Podcasts about medical professionals

The ALL ME® Podcast How Performance-Enhancing Drugs Shape Society – Dr. Charles "Chuck" Yesalis In this in-depth interview, Dr. Charles "Chuck" Yesalis shares his extensive knowledge on anabolic steroids, their impact on youth, and the ongoing challenges in anti-doping education. Discover the history from the 1970's to today, health effects, and societal influences surrounding performance-enhancing drugs. Takeaways: History of anabolic steroids and doping Health effects and risks of steroids Societal and cultural influences on drug use Policy and legal frameworks for drug control Challenges in education and prevention Chapters: 00:00 Introduction and Guest Introduction 00:34 How Dr. Yesalis and Don's Father Met 00:57 Early Concerns About Kids and Performance Drugs 01:24 The 1988 National Study on Youth Steroid Use 02:17 Dr. Yesalis's Involvement in Anti-Doping Efforts 02:59 Personal Motivations and the Loss of Taylor Hooten 03:26 Public Perception and Media Coverage of Steroid Use 03:53 Influence of Social Media and Body Image on Youth 04:25 Risks of Illegal Substance Use Among Young People 04:51 The Push to Gain an Advantage in Sports 05:19 Health Consequences and Long-term Risks of Steroids 05:43 Origins of Dr. Yesalis's Interest in Steroids 06:16 Understanding Anabolic Steroids and Their Effects 06:38 Historical Research and Early Findings 07:32 The Politics and Science of Steroid Use 08:44 Long-term Health Effects and Epidemiological Research 09:37 The Evolution of Performance-Enhancing Drugs 10:28 Credibility and Scientific Evidence in Anti-Doping 11:08 The Impact of Scientific Misconceptions 11:49 Challenges in Education and Public Awareness 12:58 The Role of Legislation and Regulation 13:47 The Influence of Money and Fame in Sports 14:40 Natural vs. Enhanced Performance and Ethical Dilemmas 15:30 Moral and Ethical Issues in Doping 16:26 Athletes' Willingness to Risk Their Lives for Fame 17:23 Obstacles in Anti-Doping Education 18:13 Public Perception and Media's Role 19:13 Generational Changes and Social Media Impact 19:55 Studies on Youth and Steroid Use in the 1980s 21:10 The 1988 Youth Steroid Study Insights 22:25 Public Awareness and Media Coverage of the Study 23:20 Attitudes Toward Risk and Self-Harm in Youth 23:40 Changes in Drug Legislation and Regulation 24:41 The Impact of the Anabolic Steroid Control Act 25:33 Societal Pressures and Body Image Trends 26:38 Current Perspectives on Testosterone and Medical Use 27:41 Descheduling Testosterone and Potential Risks 29:22 Pharmaceutical Industry and Overproduction of Steroids 30:12 Physician Perspectives on Steroid Regulation 31:34 Dependence and Psychological Effects of Steroids 33:03 Risks of Descheduling and Accessibility 34:18 Medical and Anti-Aging Clinics and Steroid Access 37:43 The Book 'Anabolic Steroids in Sports and Exercise' 39:13 Challenges in Fighting Performance-Enhancing Drugs 40:32 Cheating and Ethical Issues in Sports 40:54 Societal Attitudes Toward Winning at All Costs 41:51 Misconceptions and Public Perception of Steroids 43:08 Health Risks of High-Dose Steroid Use 43:59 Behavioral and Psychological Effects of Steroids 45:15 Physician Involvement and Safety in Steroid Use 45:41 The Role of Medical Professionals in Steroid Regulation 47:26 Reflections on Legacy and Impact in Anti-Doping 48:44 The Mission to Shine Light on the Truth 50:25 Final Thoughts and Personal Philosophy Follow Us: Twitter: @theTHF Instagram: @theTHF Facebook: Taylor Hooton Foundation #ALLMEPEDFREE Contact Us: Twitter: @theTHF Instagram: @theTHF Facebook: Taylor Hooton Foundation #ALLMEPEDFREE Email: info@taylorhooton.org Phone: 214-449-1990 ALL ME Assembly Programs: http://taylorhooton.org/education-resources/face-to-face-programs/

Walking After Stroke: What Your PT Knows That Your Doctor Doesn’t A doctor walked in, ran a reflex test, and told the patient they would never walk again. That same day, a physical therapist from Dr. Kory Langwell’s team arrived. The patient was in tears. And then they walked 70 feet. “I hope you go back and tell that doctor,” Kory said, “that they missed that.” Dr. Kory Langwell is a Doctor of Physical Therapy with over 15 years of experience. He runs a mobile home therapy practice across Southern California, and now coaches stroke survivors worldwide through his virtual program at Unlimited Potential Physical Therapy. In episode 410 of the Recovery After Stroke podcast, Kory broke down the realities of walking after stroke what’s actually possible, where the system fails survivors, and what a good physical therapist knows that most doctors don’t. The Moment the System Stops For most stroke survivors in the United States, recovery starts with intensity. In the hospital, you might receive three hours of therapy a day. Then you go home. Within weeks, that drops to thirty minutes, once or twice a week. “Insurance doesn’t know when your brain stops recovering,” Kory says. “Therapy ending doesn’t mean progress ends.” The problem is that for many survivors, the message lands the other way around. When the funding stops, the belief follows: that recovery is over, that this is where they plateau, that there’s nothing left to do. That belief, more than the stroke itself, can stall everything that comes next. The Plateau Is Not a Full Stop One of the most damaging phrases in stroke recovery is “you’ve plateaued.” It implies that the brain has reached its ceiling, that whatever function you have now is what you’ll have forever. Kory pushes back hard on this. “I’ve seen progress years, decades, 10 to 20 years after a stroke. Arms, hands, legs, walking ability. People just get fed up and stop looking for resources.” What a plateau usually means is that the current approach has stopped working, not that progress itself is impossible. The clinical response isn’t to discharge the patient. It’s to audit what they’re doing and change something. Different exercises, different load, different feedback. Reassess in six weeks. See what moves. Walking After Stroke: Why More Isn’t Always Better Walking after stroke is where survivors often get their first taste of both independence and confusion. The instinct, and it’s a good one, is to walk more. Further, longer, more often. But Kory draws an important distinction between the acute stage and everything that comes after. In the early weeks post-stroke, more isn’t always better. If someone can walk five steps, pushing them to twenty-five on back-to-back days may overtax the neurological system rather than rebuild it. Fatigue compounds quickly. Quality collapses. And when quality collapses, the brain reinforces the wrong patterns. “I’d rather have somebody walk 50 feet really well than 150 feet terribly,” Kory says. Visual feedback changes this completely. When survivors watch themselves walk in a mirror, or on a phone recording, they often see something very different from what they feel. Bill Gasiamis described exactly this: convinced his running gait was dangerous, he watched the footage and found it was far better than he’d thought. The problem wasn’t the movement. It was the feedback. Once a survivor moves into the chronic stage months or years post-stroke, the calculus shifts. Walking remains one of the best exercises available. Kory also recommends walking backwards in a safe environment like a hallway or near a kitchen sink: it challenges balance, engages the brain differently, and creates new neurological input. Why Falls Happen – And What Actually Prevents Them Falls after stroke aren’t random. They follow a pattern. The clinical term is proprioception: the brain’s sense of where the body’s joints and limbs are in space. After a stroke, this system is often disrupted. Survivors may not feel their foot on the ground, or may not register that a leg isn’t bearing weight the way it needs to. Add a divided attention task carrying a plate, thinking about turning off the television, reaching for something, and the risk multiplies immediately. Bill described this directly: he’d made a sandwich, sat down, finished eating, and went to stand up. His attention was on getting the plate to the sink without dropping it. His left leg wasn’t registered as being on the floor. He fell before he’d taken a step. The countermeasure is simple: stop, feel the floor, confirm the leg is active before moving, then carry the plate. Step by step, not simultaneously. Foot Drop, AFOs, and Electrical Stimulation Foot drop, where the muscles that lift the front of the foot are weakened or uncoordinated, is one of the most common walking challenges after stroke. Many survivors are placed in an AFO (ankle foot orthosis) to manage it. Kory’s view on AFOs is measured: they’re a tool, not a sentence. Whether to wear one, when, and whether to eventually stop using one depends entirely on the individual. “Take it off every once in a while if you’re in a safe environment,” Kory advises. “That gives new input to the brain a chance for things to improve.” Electrical stimulation is another tool worth exploring. Kory recommends starting with an affordable unit available on Amazon for around $40 to test whether the technique produces results before investing in higher-end systems. You can find Kory’s recommended unit at linktr.ee/unlimitedpotentialpt. The “Life Athlete” Mindset Kory calls his stroke survivor clients “life athletes.” Not because they run marathons or lift heavy, but because athlete thinking produces athlete results. Athletes track. They audit their approach. They celebrate small gains. They adjust when progress slows. And they don’t let one bad assessment from one clinician define what they believe is possible. “If somebody told you you’d never walk again, you can take that feedback and use it as motivation,” Kory says. “Or you can let it get you down. That’s up to you.” What to Do With a Limiting Prognosis When a doctor says “you’ll never walk again,” it’s rarely cruelty; it’s usually outdated thinking. General practitioners have limited training in neurological rehabilitation. Some are still working from research that concluded recovery stops at six months or a year. That conclusion was drawn from patients who stopped therapy and stopped trying, not from the brain’s actual ceiling. “I just want to leave the door open,” Kory says. The research on neuroplasticity is clear: the brain continues to adapt when given the right challenge, the right environment, and enough time. A prognosis isn’t a prophecy. It’s a snapshot of what one clinician observed on one day. Walking after stroke real, functional, independent walking is possible far longer and far later than most doctors suggest. And sometimes, it happens the same day they said it never would. If this episode has helped you, Bill’s book The Unexpected Way That A Stroke Became The Best Thing That Happened shares the tools and mindset that made the difference across his own recovery. If the Recovery After Stroke podcast has been valuable to you, you can support it financially at patreon.com/recoveryafterstroke. This blog is for informational purposes only and does not constitute medical advice. Please consult your doctor before making any changes to your health or recovery plan. She Was Told She’d Never Walk Again – Her PT Proved Them Wrong | Dr. Kory Langwell (Interview) Dr. Kory Langwell on the therapy gap, foot drop, and why the plateau after stroke is a label not a limit. Highlights: 00:00 Introduction – Walking After Stroke 07:24 Insurance and Therapy Limitations 11:22 Supporting Survivors and Caregivers 16:45 Community and Support in Recovery 26:57 The Impact of Electrical Stimulation in Rehabilitation 29:17 Walking: Quality Over Quantity in Recovery 30:25 Understanding the Stages of Recovery 36:39 Navigating the Challenges of Falling Post-Stroke 42:05 Setting Realistic Goals for Recovery 44:46 The Role of Medical Professionals in Rehabilitation Transcript: Introduction – Walking After Stroke Kory Langwell (00:00) So we had a client recently there. Doctor told them they were never gonna walk again. And literally, like they our therapist showed up, the patient was in tears, and then they walked 70 feet with our therapist. And it was all because it was a doctor that didn’t know them. They did like some reflex testing and said, you’re hyporeflexic, you’re never gonna walk again. And then literally that same day walked 70 feet. I was like, I hope you go back and tell them, BIll Gasiamis video 25, image (00:23) Before we get into today’s conversation, I want to extend a genuine thank you to everyone who supports this show. Whether you’ve joined as a YouTube member, contributed through Patreon, left a review, shared an episode, commented, or picked up a copy of my book, You Are the Reason This Podcast Keeps Going. Today’s guest is Dr. Corey Langwell. A doctor of physical therapy with over 15 years of clinical experience. Corey runs a mobile therapy practice across Southern California and now coaches stroke survivors worldwide through unlimited potential physical therapy, a virtual program built for people who can’t access the in-person care they need. In this conversation, we get into the gap that opens up the moment you leave hospital. While the word plateau might be the most dangerous word in stroke recovery, What physical therapists know about walking after stroke that most doctors do not, and what it actually takes to keep making progress, years or even decades post-stroke. If you’ve ever been told there’s a ceiling on your recovery, this episode is going to challenge that. Here’s my conversation with Dr. Corey. BIll Gasiamis (01:39) Kory Langwell, welcome to the podcast. Kory Langwell (01:42) Thanks for having me. BIll Gasiamis (01:43) Tell me a little bit about your background. Kory Langwell (01:47) Yeah, I’ve been a doctor of physical therapy for over 15 years and I’ve had my own mobile therapy practice for a little over five years. So helping people in their homes throughout Southern California with my staff of PTs, OTs, and speech therapists. And now we’re expanding to worldwide really with our virtual coaching program for people that have had strokes. So BIll Gasiamis (02:12) Worldwide. That’s awesome, right? So that’s where I found you on the TikTok app. And it’s a pretty decent channel to follow. Tell me just while we’re here and I remembered to ask, what is the TikTok handle? Kory Langwell (02:14) Yeah. Yeah. Yeah, yeah. It’s Dr. Kory Stroke Recovery PT and I can I can send you the link later on. But yeah, so I started two months ago and it’s been growing ever since. So BIll Gasiamis (02:38) Yeah, it’s really good because I think your information comes from the clinical background, something that I can’t do. I can put a lot of information out about my personal experience with stroke, what other people tell me about their experience, but your specific instructions around how to improve or how to do something differently or how to achieve an outcome with regards to whatever physical deficit people have after stroke. Is really helpful. So for people who are watching and listening, go to TikTok and probably the other social media channels, yeah, Kory? Kory Langwell (03:12) Yeah, yeah, I started a YouTube recently, unlimited potential physical therapy. And yeah, I’m also on Facebook, Unlimited Potential Rehab. So yeah. BIll Gasiamis (03:22) Yeah. You’re one of those people. I often get asked where can I find somebody that’s going to help me with my stroke recovery? I can’t get there or whatever. And I’m I’m often the middleman. People think that I know everything about everyone, especially from Australia to the United States, right? But what’s weird is I do know a lot of people and I can connect people. So it’s great that we connected and I found you. And I think it’s really important that. Kory Langwell (03:39) Yeah. Yeah. BIll Gasiamis (03:50) It’s your perspective and the way you think about recovery that’s different. And that’s why I reckon people A, should follow you and B, listen to this podcast episode. So don’t leave yet. F listen to the episode and then go and follow Kory on TikTok and all the socials. We’ll have all the links in the show notes. My first question is about the gap. Okay. So we’re often Kory Langwell (04:01) I appreciate that. BIll Gasiamis (04:17) Find ourselves as stroke survivors get sent home from hospital. Everyone does amazing things before we leave hospital. The care is amazing. They try and rehabilitate us as much as they can. They keep us alive. They send us home. But then the gap at home is we’re kind of left alone. Nobody to check in with us to make sure that things are kind of on track, that we’ve settled in. And it feels for a lot of people like recovery ends after therapy ends. But Can you give us a bit of a your your thoughts on that? Kory Langwell (04:54) Yeah, usually at least here in the States, people go from getting three hours of therapy a day in the hospital to literally dropping down to thirty minutes once or twice a week. So there is this huge gap where they just feel like they’re not getting enough and then that it really slows down their progress, or so they feel. and that’s where we’ve come in with our in-home care. But what I’ve seen is people just they need that accountability, whether it’s virtually or in person. And so that’s one thing that we really strive to do is just provide that that one-on-one support virtually. And also, you know, what I see with a lot of people is they think that, stroke recovery. Stops at you know, three months, six months, a year. We’ll probably talk about this more later on. But you just got to keep challenging yourself, doing new things. And I find a lot of times people get stuck on just finding random things on the internet, and then they just they don’t reach out or have the support that they need to move forward and make progress. So grant you just don’t want insurance to tell you when therapy ends or when progress ends. So that doesn’t mean your brain just immediately is yeah. Yeah, therapy’s done because insurance says it is and the brain just shuts off. I mean, I’ve seen progress years, decades, you know, 10 to 20 years after a stroke. I’ve seen progress with arms, hands, legs, general walking ability, you know, stuff like that. So it’s a lot of times they just people get fed up, they get frustrated, and then they stop doing or looking for resources. So BIll Gasiamis (06:26) Y the thing that you said is very interesting about insurance telling you when therapy ends. Now what they’re doing, what are they doing? Are they like I know what they’re doing fundamentally, right? They can’t forever pay somebody to have rehabilitation. And maybe they’re encouraged to pay them for as little as possible as well, because it costs money, right? So they they Kory Langwell (06:49) Yeah. Yeah. BIll Gasiamis (06:53) come up with some kind of a conclusion or whatever, and then they say to people, Well, y that’s about it. You’re not going to really improve any more than that. And we need you to we we’re going to stop funding it. So how does that conversation go from what you understand? And can anyone intervene in that moment and continue the therapy? Is there a way to kind of argue your case to get more therapy? Insurance and Therapy Limitations Kory Langwell (07:24) Yeah, it’s a tough one. So having worked in hospitals in acute rehab units, having worked in outpatient clinics, and then now as my own mobile practice in people’s homes, I’ve seen the whole spectrum of therapy and the issues that come along along each step of the way. in the hospital, you know, it used to be therapy they would get six to eight weeks in the hospital a lot of times here in the States. And now it it used it dropped down to like three weeks for a lot of acute rehabs, and now they’re pushing it down to like 10 to 14 days. which is not a lot of time. And, you know, we used to be able to get people to near independence with a lot of their their skills, you know, the activities or ADLs, activities of daily living. But what I see now is a lot of times hospitals when I left the hospital world in November of 2021, at that point, it was like, let’s just get people to like minimum assistance, meaning they need about 25% or less, and let’s we gotta ship them out of here because it’s like it’s like a churn. It cause hospitals, to be honest. They’re big business. They they are, you know, it’s unfortunate. and they have some of the most highly trained therapists, but the therapists are kind of hamstrung from upper management, middle management, you know, being told probably from people above them that they can only do so much. in the states we have private equity buying out a lot of hospitals and stuff like that. So there are things are changing in the length of stay that clients get. Once somebody goes to home health, they usually only get like two to three weeks, once or twice a week, because the goal of home health is usually get them to outpatient, get them to a clinic. and when they go to a clinic, most of the time somebody will reach like a maintenance level where like they’re not really making a ton of progress and the therapists know they’re not gonna be getting reimbursed as well for that. So that gets really challenging and they have to write really good goals to help. you know, progress things or continue with therapy. So if your therapist is telling you in the outpatient clinic, that’s the one area where you can oftentimes have the best chance of extending therapy. They might be able to, you know, wiggle their way around writing new goals, higher level goals that you can work towards and progressing. And then other times they want to stop therapy for one to two months, three months and then reassess, you know, down the road, which is where a lot of times people seek us out for private therapies on the side. So It’s unfortunate, but yeah, the insurance game does have a their hand in it a lot of times, telling people when they can discharge or not. So yeah. BIll Gasiamis (09:50) How hard is it for a therapist to know that the stroke survivor patient is not ready to go home, but you have to wind it up for them. Kory Langwell (09:59) Yeah. Whew, it’s really challenging. And usually, I mean, in out most outpatient clinics, you might get somebody two or three days a week if you’re lucky. Usually 30 minute sessions in in the clinic. Sometimes you have one-on-one places for an hour, which are great, or 45 minutes, but you’re it’s a volume game in the clinics because the reimbursements have shrunk in the outpatient world too. So they’re like, We need more volume here. And it’s unfortunate. It’s not on the therapist. It’s more on the, you know, just the the whole game that they have to do in order to survive, or else they would have to close up shop. But as far as like extending somebody, it it it can be a challenge. It’s it’s really you see it coming as a therapist, you know, and you’re in the outpatient insurance-based game. you’re like, ooh, you know, I I in about two to four weeks I can tell this is gonna be an issue with your insurance or whatnot. And most therapists, if you can get somebody to like 90% better. You know, that’s pretty darn good, especially after a stroke. there’s a lot of factors that go into that, a lot of variables. But yeah, so it’s it’s tough and getting somebody back to a hundred percent is can be challenging with the insurance game. BIll Gasiamis (11:07) Yeah, getting back to a hundred percent is Kory Langwell (11:12) It’s hard. It’s like the new one hundred percent or yeah, it’s another topic for yeah. BIll Gasiamis (11:13) my gosh. Yeah. The new hundred percent I pref yeah, that I love that. That’s a great statement actually, because a hundred percent, I mean Supporting Survivors and Caregivers BIll Gasiamis video 25, image (11:22) If this podcast has helped you in any way, here’s how you can help it reach more people. Share this episode with a survivor, a carer, or anyone who needs to hear that recovery doesn’t have an expiry date. Leave a review. It makes a massive difference. And if you’d like to support the show financially, you can do that through Patreon at patreon.com/recoveryafterstroke or by becoming a YouTube member. Now it’s back to the show. BIll Gasiamis (11:50) I I have that challenge with a lot of stroke survivors who are early on in their recovery. They reach out and they say, you know, how long is this going to take for me to get better? And like, dude, like it might never get better. in that what they want is they want to go back to where they were before the stroke. And there’s n nobody’s going back there. Nobody at all. Kory Langwell (11:59) We don’t know. Yeah. Yeah. BIll Gasiamis (12:11) Not a single person. And if there’s damage in the brain and the damage is permanent, which damage is in some instances, then you cannot reverse that damage. You have to accept that damage and then adjust and recover and overcome the challenges that you’ve been left with. And it’s such a difficult thing. But the new 100%, I love that, Kory, because I kind of am there. And if people ask me how do you feel, which nobody nobody understands to ask how do I feel after my stroke, my left side is completely numb. You know, I get spasticity. It doesn’t look visibly like other people experience spasticity. So I got away with that part of it. I don’t look like I’ve had a stroke, but I have the fatigue, I have the balance issues when I get tired, I have all these challenges that are always there and they’ve been there since two thousand and fourteen. Like it’s not going away. Kory Langwell (13:07) Yeah. There’s There are those silent problems too that like you said, like you’re doing so well in general that a lot of people just can’t see the fatigue or the how tight your arm feels or different things, which is oftentimes really challenging. But if you put it even, you know, towards like an orthopedic injury where somebody has like a shoulder surgery or a knee surgery, typically they also have like that new one hundred percent where it’s you know, it’s never gonna it’s hard to have it feel a hundred percent like it was before. There are certain instances where somebody might make this miraculous recovery. It does happen. Maybe they’ve had a TIA, a mini stroke, or you know, just made this miraculous recovery. Those those people do exist and it does happen. But what I find in the stroke community that happens a lot is there’s this everyone wants to compare themselves to other people, or they’re they’re wanting to get the answers from things, but there is no crystal ball on these recoveries, you know, for for neuro issues. It’s more like let’s see how it progresses in one month, three months, six months, a year, and then just continue to track because it is a lifelong issue that you have. have to manage and and continue to, you know, have things come up over over time. So yeah. BIll Gasiamis (14:14) Yeah, I agree with that. So this next question I thought about how I’m gonna ask it a lot. So I’m gonna ask it just the way my gut’s telling me to ask it, which is how much bullshit is that you’ve reached the plateau? Kory Langwell (14:31) yeah, that’s a that’s a fun one. I I love the I love the the BS part of that. yeah, it’s tough. I mean, you can see a lot of times what you’ll see is like there’s almost, you know, you think of plateau as like a flat line. And a lot of times what we do see is you’re there’s still room for progress. Like maybe somebody’s feeling like they’re 60% back to their normal self. Well, if we can get you to 65%, would you take that? Like most people would say. You know, it’s either sixty or sixty five percent. Like, yeah, let’s do that. But a lot of times what I see is Progress has just slowed down, they get upset, you know, the doctor’s like, whoop, this is as good as it’s gonna get. This is where you’re at. You’ve plateaued and you’ve entered a maintenance stage. And what I often see with that is it’s that’s the time to shift something up, mix something up, do something different. so what we like to do is take into account what kind of audit what somebody’s doing when their exercises, their daily routine and all that, and then shift things in some certain way and reassess in six weeks to see if we can progress that or make any other changes. So just like with any other training, like if somebody was a bodybuilder going for a competition or a professional athlete, we take that kind of same approach to our stroke recovery. We call athletes in general. Like they’re life athletes, you know. So we wanna help people feel as independent and as strong as they can. So yeah. BIll Gasiamis (15:50) That’s a great mindset shift, right? So if you consider yourself somebody who’s injured, somebody who’s never gonna be the same, all that kind of stuff, well, it might be accurate, but it may not be helpful in the way you approach your recovery. But an athlete, that’s very cool. Now I know some people say what an athlete runs on a track and field you know, facility. An athlete does this, an athlete does that. Well, Maybe, maybe they don’t, you know, maybe you can be your own version of an athlete that allows you to think about that constant and never ending pursuit of getting better and improving. And whether you’re getting better and improving your physical side or your mental attitude or your emotional side or your or your nutrition, you know. Community and Support in Recovery Athletes have all these things that they always constantly forever focus on and their gains come from, you know, that really last part, which is almost unattainable, but it’s about going for it. It’s about going for the last one percent. And then reflecting back, like you said, maybe twelve months later and going, Look how far I’ve come, rather than look what I can’t do or look what I haven’t achieved yet. It’s like, look what I have been able to achieve. That’s Kory Langwell (17:03) Yeah. Yeah. Yeah. And that’s where and that’s where tracking comes into it. Are there, you know, your what what are your BIll Gasiamis (17:15) Such a different mindset. Kory Langwell (17:21) you know, your KPIs, your key performance indicators that you’re looking into as far as, hey, I was only lifting one pound with my arm and now I’m do lifting three pounds. Like that’s huge improvement in a, you know, what however long it’s been. So those whatever you’re tracking, it helps to you know, it could be your diet. Am I making good choices eighty percent of the time? Am I so making sure in like all of your life assets assets and that or facets of life, that’s what we try to do as well. And like you said, mindset, movement, muscle, all that. all those things together. we we you know, tie all those things into our our program. And I think everyone needs to do that as far as, you know, their strengthen those the mental muscle, the physical muscle, you know, they’re just as important. And having that support, whether it’s with a coach or whether it’s with family, friends, outsiders, you know, other stroke survivors, it’s really important. So BIll Gasiamis (18:14) Yeah, community is the I think biggest thing for me. because then with the right community, the one that I’ve created for myself, at least I get to talk about the things that bug me about what happened to me with people who one hundred percent understand it. And then that way, even if we’re different in our attitude in the way we go about things, at least we understand. Kory Langwell (18:35) Yeah. BIll Gasiamis (18:45) And you’re totally being heard. Do know what mean? Like it takes one minute to listen to the story of a stroke survivor and to fully understand where they’re coming from because they’ve been through a a similar, a very similar experience to to myself. Kory Langwell (18:52) Yeah. Yeah, yeah, absolutely. for sure. It’s so true. I mean, as a therapist, I I never really I mean, I knew there was a mental toll to it, but having worked with people for, you know, they come on and they’re with us for several years, you really see the mental aspects, like the ups and downs that occur with that. And it’s so huge to you know, important to to focus on that as well. So and not lose sight of it. So those silent symptoms of the stroke, you know, like we were talking about as far as the the emotional aspect or other things of that. So yeah. BIll Gasiamis (19:26) Yeah. Yeah, one of the biggest complaints that I get from stroke survivors, not about their spouse, but about people about people who haven’t had a stroke, right? So often it’s the spouse that gets the raw end of the stick. But it’s that they just don’t understand me. And it’s so true, right? There’s no way that that person can understand you unless they’ve had a stroke, and we do not want that for them. That’s better that they don’t understand you and that you have to learn how to explain yourself in a way Kory Langwell (19:53) Yeah. Yeah. BIll Gasiamis (20:04) that gets the message across even if they don’t get it. Like it’s okay because they’re never gonna get it. We don’t want them to really ever get it. What we wanna do is accept that they can’t understand something that they have never experienced, which we don’t want them to experience. Kory Langwell (20:20) Yeah, that’s so true. I mean, the it a lot of times it comes from a good place. They’re like, just get up and move. Why are you so tired? or you know, things of that nature. And it y you’re right. They just they don’t understand it. It’s it’s tough. There really should be more caregiver support and education. I’ve tr I’ve strived to do that on my page or on my different resources that I’ve included on my bio. But yeah, it’s it’s in sh it’s a challenge for people to to see the whole picture and the recoveries process that’s going on with that. So yeah. BIll Gasiamis (20:51) Yeah. How common is foot drop? Kory Langwell (20:56) yeah. Strokes you you do see it a fair amount. it’s what I see a lot of times with that. You know, when in the hospital, a lot of times I don’t like to immediately put somebody in like an AFO. Everyone knows ankle foot orthosis and stuff like that. but it’s something that I like to see how the body reacts initially to to the the weaker ankle or whatnot, and how is somebody compensating? So you’ll see somebody, you know, try to march their leg up to clear their foot through the gate cycle, or they’ll kick their their leg out to the side so that they don’t drag their foot or their toe. so I like to see. See what’s going on for the first week or so before we start trying to, you know, put a bunch of equipment on somebody. But honestly, it it’s it’s pretty common. it just depends on the nature or severity of the stroke. Most muscle recovery starts proximally, meaning like at the hip and then works its way down, or in the shoulder and then works its way down to the hand. so the ankle and the hand are usually the last to recover. but yeah, so it’s obviously it’s very noticeable on somebody’s walk gate or whatnot if they have it, or you know, as you just see their AFO and you’re like, that guy’s got foot drop, most likely, or whatnot. So yeah, just trying to figure out where’s is there are there other weak links up the chain and the knee, the quad, you know, your your your glutes, your hip, what other areas could use some help to help you get that leg through and help you be more independent? So BIll Gasiamis (22:28) Mm. Kory Langwell (22:29) really treating the whole ankle or the whole walking pattern, not just the ankle or the foot. Cause we a lot of times we get laser focused into one area after a stroke like my hand or my foot, but we gotta look at the whole body. So yeah. BIll Gasiamis (22:41) So there is a conversation that happens again in the community about whether I should be wearing AFO or I shouldn’t. And you often hear people saying, I got rid of my AFO. it was causing me to walk badly or incorrectly and it was decreasing the muscle activity in the correct way. Kory Langwell (22:51) Yeah. Yeah. BIll Gasiamis (23:08) And then you hear the exact opposite. Well, you know, you should definitely have an AFO so you don’t trip over, you don’t do this, you don’t do that. Like, how do you determine that whole should I or should I not have an AFO? And do some people definitely need an AFO? And then also are there some people who can transition out of an AFO? Kory Langwell (23:20) Yeah. Yeah, it it really is with a lot of neurotype issues, it it really does depend. You’ll hear the answer, it depends a lot of times in the neuro world, neurological issue or you know, in the stroke world. But on a case by case basis, it’s really how does somebody look? How independent are they with and without it? How much strength do they have in their the muscles on your shin and on the outside of your leg that help lift your ankle up? is it something that maybe you just wear it when you’re outside? And then when you’re inside the house, you’re getting that input. with your shoes off. I I really liked the shoes off, you know, kind of full input on how your foot’s moving. You can really see it visually, get some feedback there on what’s going on. So it it and it can change over time. Maybe somebody ditches it after a while or maybe they w they know like, hey, I’m gonna be going on this longer walk. I’m gonna use my AFO so I don’t get as tired because it can be more taxing and energy draining to have to, you know, lift your leg up more, kick it out to the side or whatnot. So we’re really trying to figure out what’s the best quality over quantity for for most folks so that they’re not overdoing it, but they still are getting you know, the appropriate amount of feedback and and to help them live their life, be as independent as possible. So I’m not against or for it. It’s just wanna it depends on the person. So yeah. BIll Gasiamis (24:45) Sounds like it’s a tool to be probably continuously assessed and determine its usability and then also for some people determine whether or not it’s short term, long term thing. And then also keep looking at it. What I seem to also see is people get told something, they do it, and then they do it for a long, long time and nobody kind of ever intervenes a year later to say, where are we at with that? Kory Langwell (24:51) Yeah. Yeah. It you know, it it’s it’s good to take it off every once in a while if you’re especially if you’re in safe environment and just reassess things, you know, on your own or with a therapist or whatnot. That again gives new input and sensory, you know, feedback to your brain of like, what’s going on here? And that that’s a chance for that neuroplasticity to occur, which you know, is a is a is a big buzzword in the in the neuro world. But yeah, so we’re just trying to create those environments and those chances for, you know, things to improve and and reassess. assess things as as you’re going along. So yeah. BIll Gasiamis (25:49) Can you explain to me briefly if you can, like what happens with foot drop, why does it occur? and why don’t I hear about the opposite of foot drop, which is the foot changing and going in the other direction? The Impact of Electrical Stimulation in Rehabilitation Kory Langwell (26:06) Yeah. so your your muscles on your shin, you know, like those those are the ones that people get shin splints on from working out or whatnot, your anterior tibialis muscle, those are a prime mover of lifting your foot up. And oftentimes the feedback and the timing, the coordination down to those muscles is just weakened or impaired. So you’ll see a lot of issues with that. You also have muscles on the outside of your shin. They’re called everters. So they evert or turn the foot out. So the combination of those everters and then the dorsiflexors that lift the foot up, those muscles are the two prime movers of that motion. They’re oftentimes affected with different strokes. And then so a lot of times what we end up using is like things. like electrical stimulation. I have a really good video on my YouTube, about eight to ten minutes long on how to set that up. but you can You c I I see a lot of good impact with the with the E stem, whether somebody’s laying down or sitting, or then there’s other things like the bioness for the leg and the arm, but the one for the leg to help with the timing and coordination, all that, all those things that go into it. So it’s just not just weakness, it’s that timing, coordination, balance, all those things combined. So yeah. BIll Gasiamis (27:19) Got it, got it. So you’ve seen some positive, helpful, supportive kind of outcomes from those electrical stimulators at like Bioness and other other types. Kory Langwell (27:33) Yeah, yeah. I’ve even like I’ve I have one that I use with clients that I I bought on Amazon for like forty bucks because the the range is anywhere from thirty to forty bucks up to like hundreds of dollars. Or, you know, the Bioness is you I think they can get that covered with insurance, at least a partial bit of it, but those are a lot more expensive. like thousands of dollars from to my knowledge. But I what I’ve seen is I don’t see a huge difference between some of those cheaper versions and then the larger ones. some of the bigger ones, like the Bioness, you do get a little more feedback or like that since like it will come on at a certain point of your gait cycle. So it’s like, lifts the toes at a certain point. helps you go through whereas versus you know a standard ESTEM unit, you’re usually it’s on for like 10 seconds, it’s off for 10 to 30 seconds depending on the settings. So but as an exercise tool in the general, in general, if somebody’s having issues and they have good sensation to that area. So you don’t want to put it on somebody that like can’t feel their leg or whatever. But it can be very beneficial at like getting that sensory and then the motor or muscle input back to that area. So not saying it’s going to get to that 100%. But it’s gonna help you. it oftentimes does help people, even, you know, if it’s ten to fifty percent better, great. You know, that’s a huge difference with somebody getting around. So yeah. BIll Gasiamis (28:53) Okay. So worth people considering the possibility of getting a forty dollar version just to sort of try it out and see whether or not it might be supportive. And then if it is and they want to get something more expensive, then go f go from there. your homework after this conversation is going to be to send us the links to every single thing you mentioned. So we can put it in the show notes and everyone can have a look at it. Now, with walking, Kory Langwell (29:12) Yeah. Yeah, absolutely. Walking: Quality Over Quantity in Recovery BIll Gasiamis (29:23) I’m of the I’m I I’m I’m in the camp of do more in the from the perspective of if you’re only walking for a minute, try and get to two. If you’re walking for two, try and get to four and so on. And then if you can get to thirty minutes or an hour at some stage, doesn’t matter when, then that’s even better. but when we started that conversation about Kory Langwell (29:39) Yeah. BIll Gasiamis (29:53) you joining me on the podcast and we share ideas about what we’re gonna talk about. You came back with me with regards to something about walking that people miss that could mean that walking further, longer, and more could actually be causing a problem. Tell me about about walking and the things that we can run into that make well, not things worse necessarily, but Not from an exercise perspective, but from a rehabilitation’s pers perspective. Understanding the Stages of Recovery Kory Langwell (30:20) Yeah. Yeah, I think it there’s a little differentiator in there. It’s like where what stage are you at in the recovery? So if somebody’s in that really acute stage, it’s you know, pretty fresh on the stroke, maybe it’s like somebody less than a month post stroke. We don’t want to get to the point where they’re just like you know, nearly exhausting themselves every single walk, you know, so there’s a time and a place for that. So you know, if somebody can only walk like five steps, we don’t want to go try to, you know, you’re gonna walk 25. And like you can do that every now and then, but don’t do it on like back to back days. Don’t do it on like back to back therapy sessions or whatever. So there’s a there’s a combination of like early on we want to make sure things are good quality. And then as we get moving forward, we want to progress in a fashion that’s comfortable and not over Taxing the neurological system, because a lot of times, as you know, fatigue plays a huge role in that. And how is that affecting you? Are you like you went for a super long walk, but now you’re down for the count for two days or you know, at least a day. So you know, walking a hundred feet can feel like a marathon early on. So it’s just making sure that you’re getting the right feedback, that accountability, support, where you’re it’s quality. in not just overdoing it. So I find that a lot where people want to do a ton of reps or like they’re doing an exercise, like they’re trying to lift their arm up, but they’re doing this the whole time, you know, and I’m like, you’re just you’re not lifting your arm, they’re just like tiring out their trap muscle as opposed to like some of the the delt or bicep or different areas. So like you’re just gonna get really bulky but traps up here, but you’re not really necessarily helping yourself versus if you did good quality and like keep that shoulder down. I’m just using that as an example. But for walking, you know, same thing. Like are you using a mirror for feedback? To see, like, I’m actually, I’m every step, I’m kind of falling off to the side. Why is that? I’d rather like have somebody walk 50 feet really well than like 150 feet terribly, you know. So it’s and that that again goes into more of the acute stage. Now, if somebody’s sub-acute, more of a chronic, it’s been 10, 15 years, go for it. Like, if you want, if you feel good about it, you’re not overtact taxing yourself, getting overtired or anything, you know, do what you can. Walking is one of the best exercises for you. I also like I I’m a big fan of walking backwards. So in a safe area like by the kitchen sink or a hallway or something, it just challenges your mind and it’s a really good balance exercise for somebody post stroke or with any neurological issue because it just told you you see somebody try it the first time, they’re like, What do you want me to do? Walk backwards. And then there’s tons of ways you can adjust the the intensity on that as well. So yeah. BIll Gasiamis (33:01) So also I remember being in outpatient rehab and feeling like I actually wasn’t able to walk well. And then the therapist saying, Well, why don’t we just record it and have a look at how you’re walking? And it was also about running because I I wanted to run, but I didn’t want to run marathons. I just wanted to be able to run across the road if a car’s coming or something. And I said, Well, I’m a bit concerned about how that Kory Langwell (33:15) Yeah. BIll Gasiamis (33:30) goes ’cause I don’t want to injure myself running, et cetera. And well he said, Well, why don’t we do a run, I’ll record you and I’ll then we’ll break it down and I’ll show you what you’re doing or what you’re not doing. And it turns out that my running style was fine. What wasn’t fine was the feedback that I was getting because it was completely different to the previous thirty seven years of my life. And I and because it felt different and my brain registered it differently, it It was scary. Like it was like, well, this doesn’t I’m gonna probably injure myself is how I I thought it. But when I saw the video, it was completely different. And sure, there was some instructions still about how to do it correctly, what I might be able to improve, especially with my left leg, but the but the overall picture was more positive than I t made it out to be. And that’s the challenging part. Sometimes we think we’re less capable than we are. Kory Langwell (34:06) Yeah, yeah. Yeah, and that’s why the visual feedback is so important, whether you record it with your cell phone or you know, just getting the real time feedback on with a mirror or something like that. It’s you know, you see that used in therapy a lot because you may not notice that you’re doing something and just having somebody tell you that isn’t gonna help as much as if you’re somebody’s telling you plus they’re showing you what you’re doing. Yeah, that that can be a huge, you know, help of like, you know, that I can feel that now. It’s good biofeedback. I can, you know, move on from there. So yeah. BIll Gasiamis (35:01) Yeah. And so it sounds like there’s two parts to that conversation. Is sometimes we think we’re doing it better than we are, and sometimes we think we’re doing it worse than we are. So it’s really important to have somebody assess you or at least give you feedback and give you the opportunity to check your assumptions about yourself and then also to check via perhaps a recording to check, you know, how you are actually doing things. So you can see it from Kory Langwell (35:10) Yeah. BIll Gasiamis (35:31) their perspective and then you can adjust as you’re going forward. Kory Langwell (35:35) Yeah, absolutely. BIll Gasiamis (35:37) So what about falling? That’s a huge issue after stroke. I fell quite a few times after surgery. The first time I fell, Kory, was about I don’t know, less than twenty-four hours after I woke up after brain surgery. And the nurse said to me, Have you been to the bathroom to movie bowels? And I was like, No, I haven’t been anywhere. And she said, Well, great, get up, I’ll let I’ll help you. get there and now she was a lot smaller than me and a lot thinner framed and she said just put your arm around me and I’ll help you get to the bathroom. Okay, cool. I did that and when I stepped out onto my left leg, from the left side of the bed, as soon as I put weight on it, without her having any idea, I completely fell straight to the ground, in the ward, screaming Kory Langwell (36:32) no. Yeah. Yeah. BIll Gasiamis (36:36) I’ve got a fresh h scar and patch on my head from brain surgery literally twenty-four hours ago. so it became quite a concern after that because it was the first time I realized that my left side doesn’t work. And it was the first time I realized that th falling after a stroke with a cr a fresh craniotomy and all that kind of stuff is also very dangerous, right? So when I came home Navigating the Challenges of Falling Post-Stroke Kory Langwell (36:37) Yeah. BIll Gasiamis (37:04) I was pretty independent and I felt really good about the fact that I was able to walk on my own. but when I got up from the couch one time and many other times when I’ve fallen, when I got up from the couch on time, I forgot to connect my new leg to my my standing up, my getting up from the couch. I had just eaten a sandwich. It was in a plate. I was the one that went and made the sandwich, sat down and started eating it. And then as soon as I finished it, I went to get up to take the plate to the sink. And my left leg wasn’t aware that it was on the ground. And I fell immediately. And I dropped the plate, I broke the plate, I smashed my ribs on the arm of the couch. I thankfully didn’t injure myself terribly, but it was a close call. And I always after that, I always made a point and still do in the morning when I wake up to get out of bed. Kory Langwell (37:41) Yeah. Wow. Yeah. BIll Gasiamis (38:01) make sure my foot is on the ground before I stand up so that I don’t lose balance and fall. So that’s my that’s my story about falling, but also it’s very common in stroke survivors. I hear that a lot. Tell me about why falls happen after stroke. Kory Langwell (38:05) Yeah. Yeah. Yeah. You know, first off it Kinda hurts my therapist heart to hear that what you know, the nurse and you will fall in there. That’s where I’m like, he needed a PT evaluation to see how strong his legs are, where his, you know, sensation is and all that. Usually when we get somebody up, we want to make sure they’re safe at the edge of the bed. And then maybe we’re transferring just to like a a bedside commode in the the first time. And then you’re you you check that box then. We start moving towards walking once we make sure it’s safe. But sometimes the nurses get a little gung ho with things and get a little excited. we try to stay in our lane and, you know, just do the That PTS needed. but as far as like, you know, making sure somebody’s safe, it’s creating the right environment for them that, you know, like I mentioned, making sure they’re strong enough with their legs to, you know, and the most people will know as they started physical therapy what level they’re at, how much help they need, all those things. So, and then not over challenging somebody where we’re doing like very advanced balance exercises or doing very, you know, doing three tasks at once or like you carrying that dish, you know, and that’s a more your brain is like thinking, we’re good and I’m just gonna carry this dish and I’m gonna go turn off the TV while I’m getting up or whatever. And your brain’s like, nope, no you’re not, and you just fall over. So it’s like creating, you know, those too many environmental stimuli probably and then just where it kind of I don’t tricked your brain into to not focusing on where your your leg is at. We call that the proprioception or just realizing where your joints are, your limbs are in space. And sometimes that can be very affected after strokes. So we just wanna, you know, see how that looks, see how you’re moving, and and you know, go from there. So yeah. BIll Gasiamis (40:08) You probably describe that better than anybody, actually. Proprioception is my is a challenge that I have, but nobody ever connected that to what you just said, too many things happening at once. And it was exactly that. I had a plate, I just finished a meal, and my goal was to get the plate back to the sink safely without dropping it. And it was my my attention was Kory Langwell (40:33) Yeah. BIll Gasiamis (40:36) diverted away from making sure my leg was in the right position for me to stand up and was the muscles were activated, which I had been doing every day before that, right? I’d been making sure. But right now I had a plate in my hand and it was get up without dropping the plate. Kory Langwell (40:37) Yeah, Yeah. Yeah, yeah. Yep. Yeah. Pun pun intended, step by step, right? Just looking into like, okay, my feet are on the ground. I am able to push myself up to stand. Now we’re gonna take a step slowly, you know, go through that. So yeah, it’s it’s making sure everything looks appropriate and is, you know, safe for that specific client. So yeah. BIll Gasiamis (41:12) In my case I think now reflecting back on it, it would have been better if I’d gotten up and then reached over to pick up the plate and then moved to towards the the kitchen sink. And I think I was at home alone that day. And again, I screamed because before I knew it all was on the ground. Kory Langwell (41:27) Yeah. It happens. Yeah. Yeah. Setting Realistic Goals for Recovery BIll Gasiamis (41:35) It’s a very interesting thing to reflect back on it. under these sort of conditions where you and I are talking about things that seem they’re very glossed over. They’re not often spoken about in detail and people miss the the point. And sometimes people think I can’t do something properly, therefore I’m not gonna do it at all. But with regards to walking, what’s the best thing to do? about a walk that you haven’t been able to get back to the normal sort of style and and feel uncomfortable about doing. Some people will go, well, I’m opting out, I’m not gonna do that anymore because I can’t do it properly. It’s too difficult or it’s uncomfortable. Kory Langwell (42:21) Yeah. Yeah. I think it’s making goals that are you know, you hear about those specific, measurable, attainable, realistic time frame, the smart goals. So making sure that applies here. So It you gotta be able to walk before you can run, like with anything in life. So and that’s just you know, symbolic quote or whatnot, but you just wanna be able to do stuff that you can be working towards, but it’s also not so far out there that it’s like really hard. And then I see a lot of times people move those goalposts on themselves too much where they’re like, I got here. Now it’s like I wanna, you know, it’s you got to celebrate those small wins and then go from there as like far as you know, moving forward. So we had a client recently there. Doctor told them they were never gonna walk again. And literally, like they our therapist showed up, the patient was in tears, and then they walked 70 feet with our therapist. And it was all because it was a doctor that didn’t know them. They did like some reflex testing and said, you’re hyporeflexic, you’re never gonna walk again. And then literally that same day walked 70 feet. I was like, I hope you go back and tell them, you know, that that you missed that. So it’s BIll Gasiamis (43:15) Mm. Kory Langwell (43:36) really just making sure that you’re creating these sustainable goals that You know, and not letting people like that doctor that may not know you, a family member, you know, get in your ear and and cause these things that are detrimental to your your progress and take it in the right way. So yeah. BIll Gasiamis (43:55) You can’t actually answer this and I’m putting you on the spot, but I’m gonna ask it anyway. Like I assume that doctors, therapists, everybody is about rehabilitating, supporting, helping people and all that kind of stuff. I I not assume they definitely are, right? But what do you think is behind a questi a statement like you’re never going to X again? Like I hear that so, so much and I thought that by the time we get to twenty twenty six that that won’t be a thing that I hear about so often. Like, but I I don’t think it comes from being nasty or trying to give people setbacks or whatever. But do you have a sense of what that might be? Is it training? Is it a lack of training? Kory Langwell (44:30) Yeah. The Role of Medical Professionals in Rehabilitation I think yeah, you see a lot of like GPs, general practitioners, they don’t really have great training in like neurological rehab. So if it’s a PM and R doc, like a physical medicine and rehab doc, I find usually they’re a little more open-minded or or willing to s you know see the the progress or or whatnot over time. If you go into a doctor’s appointment, you show up in a wheelchair and it’s been, you know, six months, the doctor’s probably your general practitioner is probably gonna be like, well, this is what it is. It’s been six months. And I think some of that is from old research that came out that you can’t make progress after six months to a year, which was more because they just stopped therapy, they stopped doing things and you know, didn’t see progress because of that. So it’s, you know, yeah, if you don’t do anything and you just sit on your butt, all day you’re you’re not gonna see progress or you’re not gonna change. So but yeah as far as from a doctor’s standpoint it it can also be case by case with the doctors as far as their own experience and whatnot. And I don’t think necessarily they ever mean like harm or anything. Maybe they are trying to be realistic with clients as far as like this is what I’m seeing. I don’t think you know, the chances of this are slim, but they they it’s probably just a way of wording it better versus saying you’re never gonna do something again because there’s so many different things that are coming out, like research wise, treatment, you know, like things change drastically now. so it’s I I just like to to leave a at least leave the door open for people to see that improvement. So yeah. BIll Gasiamis (46:16) And walking doesn’t have to be the way you walked before. It could be a different version. It looked differently, feel differently, but it can still be walking. also I think it’s from ignorance, right? And again, ignorance, I don’t throw that out as a way to attack somebody, but it’s like literally that person hasn’t been in the space where Kory might work. They haven’t been in a space where they have seen people overcome some difficult challenges. Kory Langwell (46:23) Yeah. BIll Gasiamis (46:41) So they just make a assumption based on old thinking or something they heard in the past or old research that just stuck. And they’re just telling you, your job, your responsibility is to find new research to overcome that challenge because that research, it’s so bad if there was some and if they disseminated it to all the population in the medical community, and that has been continued to be passed on. I mean, that is so crazy that it persists and now. I just want to encourage people, do not believe anyone that tells you, A, you’ve hit hit a plateau, B, that you’re never going to do something again. And even though that might be true, just don’t believe it because there might be a technology around the corner that happens to solve that problem for you. You just don’t know about it yet. And always work towards the solution rather than focusing on the problem is kind of how I see it. And that’s generally what you guys tend to do. You guys tend to help people focus on. Kory Langwell (47:27) Yeah. Yeah. BIll Gasiamis (47:41) How do we overcome a problem? What’s the solution to this? Kory Langwell (47:46) Yeah, I think using it as motivation is is huge. So like you can take anything somebody tells you, you can take it one of two ways. And if you let it get you down, that’s up to you. Or if you’re like, Okay, I take that feedback, I appreciate it, but I’m not gonna accept it and use it as motivation to to strive to do better and move better. Like that that’s up to you. and who somebody is in their own, you know, life. So I always tell people it’s like, Well, what do you want to work on? You know, if some people are like, I don’t wanna do this anymore, I don’t wanna exercise, it’s like that’s up to you. So And other people they’re like, I want to push as hard as I can, I want to do what I can do. And so it’s really, you know, up to the what that somebody wants to do with their life and their progress, their recovery. BIll Gasiamis (48:28) Kory, it’s been an awesome conversation. Thanks so much for joining me on the podcast and saying yes when I reached out to have you on here and share your wisdom. Can you tell me where can people go and find th information about you? Kory Langwell (48:44) Yeah, so our our main website is unlimitedpotential.biz and you we have a health coaching page on there where people could message me on there if they want. I’ve had some people reach out. I’m pretty active in TikTok on on like DMs if people in my private messages of people reach out there as well. Dr. Kory, K-O-R-Y, stroke recovery PT. and then I’ll we’ll try to get you the handle there, the links on all that stuff. Those are probably the two best ways to reach me. I will say it’s really hard to give specific advice over a text or an email or whatnot. So I and there obviously I understand like there’s a lot of people that have financial issues or they they want the free advice or whatnot, but it’s just it’s really hard as a therapist to give a lot of that. I try my best and I can’t reach everyone doing that, but we really are able to to make a difference when we do work with people one on one. So yeah. BIll Gasiamis (49:36) Yeah. There might be programs that people can look into that you are offering either in house or somewhere else. That’s probably why I would encourage people to reach out to get an answer about your specific issue. Dr. Corey’s not going to do that. just like many people can’t answer a specific question about a problem that you may or may not have un unless they have information about your data or you know, they’re your physician or they have your scans and all that kind of stuff, that’s not gonna happen. But that’s okay. people can still follow you because your tips on TikTok are really cool. They’re on the mark and that’s where I love listening and learning from you. Kory Langwell (50:16) Thank you, I appreciate it. I’ll keep coming. BIll Gasiamis (50:19) Yeah, definitely keep them coming, man. it’s been a great thing, this social media thing because it brings information to people that otherwise wouldn’t be able to access it. Some people might be stuck with the doctor who said, You’re never gonna do this again. And that would be the most terrible place to be stuck and have nobody else to kind of throw a spanner in the works in that type of thinking and then suggest something more, more hopeful, more positive. Kory Langwell (50:34) Yeah. Yep. Yeah, absolutely. And it’s always good. I mean, I learn from stroke survivors all the time on what they’re going through. And it’s just, you know, it’s everyone working together around the world now. So I’m in I’m in California and we have, you know, like we’re talking you’re in Australia. I’ve talked to people all over the world now and it’s it’s just been great to to open those doors to a lot of people and you know, at least have conversations with them. So BIll Gasiamis (51:09) Doctor Kory, thank you so much for joining me on the podcast. Kory Langwell (51:11) Yeah. Thanks. Thanks for having me. BIll Gasiamis video 25, image (51:13) Well, that was Dr. Corey Langwell, Doctor of Physi

DJ ScizZa is in the House with unique perspective at prison mates and stories when she was a practicing medical professional there in KY. The stories will blow your hair back. Brian and Robbie poke over the fence and get their Red Riders out with the church goers next door.

Newly released U.S. Justice Department records expose how a circle of well-credentialed, “elite” physicians provided bespoke medical care to Jeffrey Epstein — and to some of the young women he referred to as his “girls” — in ways that crossed clear ethical boundaries. Rather than merely offering concierge services to a wealthy patient, some doctors appeared to tailor treatments to Epstein's preferences, kept him informed of women's medical details, and even performed procedures outside appropriate medical settings. One particularly striking example involved a plastic surgeon stitching a woman's deep head wound with 35 sutures on Epstein's private island dining table instead of in a proper emergency room, bypassing standard hospital safeguards designed to protect patient health.The documents — which include emails, appointment logs, and lab reports — show an intersection of medicine, power, and money that raises serious questions about patient privacy, professional norms, and the influence wielded by Epstein long before his 2019 death. Medical ethicists cited in related reporting argue that the actions revealed suggest more than just high-end care; they reflect a system where medical professionals may have subordinated ethical duties to the wishes of a powerful and controversial figure, potentially compromising the autonomy and well-being of vulnerable women in his orbit.to contact me:bobbycapucci@protonmail.comsource:Elite doctors treated Jeffrey Epstein and the women around him. The new files show how far some wentBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-epstein-chronicles--5003294/support.

A new Best's Market Segment report discussed by AM Best Associate Directors Connor Brach and Vicky Riggs, finds that MPL insurers have generated an underwriting loss in each of the past five years, reflecting slippage in rate adequacy and increased loss severity.

In this episode of the IRH Clinician's Corner, guest host and IRH faculty member Courtenay Fisher sits down with Lisa Fraley - attorney, legal coach, and holistic law expert—to discuss the unique intersection of legal regulations and functional health practice. Lisa brings her experience as both a former corporate healthcare lawyer and a certified health and life coach, making her uniquely qualified to help practitioners navigate the complexities of scope of practice, licensing laws, and legal documentation. Inside this episode, we explore: Where scope of practice truly begins and ends How to talk about labs without making diagnoses The legal documents every practitioner needs Social media and testimonial pitfalls to avoid The dos and don'ts of using AI in your practice How to structure your business to minimize legal risk The Clinician's Corner is brought to you by the Institute of Restorative Health. Follow us: https://www.instagram.com/instituteofrestorativehealth/ For educational content and updates on current events, join our email list here.    Connect with Lisa Fraley: Website: www.lisafraley.com Instagram: https://www.instagram.com/lisa_fraley/ Facebook: http://facebook.com/lisahangerfraley   Free Legal Chat with our team to ask any question: lisafraley.com/legalchat   Timestamps:  00:00 From health coach to legal coach 08:13 Differentiating Coaches from Medical Professionals 14:25 Discussing test results with doctors 20:50 Giving general advice as a health coach 26:13 Confidentiality in client relationships 29:48 Using AI for legal research 34:16 Health coaching tools and regulations 37:56 Understanding state nutrition laws 46:17 Sponsor Acknowledgements and Descriptions 49:12 Integrating spirituality into legal practice 54:56 Difference between RD and health coach 59:21 Licensing limits in professional practice Speaker bio:  Lisa Fraley, JD is a Legal Coach® and Attorney. She takes a holistic approach to law by blending her expertise as a former health care attorney in a large corporate law firm with the care of a Health & Life Coach trained through IIN and CoachU. Her goal is to make law easy to understand, accessible and affordable – and she uniquely aligns legal steps with the chakras.    She's the author of Easy Legal Steps…That Are Also Good for Your Soul (a #1 Amazon best seller in both Corporate Law and Ethics) and the host of the "Legally Enlightened Podcast" offering bite-sized legal tips in 20-minutes or less. She holds a Certificate in Sustainable Business Strategy from Harvard Business School Online and Certificate in AI Ethics from the London School of Economics. Lisa has spoken on international stages from the Bellagio to British Columbia and she's been a legal expert on over 350 podcasts and interviews. Get free legal tips at lisafraley.com.   Keywords: functional health practitioners, scope of practice, legal protection, health coaching, unlicensed practitioners, licensed practitioners, client agreements, medical disclaimers, nutrition law, functional nutrition, HIPAA compliance, group program contracts, hybrid client agreements, lab test interpretation, medical advice, online courses, supplement protocols, medical titles, independent contractor, employment law, telehealth law, copyright law, AI and legal documents, patient confidentiality, marketing compliance, testimonial release, social media risk, licensing requirements, direct access labs, business structure Disclaimer: The views expressed in the IRH Clinician's Corner series are those of the individual speakers and interviewees, and do not necessarily reflect the views of the Institute of Restorative Health, LLC. The Institute of Restorative Health, LLC does not specifically endorse or approve of any of the information or opinions expressed in the IRH Clinician's Corner series. The information and opinions expressed in the IRH Clinician's Corner series are for educational purposes only and should not be construed as medical advice. If you have any medical concerns, please consult with a qualified healthcare professional. The Institute of Restorative Health, LLC is not liable for any damages or injuries that may result from the use of the information or opinions expressed in the IRH Clinician's Corner series. By viewing or listening to this information, you agree to hold the Institute of Restorative Health, LLC harmless from any and all claims, demands, and causes of action arising out of or in connection with your participation. Thank you for your understanding.  

Rising homelessness in San Antonio is prompting health professionals, educators and community advocates to examine how the community can more effectively meet the health and social needs of people experiencing homelessness.

Washington is more than five months into a new pilot program that has been using AI to screen requested procedures for people enrolled in Medicare. It’s called the Wasteful and Inappropriate Service Reduction (WISeR) program, which incentivizes private companies to deny procedures. Washington lawmakers and medical professionals say the program has led to denials and delays in care for older residents. All of this is covered in a new story from KUOW that looks at the pushback to this pilot program. Guest: Stephen Howie, a senior online editor and reporter at KUOW Related links: Washington seniors face denied, delayed care under AI Medicare review program | KUOW Thank you to the supporters of KUOW, you help make this show possible! If you want to help out, go to kuow.org/donate/soundsidenotes Soundside is a production of KUOW in Seattle, a proud member of the NPR Network.See omnystudio.com/listener for privacy information.

Want to Start or Grow a Successful Business? Schedule a FREE 13-Point Assessment with Clay Clark Today At: www.ThrivetimeShow.com   Join Clay Clark's Thrivetime Show Business Workshop!!! Learn Branding, Marketing, SEO, Sales, Workflow Design, Accounting & More. **Request Tickets & See Testimonials At: www.ThrivetimeShow.com  **Request Tickets Via Text At (918) 851-0102   See the Thousands of Success Stories and Millionaires That Clay Clark Has Helped to Produce HERE: https://www.thrivetimeshow.com/testimonials/ Download A Millionaire's Guide to Become Sustainably Rich: A Step-by-Step Guide to Become a Successful Money-Generating and Time-Freedom Creating Business HERE: www.ThrivetimeShow.com/Millionaire   See Thousands of Case Studies Today HERE: www.thrivetimeshow.com/does-it-work/  

When someone presents to an emergency department after having taken an unknown drug, screening is typically undertaken. Yet for kratom, which last year accounted for over a thousand fold increase in ED visits, no screen is available. Substance use disorder … If you have a bad experience after taking kratom, can medical professionals help? Read More »

Australia continues to face a shortage of skilled professionals across several sectors, with medicine among the most affected. What job opportunities are available for doctors and medical professionals in the Northern Territory? Listen to this podcast featuring a panel of Darwin-based doctors discussing the issue. - آسٹریلیا کو کئی شعبوں میں ماہرین کی قلت کا سامنا رہا ہے اور ڈاکٹری اور میڈیکل کا شعبہ اس میں سرِ فہرست ہے۔ نارتھرن ٹیریٹری میں ڈاکٹروں اور طبِ کے شعبے کی افراد کے لئے ملازمتوں کے کس طرح کے مواقعے موجود ہیں, اس بارے میں ڈارون میں موجود ڈاکٹروں کے ایک پینل سے بات چیت پر مبنی پوڈ کاسٹ سنئے

What if everything you've lived through — every patient, every bedside moment, every loss — was preparing you for something greater? In this powerful live reading on Radio Medium Laura Lee, psychic medium Laura Lee connects with Mary, a recently retired nurse from Missouri, delivering spirit messages that bridge her medical past with a profound spiritual calling. Mary's grandmother — a woman she never met — steps forward from the other side, and spirit guide Seth confirms a path that weaves mediumship, hospice work, and healing into one extraordinary purpose. If you've ever felt that your pain, your profession, or your grief was leading somewhere deeper, this episode will speak directly to your soul. Laura Lee's intuitive reading touches on grief healing, spiritual awakening, connecting with deceased loved ones, and the courage it takes to honor both your roots and your rising. Whether you're a skeptic, a seeker, or somewhere in between, the spirit messages in this episode are impossible to ignore. 

On Sunday, September 28, 2025, Bridger and Lindsey Frampton were at church with their family when a vehicle crashed into the side of their chapel just moments after the administration of the sacrament. What first appeared to be a tragic accident quickly revealed itself to be something far more devastating. In this first half of their story, Bridger and Lindsey honor the lives lost and share the miracles they witnessed and experienced—even in the midst of unimaginable tragedy. 1:36- The Road to Michigan 4:45- September 28, 2025 15:00- Going Back Inside Again and Again 17:56- Heroes 22:58- Searching For Your Children 26:22- Smoke Inhalation 33:48- Two Mothers 36:27- Medical Professionals 42:36- The Power of Prayer "These were faithful members of the Church. …They'd just taken the sacrament. When their lives were taken, they were doing what they've always been doing. They were serving. They were helping people around them and I think God takes their actions and those things very seriously. And I hope they'll always be remembered for the way they lived. People of faith, people of service, and people who love others around them."

Often, when you go to the doctor or psychiatrist and tell them you're in a funk, or not feeling like yourself, they'll prescribe you a pill or some other type of medicine. However, in some cases, instead of being handed a prescription for an anti-depressant or anti-anxiety medicine, patients are being prescribed visits to local art and culture institutions, like museums, community centers, and the theater. Nichole talks with Erik Holmgren, Manager of Advancement and Strategic Partnerships at the Mass Cultural Council, and Chris Appleton, Founder and CEO of SocialRx, about their efforts to connect more Bay State residents to these life-changing programs.See omnystudio.com/listener for privacy information.

Newly released U.S. Justice Department records expose how a circle of well-credentialed, “elite” physicians provided bespoke medical care to Jeffrey Epstein — and to some of the young women he referred to as his “girls” — in ways that crossed clear ethical boundaries. Rather than merely offering concierge services to a wealthy patient, some doctors appeared to tailor treatments to Epstein's preferences, kept him informed of women's medical details, and even performed procedures outside appropriate medical settings. One particularly striking example involved a plastic surgeon stitching a woman's deep head wound with 35 sutures on Epstein's private island dining table instead of in a proper emergency room, bypassing standard hospital safeguards designed to protect patient health.The documents — which include emails, appointment logs, and lab reports — show an intersection of medicine, power, and money that raises serious questions about patient privacy, professional norms, and the influence wielded by Epstein long before his 2019 death. Medical ethicists cited in related reporting argue that the actions revealed suggest more than just high-end care; they reflect a system where medical professionals may have subordinated ethical duties to the wishes of a powerful and controversial figure, potentially compromising the autonomy and well-being of vulnerable women in his orbit.to contact me:bobbycapucci@protonmail.comsource:Elite doctors treated Jeffrey Epstein and the women around him. The new files show how far some went

Newly released U.S. Justice Department records expose how a circle of well-credentialed, “elite” physicians provided bespoke medical care to Jeffrey Epstein — and to some of the young women he referred to as his “girls” — in ways that crossed clear ethical boundaries. Rather than merely offering concierge services to a wealthy patient, some doctors appeared to tailor treatments to Epstein's preferences, kept him informed of women's medical details, and even performed procedures outside appropriate medical settings. One particularly striking example involved a plastic surgeon stitching a woman's deep head wound with 35 sutures on Epstein's private island dining table instead of in a proper emergency room, bypassing standard hospital safeguards designed to protect patient health.The documents — which include emails, appointment logs, and lab reports — show an intersection of medicine, power, and money that raises serious questions about patient privacy, professional norms, and the influence wielded by Epstein long before his 2019 death. Medical ethicists cited in related reporting argue that the actions revealed suggest more than just high-end care; they reflect a system where medical professionals may have subordinated ethical duties to the wishes of a powerful and controversial figure, potentially compromising the autonomy and well-being of vulnerable women in his orbit.to contact me:bobbycapucci@protonmail.comsource:Elite doctors treated Jeffrey Epstein and the women around him. The new files show how far some wentBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-moscow-murders-and-more--5852883/support.

Newly released U.S. Justice Department records expose how a circle of well-credentialed, “elite” physicians provided bespoke medical care to Jeffrey Epstein — and to some of the young women he referred to as his “girls” — in ways that crossed clear ethical boundaries. Rather than merely offering concierge services to a wealthy patient, some doctors appeared to tailor treatments to Epstein's preferences, kept him informed of women's medical details, and even performed procedures outside appropriate medical settings. One particularly striking example involved a plastic surgeon stitching a woman's deep head wound with 35 sutures on Epstein's private island dining table instead of in a proper emergency room, bypassing standard hospital safeguards designed to protect patient health.The documents — which include emails, appointment logs, and lab reports — show an intersection of medicine, power, and money that raises serious questions about patient privacy, professional norms, and the influence wielded by Epstein long before his 2019 death. Medical ethicists cited in related reporting argue that the actions revealed suggest more than just high-end care; they reflect a system where medical professionals may have subordinated ethical duties to the wishes of a powerful and controversial figure, potentially compromising the autonomy and well-being of vulnerable women in his orbit.to contact me:bobbycapucci@protonmail.comsource:Elite doctors treated Jeffrey Epstein and the women around him. The new files show how far some wentBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-epstein-chronicles--5003294/support.

email chris@drchrisloomdphd.com with "Podcast freebie" to book a coveted FREE guest spot on the show. To book a PREMIUM spot on the Podcast: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.drchrisloomdphd.com/_paylink/AZpgR_7f⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Book a 1-on-1 coaching call: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.drchrisloomdphd.com/booking-calendar/introductory-session⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Become a member of our Podcast community: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.drchrisloomdphd.com/membership⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Subscribe to our email list: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://financial-freedom-podcast-with-dr-loo.kit.com/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Click here to join PodMatch (the "AirBNB" of Podcasting): ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.joinpodmatch.com/drchrisloomdphd⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Click here to purchase my books on Amazon: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://amzn.to/2PaQn4p⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Click here to purchase my audiobooks, visit: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.audible.com/author/Christopher-H-Loo-MD-PhD/B07WFKBG1F⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠To help support the show:CashApp- ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://cash.app/$drchrisloomdphd⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Venmo- ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://account.venmo.com/u/Chris-Loo-4⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Buy Me a Coffee- ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.buymeacoffee.com/chrisJx⁠⁠⁠⁠⁠⁠⁠⁠⁠Disclaimer: Not advice. Educational purposes only. Not an endorsement for or against. Results not vetted. Views of the guests do not represent those of the host or show.  

Think your medical practice is safe from hackers? Learn why humans, rather than software, are often the weakest link in patient data protection. In this episode of the BackTable Podcast, host Dr. Chris Beck delves into the critical topic of cybersecurity in healthcare with Didier Jourdain, a certified Information Systems Security Professional (CISSP). --- SYNPOSIS Didier discusses his recently approved paper, 'Cybersecurity for Interventional Radiologists: A Clinical Imperative for Protecting Patient Data and Imaging Systems,' and shares his extensive background in software and application security, penetration testing, and cybersecurity risk governance. The conversation covers key issues such as phishing, ransomware, third-party vendor risks, and the vulnerabilities of the Internet of Medical Things (IOMT). Didier emphasizes the importance of education, tabletop exercises, and comprehensive third-party risk management strategies to enhance cybersecurity resilience in both hospital systems and independent physician practices. --- TIMESTAMPS00:00 - Introduction04:03 - Cybersecurity in Healthcare: A Clinical Imperative16:07 - Mitigating Cybersecurity Risks20:23 - Password Management and Best Practices27:33 - The Role of IT in Cybersecurity31:04 - Internet of Medical Things (IoMT) Vulnerabilities39:17 - Top Cybersecurity Recommendations for Physicians

"It is physiologically contraindicated for nurses to remain in practice" Nurses Uncorked welcomes back Dr. Lorre Laws PhD, RN to the podcast. In this episode, Nurse Erica shares her personal journey as the primary caregiver for her mother with Alzheimer's Disease. This conversation delves into the impact of unintegrated trauma on nurses and the necessity for self-compassion to aid in recovery. The discussion highlights the silent epidemic of nurse-specific trauma and how it affects nurses' mental and physical health. The statistics reveal high rates of PTSD, depression, substance abuse, and suicide among nurses. The conversation emphasizes the need for a deeper understanding of the nervous system and the importance of addressing personal and professional struggles faced by healthcare workers. The discussion also touches on trauma education lacking in nursing programs and asks the question - are nurses being traumatized to monetize? Interested in Sponsoring the Show? Email with the subject NURSES UNCORKED SPONSOR to:  nursesuncorked@gmail.com Support the Show: Help keep Nurses Uncorked going and become an official Patron! Gain early access to episodes, exclusive bonus content, giveaways, Zoom parties, shout-outs, and much more. Become a Wine Cork, Wine Bottle, Decanter, Grand Preserve, or even a Vineyard Member: https://patron.podbean.com/nursesuncorkedpodcast     Dr. Lorre Laws PhD, RN: https://drlorrelaws.com  www.drlorrelaws.com/vault Nursing our Healer's Heart: A Recovery Guide for Nurse Trauma & Burnout, by Dr. Lorre Laws PhD, RN:  Buy on Amazon Follow on Instagram:  instagram.com/drlorrelaws  Subscribe on YouTube:  youtube.com/@dr.lorrelaws    Vote Daily Here: Podcast of the Year! https://nurse.org/articles/best-of-nursing-awards/   ETSY Shop:  Stop Healthcare Worker Violence! https://www.etsy.com/shop/TheNurseErica   Chapters: 00:00 Episode and Guest Introduction 04:34 The Impact of Personal Trauma on Caregiving 09:40 Alzheimer's Disease Versus Personality Disorder 11:48 Understanding Unintegrated Trauma in Nursing 14:00 Steps to Healing and Recovery for Nurses 26:28 Nurses Uncorked is Nominated for Podcast of the Year! Vote Now! 28:10 Understanding the nervous system is key to recovery 34:35 The Need for Change in Nursing Education 45:16 Unpacking the Nurse Health Crisis: The Four S's 48:44 Nurse-Specific Trauma and Why Nurses are the Sickest Profession 56:00 What the Statistics Reveal 58:12 Pathways to Healing: Addressing Trauma in Nursing Help the podcast grow by giving episodes a like, download, follow and a 5 ️ star rating! Please follow Nurses Uncorked at:   tiktok.com/nurses-uncorked https://youtube.com/@NursesUncorkedL   You can listen to the podcast at:   podcasts.apple/nursesuncorked spotify.com/nursesuncorked podbean.com/nursesuncorked iheart.com/nurses-uncorked   Follow Nurse Erica:  @TheNurseErica on TikTok, Instagram, Facebook and YouTube! https://www.youtube.com/@thenurseerica9094 https://www.instagram.com/the.nurse.erica/   DISCLAIMER: This Podcast and all related content published or distributed by or on behalf of Nurse Erica or Nurses Uncorked Podcast is for informational, educational and entertainment purposes only and may include information that is general in nature and that is not specific to you. Any information or opinions expressed or contained herein are not intended to serve as legal advice, or replace medical advice, nor to diagnose, prescribe or treat any disease, condition, illness or injury, and you should consult the health care professional of your choice regarding all matters concerning your health, including before beginning any exercise, weight loss, or health care program. If you have, or suspect you may have, a health-care emergency, please contact a qualified health care professional for treatment. The views and opinions expressed on Nurses Uncorked do not reflect the views of our employers, professional organizations or affiliates. Any information or opinions provided by guest experts or hosts featured within website or on Nurses Uncorked Podcast are their own; not those of Nurse Erica or Nurses Uncorked LLC. Accordingly, Nurse Erica and Nurses Uncorked cannot be responsible for any results or consequences or actions you may take based on such information or opinions. All content is the sole property of Nurses Uncorked, LLC. All copyrights are reserved and the exclusive property of Nurses Uncorked, LLC.

Kiera is joined by Alexis Gallati, founder and lead tax strategist at Cerebral Tax Advisors, to talk about tax strategy not just for 2025 success, but 2026 and beyond. They discuss asking your CPA the right questions, shifting income from your higher tax bracket down, the Augusta rule, and a ton more. Episode resources: Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcript: The Dental A Team (00:00) Hello, Dental A Team listeners. This is Kiera and today I am super jazzed. I have an incredible guest joining us on the podcast today ⁓ to talk about last minute tax strategies before April 15th. Like why not? I mean, hey, maybe you were like, you're not the early bird. You were like, shoot, I forgot. Like what things can I do? And so I'm super excited. Alexis Gallati, she reached out to us. ⁓ She is founder and lead tax strategist at Cerebral Tax Advisors.   Ansari Real Wealth Academy. And I was so excited about this topic because I know you guys know I love to geek out about this and I have it on my vision board of tax expert ahead. Like I hate taxes. I love taxes. I believe that taxes are such a beautiful way for us to pay to be in this incredible country. But you better believe I don't want to pay a penny more than I need to. So really figuring that out just a little bit about her is she is got a dual master's degree in business administration and taxation, which is super rad because   Let's be real, she gets the business side of it. She gets the taxation and we were chatting before and she was like, what people make like their top line revenue versus their take home pay are two different things. And I was like, amen sister, preach on. She's enrolled agent, NTPI fellow and certified tax strategist. She also is the author of advanced tax planning for medical professionals. She specializes in high level strategic tax planning and multi-state tax preparation for healthcare professionals and business owners. She's raised in a family of physicians and married to one.   She empathizes with the financial challenges medical professionals face. This personal connection inspired her to create accessible, unbiased tax solutions tailored to their busy lives. Driven by passion and guided by cerebral thinking, Alexis forms Cerebral to help professionals keep more of their hard earned money. Amen sister. That's what we want. That's why you're here. Their approach breaks the mold of traditional financial advice, offering a unique perspective for medical professionals and business owners. So while yes, she's not 1000 % dental guys were in the healthcare world and she's so brilliant. So Alexis, welcome to the show today. How are you?   Alexis Gallati (01:54) Thank you so much for having me. I'm doing very well. Hope you had a wonderful holiday season.   The Dental A Team (01:58) Yes, likewise. And I was so excited when I heard that you would be a guest on our podcast. I geek out about this, Alexis, I know it's like our first day meeting, but ⁓ I just think the world of tax is such the game of monopoly. And I'm like, if you would have just told me that rule, I could have played and won the game better. But I feel like it's always as ever changing, ever evolving. And I know there were some big things that happened in 2025 that are impacting like our our taxes. And so, yeah, definitely a timely and   exciting podcast to throw out there. So Alexis, I know I gave you a very welcomed ⁓ bio and intro, but yeah, tell us a little bit about who is Alexis. You're married to a physician. You're in this world of tag. How does one become obsessive about CPA? I'm truly just curious. How do you like, how does this happen? How did you become this?   Alexis Gallati (02:49) Yeah, so I love law and I love money. And so when I was in undergrad, I took a tax and accounting class and loved more the tax side than the accounting side, I do admit. And so after meeting my husband in college and us starting to go through that full medical journey, was about a year and a half out from him.   The Dental A Team (02:54) you   Alexis Gallati (03:18) from him finishing his residency. And I really saw the writing on the wall. Even at that time, with him being in residency, about four months of his salary was going towards taxes. And I was like, that's not right. That's not right. With   The Dental A Team (03:36) No.   Alexis Gallati (03:38) hard he works and how hard   medical community works in general. ⁓ my gosh, that's not right. So that's when I really dedicated myself to   finding out, why do the Warren Buffets and the Bill Gates of the world have this really low to sometimes non-existent tax bracket? And I really dove into that tax planning. ⁓ And so, you know, what's very unique about, ⁓ you know, the way that I work and my business is that my husband and I are in the same exact position as majority of our clients. And so, yes, I'm looking for   strategies for my clients, but I'm also looking for those strategies for myself.   The Dental A Team (04:19) You're like, hey,   it's me. I'm going to help myself out. I'm very motivated to do this.   Alexis Gallati (04:25) Very motivated. And I love it. I love it. It's like you said, it's ⁓ Congress keeps us on our toes, changing the laws consistently year after year. ⁓ it's like a puzzle. Like, hey, how can I just keep more of what I'm earning?   The Dental A Team (04:43) Yeah, and I, this is what I get obsessed about. what I learned, gosh, it's like, I was so naive when I started the company. was like, marketing is marketing. I just need to hire a marketer they can do everything. And then I was like, oh, there's a content marketer. There's a copywriter marketer. There's a strategist. There's a growth marketer. There's like an AEO marketer now. There's an SEO. Like you guys, this thing is like a web. They're a content marketer. And then I started realizing it's similar to CPAs and financial planners that like,   I thought you hire a CPA, Alexis. Like I'm so naive to business. I'm shocked that I've made it this far. Like truly I'm proud of like the journey we've been on, but like not all CPAs are created equal. And then I realized like CPAs play by different rules. Like it's the same rule, but there's shades of gray. They're how comfortable are you with this and how uncomfortable are you with it? Like there's one CPA that told me like, here, you can totally go skiing in Tahoe. Just like put your logo on your skis and you can totally ride it off and like put your logo on your boat and you can ride it off.   And then there's like the Alexis of the world was like, oh, hard pass. No, you're going to like totally get flagged. But I'm like, what rule is right? And so I realized that there are, like you said, tax strategy and for higher wealth earners. I do believe that there's a game, like you said, how did the Warren Buffett's, how did the Bill Gates, like they're not paying this. And then you get into the real estate game and you get into all these other things. You're like, how can we do this? And so Alexis, I'm just jazz. This is me being nerdy. And I'm going to ask you a bajillion questions and I can't wait.   to learn. So let's kind of talk about most of your clients, what's the size of take home net pay that they do. So that way we know like what brackets were in. So that way right clients come to you. I also learned not all financial advisors take all people. I was like, I make 30 grand. They're like, great. So we're going to help you out just a little bit. And then like, when you get to this level, we'll chat with you. ⁓ tell us kind of that. And then let's dig into how do we keep more money, Alexis, legally.   Alexis Gallati (06:10) I love it.   The Dental A Team (06:39) I'm here for legal advice. I'm willing to go gray, but not go to jail. So that's my line. So as long as we're on the same page, I think we are, I'm here for it.   Alexis Gallati (06:40) Yes.   Definitely, yeah. I am more than happy to play in the gray areas. We just have to feel comfortable defending it in an audit. And so that's our line in the sand. ⁓ But yeah.   The Dental A Team (06:55) Mm-hmm.   She's like, this is why I went to law guys. This is why I like the law side and the CPA.   I like it. I like your style. It's so unique and I just am excited. So, okay, I'm ready.   Alexis Gallati (07:07) Yeah.   Yeah. at Cerebral, we work with those that earn at minimum $400,000 per year in taxable income. So we have lots of businesses, which by the way, 99.9 % of our clients are medical professionals. I think we have like maybe two clients that have zero ties to the medical industry. And so the practices we work with, you know,   generally range from anywhere from maybe about $700,000 in gross revenue all the way up to eight figures. So we tend to not work with those that are larger practices, that usually over 50 employees. And that's just because once you get above 50 employees, yeah, it changes quite a bit. So we're definitely in there with those smaller to medium sized practices.   The Dental A Team (07:56) Tax co-changes. Yep.   Amazing. No, that's super helpful. And I know we were talking before, like the average of your clients, about 700,000 like net pay is typical where you guys are at. You have some that are higher, but that minimum of 400,000, which is great because I do think that there are thresholds. ⁓ And I did learn through going through business that who Kiera needed as a tax support and advisor when I was in that 30,000 range compare and as a business owner, I thought it was so funny.   Gosh, taxes, like they hurt so bad sometimes. Like, whoa, easy come, easy go. Like I've never, I've always been a W-2. So that was such a fascinating world for me. But yeah, let's dig into some of the things you've seen for the medical world. Cause I know I have friends that were physicians and they're really big on real estate. And like I took the real estate Kool-Aid and I'm just like, is this really real? There's gotta be easier ways than doing this. And so I'm just jazzed to kind of go through what are some of the things we can do now before April 15th.   What are things that we can do even past April 15th to set us up for great success for 2026? So Alexis, this is your show. I'm just excited, kind of riffed us through it. Of course, I'm gonna geek out and ask probably about way more questions than you care to even be asked, but I'm really excited to learn more today.   Alexis Gallati (09:20) Yeah, great. Well, yeah, I hate to be a little bit of a Debbie Downer in the beginning and that when your past December 31st, ⁓ the number of tax strategies that are available to you are before you actually go to file your tax return are limited. It's just the nature of the code.   The Dental A Team (09:37) I agree. was super, when you were   like, what are the tech? I was like, I want to know because most of the times like when the clock strikes midnight on December 31st, it's like game over and we start again. But yes, which is why I want to know what are like the small ones, but then also Alexis like, let's set our listeners up for like, what things can they do this year to be better prepared for it in conjunction? So yes, before April 15th, but selfishly I want to know what else can I do this year that maybe I haven't thought of.   Alexis Gallati (09:52) Yeah.   you   The Dental A Team (10:06) because the clock hasn't struck midnight in 2026. So like we've got time. So yeah, for 2025 filing, but also for 2026 as well.   Alexis Gallati (10:09) Yeah.   Yeah, so let's talk about 2025 filing first. Especially if you're a business owner, there are actually a number of things that you could still put together for yourself that can impact your 2025 financials. ⁓ So even basic things like if you haven't been taking advantage of your home office deduction or ⁓ vehicle expenses ⁓ and unreimbursed business expenses. So those are expenses that you paid   personally, but our business expenses. So all of those items, you can still go and report on your 2025 return. So if you haven't taken the time to sit down and say, how much should I pay in my home utilities or insurance, repairs, et cetera, and take the percentage. So let's say your home office is 7%.   of your total square footage of your home. Well, then you can write off 7 % of your home expenses on your taxes. the treatment's a little bit different depending upon if you're a sole proprietorship or an S corporation. But in general, you still have that time to take advantage of that. And a lot of you might be like, oh, Alexis, it's such a little amount. I don't even know if it's worth it. Believe me.   All these little things can really add up together. And easily, I usually see between $10,000 to $20,000 of really ⁓ easy to grab savings for yourself if you just take even a few hours to gather all the information. ⁓ And you can even use ⁓ personal financial apps like Monarch Money or You Need a Budget, things like that to help.   organize that information for you throughout the year so it's a little more automated.   The Dental A Team (12:10) Yeah, that's amazing. I do love the YNAB. You're throwing me back to like pharmacy school days of you need a budget. I was like, oh my gosh, got to answer this every time. They have updated so much, but I love that you said like 10 to 20 grand, I think is worthwhile, but more than it being pennies or dollars, I think it's the discipline of having it prepared for next year too. So that way we don't, I think it's like, well, it might not be enough this year, but I'm like, you take that this year and we compound over the next year and the next year and the next year. I think these little things to me at least,   Alexis Gallati (12:15) Ha ha ha.   The Dental A Team (12:41) Like I said, it's their game of monopoly. And I'm like, okay, maybe I didn't get it that time, but I'm going to take that rule and I'm going to apply it this year and the next year and the next year. So I'm even taking notes over here, guys. So Alexis, if you see me, I'm writing it like, okay, I'm going to check in on that, check in on that. So make sure, make sure that they're being taken into consideration because I don't prep my own taxes. I don't even know half the stuff. Like they just tell me. So I also think being a good steward as well and always double checking your CPA to make sure like, are we maximizing every deduction we can?   Alexis Gallati (12:53) Good, I like it.   Of course.   Yeah. And being proactive is like you said, the number one thing because the IRS can deny deduction if you don't have that itemized receipt or you don't have the proper documentation. And 99 % of any fight with the IRS is that documentation. And I did a three year fellowship in IRS representation. So I'm obviously very focused on that tax savings, but also very focused on making sure   that everything's set up properly. So if the IRS were to challenge it or even the state, you're in good hands. then that way, you can just give them the stuff and say, go away.   The Dental A Team (13:51) Exactly. And I heard somebody once tell me, they're like, Kiera, it's not a matter of if I'll be audited, it's when. Like every business will most likely be audited at some point. I hope and pray like we're not. I think about that a lot of like cross my T's, dot my I's, make sure that I'm constantly trying to be compliant with things. But your wealth of knowledge on that Alexis of what things and how to become, I mean, shoot three years of IRS. Girl, you got my vote. That's impressive. And like love the love the authority piece that you're bringing to our podcast today.   Alexis Gallati (14:20) Thank you. Thank you. So some other things that you're able to do before you file that tax return, and this is a big one, is retirement. So you actually have until the filing of a tax return, and that includes extensions. So for example, if you're an S corporation or a partnership, have the original due date, which is March 15th, or the extended due date, which is September 15th, to go and   open and fund that retirement plan. So if you have employees, it can get obviously a little bit more complicated, but you still are able to do it and ⁓ do that employer contribution. And that's obviously really one of the lower hanging fruits when it comes to not only tax savings, but also wealth generation.   The Dental A Team (15:12) Yeah, no, I love that. That's a great idea. And I think a lot of people miss that. And again, CPAs, tax strategists, wealth advisors, they're all playing in their own lanes, but how can we make sure all of them are maximizing together? Because you as a human are trying to build that wealth. So I love that.   Alexis Gallati (15:30) Yeah. And don't forget as well, you know, kind of in the same vein as retirement is that health savings account. So if you had a high deductible plan throughout the year, but maybe your employer didn't actually provide a ⁓ health savings account, like so if you're a W-2, for example, or even if you're self-employed, you can still go open up your   own Health Savings account through, I think Fidelity has some, ⁓ Optum Bank, HSA Bank. So there's a whole bunch of different providers out there. can just Google and find the provider that works best for you.   The Dental A Team (16:07) Interesting. And I know like I just wrote that down because a lot of dentists don't have HSA. Like we are the providers for it. But hearing that that might even be a resource to attract people into your business if you were able to like, don't necessarily provide it, but these are some companies that we could help our employees get if they wanted to have an HSA because I know that that's something that my husband works at a hospital. So there's an HSA there, but as sole proprietors and S-Corps, a lot of times they aren't provided. That's actually really like, I think just a great tool and resource to   possibly provide to our employees, depending upon what it looks like for your business.   Alexis Gallati (16:40) Yeah, definitely. And then one other thing that you ⁓ may be able to do, depending upon your state, ⁓ to help with state taxes, is go and contribute to a 529 plan, which is for education for yourself or other dependent. And some states like Georgia, Indiana, Michigan, South Carolina, there's a number of them. They allow you to make that contribution all the way up to the   filing of the tax return.   The Dental A Team (17:13) Interesting. I did not know that I wrote that down. That's fascinating. I love this. This is like so fun. Keep going.   Alexis Gallati (17:20) Yeah. Yeah. So that, you know, is, a good, especially for, you know, higher earners. ⁓ that's kind of a good summary of what you can be doing before this, ⁓ April 15th or even the extended due date as well. ⁓ but when you start looking into 2026, who, that book, that book opens up, there is.   The Dental A Team (17:39) It does, right? It's like the   monopoly Bible. Like it's so big. Like how do I play the game of taxes? So I truly, and I think like for all the listeners, like the home office, the HSA, ⁓ retirement, the 529 plan, like there's still time. So go look at those things. And even if you can't contribute or do those things now, having that set up for next year, like, Alexis, truly, I'm like, I'm getting the popcorn. I'm getting my notepad. Like,   I am so excited because half these things I haven't heard of. And so it's very fun to just hear different perspectives. And I do love that you've got a legal background too. I love that you're in IRS. I love that you're in medicine and healthcare and like for your own personal savings too. It's like you're the Nancy Drew of like, how can I do the most amount through all of this? It's a very fascinating perspective you bring today.   Alexis Gallati (18:27) thank you. I appreciate that. yeah, when obviously when you are a W-2 employee still that your options are not as open for those that have a business. But ⁓ besides obviously retirement HSA that you can do all year, one thing that a lot of W-2 employees forget is to actually check with your employer to see what their reimbursement policy looks like.   The Dental A Team (18:29) course.   Alexis Gallati (18:55) because if you're maybe in a private practice with a large group, and I mean, these could even be groups that have sometimes hundreds of physicians in it, or even if it's just a hospital system, they'll have actually pretty generous reimbursement policies for things like your CME, your new loops, or going and   doing your mileage in between different hospitals or clinics, things like that. So making sure that you are keeping track of those things. Obviously, if you're a business owner, you definitely want to keep track of those. But some of my favorite for those that own their own practices, my absolute favorite is hiring your kids.   The Dental A Team (19:36) Of course, yeah.   Alexis Gallati (19:48) It seems so basic, but believe me, there are definitely steps in place that have to be done in order to make sure they ⁓ qualify. for me, the ⁓ court tested age is seven. So I usually don't recommend my clients going and hiring their kids until they're at least that age. You can do it younger, but the old my kids are models strategy is kind of ⁓ antiquated now just because ⁓   everybody has these great cameras now on their phones. And so it's kind of devalued, being a model ⁓ for those that aren't professionals basically. ⁓ But that's a really great way to shift income from your higher tax bracket down to their non-existent tax bracket.   The Dental A Team (20:21) Totally.   Right?   Alexis Gallati (20:40) and you can then put that money into a Roth IRA for them. And if you do that, let's say over like a 10 year period in 2026, that amount is 7,500 is the max you can put in. They're easily, by the time they're age 65, gonna have at least 2 million plus dollars in savings. So it's a really great way to create a legacy for your kids and give them a little headstart.   The Dental A Team (20:48) Mm-hmm.   Yeah, that's amazing. And I think so many people are like, I don't know how to help my kids with college or different things like that. And it's like, these are great ways to prepare them for the future for when they retire for things like that. I mean, how awesome I know a couple of ⁓ doctors because   The bulk of our audience, Alexis, are not W-2 earners. They are self-employed, like dental practice owners. ⁓ But I know that there were several that didn't tell their kids that they had done this for them. And then the surprise when they graduated college of, we've been putting this into place for you. I mean, shoot, that money's going to go to the government or to your kids. Why not invest in your children? You're going to pay that money regardless. So ⁓ definitely think that that's such a brilliant idea. And I've heard people, they're like,   their real job, like they have to have a real job. They're like a paper shredder. Like they like literally shred the paper or they open the mail or they like pick out the cards or they pick out the toys for the prize boxes, like actual legit jobs that they employ them for. But I think what an amazing gift and legacy to give your kids as well.   Alexis Gallati (21:51) they   Yeah, exactly. All four of my children are, obviously cerebral isn't a dental practice, but they're hired through cerebral. So that way they are earning enough to put that money into their Roth IRA. ⁓ And a lot of ⁓ my clients are like, man, I don't know what my kids can do. And like you said, there's a lot of admin work that they can do. Even a seven-year-old can.   like you said, shred paper, stamp envelopes. They can help with doing their ABCs and filing things away if you're an older ⁓ practice owner and they have ⁓ still the paper file system. ⁓ yeah, it really is a wonderful way to not only teach responsibility, but also to save. ⁓ I highly recommend ⁓ doing that. And even if you have parents that you financially support, you could even   The Dental A Team (22:45) Yeah.   Yeah.   Alexis Gallati (23:02) go and hire your parents through your practice ⁓ and write off their support. Of course, again, they need to also have a legitimate job in the business. with parents, you have to be careful if they have any benefits like social security or Medicare. Then you just want to make sure that you're not pushing them out of those benefits because of their income ⁓ or making any part of their social security taxable. So that takes a little bit more. ⁓   finesse than hiring a child.   The Dental A Team (23:36) No, that's great. That's a really good idea too, because I hadn't thought about parents. I have heard about children, but you're right, parents are retired. And if there's ways that you can support and give back rather than like, again, I love the government. I am happy to pay taxes, but if there's ways that I can support my own family, ⁓ I think it's great because I'm going to pay that money anyway, but paying it to people that I love and care about is really a great idea.   Alexis Gallati (24:00) Yeah. Another popular one I'm sure that you've seen on TikTok or other social media is the Augusta rule. ⁓ and this is where you're renting your home to your business. ⁓ and this is perfect example where documentation is absolutely critical. ⁓ but basically what happens is you rent your home to your business for 14 days or less. Those days do not have to be consecutive and your business gets to   The Dental A Team (24:07) Mm-hmm.   Alexis Gallati (24:28) right off the cost of that rent. So obviously lowers your taxes. But then you as the individual do not have to pay tax on that rental income. Now, if you do it for 15 days and you've ruined the strategy and you have to pay tax on all 15 days. So that's really important you do 14 days or less. But this is again a really great way if you have monthly board meetings, that's 12 days right there.   Or if you have employee parties, if you have colleagues over in discussing business, though, as long as you have a rental agreement in place between yourself and your business, and you document through meeting minutes everything that occurred during that event, then that is the documentation that the IRS would need in order to substantiate that.   strategy. And obviously a reasonable rental rate as well.   The Dental A Team (25:27) Yeah, no, didn't realize,   I did not realize that you needed a rental agreement. Can you expand more on that? like we check all the Airbnb's and the VRBO's in the area to see what does our house actually go for and like keep that documented every single year and then have an actual agenda and like have it in the calendar. So it's in our Google calendar. It's got an agenda. It's got a PDF didn't attach. But how does the rental agreement work? like, yeah, how do you, I didn't realize that that was a necessary piece to it.   Alexis Gallati (25:57) Yeah, so you can even just use ChatGPT to create it. ⁓ But essentially what you do is it's just that agreement between the business and personal. So ⁓ you just want to think about it like any other rental that you would do. If you were to go to a conference room in a hotel, for example, or go rent that Airbnb, you're going to be signing some sort of agreement saying that this can happen.   that this event can happen on this date. ⁓ you can either do one agreement for the entire year, spelling out like, here are the days that we're going to be doing these things, ⁓ or you can have an agreement for each time that it happens.   The Dental A Team (26:43) Very cool. That's super helpful. Yeah, I do love the addresses for all anything people. And I mean, I've had CPAs and like, don't go crazy. Like that's where I say like check Airbnb, check VRBO like what you think your house is worth versus what market value says your house is worth. Like, let's make sure that we are accurate on that. But yeah, that's definitely an amazing one that I think is great for offices to surely do.   Alexis Gallati (26:51) Yes.   Yep. Go and get two to three comps. So then that way can just take an average. I feel like that's a very safe way to, ⁓ show reasonableness. You're not just like, Hey, I'm taking the highest one on the block. You know, it's taking a few of them.   The Dental A Team (27:21) Totally. No, definitely agree. I love that. Okay, Alexis, what other ideas? know we're, I'm like just like sitting here. I'm like, I love this writing it down. Great ideas. What are some of the ones that like, yeah, anything else that's going to save us? Um, because like taxes are taxes and we are going to pay them, but like, what else can we do to, like you said, Bill Gates or, um, like Warren Buffett, what are the things that you found for like these higher net worth earners? Like, do they need to get into real estate and like use the big, beautiful tax bill or like,   Alexis Gallati (27:23) Yeah.   Okay.   The Dental A Team (27:50) anything else that you've seen that like really moves the noodles or is like, no, just the small consistent things are really going to help them out.   Alexis Gallati (27:57) Yes, well, they all help out. ⁓ But if you are looking for more of that, hey, Alexis, what's like Hail Mary that I can be doing to act to really save? ⁓ You can look at real estate. ⁓ That could be a whole podcast by itself. ⁓ But in general, you you tend to ⁓ get into real estate when you're not talking about like reets or things I can do through the stock market.   The Dental A Team (28:14) Right.   Alexis Gallati (28:26) ⁓ You're either doing like real estate syndications, ⁓ direct ownership, like long-term rentals or short-term rentals. And ⁓ each of those are treated differently and have different ways of making that ⁓ a tax deduction for yourself. So when it comes to, in general, ⁓ real estate syndications, this is where you're   The Dental A Team (28:49) Mm-hmm.   Alexis Gallati (28:54) buying into a partnership that maybe owns an office building. And you go in with other partners and ⁓ it's syndicated. So it's very passive. There's no way for you to write off any losses in that current year. ⁓ When it comes to direct ownership, the IRS basically says, hey, that real estate is considered passive unless you have real estate professional status or you do that short-term rental   deduction or excuse me, short-term rental exclusion. And so what ⁓ happens if you can qualify for the short-term rental exclusion or real estate professional status is that those what would have been passive losses that you can't use against your current income will be considered active losses. And then you can use it against your   active income, when I say active income, things like your W-2 or your business. So you're getting a current year deduction from that. And you can do cost segregation study to help accelerate depreciation. ⁓ So this is very, very much in the nutshell sort of explanation. ⁓ But it can really be a great way to lower your taxes if   The Dental A Team (29:57) Mm-hmm.   Yeah.   Alexis Gallati (30:16) you essentially want a second job. Just know that real estate is not as passive as the social media gurus go and ⁓ try to glamorize. It really does take a lot of extra work. You want to make sure that you are following the rules properly so that you can get that tax benefit in the current year. ⁓ But if you   The Dental A Team (30:19) Yeah.   Alexis Gallati (30:41) do have that prerogative and you want to learn and get do things properly, then it can really save you quite a bit of money.   The Dental A Team (30:48) Yeah. Are there any other things, Alexis, that are like real estate that save that much but don't require that much work? I'm asking you for the weight loss drug of taxes, please. What's our easiest way with the most amount of bang for buck that you've seen? These are the big hits that if you want, because agreed, real estate's great. If you do that short-term thing, but it is a lot of work. With the big, beautiful tax bill that came through, that 100 % depreciation is pretty fantastic. But like you said,   Alexis Gallati (30:54) Yes.   Mm-hmm.   The Dental A Team (31:17) got to have it rented out, you got to have the pieces, you got to like reno it like there are and you have to have it done by the end of the year and like it's a stressful zone. ⁓ So are there other things that you've seen that might be like 50 or 100 or 200,000 off taxes that aren't necessary real estate? The Augustus one, yes. Like paying people, there's things but is there anything else you've found that are like some of those bigger chunks that maybe people don't think about they don't recognize? Yes of course they're going to take a little bit more work but...   Alexis Gallati (31:17) You gotta work for it.   The Dental A Team (31:45) that you found that could be benefits to our audience.   Alexis Gallati (31:48) OK, so let's talk about my Hail Mary for tax savings. I   love this one towards the end of the year because you're going to want to know, have a good idea of where your tax situation is going to end up. So I use this a lot for year end planning. And this is oil and gas. When you ⁓ invest in oil and gas, again, just like with real estate, there's a lot of different options.   But my favorite is our drilling funds and this is where you invest in a partnership that owns oil and gas wells and these this allows you in that first year to Essentially write off usually somewhere between 80 to 95 percent of the investment that you've put in So let's say you invest a hundred thousand dollars Then you're getting about and let's say conservatively an eighty thousand dollar deduction that can go a   against your ordinary income. So if you're W2 or your business. usually, a good rule of thumb is that, let's say, if you're putting in $100,000, you're saving $30,000 in tax. You're putting in $200,000, you're saving $60,000 in tax. And then after year one, you're earning overall, during the life of the investment, about a 2x   The Dental A Team (33:10) Bye.   Alexis Gallati (33:11) you put   100,000, you're getting about 200,000 back. And so it's considered a very conservative investment. And just because the length of the investment, and this is one of the cons of it, is that it's usually about a 10 to 12 year period. So it's generally only about a 7 % return on investment over the life of the investment. the great thing about it is that   you let's say if you did put in that hundred thousand, you're getting that 30,000 in savings, and then you can go put that into something else that will earn you even more money. So then this is something that you can do every single year. And, you know, just depends on how much money you want to save and so that how much you put in for that investment.   The Dental A Team (33:57) Gosh, that's such a good one. And these are things of like just fun, like tips and topics. Like I said, it's the rules of monopoly. I caught like, how do we play tax strategy better? Alexis, what are any like resources? I feel like you guys have some resources. Like I feel the world of tax is so daunting. And so it's like, we hear from podcasts and we hear snippets and we see TikTok and it's like real estate games. like, where do people go if they like want to dig a little bit deeper and really become like more tax expert and more tax savvy and.   like tax strategy, like what are any resources you found or ways for people just to become a little bit more literate in the tax world.   Alexis Gallati (34:33) Yes, so ⁓ of course I'm to do a little shameful plug. My book, The ⁓ Advanced Tax Strategies for Medical Professionals, it's really just that it's a brain dump of all different types of strategies, whether it's for your business or W-2 only, charitable, these alternative investments. And so it's really a space.   The Dental A Team (34:36) as you should.   Alexis Gallati (34:58) for readers to learn more about their options. So then that was the way they can go online and do more research or bring it to their current advisor. So, you know, it's just about opening those possibilities. Otherwise, you know, one resource that is really great for especially medical professionals is the White Coat Investor that Dr. Dali, he has a wonderful, wonderful site and he puts out really good material.   The Dental A Team (35:11) Yeah.   Alexis Gallati (35:25) when it comes to not only taxes, but also for ⁓ just finances in general. And then, of course, on ⁓ CerebralTaxAdvisors.com, our website has wonderful ⁓ material that I put out all the time. There's lots of goodies there, as well as ⁓ different resources and worksheets and stuff like that.   The Dental A Team (35:52) Yeah, no, that's super helpful.   But Alexis, what do you find ⁓ as you go through this? Like one, how often are you meeting with your clients? Because I feel like so many CPAs and tax strategists meet with them in like December 1st and they're like, hey, you owe this much money. Is that how you guys plan? Like how should tax planning actually work?   or is that normal? Like I'm just trying to find a vibe of how this should work in the industry.   Alexis Gallati (36:15) Yeah.   Yeah. So when a medical professional first starts working with us, I design a tax plan for them. And that's really critical because right then and there, OK, what can we be doing to dramatically lower your taxes, legally, of course, and set you up for success? And then we meet with our clients at minimum twice a year. So we do a mid-year tax projection and a year-end tax projection.   The Dental A Team (36:34) course.   Alexis Gallati (36:45) And especially with medical professionals, your income is so variable throughout the year, depending upon insurance reimbursements or seasonality and things like that. And so we really want to make sure that we have a good, clear understanding, good six plus months in advance. Hey, what are you going to be owing tax wise? What does cash flow look like? What quarterly estimated payments do you need to make?   All of these things should not be a surprise. So that's why when I built Cerebral in the packages we have, I was really focused around how do we eliminate those surprises.   The Dental A Team (37:23) Yeah, no, I love that. that's super helpful because I feel like so many just wait till December and it's like, no, like there's things I could have been doing and if I would have known. So that's super helpful. And then I think the other question is like, okay, you guys are tax strategy. Are you CPA? Are you bookkeeping? Like kind of differentiate. Are you in the financial advisor world? Like what specifically would we say I need you for XYZ, but I'm going to need these people again, like marketing, right? Like what facet of my wealth management are you?   and who do I need paired with you?   Alexis Gallati (37:54) Yep, so we are your tax compliance, tax planning, your bookkeeping, and CFO services, and also business advising as well. So we're able to set up entities for you ⁓ as well as provide ⁓ just a lot of the years and years of experience that we have in running businesses and seeing different types of practices, et cetera. ⁓ We are not investment advisors, so we won't   say, buy Coca-Cola versus Pepsi. But we will introduce you to different investments that have tax benefits. And one very unique quality of Cerebral that's very different from other firms is that we do not take any commissions or kickbacks on any strategies we recommend or vendors we recommend. And we don't sell any products. So we're very education-based. I'm very focused on   you understanding your options so you can make a educated decision on what you want to move forward with. And then we are a white glove done for you firm that will implement those strategies on your behalf and make sure they're reported properly on your tax returns. Because that's what we've found being in this industry, especially specializing in medical professionals, is there's a lot of people out there that know about these strategies.   but they do not know how to implement them properly. And that honestly is 80 % of the fight when it comes to doing any of these strategies.   The Dental A Team (39:26) Yeah, no, that's incredible. So, and again, this is just like naiveness on my side. Do I need a CPA or are you guys the replacement of a CPA?   Alexis Gallati (39:35) Yeah, we're the replacement of CPA. We are CPAs. We are EAs. So we are taking care of your tax preparation, so personal and business. We do it all. I try to keep these packages as comprehensive as possible because I hate being nickel and dined. communication's a top priority for us. And so we don't want our clients to hesitate whatsoever to connect with us. And so that's why we don't.   The Dental A Team (39:56) Totally.   Amazing.   Alexis Gallati (40:05) shot like I, my gosh, I just got like a bill from my attorney the other day and it was for stuff that I talked to him about like in August. I'm like, I hate those pop-up bills. So that's yeah, that's, why I try to make it as comprehensive as possible.   The Dental A Team (40:10) Yep.   Right.   Awesome.   No, that's fantastic. That's really helpful. And I know a lot of people are very nervous to switch from their CPA. CPAs, feel like we're so embedded and we trust them with our souls. Truly, I see this. ⁓ So is there complementary calls we have with you? how do we start with that? Because I know, honestly, untangling from a CPA is such a pain. It is so annoying. so ⁓ how does that process work if people want to work with you, Alexis?   Alexis Gallati (40:46) So the best thing you can do is go to our website and go to the contact page. And you will ⁓ go through a very quick questionnaire to make sure that you're a good fit for us, because we also want to make sure we're a good fit for you. And we will ⁓ have a tax discovery session. And during that session, we will. We'll talk about what your needs are and what it's like to work with us. ⁓ I'm very focused on that return on investment. We actually have a guarantee.   with the design of our plans that I will save you at least two times what you pay us in ⁓ tax savings or you get the plan for free. And on average, our clients actually achieve 4.5 multiple with the design of our plans. So again, it doesn't make sense for us to work together if I can't save you more than what you're paying us.   The Dental A Team (41:39) That's amazing. No, that's incredible. And that's a great guarantee. And ⁓ then let's say hypothetical, we do get audited. How often do you guys go through audits and like success rate? Like I'm imagining if you were three years in IRS, you're probably pretty fantastic at that. But these are always things that I'm just curious. Like how does that work? And how often are your clients audited? And like, how is your success rate on that? And if you don't want to share this, I hope you do. We're just going to go for it. Like, yeah, I'm just going to ask the weird questions. Why not?   Alexis Gallati (42:01) Yeah.   I love the weird questions. They're the best. So yeah, that's one thing I can never guarantee that you won't be audited because of course there are always random audits that happen. We've only had three audits since I started Cerebral over 10 years ago. In 2014, I started Cerebral. ⁓ And ⁓ one of them was for the mortgage interest deduction. there's a limitation in that.   The Dental A Team (42:18) It's incredible.   Alexis Gallati (42:28) Um, and that was just, unfortunately, a client had not provided the correct information. And so we were easily able to just change it and be on our way. Um, and then another two were regarding actually real estate professional status. And that was just New York state saying, Hey, like we don't, we don't think that you're actually qualified for this. we're like, Oh, yeah, we do. Here's the paperwork. And they're like, Oh, okay. See you later. So yeah.   The Dental A Team (42:50) Yeah.   That's amazing.   That's a huge thing. And I'm so glad I asked the question because I think for me, that's something I'm curious on of like, I get it. Like you said, you can't guarantee that, but as long as you back in, do you guys charge extra for those audits or is that part of the plan? Like, nope, we stand behind it. Like, how does that work? Cause I know there's some firms that I have chatted with and if we do get audited, it's like 375 an hour for the audit. And I'm like, okay, like I'll just plan for that. But how does that work for you guys?   Alexis Gallati (43:18) Yep, so we back up all of our work and all of our packages. If you do receive a notice for anything that we prepare, you send it to us and we help you take care of it. So yeah, we 100 % back up our work. If you come start working with us and you have some a notice from a year that we didn't handle, like we didn't prepare, we'll still help you handle it. But that would be just.   at our hourly rate, depending upon the extensiveness of the notice. But to go back to your original question about making that change, I 100 % get it, especially if you've been with somebody for so long. And so you just have to look at that cost benefit and see, hey, staying with this person, how much is that costing me in tax savings versus   The Dental A Team (44:01) Right.   Alexis Gallati (44:12) going with somebody like cerebral and we try to go and make that process as seamless as possible when it comes to getting ⁓ up to date in your history and then ⁓ getting access to your bookkeeping and getting your tax returns. ⁓ And so, because I completely understand it can be daunting, but. ⁓   Happy to have a conversation around it when we meet about the discovery session and to see if it's something you'd want to move forward with.   The Dental A Team (44:43) Amazing. Alexis, has been such a great podcast and I just love meeting great individuals. I love how much you have a passion for the law and for the tax wealth and it's your own life and your own livelihood. So if people want to reach out, I know you said it before, how do they connect with you? So yeah, they can get started if they're interested.   Alexis Gallati (45:01) Yeah. So you can Google us or just go to CerebralTaxAdvisors.com. And which by the way, the reason why I have cerebral is because my husband is a private practice neurosurgeon and my dad's a retired private practice neurologist. hence cerebral in the brain. So if y'all can remember. But yeah, so CerebralTaxAdvisors.com is the best way to get a hold of us.   The Dental A Team (45:14) There you go.   I love it. Yeah.   Alexis Gallati (45:27) ⁓ And I look forward to potentially talking with y'all.   The Dental A Team (45:32) Well, Alexis, thank you so much for this. And for all of you listening, I hope you take advantage between now and April 15th. I hope you just like have a conversation. I'm always pro. I love CPAs. My CPA listens to this podcast and I'm always interested in meeting new people like Alexis, chatting with them. Are there different ways that they can benefit me? Because yes, I love my CPA, but I love more than that saving money and learning new strategies that maybe I didn't know about. So Alexis, I really hope a lot of them reach out to you, connect with you and for   All of you listening, thank you for listening. I'll catch you next time on the Dental A Team Podcast.  

On today's episode, Dr. Mark Costes is joined by Alexis Gallati, founder of Cerebral Tax Advisors and author of Advanced Tax Planning for Medical Professionals. Alexis brings a wealth of knowledge on proactive, high-level tax strategies tailored specifically for medical and dental professionals. The conversation covers everything from tax-saving tactics for W2 earners like short-term rentals and oil & gas investments, to advanced planning opportunities for business owners, including entity structuring, paying your children, and maximizing retirement contributions through backdoor and mega backdoor Roths.  Alexis also shares personal insights on being married to a neurosurgeon and how that inspired her mission to protect high-income professionals from bad financial advice. Whether you're looking to save more on taxes or make smarter long-term financial decisions, this episode is packed with practical gems. Be sure to check out the full episode from the Dentalpreneur Podcast! EPISODE RESOURCES https://www.cerebraltaxadvisors.com/bigbill https://www.truedentalsuccess.com Dental Success Network Subscribe to The Dentalpreneur Podcast

Think your medical practice is safe from hackers? Learn why humans, rather than software, are often the weakest link in patient data protection. In this episode of the BackTable Podcast, host Dr. Chris Beck delves into the critical topic of cybersecurity in healthcare with Didier Jourdain, a certified Information Systems Security Professional (CISSP). --- SYNPOSIS Didier discusses his recently approved paper, 'Cybersecurity for Interventional Radiologists: A Clinical Imperative for Protecting Patient Data and Imaging Systems,' and shares his extensive background in software and application security, penetration testing, and cybersecurity risk governance. The conversation covers key issues such as phishing, ransomware, third-party vendor risks, and the vulnerabilities of the Internet of Medical Things (IOMT). Didier emphasizes the importance of education, tabletop exercises, and comprehensive third-party risk management strategies to enhance cybersecurity resilience in both hospital systems and independent physician practices. --- TIMESTAMPS 00:00 - Introduction04:03 - Cybersecurity in Healthcare: A Clinical Imperative16:07 - Mitigating Cybersecurity Risks20:23 - Password Management and Best Practices27:33 - The Role of IT in Cybersecurity31:04 - Internet of Medical Things (IoMT) Vulnerabilities39:17 - Top Cybersecurity Recommendations for Physicians

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Clinical Decision-Making of Artificial Intelligence vs Medical Professionals in Patients With Syncope.

Very disturbing reports are surfacing about medical professionals who may be targeting conservatives. This is absolutely unacceptable.See omnystudio.com/listener for privacy information.

In this episode of Good Morning Liberty, hosts Nate Thurston and Charles 'Chuck' Thompson discuss the most absurd and frustrating events in politics for the week. Key topics include Lindsey Graham's emotional reaction to recent events, the funding of the National Endowment for Democracy, and the ongoing MAGA delusions claiming Javier Milei's policies in Argentina are inspired by Trump. The episode also covers everything from trans issues in healthcare, NYC's new anti-semitic token, and the controversy surrounding Trump's response to a factory worker's outburst. Tune in for a lively discussion on the week's 'dumbest bleeps!' 00:00 Intro 02:34 Sad Lindsey Graham and Iran Discussion 06:19 Ted Cruz and Foreign Relations 16:10 Presidential War Powers Debate 22:06 National Endowment for Democracy Funding 29:04 Transgender Issues and Medical Professionals 33:11 Eric Adams and NYC Token 38:15 Reflecting on BLM and Election Year 38:47 Scott Adams' Controversial Statements 40:53 Debate on Racism and Polls 47:37 Trump's Encounter at Ford Plant 50:21 Union and Free Speech Controversies 59:42 MAGA Delusions and Policies 01:05:40 Nurses' Strike and CEO Pay 01:15:01 Concluding Thoughts and Voting  

Dr Hoffman continues his conversation with Dr. Henry Buchwald, author of "Healthcare Upside Down: A Critical Examination of Policy and Practice."

Examining the U.S. Healthcare System with Dr. Henry Buchwald: Challenges, Changes, and Solutions. Dr. Henry Buchwald, author of "Healthcare Upside Down: A Critical Examination of Policy and Practice," is an emeritus professor and pioneer in bariatric surgery. He discusses the significant changes and current flaws within the U.S. healthcare system, including the commodification of medicine, administrative bloat, and the decline of the doctor-patient relationship. He explores the high costs coupled with poor outcomes compared to other countries, and Dr. Buchwald's personal experience with the healthcare system. The discussion also touches on the role of new weight loss drugs, innovations in metabolic surgery, and the potential impact of artificial intelligence in medicine. Dr. Buchwald offers insights and potential solutions to improve the healthcare system, emphasizing the need for a return to patient-focused care. And check out Dr. Hoffman's book review HERE. 

Keeping good records is boring and tedious. Why bother? Because bad records can cost you thousands of dollars per year. My guest today helps her clients find those dollars in ways that are easy to track. She'll share her ideas on this episode.Alexis E. Gallati is the founder and Lead Tax Strategist at Cerebral Tax Advisors and Cerebral Wealth Academy, and she's the author of the book Advanced Tax Planning for Medical Professionals. She has over 20 years of experience in high-level strategic tax planning and multi-state tax preparation, and she has trained at the highest level, holding two master's degrees. Alexis grew up in a family of physicians and is married to a private practice physician. That's why she understands how hard medical professionals work to get where they are and why she provides simple and accessible tax solutions tailored to busy physicians.In this episode Carl White and Alexis Gallati discuss:Some simple examples of keeping good records leading to saving money (ex: mileage deduction, home office deduction)Some not so simple examples that are worth doingTools and systems to trackWant to be a guest on PracticeCare?Have an experience with a business issue you think others will benefit from? Come on PracticeCare and tell the world! Here's the link where you can get the process started.Connect with Alexis GallatiResources from Cerebral Tax Advisors: https://www.cerebraltaxadvisors.com/practicecare/Cerebral Tax Advisors Facebook: https://www.facebook.com/cerebraltaxCerebral Wealth Academy Facebook: https://www.facebook.com/cerebralwealthacademy YouTube: https://www.youtube.com/@cerebralwealthacademyPersonal LinkedIn: https://www.linkedin.com/in/alexis-gallati/Connect with Carl WhiteWebsite: http://www.marketvisorygroup.comEmail:  whitec@marketvisorygroup.comFacebook:  https://www.facebook.com/marketvisorygroupYouTube: https://www.youtube.com/channel/UCD9BLCu_i2ezBj1ktUHVmigLinkedIn: http://www.linkedin.com/in/healthcaremktg

Mapping the Landscape of Technical Standards: A Nationwide Review of Medical Schools Interviewees: Carol Haywood, PhD, OTR/L — Assistant Professor, Medical Social Sciences, Northwestern University Feinberg School of Medicine Chris Moreland, MD, MPH — Professor of Internal Medicine; Division Chief for Hospital Medicine; Interim Associate Chair for Faculty Affairs and Development, Dell Medical School (Comments made in ASL and voiced through interpreters) Interviewer: Lisa Meeks, PhD, MA — Guest Editor, Academic Medicine Supplement on Disability Inclusion in Undergraduate Medical Education Description: In this episode of Stories Behind the Science, we sit down with Dr. Carol Haywood and Dr. Chris Moreland to explore a deceptively powerful document: the medical school technical standards. These quietly influential statements—often tucked deep in an admissions webpage—shape who feels welcome to apply, who gains access, and how institutions imagine the future of their profession. Haywood and Moreland, co-authors of a national analysis featured in the Academic Medicine supplement on Disability Inclusion in Undergraduate Medical Education, unpack what happens when ambiguous language, outdated assumptions, and vague expectations collide with real people making real decisions about their careers. Together, they dig into the nuances of functional vs. organic standards, the importance of clarity for applicants who lack insider knowledge, and the ripple effects of inequitable policies across a learner's entire training experience. What emerges is both sobering and hopeful: a field undergoing change, a growing recognition that words matter, and a roadmap for institutions ready to bring their values into alignment with their practices. The discussion reviews: How technical standards became a gatekeeper—and why revising a single sentence can shift an entire culture. Why students with disabilities read these documents differently—and why that matters for equity. How ambiguity in admissions can deter talented future physicians long before they step foot in a classroom. What schools can do now to create standards that prioritize competence, flexibility, and inclusion. Dr. Haywood brings a researcher's lens and an occupational therapist's creativity to the conversation, illuminating how functional expectations—not assumptions about bodies—should guide medical training. Dr. Moreland shares deeply personal reflections on navigating technical standards as a deaf physician, offering rare insight into how these documents land on applicants with lived experience. This episode invites the audience to imagine a medical education landscape where technical standards do what they should do—define competence, set expectations, and open doors—rather than unintentionally closing them. Bios:  Carol Haywood, PhD, OTR/L, is Assistant Professor of Medical Social Sciences in the Determinants of Health Division and core faculty in the Center for Health Services and Outcomes Research at Northwestern University Feinberg School of Medicine in Chicago, IL. Building from her work as an occupational therapist in acute rehabilitation, she completed a PhD in occupational science at the University of Southern California and a postdoctoral fellowship in health services and outcomes research at Northwestern University. Using qualitative, mixed methods, and community-engaged research approaches, she studies disability in a variety of contexts, as well as health care access, coordination, and quality. She is driven by a vision of health care that facilitates equity for people with disabilities. Chris Moreland, MD MPH, is a professor of medicine, interim associate department chair for faculty affairs, and division chief for hospital medicine at Dell Medical School at UT Austin. He practices clinically as a hospitalist. As a career-long clinician educator, his teaching has been recognized regionally and nationally. His collaborative advocacy and research efforts describe the experiences of our healthcare workforce and learners with disabilities, as well as strategies to foster pathways to thriving clinicians. He has served as president and longtime board member for the Association of Medical Professionals with Hearing Losses; he holds current roles on the Docs with Disabilities Initiative advisory board, the AAMC Group on Diversity and Inclusion steering committee, and as a consultant with the National Deaf Center. Transcript: https://docs.google.com/document/d/18hUPguWf_jWeDC1fmOgSKSXPv4xGnkQIPUi3zhfH540/edit?usp=sharing Resources: Singer, Tracey; Madanguit, Lance MD; Fok, King T. MD, MSc; Stauffer, Catherine E. MD; Meeks, Lisa M. PhD, MA; Moreland, Christopher J. MD, MPH; Huang, Lynn MS; Case, Benjamin MPH; Lagu, Tara MD, MPH; Kannam, Allison MD; Haywood, Carol PhD, OTR/L. Mapping the Landscape of Technical Standards: A Nationwide Review of Medical Schools. Academic Medicine 100(10S):p S144-S151, October 2025. | DOI: 10.1097/ACM.0000000000006135   McKee, M.M., Gay, S., Ailey, S., Meeks, L.M. (2020). Technical Standards. In: Meeks, L., Neal-Boylan, L. (eds) Disability as Diversity. Springer, Cham. https://doi.org/10.1007/978-3-030-46187-4_9 Equal Access for Students with Disabilities: The Guide for Health Science and Professional Education (2nd Ed). Meeks LM, Jain NR, & Laird EP. Springer Publishing, 2020. Key Words: Disability inclusion · Technical standards · Medical education · Admissions · Accessibility · Equity · Policy reform

Send us a textIn this long overdue episode I share where I've been and why I have been radio silent over the past couple of months!Much Love!The Heart Attack Thriver!Podcast Disclaimer:The information and opinions presented in the Heart Attack Thriver Podcast is not intended as, and shall not be understood or construed as, medical advice. While the information provided on this Podcast relates to medical issues, and health and wellness, the information is not a substitute for medical advice from a Medical Professional who is aware of the facts and circumstances of your individual situation.#heartattack #heartattacksurvivor #heartattackprevention #awarenessiseverything #knowthesigns #knowthesymptoms #knowyourfamilyhistory #listentoyourbody #itsnotalwaystextbooksymptoms #seekhelpimmediately #breathe #listentoyourheart #listentoyourbody #theheartattackthriver #theheartthriverpodcastThank you for listening and please be sure to hit “SUBSCRIBE”, and “SHARE” this podcast with anyone that you feel could benefit from it.If you'd like to reach me for support or to leave a comment or feedback, please send an email to: heartattackthriver@icloud.com

Readings: https://bible.usccb.org/bible/readings/101925.cfm 

Dr. Angie Smith

The compliance with liscencing with state Boards should not be the challenge that it is in today's world. Coming coming from Harvey County Kansas Amy continues to battle to help people.

Apply for coaching here00:00 The Impact of Daily Exercise02:51 Understanding Progress in Fitness05:57 The Truth About Creatine09:01 Evaluating Supplements: MCT Oil and Keto Creamer12:02 Addressing Upper Trap Tension15:07 The Importance of Proper Muscle Recruitment19:18 Managing Doubt in Long-Term Goals24:16 Dietary Recommendations for Liver Health27:37 The Importance of Lifestyle Changes30:01 The Role of Medical Professionals in Diet and Exercise32:29 Overcoming Drop-Off Points in Commitment34:41 Understanding Protein Intake and Its Effects35:45 The Benefits of Zone Two Training38:51 Setting Goals for General Fitness

In this episode #127 of our podcast, Shane McKay, an Associate Attorney at Pacific Workers' Compensation, joins our host Carmen Ramirez to discuss the unique rights and benefits available to firefighters under California's workers' compensation system. The conversation highlights presumptive conditions, the importance of timely injury reporting, and how workers' compensation interacts with retirement benefits. Shane emphasizes the value of proper documentation and medical evaluations, while also outlining the potential tax implications of disability benefits. He shares practical tips and guidance for firefighters navigating these complex systems.    What You'll Learn:  Firefighters have specific rights under workers' compensation laws.  Presumptive conditions are automatically accepted for firefighters.  Injuries must be reported to employers as soon as they are known.  Tax implications vary for different types of disability benefits.  Maintaining a good relationship with a primary treating physician is essential.    Chapters:    00:00 Introduction to Firefighter Rights in Workers' Comp  02:47 Understanding Presumptive Conditions for Firefighters  05:19 Navigating Injury Reporting and Documentation  08:06 The Role of Medical Professionals in Workers' Comp  11:01 Retirement and Disability: The Intersection with Workers' Comp  13:23 Tax Implications of Disability Benefits  15:55 Final Tips for Firefighters on Workers' Comp      This episode is sponsored by Pacific Workers, The Lawyers for Injured Workers, the trusted workers' compensation law firm in Northern California. With over 10,000 cases won and more than $350 million recovered for injured workers, we are here to help if you've suffered a workplace injury.     Visit our FAQ and blog for more resources:  https://www.pacificworkers.com/blog/   

President Trump recently said that children are getting 80 vaccines and the doses are strong enough for a horse. (None of that is true.) Health and Human Services Secretary Robert F. Kennedy Jr. recently implied that COVID vaccines are more dangerous than COVID. Our guests help us understand the latest in vaccines, safety, and efficacy.Our guests: Ann Falsey, M.D., infectious disease specialist with UR Medicine Steven Schulz, M.D., pediatrician with Rochester Regional Health Geoff Weinberg, M.D., pediatric infectious disease specialist with UR Medicine ---Connections is supported by listeners like you. Head to our donation page to become a WXXI member today, support the show, and help us close the gap created by the rescission of federal funding.---Connections airs every weekday from noon-2 p.m. Join the conversation with questions or comments by phone at 1-844-295-TALK (8255) or 585-263-9994, email, Facebook or Twitter. Connections is also livestreamed on the WXXI News YouTube channel each day. You can watch live or access previous episodes here.---Do you have a story that needs to be shared? Pitch your story to Connections.

This week, we’ll hear from three seasoned leaders from Cedarville University—Dr. Michael Sherr, Dr. Jason Lee, and Dr. Angelia Mickle—who bring together decades of experience in social work, theology, and nursing. United by a shared passion for equipping healthcare professionals, they explore how we can find renewed strength under tremendous pressures by bridging the gap between faith and health. Later in the episode, we’ll hear from Dr. Drew Dickens, a technologist and storyteller exploring where faith, identity, and innovation meet. As host of the Encountering Peace and AI and Spirituality podcasts, he brings deep insight into how emerging technology is reshaping the way we think, connect, and seek meaning. Links, Products, and Resources Mentioned: Jesus Calling Podcast Jesus Calling Jesus Always Jesus Listens Past interview: Brett Swayn Upcoming interview: Jenny Marrs Jesus Calling: Stories of Faith on UPTV Dr. Michael Sherr Dr. Jason Lee Dr. Angelia Mickle Cedarville University Center for Biblical Integration at Cedarville University Colossians 3 NIV Isaiah 40:31 NIV Scripture and Scrubs: A Christian Calling to Healthcare Dr. Drew Dickens Encountering Peace AI and Spirituality Whispers of the Spirit: A 40-Day Guide to Intimate Prayer Interview Quotes: “One of the things that we want to do is make sure that we’re setting our trajectory around what God wants from us, to listen to God regularly through His Word, and to connect with Him daily.” - Dr. Jason Lee “We all have to live out our call to live the gospel, to be on mission, to live our relationship with Jesus Christ as Lord and Savior in whatever endeavor we find ourselves in our lives.” - Dr. Michael Sherr “Part of the challenge is to see how we can pull the professional and spiritual journeys together and create a greater impact and a sense of purpose. But also a sense of longevity, because all these things are done not just in the moment and for immediate success or healing or any treatment, but ultimately for the glory of God.” - Dr. Jason Lee “The purpose of us being here is to comfort people and to help them in their time of vulnerability, or if they’re hurt and suffering, and just love them unconditionally—the way that Jesus would.” - Angelia Mickle “If we have Jesus in our heart, the joy is going to show. Jesus is love, and we’re going to reflect Christ, so we’re going to reflect love.” - Dr. Angelia Mickle “[AI] is still casually dismissed right now, and that’s concerning to me because we’re dealing with issues of identity, we’re dealing with issues of inspiration.” - Dr. Drew Dickens “Prayer requires effort, and we need to remember that communicating with the Creator and Sustainer of this vast universe is an amazing privilege.” - Dr. Drew Dickens “We need to have these conversations on the effects of [AI] in the pews, on families and relationships—the effects it’s going to have on community, on communion, on what it means to gather together, or just to re-engage with a physical moment of intimacy with God.” - Dr. Drew Dickens “We’re not to be a people of fear, but of hope. So we can be intentional, we can find ways to engage with AI in a redemptive way, and we can be mindful of these opportunities because there is hope.” - Dr. Drew Dickens ________________________ Enjoy watching these additional videos from Jesus Calling YouTube channel! Audio Episodes: https://bit.ly/3zvjbK7 Bonus Podcasts: https://bit.ly/3vfLlGw Jesus Listens: Stories of Prayer: https://bit.ly/3Sd0a6C Peace for Everyday Life: https://bit.ly/3zzwFoj Peace in Uncertain Times: https://bit.ly/3cHfB6u What’s Good? https://bit.ly/3vc2cKj Enneagram: https://bit.ly/3hzRCCY ________________________ Connect with Jesus Calling Instagram Facebook Twitter Pinterest YouTube Website TikTok Discover more Christian podcasts at lifeaudio.com and inquire about advertising opportunities at lifeaudio.com/contact-us.

From Surgeon to CEO: Prof. Marc Possover's Inspiring Journey in Medical Innovation The journey from a successful surgical career to the leadership of a medical company is far from ordinary. Yet for Prof. Marc Possover, this evolution felt like a natural extension of his life's mission: to improve patient outcomes and expand access to advanced treatments in pelvic neurosurgery. In this exclusive episode of the Medical Device Made Easy Podcast, host Monir El Azzouzi invites Prof. Possover to share his story—one that blends clinical excellence, entrepreneurial vision, and a deep commitment to education. A Career Built on Medical Breakthroughs Prof. Possover is internationally recognized as a pioneer in neuropelveology, a specialty dedicated to treating complex pelvic nerve disorders. Over the years, he has developed innovative procedures that offer hope to patients suffering from chronic pain and dysfunctions once considered untreatable. But his ambition has always reached beyond the operating room. By founding his own medical company, he sought to transform groundbreaking surgical techniques into accessible, reproducible therapies that benefit patients worldwide. Why a Surgeon Became a CEO Moving from the precision of surgery to the strategic demands of business might seem like a dramatic shift, but for Prof. Possover it was a continuation of his mission. Becoming a CEO meant taking responsibility not only for individual patients but for the future of the treatments themselves. Leadership allowed him to guide product development, secure resources, and create an ecosystem where new therapies could flourish well beyond his own practice. As he explains in the podcast, “At some point I will retire—or die—but what will remain are the colleagues I trained.” His decision to lead a company ensures that his techniques will survive and continue to evolve, creating impact that outlasts any single career. Patient Education as a Driving Force Throughout the conversation, Prof. Possover emphasizes the vital role of patient education. When patients are aware of new treatment options, they actively seek qualified specialists, creating a natural demand for innovation. This patient-driven movement pressures the medical community to adopt cutting-edge solutions and ensures that life-changing therapies reach those who need them most. By offering information sessions and open discussions, he empowers patients to become advocates for their own health—transforming the doctor–patient relationship into a true partnership. Building a Global Legacy Through Training Prof. Possover's passion for teaching is at the heart of his work. Through the International School of Neuropelveology (ISNP), he trains surgeons from around the world in these advanced procedures. Every surgeon he educates becomes a multiplier of knowledge, capable of treating patients in regions far beyond his own reach. This dedication reflects a philosophy that medicine's greatest achievements are collective. A breakthrough is only meaningful if it can be shared, replicated, and improved upon by future generations. Lessons for Medical Professionals and Entrepreneurs This conversation is more than an inspiring personal story—it is a roadmap for anyone seeking to combine medicine, innovation, and business. Clinical expertise can fuel entrepreneurship when paired with strategic thinking. Patient awareness accelerates adoption, creating a powerful feedback loop between innovation and demand. Education builds permanence, ensuring that treatments survive beyond the careers of their pioneers. Whether you are a surgeon curious about entrepreneurship, a MedTech innovator looking for guidance, or a healthcare professional eager to create lasting change, Prof. Possover's journey demonstrates that the skills learned in medicine—discipline, precision, and empathy—are the very qualities that can drive successful leadership. In this podcast, Monir El Azzouzi and Prof. Marc Possover invite you to reflect on the future of healthcare. Their discussion shows that true medical progress lies not only in discovering new treatments, but also in ensuring that knowledge is shared, patients are informed, and innovations continue to thrive long after their creators have left the stage. Links INSP Link: https://isnp.possover.com/index neurogyn: https://neurogyn.com/ Possover: https://www.possover.com/en/ Youtube: https://www.youtube.com/results?search_query=marc+possover Social Media to follow Monir El Azzouzi Linkedin: https://linkedin.com/in/melazzouzi Twitter: https://twitter.com/elazzouzim Pinterest: https://www.pinterest.com/easymedicaldevice Instagram: https://www.instagram.com/easymedicaldevice  

On this episode of the Flex Diet Podcast, I'm joined by award-winning journalist and food nerd David Page, the guy who created Diners, Drive-Ins and Dives. We get into the wild evolution of American cuisine, the social role of food, and how to balance eating what you love with not tanking your health.David also shares his personal story with diabetes and weight loss, plus some practical cooking tips you can actually use. It's part history lesson, part food therapy, and a whole lot of fun. Don't forget to check out the sponsors and subscribe to my free daily newsletter for nerdy nuggets on nutrition, training, and metabolism—plus a free gift just for signing up.Sponsors:Beyond Power Voltra 1: https://www.beyond-power.com/michael13PNOE - tell them Dr Mike T sent ya: https://pnoe.comKillswitch for sleep: https://www.switchsupplements.com/DRMIKE use code DRMIKE to save $$Available now:Grab a copy of the Triphasic Training II book I co-wrote with Cal Deitz here.Episode Chapters:04:34 The Evolution of Chinese and Italian Cuisine in America08:50 The Impact of Post-WWII Era on American Food Culture15:19 Cooking Tips and Healthy Eating Strategies24:08 Balancing Indulgence and Healthy Eating25:16 A Personal Journey to Weight Loss26:05 The Role of Medical Professionals in Managing Diabetes27:14 Effective Diet Plans and Medications28:21 Maintaining Weight Loss and Counting Calories30:08 Exercise and Personal Fitness Routines33:52 The Story Behind Diners, Drive-Ins, and Dives36:33 The Challenges and Rewards of the Restaurant Industry39:37 Exploring Regional Barbecue Styles41:51 Launching a Culinary Podcast46:26 Closing Remarks and Podcast InformationConnect with David: Culinary Characters Unlocked: https://culinarycharactersunlocked.com/Get In Touch with Dr Mike:Instagram: DrmiketnelsonYouTube: @flexdietcertEmail: Miketnelson.com/contact-us

SummaryIn this episode of The Chasing Health Podcast, Chase Smith and Chris Bealhen talk about one of the most overlooked parts of any health and fitness journey... people.It's not just about workouts, calories, or macros. The people around you can either lift you up or make the road harder. Chase and Chris dive into how to handle unsupportive family members, friends, coworkers, and even the medical community.They share real stories, practical tips, and strategies to set boundaries, stay focused, and lead by example. You'll learn how to protect your progress, find the right support system, and avoid letting others pull you back into old habits.Chapters(00:00) Why People Around You Matter in Your Journey(02:00) Unsupportive Spouses and Family Dynamics(07:00) Setting Boundaries with Comments and Criticism(11:00) Leading by Example Without Forcing Change(15:00) Food Environments and Family Meal Strategies(20:00) Saying “No” Without Guilt(23:00) Parents and Loved Ones Who Don't Understand(28:00) Friends, Social Circles, and Saying No to Old Habits(33:00) Coworkers, Break Rooms, and Workplace Traps(39:00) Building Confidence in the Gym Community(46:00) Handling Sabotage—Intentional or Not(47:00) Social Media and Influencer Noise(51:00) Navigating Advice from Doctors and Medical Professionals(59:00) Final Thoughts: Focus on Boundaries, Growth, and Your CircleSUBMIT YOUR QUESTIONS to be answered on the show: https://forms.gle/B6bpTBDYnDcbUkeD7How to Connect with Us:Chase's Instagram: https://www.instagram.com/changing_chase/Chris' Instagram: https://www.instagram.com/conquer_fitness2021/Facebook Group: https://www.facebook.com/groups/665770984678334/Interested in 1:1 Coaching: https://conquerfitnessandnutrition.com/1on1-coachingJoin The Fit Fam Collective: https://conquerfitnessandnutrition.com/fit-fam-collective

Today we are answering your tax questions and hopefully helping you learn how to hang on to more of your money by reducing your taxes where you can. We answer a few questions about capital gains taxes and Dr. Dahle explains how to limit those taxes but also reminds you, life is going well if this is something you are having to navigate. We answer a question about social security taxes, one about using tax losses in retirement and how to be tax efficient during your training years. 2025 is coming to a close, making now the perfect time to tighten your tax plan so you don't overpay the IRS when 2026 tax season arrives. Cerebral Tax Advisors, the White Coat Investor-recommended firm trusted by physicians nationwide, uses court-tested, IRS-approved strategies to reduce personal and business taxes. Over the past 10 years, Cerebral clients have seen an average of 453.53% return on investment in their tax planning services.  Founder and Lead Tax Strategist Alexis Gallati, author of 'Advanced Tax Planning for Medical Professionals', comes from a family of physicians and has over 20 years of experience in high-level tax planning strategies. To schedule a free consultation, visit https://cerebraltaxadvisors.com. The White Coat Investor has been helping doctors, dentists, and other high-income professionals with their money since 2011. Our free personal finance resource covers an array of topics including how to use your retirement accounts, getting a doctor mortgage loan, how to manage your student loans, buying physician disability and malpractice insurance, asset allocation & asset location, how to invest in real estate, and so much more. We will help you learn how to manage your finances like a pro so you can stop worrying about money and start living your best life. If you're a high-income professional and ready to get a "fair shake" on Wall Street, The White Coat Investor is for you! Find 1000's of written articles on the blog: https://www.whitecoatinvestor.com  Our YouTube channel if you prefer watching videos to learn: https://www.whitecoatinvestor.com/youtube  Student Loan Advice for all your student loan needs: https://studentloanadvice.com  Join the community on Facebook: https://www.facebook.com/thewhitecoatinvestor  Join the community on Twitter: https://twitter.com/WCInvestor  Join the community on Instagram: https://www.instagram.com/thewhitecoatinvestor  Join the community on Reddit: https://www.reddit.com/r/whitecoatinvestor  Learn faster with our Online Courses: https://whitecoatinvestor.teachable.com  Sign up for our Newsletter here: https://www.whitecoatinvestor.com/free-monthly-newsletter 

As part of "The Lead" Jason talks with Associate Professor of Medicine from Northwestern University Feinberg School of Medicine Dr. Mark Sala about vaccines under attack, needing a prescription to get one, the change in distribution, stopping cancer research and more.

D.D. Finder is a former Flight and ICU Nurse, EMT-Basic, Returned Peace Corps Volunteer, and author with more than 20 years of healthcare experience. Throughout his career, he has earned multiple awards for excellence in patient care, both in-flight and in the hospital. Finder lives in Colorado with his wife and continues to serve as an RN. He is the author of Ready Left, Ready Right, a powerful novel that explores resilience and courage in the world of helicopter EMS. His deep respect for first responders and nurses fuels his writing, where he highlights their intelligence, dedication, sacrifice, and compassion. A dedicated medical professional, and returned Peace Corps volunteer, Finder has built his life around service and the pursuit of human potential. Beyond medicine, he is a challenge seeker who has participated in a world record attempt and recently hiked the Grand Canyon rim-to-rim in a single day. He has lived in underserved and remote communities throughout Central and South America, working on the front lines in some of the most isolated areas. His mission is to inspire and support first responders and nurses by sharing hard-earned lessons and giving back to a profession that has both shaped and tested him.www.TheMountainSidePodcast.comAffiliates LinksSponsor Linkswww.BulletProof.comMountain Side listeners Use Discounts code: MOUNTAINSIDE to receive 20% off all Bulletproof products!www.SABObroadheads.comMountain Side listeners receive $10 off & Free Shipping on all SABO Broadheads!www.Knicpouches.comMountain Side listeners Use Discounts code: MOUNTAINSIDE15 to receive 15% off all K-Nic products!

Looking for a way to reduce your taxes? Have a second property like a vacation home? The short term rental loophole can help you deploy your vacation home to reduce your taxes? How does it work? What are the requirements? My guest today runs an accounting firm that helps their medical clients get efficient on taxes, including using the short term rental loophole when it applies. She'll explain all of this to us.Alexis E. Gallati is the founder and Lead Tax Strategist at Cerebral Tax Advisors and Cerebral Wealth Academy, and she's the author of the book Advanced Tax Planning for Medical Professionals. She has over 20 years of experience in high-level strategic tax planning and multi-state tax preparation, and she has trained at the highest level, holding two master's degrees. Alexis grew up in a family of physicians and is married to a private practice physician. That's why she understands how hard medical professionals work to get where they are and why she provides simple and accessible tax solutions tailored to busy physicians.In this episode Carl White and Alexis Gallati discuss:What the passive income rules areThe benefits of using this loopholeThe requirements to qualifyWant to be a guest on PracticeCare?Have an experience with a business issue you think others will benefit from? Come on PracticeCare and tell the world! Here's the link where you can get the process started.Connect with Alexis GallatiResources from Cerebral Tax Advisors: https://www.cerebraltaxadvisors.com/practicecare/Cerebral Tax Advisors Facebook: https://www.facebook.com/cerebraltaxCerebral Wealth Academy Facebook: https://www.facebook.com/cerebralwealthacademy YouTube: https://www.youtube.com/@cerebralwealthacademyPersonal LinkedIn: https://www.linkedin.com/in/alexis-gallati/Connect with Carl WhiteWebsite: http://www.marketvisorygroup.comEmail:  whitec@marketvisorygroup.comFacebook:  https://www.facebook.com/marketvisorygroupYouTube: https://www.youtube.com/channel/UCD9BLCu_i2ezBj1ktUHVmigLinkedIn: http://www.linkedin.com/in/healthcaremktg

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Is starting a business part of your healing journey? For Suzy Wraines, it absolutely was. In this powerful episode of the Second Act Success Career Podcast, Suzy shares her inspiring story of how she went from a military medic and veterinary technician to a trauma-informed business coach for medical professionals.Host Shannon Russell talks with Suzy about the emotional toll of transitioning out of healthcare, how unresolved trauma can resurface in entrepreneurship, and why your nervous system plays a surprising role in business success. Suzy also shares how she now empowers nurses, PAs, and therapists to pivot into consulting, coaching, and service-based businesses of their own.Whether you're a healthcare provider, military veteran, or creative professional feeling the call for something new, this episode is a must-listen.Key Takeaways:How trauma can silently affect your ability to grow a businessWhy entrepreneurship can trigger subconscious fears—and how to work through themTips for transitioning from healthcare to heart-centered businessWhat foundational steps to take when starting a business from scratchHow Suzy runs her business and podcast while living full-time in an RVSHOW NOTES:https://secondactsuccess.co/202Connect with Suzy Wraines:https://www.startingabusinesssimplified.com/podcast startingabusinesssimplified.com-------------------------------------------------- You are listening to the Top 2% globally ranked podcast Second Act Success!READ Shannon's Book - Start Your Second Act: How to Change Careers, Launch a Business, and Create Your Best Life at https://startyoursecondact.com. Book a FREE Strategy Call with host and business coach Shannon Russell - https://www.calendly.com/second-act-success/coaching-strategyFREE Resourceshttps://secondactsuccess.co/resourcesLISTEN to the How To Quit Your Job and Start A Business Podcast! https://secondactsuccess.co/listenLET'S CONNECT!Instagram - https://instagram.com/secondactsuccessFacebook - https://www.facebook.com/secondactsuccess.coTikTok - https://www.tiktok.com/@secondactsuccessFREE Resources - https://secondactsuccess.co/resources REVIEW & SUBSCRIBE THE PODCAST!

Our guest was Julia Zumpano, RD. She is a registered dietitian at the Cleveland Clinic's Center for Human Nutrition, and her expert insight helped inform the guidelines for two programs featured in the hospital's new wellness and diet coaching app, the Cleveland Clinic Diet app. Both programs aim to educate and empower users in making healthier diet and lifestyle choices. ***Fellowship Application Link: https://forms.gle/PQgAvGjHrYUqAqTJ9 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen