly where lifelog is head and try to understand the design of light. Doog is trying to understand because it doesn't start when you become twenty one. You have to be something that you can't from childhood. And this is why we choose to move to understand better the diseases in younger people.

But one of the things that's worth also highlighting is the fact of why it's an effective thing is because there's different ways of doing research. Right, you can study what other people are doing and come up with answers. And how LIFETOC started was just get in there and start doing the work and see what you learn. You know, you get in there, you start seeing the patients, not just reading about the patients, not just collecting data from other places, but one on one with patients, getting to do the work every day to see what does the data show, what does the people show, and then where do we go from there?

I gotta believe early on the first thing you saw had to have been diet as much as anything.

I mean, it's beyond that, because is beyond it. That is, of course that that is something there and we're going to go deeper in that. But but is what what I saw is that we were a dressing We were a dressing things in an uniform way. And I believe that race environment impost different race and environment and impose different challenge that requires different approach.

And said, what you're saying, what you observed early on was that race and environment required a different medical approach. I agree with. Please explain that. So for instance, because honestly, we're not supposed to say that, you know, I mean, let's be honest, We're not supposed to talk about race as a different approach. I mean, that's ooh, we got to be careful with the same things I police misunder Please don't misunderstand me and I being facetious. Of course we should talk about that. If those are the facts, we should talk about it. But that almost seems taboo.

Let me give you were I'm heading. Okay, Okay, If I get you him and I that are overweight, we have three different, totally different mechanics why we become overweight, Okay. And also if we if we are exposed to different environments, and we'll talk about what is what is usually called today's social determinant of health, used to call barriers of health care in the past, so we get access to food that is not healthy. But also the genetic predisposition. There is people that have a genetic predisposition. We human beings are exactly the same like any other animals in the world. We have predispositions in the same way the.

Pion genetic predispositions to genetic predispositions that don't have to deal with rice.

It had to do with they have to they have to do it, but.

Hold it political correctness. We don't need to talk about those but it's one thing is what you're saying, that political correctness.

Then one thing is racism. Another is race. Okay, in my country with the I learned when I what was my race? When I came to America. The first time that I came to America, I was fifteen. I came to New Orleans. And when I was when I wasn't in the custom, they asked me, what is your rise? My mother is Indian with Indian, uh with German, my father is Spanish with black. So what race? And I so, I did it? Doesn't I mean? So, I said, I have no idea. And in many countries, race is a character. It is something that they find something in the same way that that you choose horse, a horse that is good, right, race horse, the pedigree define the quality of the whole or whether or not you know it runs. So and also the genetic makeup and the genetic makeup is also exposed and modified by environment. So people that are that have never been in this level of poverty does and for generations not necessarily will understand that, but it modified. It makes a different makeup. And we have a full line of research and that okay. So, and this is something and today today build the most way the best way to do medicine is what it's called precision medicine. It's called what precision medicine precision, so meaning that that the more specific I target your condition, I will have more chance of success. This is what you did with better. They did genetic mapping. The way that he responded to the medication is different that the way that other people respond to the medication, the way that they metabolize the chemotherapy is different. So this is where medicingle pharmaco difference in the way that the people respond to treatment has been defined by genetic predisposition people in the way that they metabolize how fast. You may take a blood pressure medication that probably is metabolized faster and you don't respond well and you may need another that will require.

So when you have your clinic and you're starting to treat kids, you're mapping their reaction to your treatment to start to better understand how certain people from certain environments and certain that it make up respond to treatment well.

And they created a series an algorithm while they were doing the NIH funded research. My father and the team back then in two thousand and five, him and doctor Neira.

What were they doing.

They created an algorithm to predict who was going to be a high risk of developing diabetes, pre diabetes, and cardiometabolic conditions based on based on lab results, history, social history, family history, medical history, and just a bunch of different factors, because that lets you zone in on what is the root cause of the diabetes. For example, for me, I'm also a patient at lifetoc. I'm diabetic.

You're a patient of lifetoc that your father started crazy, I'm.

A patient of as but it you know, what he was referring to earlier is that, you know, most people, even in the early two thousands were saying diabetes, throw insulin at it, right, And that's a band aid on a problem that isn't really a great band aid because it has its own complications. But by understanding root causes, we can see what other treatments exist. I'm not on insulin. I've been diabetic for twelve years now, and I was on insulin for a while. I've and you know, because of everything that we can learn along the way. You know, I've been off of insulin now for like seven or eight years because with other medications and lifestyle and everything, but it's not type one, it's not type two, it's chemo induced diabetes. And you know it's got a different cause and treatment option.

People, the causes are different. With the model that we try to embrace is that initially the initial approach was let's find out what are the risk factors and from those risk factor what are the predictors, and then based on those risk factor and predictor we tratify. Actually, in two thousand and five we publish one of the model, one of the papers that say to teach physicians what kids is going to become with diabetes when I become obyes, and when I become with heart disease before they the better. Okay, So and this is what I try to see. We haven't done a good job stopping the propation of obesity and diabetes, not only in Memphis and the whole country. This map, when you have a chance, take a look two thousand and four, and then you will see that we haven't done anything in prevention because we choose to treat once you are to bees and going to approachect once you develop the heart disease, when you develop the diabetes. Even though nih CDC invested two hundred and fifty million dollars to prove that diabetes is a predictable, unpreventable disease. We choose to treat, not to prevent. So life doog is reusing all this data and adapted to the Memphis in order to see what are therees, How can we intervene earlier? And there is instead of way for you to develop, David.

We'll be right back in bold letters. Our mission is to build healthier communities by preventing diabetes and obesity through healthcare and research, all while serving underserved, underserved communities. We started just only nineteen years ago, So tell me what lifetoc has grown to from nineteen patients a month in Mamraa area to now.

So you know, since it is a data driven approach, we never really believe in if you build it, they will come. It's got to be more intentional. It's it's got to be based on you know, what do people need and how do we make a solution that works. Right. So it started as primary care and over the years that it developed into indo chronology, diet and exercise, optometry, cardiology, behavioral health, pharmacy and all these services get added over those and.

All right, so cardiology, pharmacy, indochronology, diabetes and obesity, optometry and behavioral health, these pediatrics and pediatricts and philoprats and all of these are now folded into lifetocs treating for the underserved communities in Memphis.

And right now we see anywhere from nine hundred to eleven hundred patients.

A week, holy crowl oh, my gosh. Yeah, and how many facilities.

So we have three clinics and we're also in four schools in Memphis.

And all the while still collecting the data, still doing the research.

The main thing is systemic change. Right, We're not going to really change the world on our own, the same way that Saint Jude couldn't change the world on their own. They have to find out what works and share it and try to instigate systemic changes to make it more doable. And when you're talking about healthcare, that talks more than just access to care. That's the things that my father was talking about earlier. You know, access to healthy food, lifestyle, safety, jobs, income, all these things are connected. And so the way that we see this is providing a roadmap for people to make better decisions who are in the positions to make those decisions.

So your father just gave me a map that I will show for those who can see it on film. This is two thousand and four, and for those listening in two thousand and four, it's just a map that is age adjusted prevalence of diagnosed diabetes and obestia among adults by county in the United States. And as you look, there's a little band in the South that's the wider the color, the less the prevalence, the darker into red purples, and honestly, around Arizona, New Mexico there's a little bit. And then there's kind of a band starting in Oklahoma, going down through Mississippi, Alabama, Georgian up to the Carolinas that has a little bit in Alaska. The rest of it is very light. In two thousand and four and twenty nineteen, fifteen years later, the map.

Is just dark purple.

It's purple the whole map. I mean, there's a really small area of white somewhere in the mountains of Colorado, and I don't even think anybody lives there. Wow, that's white. But if you look in the South, it's purple. It is it is, It is dark how you go from white new purple. And so this is your point. You circle this area. It's just deep purple. But your point is the CDC in the country has spent two hundred and fifty million dollars in research and in the last fifteen years we've gone from not that bad to horrific because we're not working on prevention. We're working on treatment.

That's it. You put it in black and white. The way, the way, and the reason that we are moving. If you choose to analyze our population is sixty sixty five percent is younger than twenty one. Because we can't prevent in this population, even though if you go most of the people that pay better more insurance in medicaid, the older people, but we won't be able to prevent. So our mission is to be sure that we prevent. So we are working with people at risk, and the lifelog model is focusing in managing the risk, the risk to become sick. But if you are sick, how can I prevent you to develop complication?

So you're saying about twelve thousand patients a year. Now you provide I don't know, fifty to fifty five thousand visits. You're in schools. You're collecting the data, you're treating people, but you're also working on prevention with.

Your identifying mapping the population.

Mapping the popul So the thing that I found phenomenal is from your experience with Saint Jude. I gotta believe your experience with Saint Jude had a part in this process. Your goal is, yes, to absolutely do everything you can to prevent and treat the most underserved communities in Memphis, to make good on your commitment because your son lived.

That's it.

But further is you are trying to get this data mapped and understand through these things that you've learned, and your goal is to share with the country to say, this is what we can do to be better. Despite the two hundred and fifty million the government spent, we have a better.

Way and also not only Joe what we can do, but also what we can do with our own resources. Okay, because all the research problem that life has been self financed, soul fun we rain best battle forward earning and understanding better the community, and it's been the bodyet has been growing significantly. But initially, like that was not recognized by any insurance, so.

It was not recognized by insurance.

Now, for the first two or three years they didn't like the model that we proposed. Now we're adding every single because yeah, because.

Unlike a lot of places like you, I know you receive some donations, but the vast majority of your revenue comes from Medicaid, Medicare right.

Medicaid, from patient care. You know, about seventy percent of the patients we see or medicaid, the fifteen is about about fifteen is uninsured, so eighty five percent is what we would consider medically underserved, and then the rest is Medicare and commercial insurances. And so the makeup of what we do is the gist of self sustainability means that we don't want what we do to be dependent on a donation or a grant, and if we don't get that donation that year, that we can't provide the care. So it's been very intentionally designed so that you know, the care that's provided is self sustainable and long term.

You could have made a hell of a lot more money going to the private practice, but that wasn't your commitment was I'm starting to really dig this commitment thing inside your family. That's a beautiful thing. So Petro Jr. You're not a doctor.

I'm not a doctor.

What are you.

Been? Whatever I needed to be since I was a kid.

You know, I've read where you said it was free child labor for a while. Yeah, and it sounds like your dad would have smacked you if you didn't go to work.

You know.

It was after high school, after wrestling practice at Cbhschool Christian Brothers High School, down to the clinic until it was time to go home, and which was seven eight o'clock, you know. You know. The idea was that we'd be doing our volunteer hours there and all those things, so you sort of get grow up around it. And then during college I would do my summer internships there.

Where'd you go to school?

I went to Florida International University down in Miami. Got it, and so during those summer internships had come back, we'd see what was going on. One of my first projects was back in twenty eleven, for the uninsured population, creating a membership model so that they could get access to everything that we do at the clinics for ninety percent off.

How do you do that?

Just projections data and trying to tie what has to happen medically to how can you make it happen operationally, Like once the doctors sort of identify what work, we can try to make sure that it can be implemented. Right, And sometimes that's the other way around.

Hold it you say that, yes, right, I get it, But that's not the reality in most places across the country. No.

Usually it's the financial people that will say what needs to happen, and the doctors have to try to make it work. And that's you know, one of the biggest things that is why there's so much purple on that map, right, is that it's not really with the health. A lot of decisions weren't necessarily made for the health.

That made it financially rather than the health decisions.

Which is normal for any country.

Right.

It's just that and is again why we are so intentional about the work that we do, is that we have to provide an avenue for people to be successful and make money by keeping people healthy and not necessarily by treating diseases.

So you go to Florida and National you do your thing, and then after you graduate.

It was actually my junior year. My father and the business were going through some pretty difficult times, so I was there here this summer I was hoping on difficult. So it was two thousand and twelve back then, and I was here for my summer internship. There was a difficult situation with his partner at the time, and so my father being a businessman, he eric sorry, a medical person, he wasn't really business. He had a partner that handled the business side of things, and some things were happening that shouldn't have been happening, and he had to end that partnership and was sort of left with the clinic in a state of I'm a doctor, not the business. And so during that summer I was trying to help with as much as I could. And when it was time for me to go back to school and register for classes, when I asked him, if you know, it'd be better if I stayed my senior year, and so I registered for on line classes and stayed in Memphis to see what I could do to help my senior year. And that's when I sort of got into this mode of going into different departments, learning what they do, helping fix something, and going on to the next thing, you know, whether that was the front office, the billing, the accounting, and all the senior in college. As a senior in college, I had one day a week where I had to go to Miami. It was Tuesday. Tuesdays was my in person days, and so I'd fly down on Monday, come back on Wednesdays. And I got to know a bar at the at the Charleston Airport very well that you know, my cocaine rum with coconut shrimp would be a weekly, a bi weekly thing every Monday and Wednesday there. And so when I graduated, I ended up seeing a path for me in healthcare, which was sort of you know, serendipitous. That's sort of what my just about.

To say, serendipity.

Really, And so that's when I decided that I was probably going to dedicate my career in healthcare in different ways. I didn't know exactly what that meant, so what I'd like doing and what I have done since it's just identifying problems and finding solutions to them.

From a business perspective.

Now from a medical from a medical implementation perspective, there's a lot of journals. There's a lot of things out there that exist that tell people what they should be doing, but don't really provide a path on how to do it? How can you operate a clinic? How can you do these things? How can you implement these things in your community and your neighborhood and your organization without having to be a nonprofit or a hospital?

Are you not so proud? You should be?

I am.

I am a kid that's a senior in college is supposed to be going to keg parties and chasing girls around and acting like an idiot. And he is flying to school for one day, flying back and basically running the operations of your clinic for he learned.

Every aspect of the clinic. He also partied a lot, but.

He did have podcast.

But is he he knows every single astpet of clinicating and the way that people should know.

So well, you are now what my role?

Yeah is executive director of lifetoc.

He was the operational director. He's been the operational director for a long time. He's been more than twelve years working.

We act as a thirty three year old. We'll be right back.

We became a nonprofit in twenty twenty one, okay, and that was a two year process that we started just because I don't.

Know, it's not easy to get a five oh one C three especially in the medical world, it's not.

And you know, we thought it was the best move for the longevity because you know, the alternatives when my father decides to stop practicing is that it can either shut down or sell the clinics. And so as a nonprofit, the organization is going to continue to live until you know, diabetes and obesity is no longer a problem.

That is so weird to hear you say, because that's Saint Jude's that's Saint Jude's goal. Saint Jude wants to work itself out of ever being needed, and LIFETOC wants to work itself.

That should be the goal of every nonprofit, right is that you know, eventually they don't have to exist, whether you're fighting a lack of education, lack of economic or income development, la of food in the goal of every nonprofit should be that they can close shop one day. But the reality is that you know it's going to take a lot. So when we developed the board, when we developed everything, we started shopping around for an executive director. And you know, after a few months is when they asked me if I could step into that role, and you know, that's where it was.

I'm pro it was not me. It was the board. It was not nepotism. I don't think it shouldn't be.

And I said, when I said that my family is committed, is that every chat had been supported in different ways. Who we are now? What we the organization that we are. So everybody raised by merit. So it doesn't matter whether they are my children or whoever. They have to compete. And Pedro actually at some point he said, and they're working the mass and in the less pain. So it's because this is what makes people.

So nepotism tends to go the other way. In our family. You know, the closer you are, the harder you have to work.

So few demographics, nine point six percent of the US population has diabetes. Shelby County, Memphis is fifteen. You guys have been cited in eighty publications based on the work that you've done. Your research has impacted seventy three practices in Tennessee. You do not depend on charity. You use insurance, Medicaid and Medicare, which many doctor's offices says you can't operate on because it doesn't pay enough. But you have spoken amazingly to how you've managed that less than ten percent of your revenues from donations, although you could always use donations for the work you do, it's still less than ten percent. And Slingshot, who has been a guest on our show, who they do through analytics, really go into philanthropic endeavors five HO, one C three organizations and they really measure the success of those organizations and do it in a very analytical way. Slingshot found that for every dollar invested in to lifetock, there's two point seven dollars in poverty fighting impact. By what you.

Did last year, we spent eight million dollars running the organization more or less, and so using what Impact saw, which they analyzed twenty twenty three, that means that those eight million dollars we spent generated over twenty million dollars in economic benefit for the communities that we serve.

Fifty percent of the impact come from the ordination diabetes and obesity prevention and early management. This is also that somebody of the Lynchhot report, so and.

So say what you just said again, fifty percent.

So they analyzed a few things, right, They looked at our medical model, they looked at our school based tell system, and then they looked at our Community Health Worker Initiative, and each one of these three parts of what we do was analyzed to understand what was the impact that it had on the patients. And you know, most investments that well, any investment that gives a two hundred and seventy percent return in a year would be considered.

A good investment to run.

Yeah, so the interesting thing about this third party analysis was trying to tie the nod of you know, why should people care?

Right?

You know, nobody wants Memphis to not progress economically, and this what this shows is that, you know, a healthy Memphis is a more prosperous Memphis. And so being able to use data to paint that picture for people is going to be extremely important, especially as we have to start having more and more conversations around what has to happen systemically for these things to be more realistic, more doable, and that it doesn't take you know, people as committed as my father and I and my family for it to be possible. You know, it should be the standard of care.

And you know what you said by extension, a healthier Memphis is a more prosperous Memphis. A healthier Little Rock is a more prosperous Little Rock. A healthier Louisville is a more prosperous Louville. A healthier US is a more prosperous Us. But I would even go as far to say a healthier Memphis is a more prosperous Memphis. Thus, a more prosperous Memphis is a safer Memphis, is a less crime ridden Memphis, is a less blighted Memphis. It all flows downhill. So when we talk about the things that are plaguing our culture and our society, it follows them that a healthier public generates a healthier culture, not just from a physical health, but a cultural health, a societal health, a safety health. And there is plenty of resources support There's plenty of research that says what I was saying, right, Well, why'd you do all the research? I just said it? But tell me about that. That's interesting because I just I'm hearing you, and I'm repeating what I'm hearing from you.

This is nothing that I'm saying, but this is the way. There is plenty of result of showing that. For intent. There is different model of healthcare. One of the healthcare is is called behavior an ecological model of health care. Has been published by heart, but by anything. So they show that the belief of the people, the access to health care, the perception of diseases, the way that the physicians treat them, the way that they feel they trust in the primary care define the outcome of the society. They associated with less crime, there is association with less depression. That is association with less expenditure and unnecessary you are, less hospitalization. Most of the resorts of whatever you said so healthier will impact the whole economy to the point. To the point. For since the stay of tennessee start to measure quality metrics, life doog have achieved one hundred percent of the quality metrics.

You're kidding.

However, even more since twenty seventeen that we start to measure financial impact, lifetog produce. Patients that are seeing lifedog have twenty seven percent lower total cost of care. Total cost of care mean that they get less admission in art, less admission the hospital, less pharmacy, later biology.

Let's start twenty seven percent reduction and the cost of health care.

For patients seeing patients from life and this is data that can be seen in think care. Okay, this is part of the patient center, medical home that have been polish by ten Care, basing that we're patients, So why.

Can't this be scaled in every city in the country.

That's one of the things that has to happen, right, is that you know it's doable, it works, but there's the systems aren't necessarily in place to support it.

Right.

A lot of the work that we do around creating models of care, models of reimbursement, creating these things so that it is more scalable, so that people can do it in their own backyards. You know, we don't want to be the clinic across the US trying to tell, you know, New Orleans how to treat New Orleans. We do want to create the around. We want to provide the path to where people can do this on their side.

We've been able to treat the underserved community and drive organization. Right, we be able to use the patient that we see. Most practices doesn't accept those patients.

The most practices won't accept the patients that you see because they don't have private insurance, they don't have prevent Doctors want to make more money than what Medicare and Medicaid will pay.

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

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

Actually, you're right because the first step that we put in the school system, when we save the significant amount of plenty to one of the HMO insurance, we didn't ask for higher reinforsement. Can you help us to impact the community, and we finance the first school program. Today we support high school program from our own resources. We spend more than three hundred thousand dollars providing care to twenty two hundred clock to twenty two hundred kids at the school. We see about more than four thousand busy and most of the basits are not reversible by insurance. Is our decision. You've been doing this. We have been doing this in twenty nineteen.

So when we talk about research and innovation, you know, we've built a model of self sustainability. However, self sustainable medical model doesn't really promote innovation, so we have to continue to invest in sort of new models of care, new ways of making sure that people in these communities that where the parents can't take off work enough times to get the kids to miss a lot of school to get them to the doctor's office, you.

Know, instead of that, you're actually meeting them where they are in their school.

In the schools again, to try to make sure that we can generate the evidence so that this can become the norm so other people can do this. We're not trying to be in every.

Sex we invest in this dross companies working with Tank Care. How why don't we and the University of Tennessee, why don't we approve this type of code and rembursement so any doctor, no lifelob they can go and serve to the community, so that there is progress. The state is very eager to make some changes that eventually not LifeLock only Life Doog will develop the model, but any other you can give it to all the doctors in the state that this is the way. That's the way that the epidemic is growing. Life Doog become non profit not because of the operations budget. Life Dog becomes because we need to expand the model faster if we want to target the obesity and diabetes epidemic in the country.

It says, one of the things I've read is your research has impacted seventy three practices in Tennessee. I said that earlier.

How So, when we talk about developing different models of reimbursement, different models, the way that we would do that is by working with the key stakeholders, right the insurance companies, the state and trying to see what models of care can help others replicate this. So in twenty seventeen, we were part of a pilot in Tennessee that was launched to try to support implement a reimbursement model that would let practices provide the type of care that we do at lifetok and you know, focused on the patient and everything that we need to coordinate for them, and so that's been rolled out to now over eighty practices since we spoke about it last and that they treat over half a million people in Tennessee those pactices and those are it's an example, I guess of what we mean when we say that we're trying to use what we do to sort of help guide the decision makers.

Again, it's really important that our listeners get that fifty percent of the benefits created come from prevention and treatment of chronic illnesses like hypertension, diabetes, and obesity. And it is it is phenomenal that by treating early on, gathering the data, studying the data, and putting together plans based on that data, you have then gone into how to best treat and prevent these diseases specific to this region. But you can use the same model for region in New Orleans. And that's poky.

That's the way that we are doing. The data that we've been collected has been analyzed and in conjunction with the University of Memphi, have been published, so any other physicians can use our model validata model, but also can use our results. So this is the reason most of the most recent of most of our publications are in conjunction with either University of Tennessee or University of Memphis. So most of what we are heading now, how can other people can replicate what we do? If in the state is happy because we are producing saving because we are fifty one percent less hospital admission, forty eight percent less er utilization. Only we are making the patient healthier, but also it's something that anybody can replicate and produce similar outcomes. So this is where we are heading now, this is where our expansion is going. How we can develop a more human ethic, patient centered healthcare model that focus on what is killing Memphis.

Will be right back.

When I when I think it's worth noting that the reason that people need to sort of start caring about that, like why should they care if we produce savings? Right is because research is also shown that your health is fifteen percent of your health is determined by the care you get, only fifteen percent is determined by the quality of the care that you get, twenty five percent is genetics and other non modifiable factors, and sixty percent is about your lifestyle and where you live, work and play right.

Which means three out of five things that determine our health we can control if we just know how.

And you made an analogy earlier where you know, healthier Memphis is more prosperous and safer, but the way that healthcare works, that's sort of the other way around. For Memphis to get healthy, we have to have a safer community. So healthcare dollars need to be starting to get spent in different ways than just treating people. Our approach. You know, America has like an eight trillion dollar a year healthcare budget. There's no other budget, you know, maybe the defense budget, but the food industry, the education nobody has as much of a budget as the healthcare industry does. And that money is being spent in a way that it's not really producing a healthier US. So what our goal is is that, you know, can we produce safer communities with better access to food, with better education, with all these things that will lead to healthier Memphians, more prosperous Memphians. Because you know, you've had a lot of speakers in this podcast, right that have a lot of really great work in different industries, and there's always a sort of a competition around who has access to the resources to support their work. And we need the healthcare industry to sort of start lining up up with these organizations and seeing that that's really the way that you're going to build healthier community.

We try to prove to the industry that the saving can be reinvested in the community to prevent diseases, No, to treat more illness. So wait until you need the bypass or the leg computation. We can prevent this earlier. And this is where we are heading with the saving. This is the conversation that we are moving forward with the stay. Actually we probably have one of the uniqueness and developing a neural version model that we choose to become at risk. We want to prove actually the patient the membership that he developed. The patient doesn't sign any contract, they stay and the membership as loans they see value and the mean stay of the patient and the membership is three to five years. Okay. So, but also with a state, we are willing to take full risk for what we do. We are willing to prove that we can produce saving in the patient a health you the more you invest early in managing the risk of diseases, there is more money for the companies and there is more money for the men for the community.

One of my guests said this a few months ago, and I've used it since a couple of times, but it's appropriate here. You can stand by the river and be heroic and pull drowning babies out of the water all day long, but eventually you need to go upstream and find out how they're getting the water in the first place.

That's the solution. Looking for the solution, and this is what we try to understand. What is predicting that we become so sick. For instance, if you analyze Memphis data Memphis, this is schildby county data, sixty sixty seven percent of the people that die from diabetes is black. It's telling that we are missing something. It's telling us that it's not because they are black. It's because we probably have not been measuring the disease and the way that they need to be measured. We are implementing approach that our general approach to the population, but we probably have not been targeting dirt risk. So it's amazing how you see that Memphis today is probably the city with the highest percentage of black Seven of every ten Memphis are overweight of abest thirty three percent are severely or abest or severely abyes and we are there is not necessarily something that that that we are trying to do as a community to organize a movement that way, and this is what we try to do. I mean, we want to be part of something. We want to but the way that we operate is basic results. I can spend most of our resources if we see that there is are helping. The model the livelog developed is based in three privacy are we helping? We measured by outcomes? Can we escalate is measure how we become from night in patients to the amount of patient that we see now? And second, can we be self sustained? So we won't be able to go to Orange Mount and tell a physician you can help this community. If we don't develop a self sustained model that allows this physician to grow the practice in a decent way, we won't develop something that will help. If I need to become an fq A CEO or a file one seed three to help people, No, and LifeLock is the brew that we can work with. It lowest rembursement insurance for the most underserved community. And we are still driving and we're still impacting.

That's the way to end that life. Tackle is proven you can work with the sickest, poorest people, receive the littlest amount of reimbursement and create the best results. That is a phenomenal legacy to our city and all from a deal you made with God because you wanted to make sure your son survived. What a phenomenal story, Pedro Alesquez and Pedro Alesque was. Somehow yours has a dash on it. I don't understand what that is. Is that right?

Probably because there was uh Rodriguez after it.

I got it.

We have.

So we've got doctor Pedro Alesquz and Director Pedro Alesquez Junior in Memphis changing the way medicine is thought about and focusing on treatment and summed up the best way possible, treating the most difficult patients to treat, receiving the least reimbursement and being the most successful because of a data driven approach toward understanding the demographic of the group you're trying to serve and fitting medicine to their needs. And now having created a scalable model, if somebody wants to reach out and hear more, maybe there's a doctor in Oklahoma City right now. That says I want to know more. How do they find you? Guys?

You know email, phone numbers.

Email you? How do they email you?

Do you want me to just say it or do you want to give you give me your email? It's pa Velaskaz.

Okay, you got it? Actually Velaskaz p A V E l A s quea z.

At Lifetock Health dot org.

At Lifetock Health dot organ.

I gotta believe I want to put up there if.

I gotta believe, if if somebody reached out, you would be more than happy to share with them anything. Because the other cool part of the story is from the hospital that saved you, you've adopted their beliefs set that what we learned we share, and when we share, we make a better world.

And we're only here because of we were the people that used to make calls to see how can we and what do we do well? We are still the people we knock on doors. And one of the cool things about Memphis is that it doesn't really matter whose door you knock on. Everyone's always willing to talk and lend a helping hand or point you in the right direction. So yeah, if people call or email. We're going to answer the same that people have entered our calls and emails.

If that is also more medical provider inter they can go to public and search life dooc model we publish and even the coach that the model what we do our outcome has been published by University of Memphis. So our inal research to impact the epidemic also have been published a major journal. Okay, so we want to be approached. We want something that we are interested is how we can attract talented physician to Memphis. How we can attract people that is interesting and serving the community. And this year that we are helping people. So I hope that this podcast can help us to spread the message the MEMPHISI is great to drive, regardless what we hear about Memphis. Memphis have a uniqueness that they tend to adopt you if they know that you are helping them. Okay, it's a relatively easy city to be two love it and we are the proof. We are four generations and every single child of my child has been impacting Memphis and their business and they are committed to this.

From Venezuela to Boston, back to venezuel who found Memphis with a sick child and who found an amazing purpose with a healed child now changing lives in our city and data points in a plan that can change lives across our country. Pedro, Pedro, amazing story. Thank you so much for joining us, and and I can't wait to see what you guys do over the next five or ten years, because it doesn't look like you're going to sleep on what you've done because of a particular word that your family seems to hold, dear and deer commitment.

We seem to be passionate. Everybody is interrecting because sometimes when we get together it's like a board meeting. What are we going to do? At some point? He said, we need to talk in another thing that won't be business, because he's everybody. He's passionately about what aspect off the health.

Passionately committed guys.

Thanks for joining me, Thank you and appreciate it.

Bill, and thank you for joining us this week. If the two Pedros or other guests have inspired you in general, or better yet, by reaching out to lifetoc Health about their research, seeking to create something like it in your own community, donating to them, or something else entirely, please let me know I'd love to hear about it. If you write me at Bill at normalfolks dot us, I will respond. And if you enjoyed this episode, please do me a favor. Share it with friends. Each of you share this story with three friends. Share it on social, Subscribe to the podcast, rate it, review it, Join the army at normalfolks dot us. Consider becoming a premium member. There any and all of these things that can help us grow an army of normal folks. Thanks to our producer, Iron Light Labs, I'm Bill Corney. I will see you next week.

An Army of Normal Folks

Our country’s problems will never be solved by a bunch of fancy people in nice suits talking big wor 
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