Taking Healthcare by Storm: Industry Insights with Christopher Moraff

In this captivating episode of Taking Healthcare by Storm, delve into the world of expert insights as Quality Insights Medical Director Dr. Jean Storm engages in a thought-provoking and informative discussion with Christopher Moraff,  a nationally recognized journalist who writes on the intersection of policing, criminal justice, drug policy and civil liberties

Learn more about PA Groundhogs.
Listen to the Narcotica podcast.

If you have any topics or guests you'd like to see on future episodes, reach out to us on our website. 

This material was prepared by Quality Insights, a Quality Innovation Network-Quality Improvement Organization under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS). Views expressed in this material do not necessarily reflect the official views or policy of CMS or HHS, and any reference to a specific product or entity herein does not constitute endorsement of that product or entity by CMS or HHS. Publication number 12SOW-QI-GEN-030824-GK

Transcript

Welcome to Taking Healthcare by Storm, Industry Insights, the podcast that delves into the captivating intersection of innovation, science, compassion, and care.

In each episode, Quality Insights Medical Director, Dr.

Jean Storm, will have the privilege of engaging with leading experts across diverse fields including dieticians, pharmacists, and brave patients navigating their own healthcare journeys.

Our mission is to bring you the best healthcare insights, drawing from the expertise of professionals across West Virginia, Pennsylvania, and the nation.

Subscribe now, and together we can take healthcare by storm.

Hello everyone and welcome back to Taking Healthcare by Storm.

I am Dr.

Jean Storm, the Medical Director at Quality Insights.

Today, I am so excited to be joined by Christopher Moraff of PA Groundhogs.

I will say I learned of his work in a newspaper article, and reached out because I really feel like his perspective is going to be important to understand really what is going on in the environment.

We're going to be focusing a little bit on xylazine, something that our stakeholders have asked more information on, and I think Christopher is going to provide a really great background of information.

Chris, thanks so much for joining us.

Absolutely.

Thanks for having me on.

Can you tell us about your background and how you arrived at doing what you do now?

Yeah, absolutely.

My background actually is probably what is most unique about me and kind of in a form is my unique perspective on a lot of the work I'm doing now.

I'm a journalist by trade, so I've been covering marginalized communities in Philadelphia for 20 years, African-American communities, and Latino primarily.

I have lived experience, so I was a drug user, a person who used drugs in the 90s.

So I have that perspective.

My stepfather was a narcotics agent with a state, so I have that perspective.

And in 2017, I was asked to go scout out some locations for a company that wanted to come produce a documentary in Kensington, which is a section of Philadelphia that is probably, I would say, the last really full-scale open-air drug market, which means 24-7 on the corner, there's people standing, lookouts, that kind of thing.

In the country, there's certainly other smaller ones.

It's definitely the biggest, the most famous.

I went there in 2017 for a two-day assignment, and I pretty much never left.

I got grant-funded to basically immersion cover the crisis as it was unfolding.

And in the course of that activity, I was introduced to fentanyl test strips, which at that point were really like, I mean, I don't think there were, there were probably nine of us in the country that were using them, you know, for harm reduction purposes.

And it became evident really quickly that Philadelphia's, we call it DOPE basically, because you don't know what it is, right?

It's any illicit opioid that comes in a bag and it's powder is DOPE.

So our DOPE supply was primarily fentanyl and had been probably for at least two years because it, you know, the price of it, what intrigued me was that the price of a bag of DOPE was cut in half from $10 to $5, but three times as many people were dying.

So that was my grip as a journalist.

You know, what's going on here?

And I never left.

Well, I guess I left a bit this year to start the PA Groundhogs, but I was an independent grant-funded journalist mostly.

Wow.

I mean, what a unique perspective you can supply.

So maybe this is an outdated term, but I was born in 1975, so when I grew up, everybody was talking about the war on drugs.

So what is your perspective on this war on drugs?

Well, I'd like to say if there is a war on drugs, we've certainly lost it.

I wrote a piece, I don't remember the exact headline, but the gist of it was, if we're gonna call it a war on drugs, reporters have to start treating it like a war and not used.

So the way that drug war is reported is we use proxies.

We talk to the police on one side, we talk to harm reductionists on the other side, maybe, but nobody's really immersed in the front lines, really talking, seeing unfold.

So I drew some parallels between Vietnam and really it was journalism that put an end to the war in Vietnam.

It was the last time journalists were allowed to just wander freely around the country.

Now you have to be embedded.

And the reason for that is because we brought to America's television stations, you know, television sets all over the nation, the reality of what this war looked like.

And I think there's a lot of misinformation around drug use, drug users, drug sellers, based on the lack of resources, for one thing.

That's something that the media has suffered with for some time now to embed people.

I mean, we've lost foreign bureaus all over the place, but that's essential.

So that's why being a nonprofit journalist, like being funded by a nonprofit was really important to me.

It gave me the leverage to spend time in the community and also do some things that like legal departments wouldn't let me do if I worked for a newspaper.

So my perspective is that Philadelphia, I like to call it the museum of failed drug policy because we've tried everything here.

We've tried the carrot, we've tried the stick, we went back to the carrot, now we're back to the stick.

I would say that every person I talk to in jail that is locked up for selling drugs is also going through withdrawal because they're getting the bottom wrong for the most part.

Oh God, I wish I had Nancy on the phone with me now.

I have a source, my translator just got arrested after being in jail for eight months.

She was out for four and she got locked up on the same exact corner selling the same exact stuff.

And her problem is housing.

There's no housing support, so she came out and had nowhere to go except back to the streets.

And so it's a revolving door of low-level drug sellers that are easily replaced and the police are overwhelmed.

And I think you and I would agree that, you know, it's a medical psychosocial, socioeconomic issue, but it is not a criminal issue, really.

It's not something the police should be dealing with, in my opinion.

And police have told me that themselves.

So I certainly am not anti-police.

I think this is a pro-police position to take, that police should not be putting themselves in harm's way for a consensual exchange of goods and services between two consenting adults in a capitalist country.

So when people say, well, so are you for legalization?

My answer is always, never now.

It could never work now.

We've got 50 years of indoctrination, of one way of looking at things.

We don't know what healthy cocaine use looks like.

We know what healthy drinking looks like.

You go to the party, you know who's not handling their alcohol well.

You know who the blush is, so to speak.

But we don't have a context for healthy usage of cocaine, say.

And until we have some sort of reeducation campaign, I don't see full legalization working.

And it's like marijuana, it took time for people to come out of the corners and say, I smoke weed, I smoke weed, whatever.

But I don't see that happening right away with the harder drugs.

But we certainly have not made any headway in the war on drugs.

There's no question about it.

The drugs have won.

So you talked a little bit about people going through withdrawal.

So how do you feel about the current state of treatment for drug addiction?

Well, I think it's travesty that the most effective treatment for opioid use disorder that there is, methadone, is so highly restricted.

Now, you can put somebody in jail and get them acclimated to suboxone because they do that here in Philadelphia.

But I rarely see it happen on the street.

We're talking about a drug that was developed for heroin, and it just doesn't translate well to fentanyl.

People's fear of precipitated withdrawal, for one thing, is so ingrained, especially if they've experienced it before, that they won't even try to get away on suboxone.

And once they're on suboxone, they're now in the system.

They can't get their Benzoscript they might have been getting to sell, to make money or whatever.

So there's a lot of intricacies that have kept people out of the suboxone market.

We have a lot of suboxone on the street for sale here.

And our DA was forward-thinking enough to decriminalize possession of suboxone without a prescription because he felt it was a life-saving drug.

It's still illegal to sell, of course.

But from everyone I've spoken with, they really can't stabilize themselves, especially if they have housing issues, if they have mental health issues.

Getting stabilized on suboxone is hard.

And here we have a drug called methadone that's been around.

It's cheap.

It's less than a dollar a dose, I think.

And yet, it's an onerous system.

I've had doctors from methadone clinics tell me a single mother of two could not maintain on this clinic, could not gain success here.

And that's because of the way that we pay.

I think the paying system, there is an incentive to keep people in groups, sessions, to test them a lot for urine, for drugs like THC, which is not part of the, that's not one of the drugs that's required to be tested for under federal guidelines, but I've never known a clinic that didn't.

So that's my big take on treatment is that, and when I was using, there were two courses of treatment.

You either went into an abstinence-only rehab, where they would, you'd get medical detox with something like darvus fat and clonidine and maybe a Valium.

And then there was just wrap, like detox.

You'd go in, they'd give you methadone starting at 30 milligrams, like walk you down over seven days or five days to five milligrams and put you out on the street, which thankfully they're not doing as much because it doesn't work.

You're not even close to being where you need to be, you know, after that time.

So, I'm certainly happy to see outpatient type, and certainly the telehealth expansion has been a godsend for a lot of people.

But at least the population that I deal with, which is largely transient, and has issues that exceed simply their drug use, I think that stabilizing on Suboxone is tough, especially given the feelings around mixing benzodiazepines with Suboxone, which the FDA in a memo said you should never kick somebody off your program because they're on benzodiazepines, that they can be used safely together if they are monitored.

But there is a belief among doctors, well, doctors are just afraid, so they won't prescribe both.

So, that's my take on that.

We need methadone reform.

It's very, very badly.

Yeah, lots of education needed.

So, shifting a little bit, tell us about PA Groundhogs.

Yeah, so, like I said, I started strip testing just sample, just talking to people on the street and strip testing their drugs or acquiring samples.

At that point, they were giving out samples on a daily basis.

There were so many homeless that the drug dealers would give out a sample in the morning and hope to get people that way.

I was picking up empty bags.

At that point, whatever I could find, I would test.

So I guess I would say I'm probably the first person that used fentanyl test strip in the state of Pennsylvania.

And then I went on to advise the PA, the Philadelphia Department of Public Health, on their acquisition of the strips as a harm reduction tool.

By which time they were more likely to be used to confirm the presence of fentanyl than to show that it's not fentanyl.

There's a strong belief that heroin won't be enough to get a person who's using fentanyl well.

I don't know if that's true or not.

I can't say scientifically, but that is the myth on the street or the word on the street.

So they confirm the presence of fentanyl.

Now, with xylazine in the mix, it's also used to confirm the presence of fentanyl because a lot of bags will come out.

Not a lot of bags, but we occasionally get bags that are just xylazine.

So all that time that I was testing from 2017, unbeknownst to me, it was illegal to possess fentanyl test strips in the state of Pennsylvania as part of drug paraphernalia laws.

This past legislative session, there was a law passed that decriminalized all drug checking materials.

So if you're following this at all, some states have now had to go back and pass another bill to legalize xylazine test strips.

Well, in Pennsylvania, they did sort of a blanket any drug checking.

And I guess to add some context, in 2018, I broke the story on xylazine.

I broke the story on synthetic cannabinoids being added to our dope here in Philadelphia a month before there was like a massive outbreak.

So I spent a lot of time talking to people and gained a network of sources that would discuss with me what they were feeling.

So PA Groundhogs is sort of a combination of networking with human sources that will talk to you and that trust me personally, and also the people that work for me and the groups that work with me.

And we do street to lab drug check, like mass spectrometry, drug checking.

So we're getting like the cream of the crop, the pinnacle of analysis.

You know, a test strip is just going to tell you the presence, and an FTIR is really just going to tell you the presence.

And one thing that complicates things in Pennsylvania is that we don't have legal syringe exchanges yet.

We were trying to get a bill passed this year, so there's no SSP, syringe service programs, outside of Pittsburgh and Philadelphia.

So where they would, even if you wanted to use an FTIR, which is a type of infrared portable mass spectrometry machine that is, again, not perfect.

Nothing will confirm something in quantitative measures.

It will tell you the purity of the drug, other than the mass spectrometry we use in the lab.

So I decided that I was going to start a statewide program after this law was passed that would hopefully get, you know, we would develop a longitudinal data set that showed changes in drug potency and drug composition.

And ultimately, the end goal will be to, you know, inform policy, but also we have a clinical awareness program where we're hoping that the data will be useful to clinicians to quantify dependency for the first time, really.

So that's the clinician consulting program?

We call it the clinician awareness program.

But yes, it's like that.

And that, of course, will come once we have more data in probably a year or two.

So we envision cutting up Pennsylvania in somewhere between 9 to 12 regions that have commonalities based on the trafficking routes, based on the, you know, there's counties that have very similar.

Philadelphia and its surrounding counties all have the same dope for the most part.

I mean, it averages 11% purity.

It goes higher.

It goes lower.

But that's like, you know, we're a cluster of maybe five or six counties that are all getting their stuff from the same place largely.

And we think similar things are happening in other more rural parts of the state.

And we've collected about 200 samples so far, and we've already seen some patterns like that.

So the idea is we realize we can't be active in every county.

We're hoping to work with hospitals in, you know, hopefully 9 to 10, 11 regional carve-outs that we consider hotspots for adulteration and overdose clusters and sort of, you know, at some point, be able to analyze that data and let clinicians know if somebody comes in and says they're using five bags a day, here's probably what that looks like.

Here's how you should be treating them, you know.

So I think this is a question that I've heard from providers.

Why is xylazine in the drug supply?

Maybe it's a really simple question, but I know a lot of providers are wondering that.

Well, do you want the long answer or the short answer?

The short answer is that they put it in there to extend the legs of fentanyl to make it seem seemingly last longer, because it's a very short acting drug.

And what we saw was people clustering right around corners and very close to and drawing attention.

So even though we have a progressive DA, drug sellers are still constantly on the lookout for police and people weren't leaving.

In the old days, there used to be a saying, cop and roll.

So you cop your drugs, you roll, you get out of here.

You know what I mean?

Well, people were not doing that anymore.

They were staying in the neighborhood.

And so I think there was an effort to, I know it was an effort to extend, to seemingly extend the high of the short acting fentanyl.

Why it came here to Philadelphia has to do with, I'll say like a shady deal between Puerto Rican communities or municipalities and Pentecostal churches here in Philadelphia to send young men mostly here for treatment.

It was called AirBridge.

And we got an influx of a lot of opioid and xylazine dependent people because xylazine was already a drug of abuse in Puerto Rico and AirBridge was a program that would send Puerto Rican, like I said, mostly men.

They would kind of fleece their families out of money and promise them they were going to be in these top rate rehabs and they would wind up in storefronts that would ultimately get shut down by L&I.

And I met many of these people on the streets.

They didn't have any language, you know, English skills.

And I think that there's a possibility, you know, there's a strong chance that their tastes sort of drove the introduction to the level that we're seeing it now.

Now it's just a matter of like, let's make as much profit as we can.

The drug market has changed a lot in that area based on the policies of the city, you know.

There used to be some, you know, Latino drugstats used to have some rules, you know.

There were case managers on the street that would mediate disputes.

There were things you couldn't put in.

Now it's the free-for-all because a lot of those corners have been shut down.

It's what I call the freelancer effect.

We've come to the lowest common denominator of drug seller that can, with a very little bit of money, can now invest in a business that used to take a lot of capital and a lot of knowledge and connections, and they can put out a bag.

Xylazine is just a quick and easy way to give the impression of a longer high.

I guess when I talk to healthcare providers, they just think the addition of xylazine means that Narcan and Naloxone isn't effective.

The impact of xylazine being put in the drug supply is bigger than this.

It's almost like it's broadening, extending the distribution of fentanyl, I guess.

Well, ironically, a couple of things are happening that are ironic.

One is that people are actually using less because they don't like the xylazine.

I know people that were using three bags a day, they're now using one bag a day.

I know people then splitting it in half.

It's too strong.

The other thing that's happening is that there's less fentanyl being placed in the bags.

I don't know if you know anything about xylazine, but it takes a whole lot of xylazine to kill somebody.

I mean, way more than could be put into a bag of dope and philly.

We don't see the synergistic effect quite like we do with benzos.

We know that benzos and opioids put together to a certain level, certainly in an opioid-naive person, will cause a severe respiratory depression.

And in death, I've come upon people that were, by all visibility, in full state of overdose, and got closer with my dark hand and realized they were breathing and that they were sedated.

They were asleep, essentially.

And I generally pull them into an upright position, sitting up, and that's usually enough to snap them out of it.

It's a very strange thing to watch.

You'll see somebody snort a bag, a dope, and they'll just sort of slump down and go to sleep and snore.

I mean, and you know, somebody's snoring, they're breathing.

So I don't think we're really like, just the science just isn't there right there, right there, isn't there right now, exactly what's going on.

But I can tell you that from having witnessed both overdoses where there is respiratory depression and you need Narcan to reverse it, the cases I've seen with like xylazine, like an overabundance of xylazine in the system, it looks different, it responds different.

Now the Narcan will still work on the fentanyl obviously, but you can still have a very sedated person because they're on an alpha-2 agonist, a very strong one, that causes sedating effects.

And I think it's a misnomer that people that use opioids want that necessarily.

Some people do.

In my case, it gave me energy and confidence and made me a harder worker.

I was in the restaurant business at the time.

A lot of people like the energy that comes from opioids.

There is an energetic quality to an opioid like heroin or OxyContin, I would imagine, although I never did that.

People just don't like it.

Universally, there is a drive to get away from it as much as they can, but it's really impossible to do in Philadelphia.

You do testing.

Do you give out testing kits?

How does that work?

The kits go out with strips.

Each kit can hold three samples.

I send strips for xylazine, strips for fentanyl, and strips for benzodiazepines.

Pennsylvania is a unique state.

There are other states like it, but we're a very long state, and we bridge both the western United States markets and the eastern United States markets.

In the western US you're seeing more benzodope.

In the east, you're seeing more xylazine.

We border five states in Canada through Lake Erie.

So we potentially could have a lot of different sources from different places.

So we try to get them as far and wide as we can, and they get sent out with three benzo strips, three phen strips, three xylazine strips, a 10-milligram scoop, which is about the size of a sesame seed, maybe, Ziploc baggies, and a couple of other things, gloves and stuff, and people are instructed to just take that little scoop and put the tiny amount, we need the littlest amount, to do quantitative testing.

And they are sealed and sent to the lab, which we work with the Center for Forensic Science Research and Education, which is a DEA certified lab here in Horsham, PA.

And within two weeks, we have your results back.

Now, right now, we're working with a lot of organizations, so organizations that are out doing harm reduction in the field with participants, and they'll send in their samples and then communicate to their participants what the results are.

But we do also have the capacity for individuals to send in samples as well.

Is there anything else on the horizon you see being added to the drug supply?

Well, I can tell you that, like I said, in any other world, in a legal regulated industry, it's a demand-driven market right now.

People are demanding something other than drank.

So I think that I know from things that we've found, like Nidazines, and we actually found it was the first ever presence in the US and we're still confirming this, but it appears to be an oxymorphone analog, which was OPANA, and it's synthesized probably in, I don't know, we think the Netherlands or possibly even the US but it's expensive.

People that can do it are ordering heroin on the online markets.

But I think mostly we're going to see some sort of innovation around something, some other, either a replacement for fentanyl, or people are going to go into different sources like the online markets, who can and who have the resources to, or create buyers clubs where they can buy, you know, combine their money to buy directly from the cartels, because the cartels are sending us a fairly consistent and like it is what it is, you know, product.

Like, you know, we're getting, you know, we've tested stuff from Mexico that it is, you know, like every time the same batch has come through from the same person, it's identical.

I mean, like they know what they're doing.

They don't have the incentive or the, you know, the need to like just turn their stuff into trash.

It's happening here in the States.

So, you know, the demand is like we don't want this trank anymore.

And how that's going to finally weigh out, I cannot say.

I think nitazines are one potential that we'll see more of those.

We know that people are bringing them into Philadelphia and, you know, that people seem to like them.

They are universally trank free whenever we found them.

But so I think we're going to see that.

I mean, there's some talk of other veterinary medicines that I can't remember the name of the one.

It starts with an M that had been found in some of the M30 pills.

You know, like there's the M30 pills, the fake Oxy 30s.

You know, we had about four or five batches of them that were identical every time.

Like whoever was making them had a formula that was doing their best to create what Oxycontin would have been.

It was like 1.8% fentanyl, like acetaminophen, and a tiny bit of something else.

But the Strapitos have sort of cracked out on Sinaloa production of fentanyl.

I don't know if you know much about the cartel dynamics that are going on right now.

But they've banned a lot of people from producing and distributing fentanyl.

So there's something of a drought now, and prices are increasing, and a lot of block owners are scrambling for new sources.

And that may drive innovations in the market that I will say are not always bad.

The push away from fentanyl-pressed Xanax to benzodiazepine analogs has certainly saved lives.

All our benzodiazepines right now, all our fake pressed Xanax are bromazolam, and that switches up about once a year when they schedule it, or the government catches up, it will switch to something else.

But hopefully whatever is on the horizon will not cause anything like the wounds that the trunk has.

It's funny, before I got on the phone with you, there was a source that popped by that I pay occasionally to take out my trash and do stuff, and he was just snorting.

He just started eating his dope because his nose was hurting.

I have a magnification light, it's really for checking your ears and stuff.

And I was like, do you mind if I look up your nose?

And he had a scab, it almost looked like a mass inside of his nose.

What it's doing to people's bodies, it's horrendous.

And so, we certainly need to get away from the xylosine, and I think there needs to be education.

We need to be more receptive to educating the seller community because safe supply is the only way this is going to happen.

And I don't see that happening legitimately through the government or something, but we can educate sellers who do care on how to do it right if we can.

I don't know.

There's a couple of programs that are popping up to do that, sort of harm reduction training for drug sellers.

There's one in Indianapolis and one in New York that's just coming online.

And that seems to be like the road people are looking down now to try to get drug sellers to realize that they have an incentive to protect their clients.

Yeah.

We talked a little bit about naloxone.

Do you think that naloxone needs to be more widely distributed?

Do you think we need to go down that route?

Do you think that it needs to happen more on a wider scale?

Well, here in Philadelphia, at least, there's plenty of naloxone.

I have hundreds of pack boxes in my basement right now.

I don't know what it's like everywhere.

I think there needs to be some sort of uniform, at least, baseline for how we treat harbor induction in the country because some localities are just really backwards and some aren't.

But I can say that I've seen naloxone save many lives.

It's been a game changer.

In the 90s, when my group of friends were using it, you had to call 911 and they would come and give you IV naloxone.

There was nothing you could do.

I would say most reversals these days are conducted before the ambulance even arrives, at least in Philadelphia.

We have had experiences that revealed that they're not perfect, like the synthetic cannabinoid outbreak.

They thought people were overdosing, and they were hitting everyone with naloxone.

It was having the effect of making people aggressive and violent because they were coming out of whatever dope high they had and being left with nothing but a powerful strain of synthetic cannabinoid.

That made them agitated and aggressive, and it was printed that way in the newspapers without really this explainer of, well, they were reacting to a drug that wasn't opioid.

Of course, with xylazine, they had to retrain.

A lot of people had to be retrained on what overdose response looks like.

Because you're very often going to come upon people that are sedated, and you have to make sure they're not in a position that's going to cause something like compartmental syndrome or whatever, things like that.

People are falling asleep.

I wanted to do a study that looked at whether there were more people being hit by cars over the past couple of years in Philadelphia.

I never got around to getting the data together, but I thought people are kind of walking around in a stupor because of it.

So naloxone isn't going to do anything there, and that's why I think drug checking has taken off the way it has.

It gives people transparency for the first time.

It doesn't necessarily mean they're going to change their behavior.

Some people do, but in Philadelphia, you're not going to get away from xylazine, but word of mouth is the best tool on the streets.

If somebody says, well, that's got a lot of track in it, stay away from it.

But that's my take.

Of course we need naloxone.

I mean, it's been a game changer.

It's just been amazing.

I've seen so many people's lives saved in Kensington in a matter of minutes.

I mean, people that were blue and are back walking around, smoking a cigarette by the time the cops get there.

So Chris, so much useful information.

I really appreciate it.

If someone wanted to learn more about PA Groundhogs or about testing kits, how do they get in touch with you?

Well, just check out our website, pagroundhogs.org.

And I'll give a little background on why the name.

I was trying to develop this as sort of like a secret program, you know.

And I learned at some point that in Pennsylvania, groundhogs are considered vermin and can be shot on sight.

And then I live in like urban Pennsylvania.

I'm in the middle of Philadelphia, and a groundhog was walking down my street one day.

And I was just like, save Pennsylvania's groundhogs.

That's what I'm going to call this project.

And so it kind of caught on.

And so we kept the PA Groundhogs name.

But they can go to pagroundhogs.org or email me at, well, I would say tips at pagroundhogs.org.

It's probably the best way to do it.

And they can request a kit that way.

We will link all of those in our website.

And thank you so much for joining us.

I really appreciate it.

Thank you for having me on.

Thank you.

Thank you for tuning in to Taking Healthcare by Storm, Industry Insights, with Quality Insights Medical Director, Dr.

Jean Storm.

We hope that you enjoyed this episode.

If you found value in what you heard, please consider subscribing to our podcast on your favorite platform.

If you have any topics or guests you'd like to see on future episodes, you can reach out to us on our website.

We would love to hear from you.

So until next time, stay curious, stay compassionate, and keep taking healthcare by storm.