Discover the secrets to maintaining the heart and soul of medical care with Dr. Nick Grasso and Kendra Rourke, as they join us to tackle the future of private medical practice. With Dr. Grasso's deep roots in orthopedics, honed through his long and outstanding military career, and Kendra's cutting-edge perspective on care transformation, we dissect the rising tide of hospital employment and its potential to wash away the personalized touch that private practices provide. Our conversation is an illuminating beacon for healthcare professionals and patients alike, offering a glimpse into a future where the art of medicine thrives alongside the forces of industry change.
Venture with us into the brave new world of preventive healthcare, where innovations once dreamt in science fiction are now at our fingertips. We're not just discussing the latest gadgets; we're examining breakthroughs that could redefine community health and individual wellness. Picture a healthcare landscape where motion analysis technology is as common as your smartphone, and AI isn't just a buzzword but a tool for crafting tailored preventive strategies. Our guests share how these advancements are reshaping their fields, potentially setting private practices as the vanguards of a healthcare revolution.
We wrap up with an invigorating look at the crossroads of medicine and sports, showcasing how cutting-edge technology is game-changing for athletes and patients alike. From reducing injuries with motion analysis to exploring the potential of robotic limbs, we're on the front lines of orthopedic innovation. And it's not all about the technology – we're also reflecting on our personal Baltimore tales, the bond between soccer and medicine, and the promise of future dialogues that blend these passions for the betterment of our communities. Join us for a journey that's as much about heart as it is about science.
Discover the secrets to maintaining the heart and soul of medical care with Dr. Nick Grasso and Kendra Rourke, as they join us to tackle the future of private medical practice. With Dr. Grasso's deep roots in orthopedics, honed through his long and outstanding military career, and Kendra's cutting-edge perspective on care transformation, we dissect the rising tide of hospital employment and its potential to wash away the personalized touch that private practices provide. Our conversation is an illuminating beacon for healthcare professionals and patients alike, offering a glimpse into a future where the art of medicine thrives alongside the forces of industry change.
Venture with us into the brave new world of preventive healthcare, where innovations once dreamt in science fiction are now at our fingertips. We're not just discussing the latest gadgets; we're examining breakthroughs that could redefine community health and individual wellness. Picture a healthcare landscape where motion analysis technology is as common as your smartphone, and AI isn't just a buzzword but a tool for crafting tailored preventive strategies. Our guests share how these advancements are reshaping their fields, potentially setting private practices as the vanguards of a healthcare revolution.
We wrap up with an invigorating look at the crossroads of medicine and sports, showcasing how cutting-edge technology is game-changing for athletes and patients alike. From reducing injuries with motion analysis to exploring the potential of robotic limbs, we're on the front lines of orthopedic innovation. And it's not all about the technology – we're also reflecting on our personal Baltimore tales, the bond between soccer and medicine, and the promise of future dialogues that blend these passions for the betterment of our communities. Join us for a journey that's as much about heart as it is about science.
That was a ridiculous countdown. But we're back with Not the Press podcast, and I have some awesome guests today and I'm just going to go around the table here real quick. We got Dr Nick Grasso from Baltimore. He's going to explain a little bit about what he does, some of the companies he's worked for, what he leads now as a president for what I know of two different organizations, and he has a person that works for him here. Her name's Kendra Rourke and she has a very interesting background too as well, doing the same type of health work. But first, before we go to them, minx, let's just get that out of the way. You're going to have to say hello real quick. Do it Hello. That was like a five. All right, we're going to work on that. So, dr Nick Grasso, let's go to you first.
Speaker 2:Great Thanks, Scott. My name is Nick Grasso. I'm an orthopedic surgeon private practice up in the Baltimore area. I spent 23 years in the Army prior to going into private practice, Got out a very long time ago and I'm now the president of two organizations. One is Centers for Advanced Orthopedics, which is the second largest orthopedic group in the country, and Medvanta, which is a next-generation health transformation company that will hopefully help improve health care in this country.
Speaker 1:Yeah, and I have a whole bunch of cool questions about what you just said and some of the stuff I was involved with with Kendra In fact, that's how we all got here today is because of Kendra. But first, Kendra, who are you?
Speaker 3:So, kendra Rourke, I'm a nurse by trade. I've been a nurse for about 20 years. I'm the VP of Care Transformation with MedVanta. I've been with MedVanta for about three years now, really trying to put forward the mission of transforming healthcare.
Speaker 1:See, that's amazing. That's what we want on this show people that have action, Boom. So one of the things you had said. Can I call you, Doc Nick?
Speaker 2:Dr Nick is what everyone calls me.
Speaker 1:Yes, I love it. So first one's going to be a really weird question, but I'm dead serious. Do you know any proctologists?
Speaker 2:that I can have on this show. No, actually I don't Damn it. No, and they don't go by proctologists anymore. I think it is called by GI gastroenterologists.
Speaker 1:Oh, okay, and you don't, I'm going to find one. I'm going to find one. I have. I have very legit questions for those people. Okay, so damn it. So, 23 years in the Army, what was your, as you can relate it to what your executive positions are now like? What was the best takeaway from 23 years in the Army to bring to what you're doing now?
Speaker 2:That's a great question, because I wasn't medical when I when I came in. I came in straight out of college.
Speaker 2:I was a line guy for four years and then I went to medical school with the military and then did all my training at Walter Reed and had various positions, um and my duty assignments. I was chief of a couple of different orthopedic departments at hospitals and I think what I learned the most was I never wanted to be part of a large organization like that again, which is why I went into private practice and I think what's pushed me and all of us who are involved with CAO and MedVanta into doing what we're doing is trying to preserve that private practice model right. It's under a lot of stress nowadays in this country. There are threats to the private practice of medicine and we're trying to preserve that and to give some alternatives to folks who might be considering going a different way.
Speaker 1:Well, let's back up a little bit on that real quick, if you don't mind. When you say there's threats to private practice, what are some of those threats and how did we get here? How did we get to where we're at today?
Speaker 2:Yeah, great question. Most people don't realize what's going on. Ten years ago, 75% of the doctors in this country were in private practice 25% were either employed by a hospital or worked in academia or in the military.
Speaker 2:Here we are, fast forward ten years. Those numbers have completely flipped. We are now 75 of the doctors in this country are employed either by a big payer, a hospital system, academia or the military, and only 25 are in private practice. And the reason why that's important is, you know, there's a few things we know about private practice. One is it provides care at a much cheaper rate than hospitals do. Hospitals, and and and are much more expensive, and when you're talking about trying to control the cost of care, we feel private practice is the way to do that. We provide care that's as good, if not better, than the hospitals do, but we do it in a much more efficient way. So we think it's worth preserving, preserving, and if we lose private practice, we're going to be at the mercy of hospital systems or PE backed groups who really only care about turning a profit, and I'm never going to, I'm never gonna let that happen while I'm working. I've got a few years left. Your family goes to that private practice.
Speaker 1:They know your family, you know them, they know like, if you go through that, like when I was growing up I had his name was Dr Varus. He was our team doctor for basketball football. All the families went to his practice. He knew every single member of those families, he knew what to treat, he knew when you know the person and you know who you're dealing with, you can treat it. You treat things differently, right, absolutely, and I think that's to me, money aside stuff, and I agree with you on all that. That's the awesomeness of private practice.
Speaker 1:And if that goes away, man, holy cow, do we lose something Like we're? We're losing a big thing in society. Society change man, because that type of shit is important across the board, absolutely. I mean, when you look at um, now, again, I'm not a woman, I'm not gonna, I'm not gonna claim I have experience in this. However, I can only imagine that, um, a woman and a woman doctor, a gynecologist, um, just uh, as one aspect of this, okay, so if you have a private practice and a woman becomes comfortable with that doctor because of woman stuff, you're seeing the same person all the time. They know you, you know them.
Speaker 1:When that becomes out of private practice. How does that change that type of relationship? I mean, because that's some very important stuff that people don't think about. And I'll go back to the proctologist. I want the same dude who's looked down that cannon before. I don't want anyone else looking down it. Um, so I'm just saying, like, like, this stuff's very, very important, um, and and people, I'm glad you're bringing attention to this and you guys are actually taking action um to to keep private practice alive within the medical field. I wish they'd do it in big pharma too. Fuck those guys, by the way, so sorry.
Speaker 2:I agree.
Speaker 1:Okay, so I'm going to go back to Kendra. So, kendra, we we've got some very funny video from today. Um, you have me trying to do stuff where I needed to be flexible not a flexible guy to be flexible, I'm a flexible guy and I'll have that footage. But it was for Medvanta and they're going down to soft week and they're going to have a video there. But so you were, you were saying what that system that you had. You had a iPad up. Explain a little bit about what that is and how that plays into CAO and what you guys are doing between the two organizations, or does it even marry up?
Speaker 3:Sure. So, yes, it does marry up, and so what a lot of MedVanta is trying to do is go on upstream to the prevention side of things.
Speaker 3:We're not trying to take patients away from CAO or physician groups, but we know that we can delay or even mitigate certain problems, which also can reduce the cost of healthcare, make it better for the patients, because really and, with my nursing background and I'm sure Dr Gross can attest to this too it really comes down to that good patient care, and when you get out of a private practice model, it becomes more of like a machine and you're just getting them through, getting them through and really not getting to know that person. And so, with this digital assessment, it's a risk of injury assessment. It can also look at balance issues, stability, flexibility, those types of things, and while tech is very important and extremely helpful in the orthopedic field, we also know that you have to have a human being behind that as well, yes, and so what we're doing is using this technology to help our humans be more accurate. So they're going back through, watching the videos of the assessments, looking at the results and they're coming up with an individualized plan for corrective exercises that are being monitored.
Speaker 3:We can do it digital. We can also send them to a practice such as the Centers for Advanced Orthopedics to get them into physical therapy, those types of things to hopefully reduce the need for surgery but know that, if and when they do need surgery, that we have a good private practice like. Cao to send them.
Speaker 1:We were talking a little bit before about preventive. Well, I mean, we were talking a little bit before about preventive, and so I'm not going to try and swing this back to Big Pharma, because they hate preventive, because that's not how they make money, but preventive. I feel like private practice brings preventive, and why wouldn't people want to? And a group of people teaching me how to prevent myself from getting hurt, that tells me they actually do care. You know what I mean. And I don't see a lot of other organizations that aren't private practices or private groups that actually put that out there, because I don't believe they care, I believe they want people to get hurt. Actually, I mean, I don't know, conspiracy theory, I don't know, but that kind of seems like it to me. I don't know.
Speaker 2:Yeah, I read an article years ago. Somebody smarter than me wrote that we don't have healthcare in this country. We have illness care, right. People don't go to the doctor until they're sick Reactive, not proactive. Reactive, not proactive.
Speaker 2:And if you look at the musculoskeletal our, our little piece of that, it's like injury care.
Speaker 2:We, we, we get the person after they've been injured. You know, we get the college athlete with the ACL tear, we get the weekend warrior with the with the Achilles rupture, uh, the old person who fell down and broke their hip, you know. And if you can prevent that, I mean, like we were talking earlier years ago, 10 years ago, in order to do this kind of motion analysis, I would have had to take you to this big motion lab with hundreds of thousand dollars worth of cameras and computers and we'd have to put reflective markers on you to go through this. The technology has evolved to the point that now we're able to do with an iPad, right, with no reflective markers, and we're hoping soon to be able to do it with a smartphone. And if we can intervene to these people, just think about what it means across all segments of society, from the elderly and fall risk athletes. We know young female athletes high school, college level are much more prone to ACL injuries if you could prevent those.
Speaker 2:And there've been elderly balance classes for years. There have been plyometrics routines for high school athletes and things like that, but that's kind of a blanket solution targeting everybody but no one specifically. This will allow us to target people individually, their going on. You just gave me an idea.
Speaker 1:Oh, it's amazing. So not only can you do like right now you're doing individuals, but the way like within marketing and stuff. You've got cameras that can detect somebody's mood because of AI stuff. So what if you were to do communities like hey look, dude, your village, 90% of you motherfuckers have some bad posture. You know what I mean. So we got to do something preventive here, you know, we got to help you out. I think that's kind of the direction that this is going Like. If you have the system and the software and the mechanism to chart that out with a camera training that model for a larger population, I mean, granted, there would have to be some left and right lateral limits of where the camera's placed this, that and the other but eventually I bet you you can get there.
Speaker 2:That'd be pretty badass man. Yeah, it's like I used to go to the mall with my wife and I'd watch people walking around. I'd go, oh that guy needs a total knee and oh, that guy needs a hip and she would make fun of me.
Speaker 1:I'd go. But cow, that's like a. It's evil thinking about this because it's a moneymaker. But you know what? It'll help people, It'll really help people, and you could do analysis. If this were ever to come to fruition, you could go to, like you know those historic blue zones in the world and look at how they are with posture and whatever orthopedic stuff, and then go to like you know, I don't know what's that town we used to live in by Millersville, Glen Burnie, and compare the two and be like, okay, who's got the better posture here and why? Is it diet, Is it lifestyle? Are they walking? What are the people in Glen Burnie doing? They're smoking on the front porch. You know what I mean. Like there's, there's a. I think there's a there there, though. You know what I mean. Like there's, I think there's a there there, though you know what I mean.
Speaker 3:And I think, to add to that, we have access to so much more data than we ever had. So we can. We have a whole tech team that's pulling data from different sources, and what we intend to do is take that data, put AI on top of it and then look at some of those predictive patterns so you take that data, you overlay it with the digital data, the screenings. I mean that's some powerful stuff.
Speaker 1:It is, it's really affect populations. It is and I don't. I'm not sure if you can answer this. So how? How quickly, like when, when I was on that camera today, or the iPad, how quickly is it determining what I am on whatever chart? Is it doing it immediately or is that a post-process thing?
Speaker 3:It's immediately so what it does, and we didn't do it today just for the sake of time. But typically what we would do is put in your gender, your date of birth, your height, your weight and if you're right-handed or left-handed, in which foot basically, you kick with your dominant foot and it compares you to people of your same gender, your same weight your same height, but it is immediate. So, as we were measuring you, it was giving us, for example, range of motion score based on your specific characters, from the data that they've researched.
Speaker 1:Look, I know you guys are trying to do the right thing from a health standpoint, but I'm telling you, in the marketing world, this would be revolutionary With what you're coming on pushing it down the road of love. Because, think about it, nike and I hate Nike, but I'm just going to put them because everybody knows who Nike is it, uh, nike and I hate nike, but I'm just going to put them because everybody knows who nike is. Um, so you got a bunch of people that have bad posture and then you know that through your analytics and you, you give that data to a shoe company. Be like, look, you need to market this product to them because they need it, and this is the reason why I've given you the information. You bought the information, run with it and then, whatever, however, they market that, but that's valuable information, that's very, very valuable information that people will pay for. But whatever, I mean, it's a marketing thing, it's not a. Actually it does help the world. I mean, come on, someone's got to bring it right.
Speaker 1:Anyways, I'm going to reel back a little bit. So, one of the things that I I do have some questions about Baltimore, but we'll get to that. I want to. I want to know more about the, the, the medical plan or what, what you guys have building right now. So you talked about your plan from this assessment going from iPad to iPhone. What's the next leap after that? Like, what's the five-year outlook on this?
Speaker 2:So what we would love to see is everyone have an app on their phone, right, and they can do the analysis on their phone and then get their exercises, their personalized exercise program, back from that right. So your personalized exercise program is going to be a lot different than an 85-year-old woman who's a fall risk, right, or a high school volleyball player who has hamstring weakness, and then be able to follow them as they progress and then collect that data. Like you said, the data is hugely valuable. The more people we get scanned, the more people we get into the system, the better the data gets, because the more data points you have to collect from and it's going to, like you said, it has a cost, but, yes, it does have a cost upfront, but it's reducing the cost on the back end oh, big time. And that's the ultimate goal. Our ultimate goal is value-based care population health.
Speaker 2:You know, the cost of medicine in this country is crazy, right? We all know that it's up to 17% of GDP. It's absolutely insane, and the only way you're going to bend that curve is you've got to be early intervene early and especially in the musculoskeletal world, and we also have to do things.
Speaker 2:We've got to look at ourselves too. We've got to find those guys. In any group there's going to be a few guys who are outliers for whatever reason, and you got to look at those and you got to kind of reign them in, get people doing things pretty much the same way. We don't want to dictate exactly how people practice medicine, but you got to be doing the right thing. You got to be doing it.
Speaker 1:Well, maybe you can tell me if this even exists. But I was just thinking in the orthopedic world with with cars and saying, look man, this is according to our charts and the information and data that we have. The way that seat is is absolutely not the right thing for somebody. You probably need to go in this direction with it. I mean, does that something like that?
Speaker 2:exist. Yeah, I mean, they've had ergonomic analysis like stuff like that for years, but I mean not the way you're talking, though. Like yeah, I'm not sure how that would directly apply, but yeah, I mean there's so many uses for this, you know, as as we go down the road, it's just going to be limited to people's imaginations and how it's used, but the key is getting the data and being able to do something with it.
Speaker 2:That's, that's constructive and, like I said, we're right at the very beginning, right now, right, you, you, I mean, nobody knows this exists. So, hopefully, as people start hearing about it, then you know, like the the Malcolm Gladwell stages of adoption of any new technology you get your early adopters and then you get a lot of growth.
Speaker 2:and then you get the explosive growth. And, like I said, this is applicable across all segments of society. Think about the factory worker who does repetitive work at work all day, or the construction guy who's shoveling and things like that. You could apply this to them reduce risk. Workman's comp claims go down. Work time goes up. Everyone benefits risk workman's comp claims go down, work time goes up, everything.
Speaker 1:Everyone benefits well, so I mean, uh, I'm sure I'm assuming that, like you guys are, are running this for special operators, right, like you're trying to get this into the special operations field correct. Um, now I would assume you guys do a baseline, like like, if I'm a new SOF operator, the very first thing that they're going to want to do is, okay, baseline with this system. And when I come back off of the deployment I've been blown up 15 times. Whatever, I'm going to do that assessment again. And then it's going to assess and say, look, these are the changes. Let's go through and actually sit down and have an interview of, okay, what happened on your deployment and we need to figure out how it got to this point, and then we've got to figure out how to correct that.
Speaker 2:Is that part of it? Yeah, even beforehand, though, think about your training for a mission. You scan during the training phase and you identify certain weaknesses, like your lack of flexibility may predispose you to hamstring injuries. So we're going to put you on a hamstrings training program, because what happens when you go down range and you pull a hamstring right? That's a. That's a bad thing. So now, all of a sudden, you're a liability. You have to be Aravac or, or, or, or whatever.
Speaker 2:Or suck it up, or just suck it up, but you know, if you can prevent that right beforehand, that's that's even more important than dealing with it when you get back.
Speaker 1:Yeah, yeah, I mean, I think there's, uh, there's other things too that you know orthopedic, muscular skeletal. That's what orthopedic is right, right, exactly, um. But let me ask you this you know what are what studies exist out there where, if I go out and from a concussion nothing happened to me physically, but from a concussion of a bomb or grenade or whatever a breach, I got a TBI? How does just that TBI even though I wasn't nothing physically happened to me when that explosion happened, but how does that TBI affect my muscular skeletal system? And I think I'll bet you there's something there too. I, I, I will bet my testicles on it, don't? We're going to edit that out.
Speaker 2:But yeah, it's a good bet, Cause you're right, okay, yes.
Speaker 1:I win.
Speaker 2:That's mine still. I remember going. I trained at Walt, the old Walter Reed on 16th street, and now that they have the new Walter Reed at Bethesda Naval Hospital, I went and visited and looked at the technologies that they have and the way they were dealing with these you know they have multiple amputees coming back.
Speaker 2:This is at the height of Afghanistan and the TBIs. They actually came up with a room. There's only two of them in the world there's one in San Antonio and there's one in Bethesda and it's a large dome and you get on a treadmill there's actually two individual treadmills and as you're walking on the treadmill it's flashing pictures and math equations and stuff up in the thing and it's for these guys with tbi who are trying to retrain their brain.
Speaker 2:Yeah, both for you know, balance and strength and coordination as well as cognitively, so the two are interrelated one.
Speaker 1:Oh geez, because you? Because a friend of mine, he lost some limbs and talking with him after the fact, he still thinks that his limbs are there. His brain tells him his limbs are there Now. Some people would think, there, now, that's, that's just a. Some people would think, okay, that's a thought. But no, if that's a thought, then that transfers to your whole muscular skeletal system because your nerves are. I mean it's all connected.
Speaker 2:It's called phantom pain. It's been around. Been around since. We've known about it since the civil war.
Speaker 1:Yeah, you know phantom pain. But I mean, how does that so? If my brain's telling me that I still have that limb, then I guess my, and correct me if I'm wrong my muscles are still acting as if I have that limb, at least tightening and right the nerves are firing anyway, yeah yeah, and I, I mean, I holy cow like this.
Speaker 1:What you guys are doing on this is awesome. There's a group group that, um recently we we had on here, uh, they do. It's what's called the 38 challenge. They're big on to uh TBI, cte with the NFL players, um, and they're doing a lot of stuff with a brain type medicine, and I, I, I think it'd be interesting to get you both in one room and talk about this, all the same stuff, and you know, I'll, I'll bet something good, really good, comes out of that, some kind of collaboration or something I don't know. That'd be pretty cool, though, yeah.
Speaker 2:It'd be interesting to see if we could determine, through our screening process, the early stages of CTE. Right, yeah, cause you get these athletes 10, 15, you know even less than that 5, 10 years into the league. Um, they probably all have a little bit of yeah, especially the linemen, because they're they're hitting their heads all the time. And is there something we can determine in the screening that points to that?
Speaker 1:and that would be a great study, because right now they, um, what you know what? Uh, uh, brant mccartney is you, he's kind of the leading dude for this. Um, he was. He told us, you know, they don't know that you have you cannot be diagnosed with CTE until after you're dead. At this point they have to, like, cut your head open and look at your brain to see, is that is that accurate? Yeah, it is so. So how revolutionizing would that be if something with what you guys are doing leads to the diagnosis of CTE without dying Like holy shit man, that's like right Before it gets to the end stage, it becomes obvious, right yeah?
Speaker 1:That's huge. That's huge. See, I'm glad I put that bed on my testicles and I won. Damn it. Yeah, um, okay. So I should have asked you this before, when you guys were first going over through our first introductions how long ago did you start with CAO, like, when did you become the president, or did you start with CAO as an executive?
Speaker 2:Yeah, we formed CAO about 13 years ago.
Speaker 3:Okay.
Speaker 2:In order to kind of deal with this switch between private practice and employed medicine. There was a bunch of us in private practice who wanted to stay that way, so we formed CAO by joining 24 different independent orthopedic groups into one one group. Right, we merged 24 groups together. Um, that was quite a challenge and I'd been president since day one. Um and uh, you know we've done very well. We're up to 28, 29 groups now Wow, and we cover pretty much all of the DMV Northern Virginia, maryland and DC and it's been great. So it's allowed us to stay in private practice, it's allowed us to do some very neat things and allowed us to create Medvanta, which basically we funded ourselves. We funded all this ourselves.
Speaker 1:Yeah, yeah.
Speaker 2:Because we are very much against taking any private equity money because they own you and I don't want to be owned. So, uh, you know. So I'm very proud of that and what we've, what we've done, and uh, I think there's great things that come now what?
Speaker 1:so we were talking a little bit about what you know, how you see the future, but is there any other things that you could talk about that you have on your growth template of other organizations or companies that are kind of going in this realm that may be on the line to start soon? Is there anything like that out there there?
Speaker 2:are a lot of big orthopedic still private practice orthopedic groups around the country who are doing very similar things to what we're doing. As far as CAO goes, I don't know of anybody who's doing what we're doing with what Vant is doing.
Speaker 1:Yeah, yeah.
Speaker 2:Who's not a PE-backed third-party vendor kind? Of person right. So we want to have all of our pieces and parts homegrown and fully owned by us, so you're not beholden to anybody. Because as soon as you start signing contracts with third, you have to have some third party vendors. Don't get me wrong. But you know, if your major pieces and parts are owned by somebody else and you're just signing a contract with them, they can pull the rug out onto you at any time.
Speaker 1:Yeah, and I mean, you can't be dependent on your vision.
Speaker 1:Like like if you're dependent on someone else and it's your dream and your vision and you're running with it and it takes that one little link to destroy that. Fuck that Exactly. Nah, screw that. Now, what about? So you talked a little bit about, we talked a little bit about people losing limbs and stuff. So how does like robotic limbs and stuff play into this? Because I feel like that has a place here. I mean, if it's orthopedic and you're attaching a robotic limb to nerves and and this has been already been developed this stuff exists. How does this with med vanta? How does this all roll into that?
Speaker 2:I mean it's something we'd have to look at. It's not something that's, at least in our current practice, prevalent enough for us to really yeah develop a separate line for it, but certainly if we start getting involved with the military. I mean, there's so many entities out there right, I've dealt with a few of them in my practice but through the VA or whatever, there's certainly opportunity there.
Speaker 1:There is opportunity and I'll tell you what man. The military is the correct place in my opinion. I'm biased to start that, because those dudes lost their limbs for the country. You know what I mean, and I think they deserve it. If someone's going to go that route and do the exploration on this and start something good with it, it needs to start with the military veterans that have lost limbs in wars and the vast majority of amputees in this country, especially when you talk about multiple amputees, are are are military veterans.
Speaker 1:Yes, absolutely Yep, and you know they 100% deserve every piece of attention someone can give to them to help them live a better life, the rest of their life, Uh, after what they sacrificed, uh, you know there's a lot of, there's a lot to be done in that space.
Speaker 2:Oh, I mean I'm old, but when I started at Walter Reed 91, yeah, 91, I was a resident at Walter Reed they still had leather and wood for their prosthetics. I mean literally there were no microchips, there were no pneumatic hinges, there was none of that. That all came relatively quickly.
Speaker 1:But I mean how far that stuff has come it's a whole different conversation is absolutely amazing it is and, um, I don't think most public, uh, they don't even know, like they don't even have an idea of how far they've come. There's some people that are working that sec or, and you know, there's a couple amputees that I know that um have been part of testing and stuff like that.
Speaker 2:So they, they have a very good idea what's going on with it, but it's so far advanced it's crazy, um, I mean just in the five years I was at walter reed um, I took care of a guy who was a golden dite who lost both his legs in a jump in a practice jump, he lost.
Speaker 2:He was a below knee amputee on one side and above knee amputee on the other. Yeah, and because we had come so far in just a few years, he was the first double amputee ever to go back on active duty.
Speaker 1:Wow, yeah, it's pretty cool you know, there was a guy I worked with um he he was a he was a r, lost his leg, got a prosthetic, went back and qualified for the Rangers again, was a team leader and then wrote books. We actually talked about this with the 38 Challenge guys, wrote books, went on to do amazing. He was the epitome of who an American hero is. I mean, like this dude overcame every obstacle he could ever think of, went back out and did it again and I, you know, not too long ago he committed suicide. I think it was two years ago.
Speaker 1:But you know then, if, if the thing is, the whole reason why I bring that up is because a lot of people, when people don't realize, think about losing a limb. Okay, really, think about this. How much your life changes. Like, really, people really need to try to understand this. It is not something that oh yeah, you know, I lost my arm, I'll be fine. Your entire life changes. Everything, your legs especially. Everything that you do changes, not to mention the pain that you're going to have the rest of your life. And to lose sight of that and to not think about why people commit suicide. I can't even imagine what those guys deal with, especially being this hero that I'm talking about. Like the guy was a stud man. It was just someone you look at and be like man. I want to be that guy, um.
Speaker 1:But anyway, a little bit off topic on that Um, but still important to talk about, um. So, uh, I'm going to go back to your minx. Can you do a little data check for me? Can you look up Dr Nick Grasso and the reason why I want you to? So he, he won the best doctor in Baltimore award or something like that. I don't know what it's called, but for like multiple years, and I just want to be factually correct because I think it was like 1996, 97. I was basically every year, except for 2022 because Fauci took that, cause he's an ass wife.
Speaker 2:Now there's a sorry, I won at that. Baltimore Magazine does a thing every year Best Docs and it pulls a bunch of people and it's a peer-reviewed thing. Right, the docs vote for other docs.
Speaker 1:Look, man, that's the best award to get if it's a peer-review award.
Speaker 2:Yeah, it is. It's awesome. It's amazing. There are a large number of CAO docs who make best of Baltimore or best of DC, so I I informally I'm sorry to call you dude, but that's just my language.
Speaker 1:But listen. So I'm a big fan of peer reviews because you know, in the military and stuff that I was doing there, your peer evaluations are huge. If you are winning an award from your peers and something like that, that's ginormous. It's not some asshole that's voting that knows nothing about what you're doing, it's your peers that are doing the exact same thing. They're saying now that dude's the best dude and that guy needs it. You know what I mean. Like that's huge man. That is ginormous.
Speaker 2:That's ginormous. I think we had 30-something docs in CAO who voted best of Baltimore or best of DC.
Speaker 1:Yes, that was awesome. Okay, so you just pulled up here. Yeah, yeah, 2014, 2016, 2020, 2021, 2022. And I'm just going to remind anyone that's listening or eventually watching this on YouTube Baltimore Magazine that kind of includes some of those big name hospitals there. What's the big one there? Hopkins Hopkins, johns Hopkins hey, look, I've had a couple tequilas. I'm allowed to forget stuff. So, okay, we're on the. I have to ask you, how has the bridge affected you? We just talked about Baltimore, so I need to go into this a little bit.
Speaker 2:It hasn't affected me at all, really, because I live in Howard County.
Speaker 1:Ah, that's right. Okay, so you're on the other side, yeah, other side.
Speaker 1:And I'm sure people who travel the Beltway every day, probably on the western side a lot of traffic is getting diverted that way. But yeah, other than that I haven't really noticed anything. Man, like when I saw that, it's like holy cow man, like that thing is the key bridge. Geez man, that's pretty major. Uh. Um, there were some other things in baltimore that I was gonna that. So carrie and I, the minx and I call her minx on the podcast we lived outside of Baltimore and there was a lot of things we loved about Baltimore. I mean, there's a lot of things we did not like about Baltimore. Things went south there for a little bit, but the big thing is crime. Like I'm so pissed off and disgusted about crime and corruption and we had a police officer that lived right next door to us Great dude, pretty sure that guy was pretty damn corrupt too. I don't know.
Speaker 2:Pretty sure. No, it's very sad it is. It's a great city. There's history there. Yeah, there's great stuff to go do up there. I love going to the ball games you know Ravens and the Orioles, Great restaurants, but my wife won't even go in. She won't go to Baltimore anymore.
Speaker 1:I don't allow her to drive through. And the thing is, it's because I feel like you cannot protect yourself if you needed to. I could be wrong about that, it's just how I feel. But it's a beautiful city. It's a beautiful city and there's so much history there, the restaurants, and it's a shame that some people kind of had to go down the drain. But our son was born in Baltimore Harbor Hospital Is that what it's called? Right? Yeah, I mean it was a pretty nice hospital there. It was right on the water there. It was pretty cool.
Speaker 1:But I almost got mugged driving home after he was born and trying to help someone out. You know, the guys came out of the woods, I got on my truck and they thought they were going to jump me and I was like, don't do it. And they didn't and I drove off. But it's like you know why? Why does it have to be like that there? Why, on, man jeez? But anyways, I digress from that. We're gonna go back to the topic. Do you guys have any questions? For not the press, nothing, oh, come on. Come on, there's something, anything anything.
Speaker 2:So what'd you do when you were in the marines?
Speaker 1:oh, what I do? Oh, man, I was. I enlisted to be a cook. I did, yeah, I was going to be a cook. And then I'm pretty sure they I had a mistake on my ASVAB test and they were like no, this dude cannot be a cook. They put me in some kind of intel thing. And then, when I was in A school, I met a radio recon guy. He was my platoon sergeant and I was like that's what I want to do right there and that's what I did my entire career. You know, I went to radio recon. I still live and breathe to this day.
Speaker 1:In fact, two nights ago the radio recon brothers came over and we're sitting around this table bullshit and, um, you know, did Mars sock, did, uh, you know the debt. One thing, and which I? You know I didn't really even belong there. I should. I didn't have the maturity to go to that level of a unit, um, but uh, you know, it was I. That's where we met, you know, she. I'm not going to tell the story of that, but we met as Marines. I ended up getting out as a gunny and then continuing doing the same stuff, but for other people. But great fate was awesome was awesome If I would have been a cook in the Marine Corps. Holy fuck, I would have. Probably, I have no idea I would have got out after four years. I would have been in jail. I'd have no idea. I probably would have been. I would have got out because of a dishonorable discharge from doing lines of coke off a stripper's ass or something, because I would have not want to have been a cook.
Speaker 2:I'm just saying you don't strike me as a cook.
Speaker 1:Well, the funny thing is, I did go to culinary school before the Marine Corps, and that's why I was like, yeah, screw cook, let's go. But I don't do that. I mean, I like to cook as a hobby now, but working in the kitchen no, not for me. But working in the kitchen no, not for me. Yeah, and so where were you stationed at when you were in the Army?
Speaker 2:Oh my goodness, Alabama, texas, alabama, bethesda, georgia, walter Reed, korea, fort Meade.
Speaker 1:Fort Knox when you were in Georgia were you at Benning or whatever?
Speaker 2:No, I was at Hunter Army Airfield, which is part of the Fort Stewart, but I was a flight surgeon at the time.
Speaker 1:Yeah, Fort Stewart. Yep, so in our not the radio recon field, but another signals intelligence field, fort Gordon, fort Gordon, we had a lot of guys there.
Speaker 2:Yeah, that's where the masters is.
Speaker 1:Yeah, right now, actually, we might be able to put up on the TV. I'm just saying we don't need that. Put the masters up, babe. Come on Seriously, you got this. Put masters up, just make sure it's muted. Yeah, I love watching. I mean, I like the end of the Masters, I think probably around 5 o'clock. It's going to be the best today because that's going to be the last part of it. But I love that last part, especially if it's close. It's going to be amazing and from what I hear, it's pretty close right now.
Speaker 2:Yeah, there were three guys within a shot of each other, so hell, yeah, yeah, um.
Speaker 1:Do you guys watch UFC at all?
Speaker 2:I don't know.
Speaker 1:I have.
Speaker 2:I have friends that are totally into it, but I don't, yeah, oh man Like the.
Speaker 1:Apparently the fights last night were amazing. Um, we, you know, we've got a couple of friends that are big into it and very involved with the deep into the high ranks of the UFC scene, and one of them is a trainer for one of the guys that was fighting last night, so I have yet to call him. I was going to say, if you guys are into UFC, we'll give him a call right now and see what he's doing, see what's happening, but he's a very colorful human being though, so that might not be a good idea. He's a good friend though, man, so I actually do. I've had a whole bunch of questions in the back of my head as you were talking, but then I completely wrote a one-word word thing and I'm like what did I mean by writing that? I have no idea. Oh man, son of a bitch. Oh, you know, kendra and I were talking. This is not orthopedic. I'm asking you this as a medical professional.
Speaker 2:How do?
Speaker 1:you feel about TRT? I'm not sure I know what TRT is. So, as a you know, I go and I get my blood checked and they tell me hey, look, dude, your testosterone level is a little bit low. We can supplement that and bring it back up to where it's at, and then also it's going to even out these other hormones and chemicals in your body. That's TRT. Okay, how do you like? How do you feel about cause? I like I talked to a lot of different people that are professionals within the industry and they have different opinions on it, and like I just I want to gather as much uh, there, you know, there's facts and there's opinions, but from a medical professional, your opinion actually means a lot. It's pretty damn close to a fact.
Speaker 2:Well, I'll tell you from the orthopedic standpoint. You want your testosterone to be high, normal. Right and for muscle mass, for bone strength, for a lot of other reasons. Right, the problem with the testosterone is the range of normal is so wide, okay, and I was at a meeting one time and there was a real famous orthopedic surgeon up there. I won't use his name, but he goes hell. No, I don't want to be low normal he goes, I want to be high normal right.
Speaker 1:What is?
Speaker 2:that. Well, if there's a range, say the range is from 900 to 1,800. You don't want to be 950. That's ridiculous. And I don't know the exact ranges because it's not what I do. But he was pretty adamant about being high normal. You don't want to be extra normal. You don't want to be like these bodybuilders. No, with juice, because there's all kinds of downstream problems from that. Yeah, but if you're doing it with a medical professional's advice, then it's probably a good thing.
Speaker 1:Yeah, yeah, I mean, the reason why I ask that is because I started doing it. I guess it was two yeah, it wasn't long ago. But my thing was I'm not doing it until after I'm 45, and I waited until I was after I was 45, and then I did it and I don't do whatever high normal is. It's up to an average I don't know what normal to me is for being active and it's been life-changing. It has absolutely been life-changing. But there's probably other health things you've got to think about with it, right. So that's why I try to get everyone's opinion on it, and especially in the medical field and medical professionals. But it's 100% been life-changing for not just physical ability but everything else.
Speaker 2:Yeah, but anything like that. If you're doing it under a medical professional supervision and they're testing what they need to test and everything, I get worried about people who are taking all this crazy stuff that's available out there. You just don't know what it's going to do.
Speaker 1:Yeah, like with the program that I'm on, I have to get tested or they won't. Like, a physician has to prescribe anything to you, which means if you don't go get your blood work done, they're not prescribing anything, and then even then they may not like you know, you have to, you have to meet their standard and talk to them about what your goals are, and it's a, it's an entire whole health thing. It's not just testosterone, it's everything involved with that. Um, but you know, again, I I like to get everyone's opinion on that, man, because I, here, I am telling all my buddies dude, you got to do this, and I don't want to be giving them bad advice, although they've all done it now and they're living great too. All their wives have thanked me. Just just throw it out there.
Speaker 1:Um, yeah, it's, but you know anything in the medical field that like. So, when you like, as a doctor, you're an orthopedic doctor um, when you get questions like that, I like the fact that you said I don't know anything about that. However, if you have a doctor that's administering this for you, then it's probably okay To me. That's the correct answer, man, because I see a lot of doctors out there that have the title doctor and it's not necessarily their field field, but yet they're throwing out their expertise anyways, and that's the wrong way to do medicine, in my opinion. I'm not a medical expert and I know that yeah it's like don't.
Speaker 2:If you have got a medical problem, don't come to me unless it's like a sprained ankle or something there you go twist, twist it, twist your arm or something. Then come to me but yeah, I've got a wife and two daughters. I get a lot of skin issues.
Speaker 1:Oh jeez, good Lord. I have to find this proctologist, though. What is it? A GI doctor? You have a GI doctor. You're going to have to give me that I forgot about that. I've told him twice now.
Speaker 3:I have a procedure coming up next month.
Speaker 2:I was like when you come to pick me up, you can meet him.
Speaker 1:Yeah, but I asked you if he was cool and you said no, I don't want to know. I've got to have someone cool on here that's going to answer questions that I have.
Speaker 3:You can butter him up.
Speaker 1:Sauce him up with some bourbon, Boom, yeah, Um, well, I mean, I don't have a whole lot of other uh questions. I think our conversation has been pretty awesome, though, and I would like to I would like to link you up with, um, the, the 38 challenge guys. Um, what was the? The? The nonprofit they were starting, the Brain Lab yeah, Brain Lab. I think they're starting to make a lot of movement and there's a few NFL players doing it. There's some pretty big-name veterans that are out there in the world that everybody knows of, that are a part of it. But it's pretty cool, man, because there is a there there, I think.
Speaker 2:Yeah, I mean.
Speaker 2:This technology we're talking about is in its infancy right this is like I said, five years ago we couldn't have done this and it's getting better and better and it's progressing very quickly. So at some point, yeah, someone's going to have to take and look at that kind of thing and do a study to see if there's a, like you said, is there a there there? You know you take some patients you think are at high risk for CTE and you do an analysis of them. Take another group of patients who have never had a brain injury and do the same analysis of them and see if there's a difference there.
Speaker 1:And that that might be predictive. Well, so, so what else with this technology? Because you, like you just said it's at the infancy, um, what other? What are some of the other ways? Uh, that maybe people aren't really even concerned. Like, I think when, if I heard people talking about this, I would immediately think you know, physician led, um, this has to be something that you're just seeing if you're healthy, whatever. But there's, this goes way beyond that, man. There's, there's a lot of other, like a golf swing, Like how could this not help your golf swing? You know what I mean. Like, eventually, they could move in that direction, or something like that.
Speaker 2:You know, yeah, I mean you know swing analysis baseball pitchers you know, all, all that stuff.
Speaker 3:It's applicable to that.
Speaker 2:I mean, that stuff is there now today for the app for the pro athletes. Right, right you. You go to a pga golfer and I guarantee you his swing is analyzed every every week, right, um?
Speaker 2:but for the average guy he can't afford to go get his swing analyzed oh but if you got it on your iphone and you just set it up on a little stand and take a swing and it tells you, you know what you're doing wrong. I mean, that's this technology. Like I said, the old motion analysis labs were crazy, expensive and huge. Now it's going to be on your iPhone, so it's limitless.
Speaker 1:Well, and some of these schools, like high schools, like having something like this at a high school level, know, because, like you just said, you can't really afford that unless you're a pro or something. But what you're talking about is affordable for a small high school, middle school even grade school.
Speaker 2:We're actually in in going to be rolling out very soon with a major soccer league here in northern virginia and doing an analysis of all their players and any family members who want it. But is that?
Speaker 1:the one you're involved with. Yes, that's the same one. We support them.
Speaker 2:Good and it's it's going to be, it's going to be a learning process and hopefully they're going to love it. Hopefully we're going to see some good results and you know it's one. It's one of those things that it's not immediately measurable. I mean, you put this stuff in place and then you got to wait a while and see are your injury, your injury rates, down or not? And and? That stuff will come, but then it'll hopefully expand from there.
Speaker 1:Well, I mean, uh, I was telling her um about, uh, the, the, can I, can I say who it is?
Speaker 3:I don't think it's been announced yet. Okay, no.
Speaker 1:I won't, I won't then. Um, we're, we're pretty involved with them too. Our son goes to the academy and then we're pretty good friends with. I actually used to work for the owner a while back. He's a silent owner and then we know them pretty well and the program they have, man, oh my God, is it glorious. It is the complete family program. So if you can imagine going to this property where there's a barn, there's a bar, the kids are running, there's a pro game going on, that's one part of it. But then all these kids are growing up with this program until they become semi-pro and pro. It's amazing and the passion like that, the passion there, is just so ridiculous it's so amazing.
Speaker 2:It's modeled after the european programs, you know the english programs and yep and that's exactly where uh, the one, that's where he brings it from.
Speaker 1:We're trying to convince them. There's an opportunity to bring a couple of lacrosse young lacrosse team over and then grow that into the same thing that they have with soccer. But that's still kind of in the workings and it wouldn't be anything major yet. But it's cool that you're doing this with them because that's going to kind of boil over to all the other soccer leagues and soccer teams or academies, just like this one. It's going to blow over to them and it's going to come wide range. Everyone's following suit with what these guys are doing. That program that they have is amazing, I'm telling you. I never even imagined anything like that, the fact you can go there with your family and just have fun.
Speaker 1:I had the opportunity to go take some video of a couple of the players. They were actually part of a little kids camp. They were the coaches and what I observed during those three days is these players that are the players who are coaching. They're not just good soccer players, they're just good humans. And I watched, I observed some of the interactions they had with some of these little eight-year-olds and I was just floored. I was like holy shit, that kid's 20 years old and he just managed that like a superstar. What that kid just did, and it's life lesson stuff.
Speaker 1:There was this one kid. They were doing this some kind of drill. It was timed, they were teams, the ball kind of rolled off and the best player by far on the field was just walking along and this kid that's always hustling runs past him to go get the ball. He's like move your ass, little eight-year-old Goes and grabs the ball, bring it over. And then one of the players here, who's the coach for this little league, he comes over and he's like you will never cuss like that on my field again and it kind of startled the kid but then he got. You know that's him talking up here. Then he gets down and kneels in front of him and he's like but that was an amazing initiative and you have the right frame of mind.
Speaker 1:A 20-year-old said that to an eight-year-old. You know what I mean. The life lesson there is just amazing and I witnessed that all three days of that. It was just over and over little things like that. And when we go to the games here, the players there's three or four of them that always come up to where we sit and they come over and shake everybody's hands. Thank you for coming to our game, and that's it. The program is just so damn amazing. It's the fact that you guys are getting in on that. Um, that is a good program to grow with with this, because they believe in it.
Speaker 3:Yeah, I just had a call with them last week and talking through various possibilities that we have to build out, like Medvanta plus the CAO.
Speaker 3:So, Medvanta for prevention and then CAO for when they get injured. Now what? And a big problem that they were talking about is, right now, as it stands, if they get injured, they go somewhere else. They have no idea what's happening with that journey. And if we can help along, keep them in the loop, keep the coaches in the loop on, okay. Well, now they're in physical therapy. This is how we're going to get them back in the game and really working alongside them the coaches, the athletes, the families.
Speaker 1:It's a huge opportunity for both of us and the parents that are having these young kids grow with that program all the way to that are going to see that too, and it's going to be like. This is going to be so awesome when you guys get to stroll on like mainstream with them. That's going to be so awesome, I'm excited about this.
Speaker 1:It's cool. It's cool and the person that her and I and the Minx know mutually, they kind of linked all of us up together. You know again a good human being who I'm really happy that you guys are, have all linked in together and you're doing great things. It's pretty awesome. It's pretty awesome and you know there's so many other opportunities with. I got to keep talking about these guys because I cannot stress how badass the program is.
Speaker 1:So we have during the winter they have what they call a futsal program. It's indoor, all the kids they go and it's a league and there's no games. Really what it is is they just practice doing foot drills with a heavier soccer ball, practice doing foot drills with a heavier soccer ball, and the main owner for this program he's there with these eight-year-olds coaching Like the owner of the entire, like that's his passion for this. He's there passionately coaching these little eight-year-olds, nine-year-olds, some of them are five-year-olds, because he believes in this and the fact that he's bringing in this type of that means he believes in what you are doing too, and I'm telling you that's solid this dude is. He is a pretty amazing person. It's pretty cool.
Speaker 2:Yeah, we're excited about it. I think it's going to be a good partnership it will be, and you had mentioned the high schools, so it's a very short leap from this kind of thing into the high school doing sports screenings. My two girls both played high school volleyball and softball and they would get a pre-season physical and that's it.
Speaker 3:There was no analysis there was no anything.
Speaker 1:This gives you another tool that could hopefully help prevent injury. I was going to give you a good story about a, a physical I had to do once. Should I give that story? Oh, I mean I won't, I'll do it off topic, but but I'll tell you what it, what it involved, and I won't go through in the details. But I was doing a, so I had to do a. Uh, I was supposed to go to free fall and I had to go do my free. I've already done jump and all that stuff but I had to do a different free fall physical and, of course, uh, you know there's parts of that that you got to do that are not very comfortable.
Speaker 2:Um, and that's the class one physical.
Speaker 1:Yeah, yeah, yeah, yeah, but I won't, i'm'm not, I don't even want to talk about on camera or on a record that's. This is a personal, a personal thing. Only people, only special people know about this. Um, yeah, I mean, I, I think that you know, with what you're saying, with, like the high school stuff, it's not a, it's not a huge leap. No, it's not a huge leap at all. Man, like, once you guys get this rolling, especially when it comes to iphone, and it's not, and it's at all man, once you guys get this rolling, especially when it comes to iPhone and it's not just iPad, and if you could do it on iPhone, then it's going to be a little bit easier. It should be easier to do on Android. As far as an app, it's just the camera capability, and I think the Galaxy is 23 or whatever it is that camera capability is just as good, if not better, than any iPhone capability right now. So that opportunity is going to be there too. That's going to be pretty cool. Yeah, I appreciate you guys coming.
Speaker 3:Thanks for having us.
Speaker 1:No, no, it was fun. I mean, I hope, I think I'm pretty sure the guy that is the other owner of the league that you guys are talking about is going to come on the podcast and it would be cool to get you guys on with him and we just talk about soccer, because it will go right into the medical stuff.
Speaker 2:Yeah, especially after we get the program rolled out.
Speaker 1:That's what I mean, like after that you know, I think that'd be pretty cool. You know, mix it up a little bit and you know, get two different professions that have linked together and just bullshit about how your professions are intertwined and you know what goodness that's creating. But yeah, he had said he's going to come on. It's just, you know, finding the time. And then I think the time now that I know this is, let's wait until you guys get this rolled out with them and then bring you guys on together. I think it'd be pretty bad-ass. That'd be great, yeah. So all right, well, we're going to end this segment then. And man man, awesome conversation. Yeah, thank you. There wasn't a whole lot of fuckery on this one, but that's good, that's a good thing, that's not a bad thing. Sometimes there's a little bit too much fuckery going on. So, all right, cool, that's a wrap, all right.