Podcasts about resource optimization network

In a world overwhelmed by noise and confusion, Dr. Kyeremanteng "Dr. K" shows us what it looks like to lead with authenticity, courage, and purpose. In this powerful episode, Dr. K shares his journey from ICU department head during the pandemic to TikTok influencer, bestselling author, and sought-after speaker on leadership, health, and personal transformation. Majeed and Dr. K dive deep into what true high performance really means for today's business leaders—and why physical health, emotional resilience, and living your purpose are non-negotiable for leading in today's world. Whether you want to sharpen your leadership, improve your wellness, or step into your true identity as a changemaker, this conversation will inspire you to think bigger and act bolder. Key Takeaways: Why connecting with your purpose is the #1 key to sustainable health and leadership The 80/20 rule of wellness: Focus on simple habits that move the needle How to lead yourself when you're tired, overwhelmed, or burned out The real definition of confidence (hint: it's not what you think) Why identity—not willpower—is the secret to lasting change How authentic leadership can create ripple effects across teams, companies, and communities Notable Quotes: "If you don't know your purpose, the gym won't save you. The diet won't save you." – Dr. K "Confidence is showing up as your most authentic self, even when it's hard." – Dr. K "Healing happens when your actions align with your purpose." – Dr. K "Leadership isn't just about making decisions. It's about leading from your values, not your fears." – Majeed Mogharreban "The future is made up—but confidence is deciding how you will walk into it." – Majeed Mogharreban About Dr. Kyeremanteng: Dr. Kwadwo Kyeremanteng is the Department Head of Critical Care at The Ottawa Hospital, where he dedicates his time to caring for critically ill patients in the intensive care unit (ICU). As a researcher, he focuses on improving ICU resources and founded the Resource Optimization Network—a multidisciplinary research group aimed at reducing health care spending without compromising patient care. In 2019, he launched the Solving Healthcare podcast, bringing vital conversations about improving Canada's healthcare system to a broad audience. During the COVID-19 pandemic, Dr. Kyeremanteng founded Solving Wellness, a virtual health and wellness platform designed to support healthcare professionals battling burnout. In 2023, he published his first book Unapologetic Leadership and was recently appointed to the Board of Governors of The Ottawa Hospital Foundation. Through his work as a physician, speaker, author, and advocate, Dr. K is redefining leadership at the intersection of health, courage, and community. Connect with Dr. Kyeremanteng (Dr. K):

Dr. Kwadwo Kyeremanteng is a returning guest on our show! Be sure to check out his recent appearance on episode 471 of Boundless Body Radio! Dr. Kwadwo Kyeremanteng is a critical care and palliative care physician at The Ottawa Hospital. Dr. Kyeremanteng cares for the sickest of the sick patients in the intensive care unit (ICU). As a researcher, he is interested in using ICU resources more efficiently and improving access to palliative care in the ICU. To help do this, he founded the Resource Optimization Network, a multidisciplinary research group working to reduce health spending in this area without compromising care. In September 2019, Dr. Kyeremanteng launched his ever-growing podcast Solving Healthcare with Kwadwo Kyeremanteng. These podcasts feature interviews and discussions on the topic of improving healthcare delivery in Canada. Underpinned by the values of cost-effectiveness, dignity, and justice, these podcasts will challenge the status quo, leaving no stone unturned as we explore gaps, assumptions, and different perspectives in the pursuit of finding solutions to problems in major healthcare systems.He is also the author of the 2023 book Unapologetic Leadership: Finding the Moral Courage to do the Right Thing.Dr. Kyeremanteng was a presenter at Low Carb Denver 2023, where I met him in person, and it is such an honor to welcome him back to Boundless Body Radio!Find Dr. Kwadwo Kyeremanteng at-TW- @kwadcastIG- @kwadcastPodcast- Solving Healthcare with Dr. Kwadwo KyeremantengAmazon- Unapologetic Leadership: Finding the Moral Courage to do the Right ThingFind Boundless Body at- myboundlessbody.com Book a session with us here!

Dr. Kwadwo Kyeremanteng is the department head of critical care at The Ottawa Hospital. He dedicates his time to care for the sickest of the sick patients in the intensive care unit (ICU).  As a researcher, he is interested in using ICU resources more efficiently and improving access to palliative care in the ICU. To help do this, he founded the Resource Optimization Network, a multidisciplinary research group working to reduce health spending in this area without compromising care. In September 2019 Dr. Kyeremanteng launched his ever-growing podcast “Solving Healthcare with Kwadwo Kyeremanteng. '' These podcasts feature interviews and discussions on the topic of improving healthcare delivery in Canada. Underpinned by the values of cost-effectiveness, dignity, and justice, these podcasts will challenge the status quo, leaving no stone unturned as we explore gaps, assumptions, and different perspectives in the pursuit of finding solutions to problems in Canada's healthcare system. During the COVID 19 Pandemic Dr. Kyeremanteng created ‘Solving Wellness' a virtual health & wellness platform for health care professionals. ‘Solving Wellness' has been helping address health care burnout and providing health, fitness and self care for its members. You can connect with Dr. Kyeremanteng via Instagram @kwadcast Related Episodes: Ep 168 - Avoiding the ICU + Racism in Medicine with Dr. Kwadwo Kyeremanteng Ep 143 - We Work Until It's Done: Caity Henniger on Rogue Fitness and its Response to COVID-19 If you like this episode, please subscribe to Pursuing Health on iTunes and give it a rating or share your feedback on social media using the hashtag #PursuingHealth. I look forward to bringing you future episodes with inspiring individuals and ideas about health. Disclaimer: This podcast is for general information only, and does not provide medical advice.  I recommend that you seek assistance from your personal physician for any health conditions or concerns.

This week on the podcast Mikki speaks to Kwadwo Kyeremanteng about health in the time of Covid. He's an ICU, an intensive care unit doctor in Ottawa Canada. But he's also got a Masters of Health Administration, he's a podcast host, he runs the Resource Optimization Network, which is a research Institute with the goal of transforming healthcare and optimizing the use of health care resources. Dr Kwadwo was front line as the first cases hit Ottawa and he shares his experiences and perspectives, about what he saw day to day versus what was being highlighted in the media. His realisation that underlying poor metabolic health was a big driver for the severity of the illness drove him do what he can to get this message out there in the public. While the dust has almost settled on Covid, the PTSD associated with it remains. Mikki and Dr Kwadwo talk about this and more, this week on the podcast.Dr. Kwadwo Kyeremanteng is a critical care and palliative care physician at The Ottawa Hospital. Dr. Kyeremanteng cares for the sickest of the sick patients in the intensive care unit (ICU). As a researcher, he is interested in using ICU resources more efficiently and improving access to palliative care in the ICU. To help do this, he founded the Resource Optimization Network, a multidisciplinary research group working to reduce health spending in this area without compromising care. In September 2019 Dr. Kyeremanteng launched his ever-growing podcast “Solving Healthcare with Kwadwo Kyeremanteng” these podcasts feature interviews and discussions on the topic of improving healthcare delivery in Canada. Underpinned by the values of cost-effectiveness, dignity, and justice, these podcasts will challenge the status quo, leaving no stone unturned as we explore gaps, assumptions, and different perspectives in the pursuit of finding solutions to problems in Canada's healthcare systemDr Kwadwo Kyeremanteng https://kwadcast.substack.com/ Contact Mikki:https://mikkiwilliden.com/https://www.facebook.com/mikkiwillidennutritionhttps://www.instagram.com/mikkiwilliden/https://linktr.ee/mikkiwillidenSave 20% on all NuZest Products with the code MIKKI20 at www.nuzest.co.nzCurranz supplement: MIKKI saves you 25% at www.curranz.co.nz

Dr. Kwadwo Kyeremanteng is a critical care and palliative care physician at The Ottawa Hospital. Dr. Kyeremanteng cares for the sickest of the sick patients in the intensive care unit (ICU). As a researcher, he is interested in using ICU resources more efficiently and improving access to palliative care in the ICU. To help do this, he founded the Resource Optimization Network, a multidisciplinary research group working to reduce health spending in this area without compromising care. In September 2019 Dr. Kyeremanteng launched his ever-growing podcast Solving Healthcare with Kwadwo Kyeremanteng, and these podcasts feature interviews and discussions on the topic of improving healthcare delivery in Canada. Underpinned by the values of cost-effectiveness, dignity, and justice, these podcasts will challenge the status quo, leaving no stone unturned as we explore gaps, assumptions, and different perspectives in the pursuit of finding solutions to problems in Canada's healthcare system. Dr. Kyeremanteng was a presenter at Low Carb Denver 2023, where I met him in person!Find Kwadwo at-TW- @kwadcastIG- @kwadcastPodcast- Solving Healthcare with Dr. Kwadwo KyeremantengFind Boundless Body at- myboundlessbody.com Book a session with us here!

My discussion is with Dr. Kwadwo Kyeremanteng who is a critical care and palliative care physician at The Ottawa Hospital. Dr. Kyeremanteng cares for the sickest of the sick patients in the intensive care unit (ICU). As a researcher, he is interested in using ICU resources more efficiently and improving access to palliative care in the ICU. To help do this, he founded the Resource Optimization Network, a multidisciplinary research group working to reduce health spending in this area without compromising care. In September 2019 Dr. Kyeremanteng launched his ever-growing podcast “Solving Healthcare with Kwadwo Kyeremanteng” these podcasts feature interviews and discussions on the topic of improving healthcare delivery in Canada.Dr. K recently discovered the importance of metabolic health and a low carb lifestyle especiallly as it pertains to patients in critical care. You can find more about Dr K at: Kwadcast.substack.comInstagram: @KwadcastDr Greg is at:Vibrantlifedc.com

Dr. Kwadwo Kyeremanteng is the department head of critical care at The Ottawa Hospital. He dedicates his time to care for the sickest of the sick patients in the intensive care unit (ICU). As a researcher, he is interested in using ICU resources more efficiently and improving access to palliative care in the ICU. To help do this, he founded the Resource Optimization Network, a multidisciplinary research group working to reduce health spending in this area without compromising care. In September 2019, Dr. Kyeremanteng launched his ever-growing podcast Solving Healthcare with Kwadwo Kyeremanteng” These podcasts feature interviews and discussions on improving healthcare delivery in Canada. Underpinned by the values of cost-effectiveness, dignity, and justice, these podcasts will challenge the status quo, leaving no stone unturned as we explore gaps, assumptions, and different perspectives to solve problems in Canada's healthcare system. During the COVID-19 Pandemic, Dr. Kyeremanteng created ‘Solving Wellness,' a virtual health & wellness platform for healthcare professionals. ‘Solving Wellness' has been helping address healthcare burnout and providing health, fitness and self-care for its members. This podcast discusses why COVID was a missed opportunity to improve healthcare, why physicians should be open-minded to alternative treatments, the importance of breathwork and why Dr. Kyeremanteng wrote a blog on deadlifts in his latest substack.

Brian sits with Dr. Kwadwo Kyeremanteng, an ICU Physician, and Head of the ICU Department, who also has a background in palliative care. Working on research into ways to make the healthcare system more sustainable, Dr. Kwadwo created the Resource Optimization Network and hosts the Solving Healthcare podcast. In his work Dr. Kwadwo noticed the relationship between metabolic syndrome or other underlying chronic conditions and covid outcomes. Following this, he took up a mission to empower patients with tools and knowledge to make healthy life choices that prevent and even reverse these diseases.   GET THE MEAT http://NosetoTail.org FREE SAPIEN FOOD GUIDE http://sapien.org   SHOW NOTES: (07:43) Facing the pandemic, Dr. Kwadwo's mission was to inform people about crucial factors that affect covid outcomes. (16:40) Many doctors are also struggling to balance their work with healthy living (19:35) How do doctors respond to the newer dietary recommendations as against the typical nutritional training? (17:34) The rigidity of doctors, whether due to ego or fear of being wrong, played out negatively in the pandemic. (24:57) Dr. Kwadwo has seen no case of a healthy patient ending up in the ICU due to covid-19. (35:53) The protein hack. (46:55) How can all these health strategies be passed across to the larger public? (54:00) How do families implement these changes?   GET THE MEAT http://NosetoTail.org FREE SAPIEN FOOD GUIDE http://sapien.org   Follow along: http://twitter.com/FoodLiesOrg http://instagram.com/food.lies http://facebook.com/FoodLiesOrg  

In this episode, we welcome Marie-Josée Forget. Marie-Josée is a bilingual Pelvic Health Physiotherapist, educator, and mentor with 18 years of clinical experience. She operates a private physiotherapy practice focused on treating pelvic floor dysfunction and teaches courses related to pelvic anatomy and health at Pelvic Health Solutions. Marie-Josée Forget speaks with us about women's health. We learn about perimenopausal, and menopausal women and their pelvic health. How your pelvic health affects your lifestyle and sexual health, Kegel exercises, navigating perimenopause, menopause, and more!SPONSORBETTERHELPBetterHelp is the largest online counseling platform worldwide. They change the way people get help with facing life's challenges by providing convenient, discreet, and affordable access to a licensed therapist. BetterHelp makes professional counseling available anytime, anywhere, through a computer, tablet or smartphone.Sign up today: http://betterhelp.com/solvinghealthcare and use discount code “solvinghealthcare"Thank you for reading Solving Healthcare Media with Dr. Kwadwo Kyeremanteng. This post is public so feel free to share it.Solving Healthcare Media with Dr. Kwadwo Kyeremanteng is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.TRANSCRIPT KK: We are on the brink of a mental health crisis, and this is why I am so appreciative of the folks over at BetterHelp. It provides the largest online counseling platform worldwide to change the way people get help with facing life's challenges by providing convenient, discreet, and affordable access to licensed therapists that are helped make professional counseling available anytime, anywhere through a computer, tablet, or smartphone. Sign up today. Go to betterhelp.com And use a promo code ‘solvinghealthcare' and get 10% off signup fees. SP: COVID has affected us all and with all the negativity surrounding it, it's often hard to find the positive. One of the blessings that is given us is the opportunity to build an avenue for creating change. Starting right here in our community discussing topics that affect us most such as racism and health care, maintaining a positive mindset, creating change, the importance of advocacy, and the many lessons we have all learned from COVID. If you or your organization are interested in speaking engagements, send a message to kwadcast@gmail.com, reach out on Facebook at Kwadcast or online at drkwadwo.caKK: Welcome solving healthcare. I'm Kwadwo Kyeremanteng. I'm an ICU and palliative care physician here in Ottawa and the founder of ‘Resource Optimization Network' We are on a mission to transform healthcare in Canada. I'm going to talk with physicians, nurses, administrators, patients and their families because inefficiencies, overwork and overcrowding affects us all. I believe it's time for a better health care system that's more cost effective, dignified, and just for everyone involved.KK: Kwadcast nation welcome back. We have a tremendous episode with MJ Forget. She is a pelvic floor specialist in physiotherapy and sees a lot of perimenopausal women and was really knowledgeable in terms of the issues that she sees firsthand. Many people can benefit from a pelvic floor physio, for example, if they're having incontinence, pain or with sexual health, this is such an important aspect of things. Then she dives into how holistic the approach must be how the physio can actually make some significant strides. How lifestyle changes can impact things. Honestly, I learned so much in this episode. So, we'll jump on it right away here. But first, I want to give a quick plug to our latest newsletter on substack kwadcast.substack.com. Where you can stay up to date with all our releases, our blogs, or blogs or guest appearances, courses all are on one site and it's all point. Check out kwadcast.substack.com and jump on the train. So, without further ado MJ Forget. KK: Welcome to the show. We we've been talking more about women's health, specifically, perimenopausal and menopausal women. One of the areas that I must say it was a bit foreign to me and I didn't realize it was such a big issue was pelvic health. So MJ you've been at this for a while, like when you started? You said over 20 Maybe 25 years? MJ: 25 years? Yeah. KK: What lured you to pelvic health and like how big of an issue has is pelvic health ben for people?MJ: When we graduate from university, you know, and the medical fields we get to find areas of interest when we graduate and that's kind of all that we do. And you know physio, some of them want to do orthopedics and work with sports teams. When I graduated, I went to the hospital system, which is a lot of what physios do, and I worked in ICU and I worked on the floors, I did orthopedics, post knee posts, hips, and it really wasn't where my passion lied by any means. But it was a really great introduction to all thing's physios working in a hospital setting. So, when I thought about where do I want to go? And what do I want to do? I always had an interest at the time what we call more women's health. Now we call it pelvic health because again, all genders have pelvic health issues. I had classmates who did their thesis on incontinence. I remember thinking at the time oh my gosh “That's something that we can do?”. It really wasn't anything we were taught in university, nobody really talked about, again pelvic health, women's health, women's health issues, menopause, that was never covered in our degree. So, I took my first course and Alberta back in 1997 and I never looked back. I had no idea how much pelvic health issues was a problem. Remember 25 years ago, nobody talked about any of that. Nobody talked about bladder control issues or bowel control issues. Certainly, nobody talked about menopause, and nobody talked about sexual health, which is a lot of what we do in pelvic health. So, I started my career, like I said, I was in my early 20s and that's all I've been doing now, for 25 years. This is where I'm at. KK: Wow. You alluded to, you didn't realize how big of a problem it was, like how big of a problem truly is it? MJ: If we talk just about incontinence in Canada, if we just talk about general stats in Canada, 3.3 million Canadians have bladder issues in Canada. When we think about gender differences, one in four women, one of one to nine men, so it's significant. It actually gets a little worse as we age. That's an issue with menopause. So, if we think about the female population, there's about a 20% to 30% incidence of incontinence in our young adulthood. Think of like your 20s and 30s. Then that spikes up to almost 40%. By the time we get into middle age, which is kind of the perimenopausal menopausal age. Then it goes up as high as 50% in our elderly, which is a really big concern. One of the main reasons that our clients get admitted into nursing homes is because of bladder issues, and fecal incontinence rate, loss of bladder and bowel control is usually kind of an event where families then have a hard time maybe coping with taking care of their of their loved ones, and that will increase admissions to nursing homes. So, we're not talking about small numbers. It's a significant number and we have an aging population in Canada. We have a lot of people going through perimenopause and menopause. One of the biggest risk factors of incontinence is actually menopause. We have a lot of people right now who are entering kind of that phase, you know, and I think in Canada, the stats are that there's 10 million of us in this age group in perimenopause, heading into menopause in Canada. That's a big number.KK: It's massive. And I think this is what's motivated us to cover some of this content because these are years of productivity, have high needs, like moms that are in that perimenopausal age where you're active with your family, your career paths, like a lot of people this is where they're starting to peak in their careers, a lot of demands just to be to be on the workforce, like when I think of health care workers. So, anything we could do to make them more functional and thrive. I think we need to really look at. I don't know if I realized that, like this is kind of like the peak or one of the main concerns during the perimenopausal perimenopausal menopausal timeline. What can you do? What do you do to help? MJ: There's so much we can talk about this for hours, but we'll try to kind of keep in to keep our timeline because I can get started. I mean, if we're just going to focus on, we'll talk the impact of perimenopause and menopause. Like you said, it's such a difficult time. You know, people going through perimenopause and menopause, like you said, are working. They are often parents, with children that still require a lot of our attention. Plus, sometimes we're taking care of our parents as well. We're kind of like in that middle group where we're busy with our careers. We may or may not have children, but we also may have parents that we help and it's a really stressful time, and quality of life really starts to take an impact. So typically, when people come to see a pelvic health physiotherapist, or a physiotherapist who's done postgraduate studies in pelvic health, what we do is we are often seeing people that come for problems of bladder control and bowel control. So that would say that's kind of when I started that was the most of what I've seen, but we also help our patients with sexual function and the ability to have pain free sexual intercourse, which is a big issue again in perimenopause and it can actually worsen and menopause as well. We help with conditions called pelvic pain, pelvic pain can be anything like you know, our patients telling me I have vaginal pain or rectal pain, and when I treat my population of men it could be prostate related type of pains. Pain in the pelvis. A lot of pain in the pelvis affects sexual function and has an impact on your bladder and bowel function. So, it's all related together. When you come and see a pelvic health physio, what's important to know is we take what they call a biopsychosocial approach to care. So that means when you come and see us, we're looking at you as a whole person. What's really great about our profession is we have the luxury of time, because when you come and see us, we have an hour on assessment with you. Follow up treatments can be half an hour, 45 minutes or even an hour. So, we have the luxury of time, and we have the luxury of talking. S o the main thing that we always want to do is let people tell us their story, you know, why are you here? What's bothering you? And how much is this bothering you? Because again, when it comes to menopause, or bladder issues, or sexual function, these are not subjects that people want to talk about easily, right? There's a lot of taboo, a lot of embarrassment. A lot of my clients think they're the only ones who cant have intercourse anymore than the only ones who are losing bladder control and can't, you know, run a marathon. Everybody thinks they're the only ones but there are in fact, not, the stats are actually quite high in terms of impact of blood, bladder, health and sexual health on our patients. So, we talk and then we address all things incontinence, bladder, bowel, sexual function, and things like constipation and pain in the pelvic area. So, we do all of that. It's quite a bit and it spans quite a lot of topics. We also talk about lifestyle because lifestyle is important. On the on, on maybe my first visit or second visit, I'm going to talk to you about are you sleeping well? Are you managing your stress well? Are you having any issues with your mental health? depression, stress, anxiety that you're not managing? Well, how are you feeling hormonally? Because part of what we do and what I've noticed during COVID a lot as well is we've kind of become a little bit of the gatekeepers, I want to see we really had to help our patients navigate the healthcare system, and a time that it was really difficult to navigate the health care system. I always tell my clients, I'm here to help build your team around you who do you need to help you navigate perimenopause and menopause so you can live your best life, because as physios, we have to stay in our scope of practice, we can't do everything. So, if I talk about nutrition, I can talk about why nutrition is important, but I'm not allowed to give you advice on nutrition because it's not in my scope. But I'll send you to the people who do that. And the biggest challenge and menopause is that for a long time, there was nobody to send people to. Right? If you think about, you know, how many menopause clinics do you know, that exist out there? Right. There's one at Mount Sinai. There's just not a lot of menopause clinics that are run by a gynecologist and maybe have a nutritionist and a psychologist all working together and maybe with a pelvic health physio, that'd be great. That could look at that whole biopsychosocial approach to care to really help our patients navigate menopause. I think that's now starting to change. I think now, you know, the tagline right now is menopause is having a moment while menopause is having a moment. I think partly because there's a lot more of us in our field talking about it on social media, there's definitely some gynecologist now that are much more vocal on social media, talking about hormones, talking about safety of hormones. When I started 25 years ago, hormones were a no go, there was so much fear around all things hormonal replacement therapy, and it was really difficult because as a physio, I could see how devastating some of the symptoms of menopause were and there wasn't really a lot of options for my patients at the time as to what to do about it. Because everybody has such a fear of hormone, whether it's topical hormones or hormonal replacement therapy, and I think that that's shifting as well. So, we talk about all of these things with our clients when they come in. Then we help navigate and say, Okay, if you're struggling with nutrition, who could we send you to? If you're really struggling with your hormones, who are the hormone, menopause, hormonal experts out there to send you to? If your mental health is an issue, who do we send you to for that so that you can kind of work on your anxiety and your depression and your stress? There's been a lot of stress, you know, in the last few years, and then as physios, we take care of more that kind of the physical kind of component of incontinence, pelvic pain, bowel health, constipation and sexual health.KK: You know, what I'm really appreciating is you're saying MJ is how holistic the approach is, it's not so just the physical aspects and the rehabilitation, you need to know how it's affecting your life, how you're doing from a lifestyle perspective, stress level, sleep, how well you're eating, and just approaching it that way. That's what I'm finding really encouraging about this is that you know, you're just not soloing the approach, it really comes down to how the person is doing as a whole. In my opinion when it comes to so many issues in medicine, this is the only way like, you need to really address so many of the needs outside the actual physical concern. Another thought just came to mind too, is just hearing all the, the symptoms that so many perimenopausal and menopausal women have to go through it, it just, it really is sad that so many people have had to go through without it go through all this without attention. You put it together, the hot flashes, the mental health concerns, weight issues,MJ: the insomnia, the anxiety KK: Then you add the pelvic pain, the incontinence on top of that MJ: It's significant, and it's all today can be a very overwhelming time and our client's life, because, again, they're so busy, they're under a lot of stress, they have a lot of obligations. Then they're dealing with, you know, ‘I can't have intercourse with my partner, it hurts too much. I'm leaking urine, I can't exercise. Now I'm gaining more weight. I am going through perimenopause, I got insomnia, I can't sleep'. That has huge repercussions on the human body. It's important that we all talk about those things. And it's important that we recognize the lane that we're in as, as health professionals and find the right people, for our clients so that they get better. I think you know, again, it's the tides, I think are changing that we're taking a little bit more of this kind of like sort of biopsychosocial approach, looking at the whole person. Also giving permission to our clients to talk to us about these things that it's okay to talk to me about your bladder issues and your sexual health concerns and, and your stressors in your life and how maybe you're having really hard time balancing work life balance and seeing how we can help with that. We can all help with that, in our own way. KK: Absolutely. Give us a sense, MJ when someone walks into the office what some of the stuff you're assessing? what do you do as a physio to help patients that's within your scope? the exercises? help me understand the potential and the things that you do to help address these issues.MJ: So, once we've listened to everybody's story, and they tell us what their main concerns are, and what their goals are, in terms of what would they like to achieve with our time together. We do a lot of education, and education can be like I said, lifestyle, sleep, how are they functioning with nutrition? Are they exercising? are they happy? Are they stressed? then we really go into the function of the pelvic floor. So, if we talk about the main concerns most of our clients are coming in with often it will be bladder issues, bowel issues, it will be sexual health issues, and maybe constipation issues, like some bowel issues, that all tends to act up in perimenopause. That's when we take out our props. I have lots of props to explain to people about the pelvis. Because again, we are not taught anything about the pelvis as human beings. And if we think about our education in our primary schools, in our high schools about pelvic health, there's none of that. So, we often don't really know about the pelvis, right? And where the pelvic what's happening to our pelvis. If we look at this wonderful pelvis has been with me for 25 years, so it's falling apart. KK: People listening, you might have to be extra descriptive, extra descriptiveMJ: Okay, so when we look at the pelvis, if I take the muscles out of the way, this is the front of your pelvis. So that's your pubic bone. By turning the pelvis around, that's your kind of your spinal column and your tailbone would be right here. And if we look at the bottom, while the bottom is all muscular, it's just muscles down there, and you have layers of muscles, and we call it because we're not very clever. We're calling it the pelvic floor muscles. There's a lot of fancy terms in anatomy, so we won't go through that but for the sake of purpose, the pelvic floor and there's layers. The first layer, which is the most superficial, so meaning that you can touch it from the outside. These muscles here go from your pubic bone to your tailbone here at the bottom, they wrap around your clitoris, and your vaginal opening, and then they also wrap around the anal opening. All of these muscles here, the main function of these little muscles are that the vaginal opening or for sexual function, which is why sometimes we can have difficulties with maybe having an orgasm, libido, desire orgasms, and maybe we have pain with intercourse. These muscles which are under voluntary control, so we can learn to use them, they must contract, but they must relax. When things go in the vagina, all these muscles must have the capacity to stretch into expand, and that should never cause us pain. So that's this first little group. We'll maybe dive into kind of sexual function a little later. But that's the first little group. Then deeper inside your pelvis, you have another group of muscles that are deeper inside your body. These muscles, they're quite big, quite large, they wrap around your vaginal opening and your anal opening all the way from your tailbone at the back to your pubic bone at the front, those are your bladder and bowel control muscles. So if I take that muscle out, just to show you how big it is, the big muscle, front to back. When you laugh, when you cough, when you sneeze, when you lift things that are heavy, these muscles tighten around your urethra, or tighten around your anal opening so that you don't lose bladder control, you should be able to hold on to those muscles to get to the bathroom on time. Then when you sit to go to the bathroom, they relax this stretch the expand to allow us to go to the bathroom. So, when people come to see us for bladder issues, bowel issues, or sexual health issues and sexual pains, what we're trying to determine is what's happening to that little group of muscles, what's happening to that pelvic floor. I always tell my clients, there's two groups of you. There's a group that come that comes to pelvic health physio, where when we evaluate the function of their pelvic floor, they just lost a lot of strength and endurance. We see that in perimenopause and menopause because this is my hormones are important. When you go through perimenopause, your hormones are starting to dip down. They're not gone yet. But your estrogens are dipping your testosterone and your DHEA, which are your androgenic hormones are decreasing. We need estrogen for muscle strength, and protein synthesis and collagen. When we have a loss of estrogen, we start to lose muscle strength, we start to have what we call sarcopenia. Right. And that starts to increase as we age if we're not moving and exercising. So, estrogen is really important for muscle function to testosterone, which we have, we don't maybe have as much as our male counterparts. We do have some in it, it is important because it helps with muscle strength and muscle tone. That impacts the pelvic floor. So, I may have someone who has never had babies never, never could not have children or decide not to have children who come to see me, and perimenopause and menopause and they'll say, Why am I having incontinence, I never got pregnant. Well, that's because even if you have not had children, you're gonna go through menopause, you're gonna have those hormonal fluctuations. You can still have some symptoms of menopause and one of them could be incontinence. And the other thing what these pelvic floor muscles do, which is really great when they're working well, and you're able to use them properly, they help decrease the sense of urgency and frequency, right. So, some people say I go to the bathroom all the time I'm peeing every half an hour, I'm getting up three, four times a night to go to the bathroom. When we help regain function of these pelvic floor muscles to reduce incontinence can also reduce urgency and frequency and the need to get up at night. So, group number one may have a lot of weakness and loss of strength in their pelvic floor. Again, that happens in menopause with the loss of our hormones. A lot of the symptoms tend to worsen about seven to 10 years after you're done having your menstrual cycles remember that you are menopausal if you've gone 12 months without your menstrual cycle, usually symptoms of menopausal peak a kind of that seven to 10 years. I's about honestly, they're saying about 50 to 65% of the population may have actually some symptoms, you know, at those seven years, post menopause. Second group of people that often come in is when we evaluate their pelvic floor, they have all the same symptoms will have bladder issues or going to the bathroom a lot. But then they tell us they have pain, they have pain with sexual activity. Then when we look at their pelvic floor, they actually have too much tension. Okay, and that's a problem because if you look at this little layer of your pelvic floor, these muscles that wrap around the vaginal opening and your clitoris, so these are your clitoral muscles. So important to have orgasms if you have too much tension in these muscles like this when things going in the vagina start to hurt. Again, that can start to be a problem in perimenopause and into menopause, again because of hormonal changes. What happens is, you're going through perimenopause, or menopause, or maybe you're in menopause, your estrogen levels have dipped down. Estrogen is like the fountain of youth, estrogen plumps up our tissues, it increases blood flow to the area, it provides elasticity to all of our tissues, and that's your labia, and at the vaginal opening. This area is really, really rich in what we call estrogen receptors. And of course, when we go through perimenopause and menopause, that's a decreasing, and so things get a little thinner, things get a little drier, and things lose the elasticity. What often can happen is, my clients will have intercourse, and it hurts, and maybe they bleed a little bit, because again, you know, when estrogen goes low, everything gets a little drier and more sensitive, and they've been prone to maybe even some tearing, well, then that pelvic floor is actually very clever, these muscles here, they're there to protect us as well. So, if you have pain, then the next time you think about engaging in sexual activity, your brain is going to say, You know what, that really hurt last time and right away, we start to tense up our pelvic floor. And then we get caught in this vicious cycle, where we have that episode of pain because of hormonal changes, then it hurts and then our pelvic floor tenses up. Then we keep trying to have intercourse, but then we keep irritating that area, then the pelvic floor just increases in tension and increases in tension. That can lead to more pain, with sexual activity as well. So, I always tell my clients that we need to figure out which of the two groups do you belong to? Do you have a pelvic floor that just needs strengthening? Or do you have a pelvic floor that maybe requires a little bit more stretching and relaxation, to help you regain proper sexual function? You know, having sexual function without pain? In everything that we do, you know, we always take that step back and go, Okay, well, you know, what are the stressors in your life that also increases muscle tension, right? So, stress and anxiety, and lack of sleep, all increase our fight or flight response. And that's why sleeping is so important to kind of really get you restorative health, you know, and to make sure that we're refreshed in the morning, managing our stress is really important, because when you're under stress through the day, and you're in that fight or flight responses, all your muscles tense up, including your pelvic floor, right? So, then what we do is we do a physical exam. This is kind of where, you know, doing a really good explanation of the pelvic floor is really important. So, I have these really great models that I've designed over the years. And what I do is I show all of the muscles, so you've got muscles at the vaginal opening, that can be the reason you have pain with sexual activity, you've got deep muscles inside that your bladder and bowel function muscles. So, when we do a pelvic exam, we do not use speculums. We don't have you in stirrups, it's not like kind of a pap, we're going in manually with one finger and we start on the outside and we just have a look at all these muscles to see are they causing you any discomfort that could actually explain some of your pain with sexual activity. If we're able to do that, then we can go in. We can look at all of these bands, all of these muscles that you see here that's colored, these are all your pelvic floor muscles. We can evaluate all these bands of muscles right side left side to determine Are any of these muscles causing you any pain, because pain with sexual activity can be pain at the opening? or some people will tell me you know, it's deep inside. ‘It's like I can't like we have to stop it hurts so much deep inside'. Then we evaluate these muscles I say, ‘Okay, if I said to you try to contract, try to squeeze those muscles, especially with people that have incontinence, bladder or bowel, I'll say try to contract your pelvic floor'. That's where we're assessing strength and endurance, okay, how strong are your muscles? You know, how much endurance and power does your muscles generate? And if that's lacking, we're gonna work on that. So that's kind of the physical exam and the physical exam is as per our client's comfort levels. So, some people on day one will say, I'm not comfortable with a pelvic exam, maybe they need a visit or two to get comfortable with the idea. You know, some people are not aware that that's what a pelvic health physio is trained to do. We are trained to do pelvic exams for the purpose of evaluating what's happening to all these layers of pelvic floor muscles. So, you can regain bladder control bowel control, and sexual function. The other thing that this pelvic floor does, it's like a shelf, it holds up our organs and so a lot of our clients will say, ‘I feel like feel like something's falling out of my vagina'. They get diagnosed with something called the ‘prolapse', which is everything kind of softening up and estrogen is important for that because estrogen is what we need to have strong ligaments and strong tendons. A lot of times heading into perimenopause or menopause, somebody may have had a prolapse when they had their, two, three children in their early 20s, and did absolutely fine. But now they're starting to have symptoms because their estrogen levels are decreasing. That's really altering kind of the function of what we call the collagen fibers in their tendons and in their ligaments. We have a lot of ligaments that hold up our organs, and everything just kind of soften. So obviously, nothing's ever going to fall out of your body. It's never going to happen but everything softens a little bit and part of what we have to do is strengthen that pelvic floor if needed to kind of create that supportive system from the bottom. It really is all about exercise. It's about exercise. KK: That was going to be my next question, maybe with that first option of picking up someone that is having issues with incontinence, assuming you're addressing the lifestyle issues, and so on. But what's an example MJ of exercises or type of exercises that they will be using to try and rectify the problem? MJ: Everybody's heard about those famous Kegels right? Everybody's heard about Kegels KK: I'm doing them right now MJ: Kegel, he was a physician; he was a gynecologist back in the 50s. Dr. Kegel and who's who had done kind of a lot of research on the field of the pelvic floor. We call them pelvic floor exercises. So yeah, we teach our clients how to properly contract their pelvic floor. What's important to know is that you can read online on how to do cables, and how to engage your pelvic floor, but they're not easy to do. It's important to see a pelvic floor physio, because a lot of people think they're doing them properly. Then they come and see us and they're confident ‘Oh, no, no, I've been doing my ‘Kegels' fantastic, I think I'm good' and we test them, and they're not doing them properly. We tend to cheat a lot. When we try to engage your pelvic floor, we're holding our breath, maybe we're squeezing your bum, or we're sucking in our belly. Really, you should be able to squeeze your pelvic floor, you can think about I was kind of give the example to my clients, I'm like, imagine a little ping pong at the opening of your vagina and just try to grab and pick up your ping pong and for my patients that have penises, I'll say try to lift up your penis, right. Those are some of the things that we explain. That's how you think about engaging your pelvic floor or think about stopping gas. The reason it's so important for us to do a pelvic exam is from the outside, I can't tell if you're doing a proper pelvic floor exercise. When we do a pelvic exam, it really tells us how well you are using those muscles. If you have pain, then we're at least kind of finding out that there's too much tension and if you have too much tension, I'm not giving you Kegels to do. That makes sense, right? So, if you're coming in just for incontinence, I evaluate your pelvic floor, there's no discomfort, when I'm palpating those muscles and you're good to go. Yeah, then we're going to work on some strengthening. If you're already here, and then you've got pain, with intercourse, maybe it hurts to go to the bathroom, you're not peeing really well. So the muscles are not relaxing, and I evaluate your pelvic floor and there's too much tension, well, I'm not going to give you more Kegels to do. So, in that case, we're doing things to relax the pelvic floor, and this is where we do breath work. And we do yoga-based movements, a lot of pelvic openers and yoga, a lot of breathing, maybe some meditative type of practices to help relax that tension. Once we relaxed that tension, once the pain goes away, then maybe we can do some strengthening, if that's what your body needs at that time. That's why it's so important for us to do an exam because again, I can look at you and I have no idea if you've got a pelvic floor that's too weak or a pelvic floor that has too much tension but when we palpate it we can see and then we can give you the proper exercisesKK: This is good because once again I think there is a lot of women that are struggling with these concerns and with that are maybe at a loss. Are there a lot of pelvic specially physios out there? for example if people want to get access to someone of your caliber and this is not something you could be doing virtually either right? MJ: I did a lot of virtual; I still do. Virtual is really good for is sometimes even just the initial assessment like the first time because we do talk so much and we do a lot of education. So during COVID we did quite a lot of virtual and I continued to do so and sometimes that day one. Maybe you know if you've got COVID You can't come into the clinic well then, I'll just do a virtual with you do all the education and then you come back in to see me for kind of an in person visit when you're feeling better you know when you're not sick, things like that. So there's a lot of us doing virtuals as well. The best place to kind of find a physio in your area that has the qualifications to do a pelvic exam and to do pelvic health, is to look at the website called pelvichealthsolutions.ca and there's a find a physio feature there. You can actually click in your area, look at people's names, it shows all the courses they've done, so then you can kind of look at, oh, this person's done a menopause course, great. This person's done a hormonal health course. That can help you choose a physio in your area. That's a really great feature that we have. pelvichealthsolutions.ca is a great resource. There's a lot because we're, when I started 20 odd years ago, there was four of us in Ontario doing pelvic health. Now we have hundreds of physios who decided to take pelvic health courses as postgraduate training. We are not without pelvic health physios out there to help anybody who has a pelvic floor, anybody who has incontinence, anybody that has any problems with sexual health, anybody with constipation, there's so much we can do. Like I said, we've become resources for our clients to help them find the right people to go see whether it's nutrition, stress management, mental health and whatnot is really part of what we do to help her patients navigate perimenopause and menopause. KK: Wow, MJ, pure gold. In terms of knowledge and resources I must say, this was some of the best explanations of the issues when it comes to pelvic health. This is the stuff as a physician, you hear about these concerns, but the way you just simplified it, using language that all of us can understand, conceptualizing it in ways that we will understand. Putting it into, for example, two frameworks, or two patient populations that you typically see, you're the GOAT. MJ: Thank you! That's why we say to people, if you're not sure at least come in for the first visit. So, you get a chance to chat, you know, and that's a nice thing about doing virtual, you're not sure about it, we'll do a virtual and we can talk through and I think a lot of people then realize, ‘Oh, there is help for me, oh, sexual, sexual dysfunctions and payment sexual activity'. That's not okay. No, it's not okay. It's not okay, that you're not sleeping through the night because of hot flashes, right. Then really talking about the research and the evidence behind what we do. And we have a fairly high level of evidence in what we do in terms of treating incontinence and prolapse and pelvic pain. Having a chance to talk to our potential clients about that is good. Again, to make everybody feel more comfortable with topics that are not comfortable to talk about. I mean, there are still a lot of taboos around bladder and bowel health. There's a lot of taboos around sexual health. There's a lot of taboos about talking about menopause. Because we've been told, while menopause is just part of life and deal with it, suck it up, right, suck it up, you know, don't complain about it, you know. I think, I think our clients are starting to get fed up with feeling so poorly, and so discouraged about their quality of life. Like I said, it's not insignificant, there's over 30 symptoms of menopause. If we can improve any one of them, I think we're doing well, to help navigate, you know, and these challenges that our clients have. We have great research, I was just reading, just to get ready for today, that strength training again, we're physios you know, we're all about exercise motion is lotion. We encourage our clients to even get out like I always tell my clients, even your pelvic floor loves to go for a walk, just walk outside. The thing with walking is that you're outdoors in the fresh air in the sunlight, you're getting your vitamin D, you're setting your circadian rhythm, there's good research to say that if you get outdoors in the morning and bright sunshine for a good walk, you're gonna sleep better at night. Right? But strength training, which we again love to encourage your patients to do reduces hot flashes by 44%. you know, again, this is kind of in the purview of a pelvic physio or any physio is we're all about, you know, strength training to help mitigate the effects of losing estrogen and testosterone, right, strength train to reduce your hot flashes by 44%. Wow, you know, strength training to reduce osteoporosis because that increases when we hit menopause as well, because of all the hormonal changes, strength training to improve your insulin resistance so that you can lose weight and strength train for your pelvic floor because when you're strong, your whole body, everything's strong, even these little muscles here, and so kind of giving permission to your clients to exercise, but it's hard, right? because, you know, it's time, you know, and part of what happens in menopause is that people are overwhelmed with stress, and people are not taking the time to do the things they, you know, that we all get told to do, you know, eat well, sleep well ,exercise. So, it's kind of helping our clients navigate, you know, where could they find time to sneak in a little bit of exercise? What can they cut out? Right? What can they let go? What's not important, you know, and, you know, talking about the importance of strength training, I think, again, it's an eye opener. So that's why the education is so important, because when we educate people go, ‘Oh, okay, well, that's a good reason to act' maybe that's the one thing you needed to hear, to allow you to go and think about strength training, and it doesn't have to be a lot, you know, just a couple of, you know, 10-15 minutes a day can maybe be a good start. Because the impact is so amazing, just like the impact of yoga and osteoporosis and yoga and constipation and it doesn't have to be an hour of yoga, you know, I can help find a video, that's like, 15 minutes, maybe you do that before you go to bed, right to help you sleep and so education is really key, and to, to really help our clients navigate all of these crazy symptoms they have and making sense of it all. Hopefully, get that buy in that motivation that something that speaks to them that says, okay, I am going to try to make a change. When it's hard, you know, you know, one of the things that happens with our clients and menopause is they stopped exercising because they're losing bladder control. KK: Yeah, that was actually one of the things you're mentioning the resistance training. To create the habit, it's not about the result always. You got there, you did your part of the process, even if you get to the gym for that five minutes, and you didn't do all the exercises you were planning to do, but you're getting that that habit developed. So, yeah, as you alluded to, it's hard to do all these things. But to develop the habits, I think is, is where, if you could develop the habits, you'll be moving in the right direction. MJ: Yeah. And I think the more information people have about the benefits, beyond what we already know, right? I mean, we kind of go, weight loss, and I gotta quit smoking, but sometimes you can actually reduce your symptoms of menopause this way or that way, you know, again, that might be enough to persuade someone to say, okay, you know what, then I do need to carve out time in my day, I need to let go of the things that maybe are not that important, and really spend time on myself, and really improved my sleep, and improved my nutrition, and improved my stress management and try to think about exercising, because again, it doesn't take a lot to make a really big change. It doesn't take a lot to go for a walk, I'm happy if you start off with 10 minutes, I'm happy. If we decide Yoga is the best way for you to manage your stress or to help with your IBS or osteoporosis that you're doing even 10 minutes of it. 10-15 minutes of it. We start small, and we build on that. We provide encouragement, because again, we all have bad days where we fall off the rails, and it's okay, we're humans, we're human beings. As long as you just keep at it, you'll start to see some changes. And, and like I said, it's building a team, because our clients need to have the right people helping because MJ can't do everything for everybody like that, you know, if we're only one person, so who are the menopause experts out there who are the nutritionists out there who have a really good interest in menopause and Hormonal Health. Who do you go see if you're having insomnia, right? Because there's CBT there's cognitive behavioral therapy for insomnia. Okay, who are the people for that? Do you want to get hooked up with a personal trainer to kind of motivate you to strength training? Okay, let's find you someone to do that. It's all about building a team and it's all about dialogue, and always talking about these things and giving our patients permission to talk about what's bothering them, and to be open about their frustrations and you know, if they're having frustrations with their weight loss and okay, let's see who's out there who can help you with that.KK: MJ, this has been grand, it's been grand! How do people get a hold of you? I am working right now, I'm in downtown Ottawa. I'm at a clinic called Killens Reid physiotherapy, killensreid.com, we're three pelvic physios at that clinic. There's myself, my lovely colleagues, Natalie and Sophie all of which can help you with menopausal issues. You can look at that pelvic health solution website to find people in your area. It's a great resource. That's the group that I'm one of the teaching instructors for pelvic health. You can see how many great pelvic health physios we have all across Canada. There are also naturopaths, who have taken our courses that are listed. So, if you want to maybe work with a naturopath who has a knowledge of pelvic health, they're listed on there as well. We have some nurse practitioners that have taken our courses, who again have developed an interest in pelvic health. You can find all those people on the pelvichealthsolutions.ca website. Killensreid.com to reach the clinic that I'm at, you can I have a website as well mjforgetpt.ca. I'm on Instagram ‘mjforget'. There's lots of different ways to find us and, and to kind of help you with all your symptoms. KK: I love it. I love it. Thank you, MJ, for the knowledge that you threw down the holistic approach the benefits of seeing the likes of you, I really appreciate you coming on. This is awesome. I appreciate any opportunity to talk about all things pelvic health, and I appreciate all of you've done again, because you've taken quite a holistic approach yourself as someone in medicine right in really thinking about nutrition or sleep or stress or you know, exercise mindfulness and it's always nice to talk to kindred spirits, I say.KK: Thank you so much. Alright, well, I hope you've enjoyed that episode. Please follow us on Instagram YouTube, Facebook, TikTok, Twitter at kwadcast. Please leave any comments kwadcast99@gmail.com. Leave a five-star rating on wherever you listen to podcasts. Leave a review. Check out our newsletter at kwacast.substack.com. Everybody stay beautiful Get full access to Solving Healthcare Media with Dr. Kwadwo Kyeremanteng at kwadcast.substack.com/subscribe

Dr. Kwadwo Kyeremanteng joins Dr. Peris this week and BRINGS his shining light and hope into the community.  Dr. K is a critical care and palliative care physician at The Ottawa Hospital. he cares for the sickest of the sick patients in the intensive care unit (ICU).  As a researcher, he is interested in using ICU resources more efficiently and improving access to palliative care in the ICU.  To help do this, he founded the Resource Optimization Network, a multidisciplinary research group working to reduce health spending in this area without compromising care.  He challenges the status quo, leaving no stone unturned as we explore gaps, assumptions, and different perspectives in the pursuit of finding solutions to problems in Canada's healthcare system. Courage, action, and passion.  Listen up, and tune in, this is a dynamite episode Connect with us on Instagram @_the_wild_collective Registration for Mom & Daughter Empowered Teen Program HERE  *1 SPOT LEFT* This episode is brought to you by: www.the-willd-collective.com Ready to reclaim your Wild? JOIN THE WAITLIST Learn more about The Poppy Clinic: www.poppyclinic.com Is Naturopathic Medicine for you: LEARN MORE HERE Take our HORMONE QUIZ Are you a clinician looking for more impact? START HERE

In this episode we welcome Indigenous medicine woman and best selling author, Asha Frost, to speak with us about homeopathic medicine, spiritual journeys, healing, and more! Asha is a member of the Chippewas of Nawash First Nation and has a BA in Psychology from the University of Guelph and a degree in homeopathic medicine. Her book ‘You are the Medicine' is full of powerful teachings and has guided thousands. Today we learn about Asha's path through Indigenous medicine, racism, creative ways to heal yourself, spirit animals, and much more! Asha is an incredible mentor and she also leads us through a moving guided journey, and gives us some great perspective into mental health. SPONSORBETTERHELPBetterHelp is the largest online counseling platform worldwide. They change the way people get help with facing life's challenges by providing convenient, discreet, and affordable access to a licensed therapist. BetterHelp makes professional counseling available anytime, anywhere, through a computer, tablet or smartphone.Sign up today: http://betterhelp.com/solvinghealthcare and use discount code “solvinghealthcare"TRANSCRIPT KK: We are on the brink of a mental health crisis. This is why I'm so appreciative of the folks over at BetterHelp. The largest online counseling platform worldwide to change the way people get help with facing life's challenges by providing convenient, discreet, and affordable access to licensed therapists. BetterHelp makes professional counseling available anytime, anywhere through a computer, tablet, or smartphone. Sign up today go to betterhelp.com and use a promo code ‘solvinghealthcare' to get 10% off signup fees.SP: COVID has affected us all and with all the negativity surrounding it, it's often hard to find the positive, but one of the blessings it has given us is the opportunity to build an avenue for creating change. Starting right here in our community discussing topics that affect us most such as racism and health care, maintaining a positive mindset, creating change the importance of advocacy, and the many lessons we have all learned from COVID. If you or your organization are interested in speaking engagements, send a message to kwadcast99@gmail.com, reach out on Facebook @kwadcast or online at drkwadwo.caKK: Welcome to Solving Healthcare. I'm Kwadwo Kyeremanteng. I'm an ICU and palliative care physician here in Ottawa and the founder of ‘Resource Optimization Network'. We are on a mission to transform healthcare in Canada. We're going to talk with physicians, nurses, administrators, patients and their families because inefficiencies, overwork and overcrowding affects us all. I believe it's time for a better health care system that's more cost effective, dignified, and just for everyone involved.KK: Kwadcast nation, welcome back! We got a great episode with Asha Frost, and I tell you this, this one was extremely moving. We talked about ways of healing thyself, looking at creative ways to not only bank on conventional methods of healing, but also looking at spirituality, looking at our mental health, the mind body connection to create healing is tremendous. We go into some of the indigenous ways that could improve our overall health, we go through a guided journey, which as you'll hear was extremely moving from my perspective, I was a little verklempt after that one. Then we talked about we talked about racism, we talked about our own experiences within healthcare, she tells her story about being treated like an animal, within the emerge our own experience not that long ago, which I think a lot of people need to hear. It's tough to hear, but it's just another reinforcing message that we got work to do. So, looking forward to you guys hearing that. Before I forget, please check out our new substack kwadcast.substack.com. We have all our jam on there. We put all our jam on there,  our newsletter, previous episodes, we're all in on substack. Video, video messages, our community chat, you could chat we have a chat community on there too. So please check it out. You guys gonna love it. It's a better way of us staying connected. So, without further ado, check it – Asha Frost. Kwadcast nation, man this is a real privilege today, folks. It's a real privilege today because we got Asha Frost, who honestly, I just met in November. We were both that ‘Impact' live, amazing event put on by Meghan Walker. Your keynote, everybody was talking about this bad boy.  I got to connect with you backstage. Show me your book, all the magical things that you're doing. I was like, she's got to come on the show folks. Asha's got to come on the show. So welcome to the kwadcast.AF: Thank you. That's quite the introduction. Thanks for having meKK: Oh, man! It's the least I could do after all the magical stuff you're doing Asha. Seriously, this is an exciting show for me. So maybe, to give context to why you're doing all these workshops, the book, the essays, I think a lot of it comes from your personal experience. So maybe just tell us a little bit about how you've gotten here.AF: Sure. So, I'd say my healing journey started when I was 17. I was diagnosed with lupus. At that time, doctors didn't really know a lot about lupus and the antibodies that were positive in my bloodwork really were like quite serious. So, they were saying ‘You're gonna have to go on medication for the rest of your life, you're might not have children, you might not live a long life' and of course, as a 17-year-old, I was really scared. At that time, I lived in a really, I'd say, non diverse town. So, there weren't a lot of indigenous people. My grandparents had been in residential school, I had been colonized away from our medicine ways or away from our ways of healing and knowing and being. So of course, I thought, oh, we'll try the medication. So, I did, and I got so many side effects from the prednisone and the anti malarial drugs. So I knew there had to be a different way. I went to university and at that time, I got really sick because of the stress of university, and somebody said, why don't you go see naturopath. That sort of opened up everything for me, I saw naturopath at about 21. Then I thought, ‘Oh, my goodness, there's a remembering of myself and my blood and my bones calling me back to these ancestral ways of knowing and the earth' and I had to uncover that. That was like the beginning of my journey just going on this. It's always just been ‘How can I heal myself?' and then, of course, as I heal myself, I share that with the world. So that was the beginning.KK: Wow, wow. So really, unfortunately, having a relatively serious diagnosis at a very tender age of 17. Going through the conventional treatments, were you finding you were getting better when you were taking the conventional meds?AF: Not really, I'd say, no, it made me so much sicker. I just I've had new symptoms that I wasn't experiencing with the lupus symptoms. So, it wasn't making me better. I thought, well, this doesn't feel like it and maybe if I tried it longer it would have, but it just didn't feel like a really good exchange of I'm taking these and I'm feeling worse in my body. So, it wasn't helpful at the time, I have subsequently taken little small doses at times that have been helpful, definitely. But at that time, it wasn't helpful.KK: So you walk through this, this journey and will really having an incentive to heal thyself, like really looking at ways to heal thyself, and going through natural paths and so forth. What came of it? what was it mostly, nonconventional medications, was it meditation was a nutrition what changed for you? And was it effective?AF: Yes, so I saw a naturopath who was amazing at homeopathy. She prescribed a remedy. It was all so new to me and I thought, this is kind of neat and she told me ‘this is going to match your physical symptoms, but also your sort of personality, your essence, your emotional body' it really looked at the whole being, and it made sense to a part of me. I remember taking that that remedy, and my hair was falling and at the time really bad, and that got better. I remember my joints were really achy and not got better. So, I got really interested in lit up by homeopathy. It actually inspired me to go to school for homeopathic medicine, because it helped me so much in my own journey that I thought ‘I want to offer this to others'KK: Wow. So basically, you wanted to help create that magic for other people. You saw how the homeopathy improved your quality of life, and improved your symptoms, and wanted to create that. That loveliness for the greater for the greater masses. How has that journey been? when it came to getting people healthier - how's that been for you?AF: I loved having a private practice. I loved sitting with people, I loved holding space for their highest vision of who they were. Everybody I feel like we are sort of conditioned to feel like there's always something wrong with us, you know that everything over the messages are always coming at us that there's something wrong with us. I believe that my private practice held space for the truth that you have this vital force, you are divine, how can we just remind your body? how can we remind your spirit? so my practice ended up turning into like a homeopathic practice. But then of course, I started to weave in indigenous ways of being and knowing and indigenous healing because that's who I am at the core. That's what I was discovering about myself. So, it was a combination of spiritual healing and then the homeopathic medicine.KK: I think that's what really attracted me to what you were what you were throwing down, was this the ‘spiritual' component adding that indigenous side. Who you are to a healing practice and delivering it to patients. I must say, as ignorant as possible. I have no idea what that would look like. I have no idea not only what it would look like, and just the impact it can have. So, walk us through the potential and what treatment would look like, what the outcomes could be. I mean, I don't know if you need to give a specific case, but just give us a sense of what the potential is from your practice?KK: Well, I tend to attract a lot of people who had anxiety or depression. That was like a lot of mental health that tended to come through my practice. So, people would want to get off meds, like anxiety meds, or depression meds, and we would just do that with their doctor, they would be tapering, and then this homeopathy would support sort of their tapering off and bring them back to sort of that truth that they do have something within the MEK and help them balance themselves and come back to that healing. So, I saw a lot of a lot of folks with that. I saw a lot of folks with autoimmune conditions because that's what I lived. So, I tended to know a lot about that. I'd say that people's arthritis got better. Their fatigue got better. They their movement was better; they just had more ease and grace in their lives. I think, on the spirit level, they felt more connected to who they were, and for some reason, that just trickled down to their physical body. So, they would feel more connected to themselves through guided journeys, or meditations, or I would do hands on healing. They would come home to that truth, but they have power, they have presence, they have medicine, and for some reason that like switching on that light bulb really helped people.KK: That's amazing. We talk a little bit about on the show, that whole mind body connection, how it's all tied, how you feel, how you're doing upstairs affects your body and your ability to heal and to get better. I'm just really interested to hear what its like to walk through the term, how did you phrase it again, you're walking journey? Your guided meditation? what does that look like?AF: Yeah, so from an indigenous perspective we really believe in the power of dreaming and visioning and quiet because that's when you can hear spirit. So, getting somebody in that state of quietness, when they're listening to their own connection to spirit was so powerful. So, what maybe animal spirits might come in to help with medicine that they want to offer, or it might be their ancestors, or their grandmothers or their guides. So, there was a lot of spirits support, helping people and then some of the sorts of techniques that were used were of a shamanic. I've taken a lot of training around like shamanic enters, there's a lot of energy healing energy work, that would shift some of the blockages maybe for a vital force to flow through more effectively. It always came back to that person, again, like sort of seeing and remembering, oh, my goodness, I can do this, like, I have sovereignty in my own being and body. I have I have power, because I think sometimes in the medical system, we can sometimes feel like we don't. Our power, we kind of give it over to say, ‘well, you have all the answers' and that might be true. They might have answers, but we have answers to.KK: Yeah, we have an ability to call on to contribute to our own healing. Right. I mean, like I said, this is not the typical approach to medicine, I've been practicing almost for 20 years. We don't often add a spiritual component and, and, and so forth. Do you like how the results been in your practice? Asha, when you add these elements, on top of everything else that they're receiving? How do you feel the response has been?AF: Well, I no longer practice privately anymore, but I had a practice for 15 years, and it was really busy. So, the word of mouth was always really, really strong. I was booked solid with a waiting list. I would say the results were really, really amazing. People tend to leave my space, just feeling uplifted and feeling better. So, I wish I could quantify that with like, you know, we had this many cures or whatever that is, but I think that's the difference between being healed and being cured. I think we look for a cure, but we kind of forget about, what kind of healing leaps have we made? how much more satisfaction do we have in life? how much more peace do we have in our heart? how much more gratitude and joy is emanating from our system and ourselves? I think those things are maybe not measurable, but they are really important.KK: Oh, man. Absolutely. I think especially now, I feel like this is so valuable coming up, post pandemic where people were from a spirituality perspective, from a mental health perspective, just beat down. We're seeing the resurgence, unfortunately, of so many ailments, which is obviously very complicated because of lack of access to care, people weren't getting screenings, and so forth. This is something that I feel like could be so valuable to so many. I think one of the magical things that you're doing ashes is, is creating that at scale now, you're really trying to make this accessible to not just a patient in front of you, to everyone. So how are you doing that right now?AF: So, I closed my private practice maybe four years ago now. At that time, I wanted to bring all these teachings online. I created like a global membership with indigenous teachings and healing. I loved doing that. So that really like scaled up the folks I was able to touch. At that same time, I got a book deal by through Hay House, and that has just expanded my reach, I think, to all the people that I can touch with my words. Writing that book is just it's so interesting, because you write this book, and this little cocoon was in the pandemic, my littlest was two, and they were home. It was kind of a disaster, but I put myself in this little cave. I wrote this book. I didn't realize I didn't really think ‘Oh, these words might actually touch people, oh, these words might actually be shared by people' I just kind of thought I'm gonna write this, put this out there. Now it's rippling out way bigger than I could have ever imagined. It's just rippling out in so many ways. That's the most important thing for me is that people remember who they are. They're touched by my words and it kind of ignites something within them. That was my intention for the book was that they could see that that presence that they are, it's called ‘You are the medicine' that they are the medicine, they carry medicine. And they can share that with other people too because we need that message shared, I think.KK: Absolutely. Absolutely. Obviously, the book is out you do public speaking engagements. I saw also you're doing workshops amongst folks, walk us through that, is it small workshops? Is it organizations? who are you seeing?AF: Yeah. So, for the longest time, when I was in my private practice, I did healing circles. That was a way that my medicine was shared. I was doing a lot of those probably hundreds and hundreds of healing circles. Then when my book came out, actually last year, it came out last March. Folks begin to ask me to come and speak to bigger audiences. So, it's lit me up. So huge, so yeah, it's some like health conferences. People really need healing right now, so people are asking me to come and do like opening ceremonies as an indigenous person to offer some messages around like cyclical living. It's really the vibe of healing. Everybody just seems to need it. So, I've been invited to do that and it's something that I've always wanted to do in like a bigger scale. So, it feels so in alignment, I hope it continues, because it's really something that lights me up. But yeah, those workshops, you know, I do smaller workshops, during the pandemic online as such, that's how we connected so I was invited to a lot of people's programs to share, and to offer that healing component to their work too. So, I love being asked into spaces.KK: What are the principles that happen there? When we're doing a healing practice or speaking to the masses is it is it a matter of ‘Hey, folks take more time to be with yourself and, and or listen to this guided meditation' what's some of the take homes people leave with when they when they hear Asha throw down?KK: So many times I speak of the medicine meal because our traditional medicine meal speaks about the importance of the whole system. So, I'll take us through the way of living seasonally and cyclically and listening because we are Earth. All of us have been colonized away from that that truth that we are we do live seasonally, and we go through our highs and our lows, and the world wants to tell us ‘no, you have to be hustling all the time'  and then we end up in burnout. So many of my messages are around because I've had to do it myself. How do I come home to the medicine of rest? How do I come home to the medicine of listening? all the things that the world pulls us out of my message tends to be around that and I love working with animal spirit medicines. The animal teachings those are brought a lot into my teachings and then we always do a guided journey. I have done this with thousands of people. I can say that almost everyone that I've ever worked with has seen an animal spirit or they're able to see sensor I do believe that I can hold a space somehow that can get people visioning and get people into that space where they're connecting to something greater than themselves.KK: Wow. Wow. So how do how do people get in more in tune with resting and listening? How do we get more in tune with our seasonal aspects of life?KK: Such a good question, I think it's really hard. I think the first question to ask ourselves is about our relationship to the systems. how has colonization impacted us? How has the patriarchy How is capitalism? just feeling the impacts of that collective energy and how we've marinated in it, it's just sort of an acknowledgement and validating ‘Oh, right, we come by this honestly' because we were born into it. And this is like the, the energy that's up all the time. There's a lot of unwinding. Especially if you have ancestral wounding, or generational trauma that is connected to a lot of the folks that I work with do have. So, we have to dive deep into that healing and say, ‘our ancestors did this so we don't have to anymore' We can take that like labor off of our back. We're allowed to invite in rest and ease and abundance and it's hard for folks of color to really lean into that, because our cells are telling us something different. It's a lot of journeying, reflecting, going into our dream time, I think it's like simple of just like rest actually going to bed earlier to say ‘Oh, my dream time is here, It's going to offer me some medicine and some wisdom' Can I allow myself to have that? So might be like sound kind of strange but to me, going to bed early during this winter season is a way that I receive so much wisdom.KK: I mean, it makes sense. It's a time to hibernate, recharge, with the sun going down that much earlier there's a lot of a lot of things pointing towards being more restful during that time. The other question? this might be a tough one. I'm putting you on the spot here. What's the guided journey? I don't know if we could do one or if that's too difficult. I want to get a sense; I think our listeners will get the chance to showcase Asha skills. You know?AF: I would love to.KK: Yeah. If you're interested, let's drill down.AF: Definitely, we're talking about rest, we're gonna set the intention for this journey, to connect with an animal being so you know, we talk about spirit animals or animal spirits. We want to do this in an appropriate way where we're appreciating this animal. So, I'm just going to start by saying whatever comes forward to you, to trust what you get, to trust if we've not worked together before, your spirit knows. Then in a way after, when the animal comes to honor it with deep gratitude, because it's an important practice and teaching. We're gonna start with closing our eyes and if you're seated, you can just feel your feet on the ground. We acknowledge the earth beneath us, the land beneath us. Just feel the land beneath you. I'm going to acknowledge that I'm on the lands of the Anishinaabe. We are still here. Feel the spirit of the land and all that it's seen and experienced, rising up through your feet, warming you comforting you, grounding you, with every breath you take. Today we ask for all of the beings that wish to support and guide and surround us to be present here. We call upon the sacred door an opening to the spirit world. The store is shining with golden light and around the light. There's this rainbow light. We feel this rainbow light spark ling and shining so bright. But as you walk towards it today, it flushes and washes upon you. Washing over you and you begin to feel sparkles of reds and purples and violets, greens and golds, pinks and turquoises in your own cells and tissues for you our prismatic being shining and sparkling here.  As you walk through, you see the land beneath your feet, your feet are bare, and you sink your feet into the soil, squishing your toes with every step. You continue walking, feeling yourself being led down this path and in the distance, there is an ancient forest. The forest looks so inviting the trees and the plants that are here are familiar to you in some way. You walk yourself over to this forest. As you step in, you breathe and the medicines that are here. The medicines that are perfect for your body and your spirit today surrounds you. With every step, you walk in deeper, the forest gets a bit darker, surrounding you with care, holding you with love. As you walk deeper, we set that intention.  That intention for the animal spirit that is helping us the most right now to appear in some way. As you are closer, there's a clearing where the sun is peeking down through the trees. As you walk closer, we asked for that animal to become clearer, more powerful, and to appear for us in some way. Notice what you see, listen to what you sense or feel. who arrives for you? Trust this animal gets closer to you. You ask them ‘why are you appearing for me right now? What are you here to remind me of that I have forgotten about myself?' and do you listen. You ask this animal ‘What is the word that I need to carry with me in my heart? The word that will remind me of who I am this year?' and you listen. This animal becomes really sparkly, it wishes to align with your energy. You step into this light, and you feel this rush of light source through your mind body and spirit. The medicine of this animal dropping in tear being you feel that message in your heart that it was just to offer you. You feel yourself walking back out of that forest with that message from that animal making your way all the way back to that path where you started carrying that animal medicine with you, honoring it with gratitude and love and moving it all the way back to the door. Taking a breath here, the animal places a gift in your hands so that you may remember them that you are walking with them. You walk through that door and then you breathe yourself back into your space. Feeling your feet on the floor feeling the lands beneath your body and when you feel ready you can open your eyes. Welcome back.KK: Wow. Wow, that was quite an experience.AF: what did you see? if anything?KK: It was some form of bird, a hawk or something like that. The message was like love, just focus on love.  Past me in terms of an object image just some rocks, but yeah, love. Bird, love, rocks. That was moving.AF: Yeah, it's always is different based on the energy that I'm sitting with. But today, the animal really said, ‘I want to come into your heart' So when you doubt your path, or you forget who you, place your hands there and just activate that energy there. I got a big moose. I got a moose. So, that was beautiful, but it was just really to remember that like they are here for us, to remind us to come home to ourselves. You can honor that Hawk in some way. Get your kids to make a little altar for it.KK: Absolutely. It's funny as you were saying, animal I was thinking Lion. I don't know why I've been thinking about lions lately. A lot, too. I thought that's where I was gonna go. But the image that came to me as you were speaking was a hawk. It was a bird was substance.AF: You know, for the listeners, I know everybody the questions ‘what does it mean?' Right? And there are different ways you can look up. The first question I'd ask myself is ‘what does it mean to you?' Right? What does that animal? How does that animal move in the wild? What strengths do you think that animal has? How does it carry itself? All those things are the medicines it's bringing you. Then of course, you can look up on Google if you want to see like, what is the animal spirit? Next year, I'm doing an Oracle deck that will have all the animal cards in it so that I can say you can look at my Oracle deck and see what they mean. But right now, there's a couple of books ‘Animal Speak' by Ted Andrews is really good, too.KK: Wow. It must be pretty powerful. Doing this in a group setting. I'm curious to hear what people like the feedback that you get after having such a amazing, guided journey.AF: Yeah, people always, it's something I know because I've practiced so many times and edit so many times that it's opening up some sort of portal to some sort of different understanding and people always come back touched. So that's a common people say they feel touched or like part of their spirits moved.KK: I mean, I'll be honest with you, that's how I'm feeling at this time. Touched. Something changed. So, thank you, Asha, for allowing me to be part of that. That was something. If you hear a little bit me being a little off. It's because I am a little off. After that, was emotion. It's a bit vulnerable. Why love? Why the hawk? It's, it's clearly something that was needed. Once again, thank you. Asha.AF: You're welcome.KK: I can't remember if it was at the conference, at the conference or, or another time, but, you know, we often talk about systemic racism and the experience of being a person of color when it comes to being treated as a patient. I wonder if some of this ties into your experience, and I don't know if you've had any, any experience that made you really concerned about how systemic racism affects our people?KK: Yes, I had one incident. It's so interesting, because I doubted myself for so long, I gaslighted myself for so long thinking of that was nothing but then when I had the capacity to think about it, it was it was definitely something.  My eldest was two at the time. I remember just, he wasn't a good sleeper. So, I was really overwhelmed and burnt out and I got a really bad pneumonia. I was caring for him, I kind of left it a little bit too long. By the time I got to the hospital, I couldn't breathe at all. It was very serious. In the wintertime, I always wear my mukluks because that's what I wear. I think I probably had beaded earrings on when I went to the hospital. They put me in a corner, which I understand lots of people have had that experience. There's not room and all of the things but I was there for a really long time considering I couldn't breathe and I was really, really struggling. Then when the doctor finally came in in the middle of  the night he said to me, he looked at me and he said to me, he knew I couldn't breathe. And he said, ‘How much alcohol have you had to drink? And do you have a home?' Those were the first things he said to me. So, he didn't ask me how I was doing or what I was struggling with. I think I was so shocked by that, that I just I froze, I said ‘Yes, I have a home with my husband and my son, and I haven't drank any alcohol' I sat with that probably for a good six months, not really knowing what that meant. Then, you know, it sticks with you. So, I started speaking about it, because at that time, that was like 2014. But indigenous, I feel like we've been so invisible across Turtle Island. That continues to happen. So, it wasn't really until the children were found her in the residential schools that people released her talking about some of these issues. So, I held on to it for quite a while before I really started writing about it and sharing about it. Of course, people are shocked and they say ‘how, like, how does this happen?' the truth is, it happens all the time, every single day. Oftentimes, I think indigenous people just feel like we just suck it up, like, well, that's just part of who we are. That's what everybody thinks we are all about. So, we don't speak on it, because it's, nobody's gonna hear and listen to us.KK: What you're describing I'm sorry, you experienced that. I've seen it firsthand. Okay, folks, I've seen this s**t firsthand whether I was med student in Edmonton, whether it was being a trainee or staff person in Ottawa, you name it. This, unfortunately, that attitude towards racialized folks was, but especially when I'm talking about with indigenous population is a reality. I talked many times, the episode we did with Mike Curlew about Sioux Lookout, not that long ago, have segregated hospitals, running out of medication, running out of sedative medications, antibiotics in our own country. Yes, we have been increasing the awareness, which is great. In terms of these issues, like George Floyd, the residential schools, you're hearing a movement and you're seeing that push towards diversity, inclusion, and equity, and so on. But I'll tell you this, this is not enough. I'll just say, we're moving in the right direction, but it is not enough. These attitudes are deep seated. They're systemic. From my perspective, maybe I've got a little bit of edge here, but it's like no more. No tolerance for this s**t. I am just done. I've been in those experiences to Asha, where you, you question? ‘Oh, maybe it's not really me, or maybe its what I was wearing' I'm now at this stage. F**k that. I'm sorry. No, enough, is enough. I hear these stories and it just breaks my heart. Folks this is one example. Picture yourself. You're relatively new mother is right, with your two-year-old. You've been fighting off going into a hospital because you want to be there for your family, you can't breathe because you have pneumonia, and some cat comes in and asks you how much you drink? Do you have a home? what part of me is screaming ‘I have a problem?' Just by the way I look you make these assumptions. How are you feeling at that time? How vulnerable do you feel you bring your life in somebody's hands, that is judging you out of the gate? This is this is not right and I hear these, I hear the naysayers ‘who gives a s**t about D&I and all that stuff' If I'm being honest, there's ways to approach it and there are ways not to approach it, and I think people are trying, but this is why diversity matters. This is why it matters. This is why you need people at the table, at your boardroom, in your exec room that look like us. So, they could so they could address these needs, they could put awareness to these needs and do all we can to prevent it from happening to some of our most vulnerable folks, enough of abandoning these people. I'm just so sick of it. I'm so tired of it. I know I'm making this about me a little bit I'm sorry, a few months ago my kid got my eldest kid got called the N word at school. I gotta say, it was very triggering for me, I look at my nine-year-old son and knowing now that his innocence to a certain degree has been taken away from him. He knows now get that sense that we've many of us have had, you and I have had that we're being judged by our appearance. He now knows what that's all about. I don't want that for my kids. I don't want that for my boys. I know it's a reality. I know are gonna have to go through talking to them about how they conduct themselves with police. I will have that conversation. But you and I shouldn't need to have that conversation. It's just heartbreaking hearing like this not that long ago. How old is he now?AF: He's ten so that was eight years ago.KK: Eight years ago, but s**t. Like enough? I just went off there unexpectedly. But it's just like I said, I get triggered by this s**t. How did that frame your practice? Do you feel like that change the way you deliver? Care? Did you like it? Was that motivating in any way? How's that shaped you?AF: Well, something I was really, really present with was the fact that I am in a privileged indigenous woman, and I have a ton of support family friends.  I have a home; I have a ton of that and it impacted me so deeply. I just think about folks who don't have that type of support system, to even go bring it to a therapist, or to even like, you know, it just keeps building up building up building up. So, it really struck me in that way. It really struck me that I need to be a voice for those who don't have a voice or a voice who don't have those who don't have the capacity to speak up. That's when I started speaking up on social media, I can't not do this. So. And then I wrote this letter called ‘Dear White woman that wants to be like me' because at the time, I would just see a ton of whiteness. I know people hate this term, white women, but it was white women, it wasn't black women, it wasn't South Asian women, it was white women taking our teachings and our beautiful things and then using them for their profit or using them for their advancement. Obviously, all these white women rising in the spiritual places on social media and in their online businesses, and I thought ‘I've been in business for 20 years. Why is this? How, like, why is this happening? What like, why am I so invisible?'  it just hurt to have these things taken and no acknowledgement of where you're taking it from, of the history of our country of indigenous people. So, when I wrote that letter, I wrote it on my blog, and I thought, oh, maybe like 20 people will read it. It went viral. And I think 25,000 people shared it. I think it was at hospital incident that just kind of led to this, like, speak up, let your voice be heard, even if it's scary, all those things. Then when that went out really wide. I said ‘there's no turning back now'. This is this is the truth. This is the truth about how our country doesn't see us. I want to be a voice for those who cannot speak it.KK: I want to really commend you Asha for being that voice, because it's not easy. You have to go to a difficult place anytime you speak up. When we speak to issues such as this, go to your own experiences. It's great to have that courage and to have that will and it's what we need. It's what we need. That's why we have a mentorship program for black youth that are aspiring to be physicians and then go into the medical field and one of the things that I'm trying to do instill in these guys is it's okay to be authentic, I want you to be you, I want you guys to be you, for your mental health your overall wellness. There are a lot of messages that being you is not safe, but I'll tell you, we're gonna change that.  We're gonna be our authentic selves walking through the door, so that you could thrive. It's similar to the Impact event just like enough of just surviving people. I want you cats to thrive. When y'all excel, I want you to get a seat at the table and realize that you could achieve your dreams. When I give that example of walking into a hospital and a young black kid was a patient and he saw me he's like ‘Wow, that's incredible. There's a black doctor here' at the time, I thought it was awesome. I'm being a role models to folks. At the same time, I was like, how? Why am I a unicorn? I shouldn't be special. There's no way I should be special. So like a lot of you know, racialized community members don't even think this is a reality. Us doing what we do, they don't think it's a reality. So, you know, putting ourselves out there being an examples, being a voice to say like enough is enough to important.AF: I realized how long I carried sort of so much responsibility over responsibility. When the, the children were discovered, I said ‘If every Canadian could take one piece of like, what's on my shoulders, you know, if you could just carry some of this with us, and really be allies for our voices' Yes, we do this and it's important and we have to and we're so tired of always having to do this. I'd rather just go dance in my living room to be honest, I want to call him that grace, ease, joy, abundance. Speaking the truth doesn't always do that. I know I'm making huge changes for the next generations. I feel like it's so impactful and also I'm tired. So, I would love to like invite folks to like, can you also just like, you know, spread some awareness and care. Just care.KK: Yeah, more importantly be that ally. I mean, just sit with it, think of the kids in that school. Think of a kid who is alone, away from their people, abused and dying alone. How can you not have compassion? Most of us are our parents, think of your own child. Really sit with it. Think of your own child being away from you and being abused and neglected. This happening in our own country, these attitudes persist, that we could treat people like animals. Still to leave that and not have a lens of compassion or not want to be an ally. Screw that, man. It's time. It's time. I'm, I'm ready to drop kick some of this racism stuff in the pelvis. I've always been a bit. You know, we need to do better but George Floyd, residential schools, seeing it in my own child. You know, for me we have no choice but to speak up. We really don't. Oh my God, this is an emotional episode, Asha. Going from love, the anger to sadness. I'm exhausted. This that's a sign of an amazing interview. So, I wholeheartedly want to thank you for all that you're doing - your courage, your voice. The ability to reach so many folks is what we need and just being creative to like, to you thinking outside the box on how I can reach more and more folks. I really want to commend you. Can you give folks the best ways of connecting with your book? ‘You are the medicine' , your website, I also want them will have a link to ‘Dear White women' tooAF: Yeah, my websites ashafrost.com and if folks are open to looking at oracle decks, I have my Oracle deck coming out the end of February. It's called ‘Sacred Medicine' Oracle. It is so beautifully illustrated. You get to choose a medicine for your day, every day. So, I invite folks into that next part of my work and then follow me on Instagram asha.frost.  I'm there most often.KK: Your IG is fresh and growing. Listen, thank you so much for joining us on the show today. You've truly moved me. I know you're gonna move many of our listeners too, thank you so much.AF: Thanks for having me.KK: Thank you so much for joining us. I hope you enjoyed that episode. Please check out all our content on Instagram YouTube, Tik Tok, Facebook, Twitter @kwadcast. Check out our Substack that's where we have everything housed now. I'm telling you changing the bogey. Leave any comments at kwadcast99@gmail.com. Leave that five-star rating. Everyone would give some love to your loved ones. Let's start healing together.Solving Healthcare Media with Dr. Kwadwo Kyeremanteng is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.Thank you for reading Solving Healthcare Media with Dr. Kwadwo Kyeremanteng. This post is public so feel free to share it. Get full access to Solving Healthcare Media with Dr. Kwadwo Kyeremanteng at kwadcast.substack.com/subscribe

Episode SummaryIn this livecast episode, we welcome back Dr. Zain Chagla, Dr. Stefan Baral, and Dr. Sumon Chakrabarti to address some of the issues we've seen throughout the pandemic, new variants and what to expect with future variants, discussing what we've done well over the past few years, misinformation, the effect of social media and the messaging on Twitter, the role media plays and the influence of experts on policy, public health agencies, booster shots to combat new variants and who actually needs them, where we are at with public trust, and much more!SHOW SPONSORBETTERHELPBetterHelp is the largest online counselling platform worldwide. They change the way people get help with facing life's challenges by providing convenient, discreet and affordable access to a licensed therapist. BetterHelp makes professional counselling available anytime, anywhere, through a computer, tablet or smartphone.Sign up today: http://betterhelp.com/solvinghealthcare and use Discount code “solvinghealthcare"Thanks for reading Solving Healthcare with Dr. Kwadwo Kyeremanteng! Subscribe for free to receive new posts and support my work.Thank you for reading Solving Healthcare with Dr. Kwadwo Kyeremanteng. This post is public so feel free to share it.Transcript:KK: Welcome to ‘Solving Healthcare' I'm Kwadwo Kyeremanteng. I'm an ICU and palliative care physicianhere in Ottawa and the founder of ‘Resource Optimization Network' we are on a mission to transformhealthcare in Canada. I'm going to talk with physicians, nurses, administrators, patients and theirfamilies because inefficiencies, overwork and overcrowding affects us all. I believe it's time for a betterhealth care system that's more cost effective, dignified, and just for everyone involved.KK: All right, folks, listen. This is the first live cast that we have done in a very long time, probably a year.Regarding COVID, we're gonna call it a swan song, folks, because I think this is it. I'm gonna be bold andsay, this is it, my friends. I think what motivated us to get together today was, we want to learn, wewant to make sure we learned from what's gone on in the last almost three years, we want to learn that,in a sense that moving forward the next pandemic, we don't repeat mistakes. We once again, kind ofelevate the voices of reason and balance, and so on. So, before we get started, I do want to give acouple of instructions for those that are online. If you press NL into the chat box, you will be able to getthis. This recording video and audio sent to you via email. It'll be part of our newsletter. It's ballin, you'll,you'll get the last one the last hurrah or the last dance, you know I'm saying second, secondly, I want togive a quick plug to our new initiative. Our new newsletters now on Substack. Everything is on therenow our podcasts our newsletter. So, all the updates you'll be able to get through there. I'm just goingto put a link in the chat box. Once I find it. Bam, bam, bam. Okay, there we go. There we go. That's itright there, folks. So, I feel like the crew here needs no introduction. We're gonna do it. Anyway, we gotDr. Zain Chagla, we got Dr. Stef Baral, we got Dr. Sumon Chakrabarti back in full effect. Once again, like Isaid, we were we chat a lot. We were on a on a chat group together. We were saying how like, we justneed to close this out, we need to address some of the issues that we've seen during the pandemic. Talkabout how we need to learn and deal with some of the more topical issues du jour. So, I think what we'llstart with, well get Sumon to enter the building. If you're on Twitter, you're gonna get a lot of mixedmessages on why you should be fearful of it or why not you should be fearful of it. So, from an IDperspective, Sumon what's your what's your viewpoint on? B 115?SC: Yeah, so, first of all, great to be with you guys. I agree, I love doing this as a as a swan song to kind ofmove to the next stage that doesn't involve us talking about COVID all the time. But so yeah, I think thatwe've had a bit of an alphabet soup in the last year with all these variants. And you know, the most oneof the newest ones that we're hearing about recently are BQ 1, xBB. I think that what I talked aboutwhen I was messaging on the news was taking a step back and looking at what's happened in the last 14months. What that is showing us is that we've had Omicron For this entire time, which suggests a levelof genomic stability in the virus, if you remember, variants at the very beginning, you know, that wassynonymous with oh, man, we're going to have an explosion of cases. Especially with alpha for the GTAdelta for the rest of, of Ontario, and I'm just talking about my local area. We saw massive increases inhospitalizations, health care resources, of patients having been sent all over the province. So, it was itwas awful, right. But you know, I think that was a bit of PTSD because now after anybody heard theword variant, that's what you remember. As time has gone on, you can see that the number ofhospitalizations has reduced, the number of deaths has reduced. Now when omicron came yeah, therewas an explosion of cases. But you know, when you look at the actual rate of people getting extremely illfrom it, it's much, much, much less. That was something that, you know, many of us were secretlythinking, Man, this is great when this happened. So now where we are is we're in January 2023, we'vehad nothing but Omicron, since what was in late November 2020, or 21? Maybe a bit later than that.And x BB, if you remember, be a 2x BB is an offshoot of BH two. Okay. Yeah, if you're noticing all thesenew variants are their immune evasive, they tend to be not as they're not as visually as, I see this in myown practice, like all of us do here. You know, they are, well, I'm kind of piecemeal evolution of thevirus. Now, there's not one variant that's gonna blow all the other ones out of the water, like Oh, microndid or delta. Right. I think this is a good thing. This is showing that we're reaching a different stage of thepandemic, which we've been in for almost a year now. I think that every time we hear a new one, itdoesn't mean that we're back to square one. I think that this is what viruses naturally do. And I thinkputting that into perspective, was very important.KK: Absolutely. Zain just to pick your brain to like, I got this question the other day about, like, what toexpect what future variants like, obviously, is there's no crystal ball, but someone alluded to the ideathat this is what we're to expect. You feel the same?ZC: Yeah, absolutely. It's interesting, because we have not studied a Coronavirus this much, you know, inhistory, right. Even though we've lived with coronaviruses, there probably was a plague ofcoronaviruses. What was the Russian flu is probably the emergence of one of our coronaviruses areseasonal coronaviruses. You know, I think we had some assumptions that Coronavirus is when mutate,but then as we look to SARS, cov two and then we look back to see some of the other Coronavirus has,they've also mutated quite a bit too, we just haven't, you know, put names or other expressions tothem. This is part of RNA replication of the virus is going to incorporate some mutations and survival ofthe fittest, the difference between 2020, 2021, 2022, and now 2023 is the only pathway for this virus tokeep circulating is to become more immune evasive. This is what we're seeing is more immune evasion,we're seeing a variant with a couple more mutations where antibodies may bind a little bit less. But Ithink that the big difference here is that that protection, that severe disease, right, like the COVID, thatwe saw in 2020/2021, you know, that terrible ICU itis, from the COVID, you know, for the level ofantibody T cell function, non-neutralizing antibody functioning mate cell function, all of that that's builtinto, you know, humanity now through infection, vaccine are both really, you know, the virus can evolveto evade some of the immunity to cause repeat infections and, you know, get into your mucosa andreplicate a bit, the ability for the virus to kind of, you know, cause deep tissue infection lead to ARDSlead to all of these complications is getting harder and harder and harder. That's us evolving with thevirus and that's, you know, how many of these viruses as they emerge in the population really have kindof led to stability more than anything else? So, yes, we're going to see more variants. Yes, you know, thisis probably what what the future is, there will be some more cases and there may be a slight tick inhospitalizations associated with them. But again, you know, the difference between 2020/2021/2022/2023 is a syrup prevalence of nearly 100%. One way or another, and that really does define how thisdisease goes moving forward.KK: Yeah, absolutely. Maybe Stef we could pipe it a bit on, the idea that, first of all, I just want toreinforce like as an ICU doc in Ottawa with a population of over a million we really have seen very littleCOVID pneumonia since February 2022. Very minimal and it just goes to show know exactly whatSumon and Zain were alluding to less virulent with the immunity that we've established in thecommunity, all reassuring science. One question I want to throw towards Stef, before getting into it. Youdid an interview with Mike Hart. As you were doing this interview, I was going beast mode. I was hearingStef throw down. I don't know if you were, a bit testy that day, or whatever. There was the raw motionof reflecting on the pandemic, and how we responded and far we've gone away from public healthprinciples, was just like this motivator to say, we cannot have this happen again. I gotta tell you, boys,like after hearing that episode, I was like ‘Yeah, let's do this'. Let's get on. Let's go on another, doanother show. I'm gonna leave this fairly open Stef. What has been some of the keyways we'veapproached this pandemic that has really triggered you?SB: Yeah, I mean, so I guess what I'd say is, in some ways, I wish there was nobody listening to this rightnow. I wish there was like, I don't know what the audience is. I don't know if it's 10 people or underpeople, but I think it's like, I wish nobody cared anymore. I want Public Health to care. I want doctors tocare, we're going to keep talking because you know, Kwadwo, you've had folks in the ICU we we'vewe've seen cases in the shelters, we have outbreaks, like public health is always going to care aboutCOVID, as it cares about influenza cares about RSV, and other viruses, because it needs to respond tooutbreaks among vulnerable folks. That will never stop COVID, it was just clear very early, that COVID isgoing to be with us forever. So that means tragically, people will die of COVID people. I think that, youknow, there's that that's a reality, it's sometimes it's very close to home for those of us who areproviders, as it has for me in the last week. So COVID never ends. I think the issue is that like when doesCOVID And as a matter of worthy of discussion for like the average person? The answer is a long timeago. I mean, I think for the folks that I've spoken to, and the way that we've lived our lives as a family isto focus on the things that like bring folks joy, and to kind of continue moving along, while also ensuringthat the right services are in place for folks who are experiencing who are at risk for COVID and seriousconsequences of COVID. Also just thinking about sort of broader systems issues that I think continue toput folks at risk. So, one: I think it's amazing, like how little of the systematic issues we've changed,we've not improved healthcare capacity at all. Amazingly, we've not really changed any of the structuresthat put our leg limitations on the on the pressures on the health system, none of that has changed. Allof it has been sort of offset and downloaded and just like talking about masks and endless boosterswhen we've never really gotten to any of the meaty stuff. As you said three years into it, andeverybody's like, well, it's an emergency. I'm like, it was an emergency and fine. We did whatever wasneeded, even if I didn't agree with it at the time. But irrespective of that, whatever that was done wasdone. But now it's amazing that like the federal money expires for COVID In next few months, and allwell have shown for this switch health guys got became millionaires like a bunch of people, I don't mindnaming and I don't care anymore. These folks, these Grifters went out and grabbed endless amounts ofmoney. These cash grabs that arrival, the ArriveCan app with, like these mystery contractors that theycan't track down millions of dollars. So it's like all these folks like grabbed, you know, huge amounts ofmoney. And I think there's a real question at the end of it of like, what are we as a country? Or youknow, across countries? What do you have to show for it? How are you going to better respond? Andthe answer right now is like very little, like we have very little to show for all this all these resources thathave been invested, all this work that has been done. That I think should be the conversation. That tome needs to be this next phase of it is like billions and billions and billions of dollars trillion or whatever,like 10s of billions of dollars were spent on what? and what was achieved? And what do we want to donext time? And what do we have to show for it? that, to me feels like the meat of the conversationrather than like silly names for these new variants that do nothing but scare people in a way that isn'thelpful. It does not advance health. It doesn't you know, make the response any more helpful. It justscares people in a way that I think only detracts them from seeking the care that we want them to beseeking.KK: Yeah, I think you brought up a point to about or alluded to how some of this was the distraction.That was one of the points that really stuck home is that we, we didn't really dive into the core s**t, thecore issues. This is why at the end of it all, are we that much more ready for the next pandemic that wellsee, you know, and so like maybe Sumon, what do you think in terms of another tough one, are weready for the next pandemic? Do you think we've done enough? do we think are in terms of what we'veinvested in, how we've communicated to the public. The messaging to the public. Are we learning? Is myquestion, I guess.SC: I'm a clinician and I don't work with the public health and the policy aspect as closely as Stefan does.But I will say that, obviously, I've been in this realm for quite a long time, since in ID, I think that, youknow, what that's important to remember is that for SARS 1 we actually had this document thatoutlined all of this, you know, masking, social distancing, what to do with funding and all that kind ofstuff. Basically, I was actually interviewed about this, I remember back way back in 2020, and half of itwas basically just thrown out the window. I think that a lot of what happened is that fear came indecisions were made from emotion, which is, by the way, understandable, especially in April 2020. I'veshared with you guys before that, in February 2020, I was waking up at night, like nervous, that I wasgonna die. I that that's where I was thinking I it was, it was terrible. I completely understand makingthose decisions. I think as time went on, I wish that, you know, there's a bit more of public healthprinciples. You know, making sure that we're dealing with things without, you know, stepping onpeople's bodily autonomy, for example, you know, doing things in an equitable way, where you, youknow, we all know that every intervention that you do is squeezing a balloon, you must remember theunintended consequences, I think that we did. So, kind of putting that all together. I think, right now, aswe stand in Canada if we do have another pandemic. I fear that a lot of these same mistakes are goingto be made again, I should say, a disruptive pandemic of this because it's not forgotten H1N1, thepandemic it that was a pandemic, right. It wasn't nearly as disruptive as COVID was, but I do think thatinquiry and like you mentioned at the beginning, Kwadwo was talking about what we did, well, we didn'tdo well, and making sure the good stuff happens, and the bad stuff doesn't happen again, because this islikely not the last pandemic, in the information age in our lifetimes.KK: Zain, was there anything that stuck out for you? In terms of what you'd really want to see usimprove? Or whether it is messaging, whether it is public health principles, does any of those stick out inyour mind?ZC: Yeah, I mean, I think the one unique thing about this pandemic that is a lesson moving forward andfor us to kind of deal with I think we talked about messaging. This was the first major pandemic thatoccurred with social media and the social media era, right, and where, information, misinformation,disinformation, all the things that were all over the place, you know, we're flying, right, and there doesneed to be some reconciliation of what's been we have to have some reconciliation of some of thebenefits of the social media era in pandemic management, but also the significant harms the people,you know, we're scared that people got messaging that may not have been completely accurate, thatpeople had their biases as they were out there. I will say even that social media component penetratedinto the media. This is also the first time that I think we saw experts you know, including myself andSuman and all of us you know, that you know, could be at home and do a news interview on NationalNews in five minutes and be able to deliver their opinion to a large audience very quickly. So, you know,I think all of that does need a bit of a reconciliation in terms of what worked, what doesn't how youvalidate you know, good medical knowledge versus knowledge that comes from biases how we evaluatepsi comm and people you know, using it as a platform for good but may in fact be using it you know,when or incorporating their own biases to use it for more, more disinformation and misinformationeven if they feel like they have good intentions with it. I you know, I think this is a, you know, for thesociologists and the communications professionals out there, you know, really interesting case exampleand unfortunately, I don't think we came out the other side. Social media being a positive tool, it mayhave been a positive tool, I think in the beginnings, but, you know, I think I'm finding, it's nice tocommunicate with folks, but I'm finding more harm and more dichotomy and division from social mediathese days is compared to the beginnings of the pandemics where, you know, I think, again, there's justbeen so much bias, so much misinformation so much people's clouds and careers that have been, youknow, staked on social media that it's really become much, much harder to figure out what's real andwhat's not real in that sense.KK: Absolutely, I fully agree Zain. At the beginning, in some ways, I'll tell you, ICU management, thatwhole movement for us to delay intubation, as opposed to intubation early, I really think it was pushedby in social media. So, I think it saved lives, right. But then, as we got through more and more thepandemic, wow, like it, like the amount of just straight up medieval gangster s**t that was going on thatin that circle, in that avenue was crazy. Then just like, I mean, this might be controversial to say, I don'tknow, but news agencies got lazy, they would use Twitter quotes in their articles as, evidence, or asproof of an argument. It's like, what is happening? It? Honestly, when you think about it, it was it wascrazy. It still is crazy.ZC: Yeah. And I think expertise was another issue. Right. And, you know, unfortunately, we know of, youknow, certain experts that were not experts that weren't certified that weren't frontlines and a varietyof opinions and various standpoints and epidemiology, public health, intensive care, infectious diseases,whatever is important. But, you know, there were individuals out there that had zero experience thatwere reading papers and interpreting them from a lens of someone that really didn't have medicalexperience or epidemiologic experience, that chased their clout that made money and, we know someexamples that people that eventually had the downfall from it, but you know, at the end of the day,those people were on social media, and it penetrated into real media, and then that is a real lesson forus is that validation of expertise is going to be important. You know, as much as we allow for anyone tohave an opinion, you know, as they get into kind of real media, they really have to be validated that thatopinion comes from a place that's evidence based and scientific and based on a significant amount oftraining rather than just regurgitating or applying one small skill set and being an expert in many otherthings.KK: SumonSC: So we're just gonna add really quickly is that, in addition to what Zain saying. When this stuff bledover from social media to media, the thing that I mean, at least what it seemed like is he was actuallyinfluencing policy. That's, I think that's the important thing is, so you can have 10 people 20 peopleyelling, it doesn't matter if they're extreme minority, if it's influencing policy that affects all of us, right.So, I think that's important.KK: I'll be honest with you, like, I got to the point where I really hated Twitter, I still kind of hate Twitter.Okay. It was conversation. I remember Sumon that you and I had I don't remember it was we weretexting. I think we talked about this. But the fact that policy could be impacted by what we're throwingdown the facts or the messages that we were doing on media that this can impact policy, you had tolike, especially when there was some badness happening, we had to step up. We had to be a voice oflogic, whether it was mandates, whether it was you know, lockdown school closures, whatever it mighthave been like, the politicians, we heard about this politicians looking at this, the mainstream medialooking at this, and for us not to say anything at this point, like we had, we had to do something Sorry,Stef, you're gonna jump in?SB: Yeah, I think I think what was interesting to me to see and I think a clear difference between H1N1was that in a lot of places, and including in Ontario, across the US, where this sort of emergence of theselike the science tables, these task forces, these whatever you want to call them, it was like a new bodyof people often whom had never spent a day in a public health agency. Often academics that you know,are probably good with numbers, but really don't have a lot of experience delivering services, you know,all of a sudden making decisions. So I think there's a real interesting dynamic that when you compare,for example, Ontario and British Columbia, one has this science table one does not, and just howdifferent things played out, I mean, given it's a, you know, an end of have to, or no one in each camp,but I think what you see is like, there's a place there where like public health or you know, let's say,Sweden, you know, as a public health agency that didn't strike up its own taskforce that used itstraditional public health agency. I think was in a place to make more like reasoned and measureddecisions, and just was better connected, like the relationships exist between the local healthauthorities and the provincial health authorities and the national ones. I think when you set up these,the one thing that I hope we never do, again, is that something like the science table never happensagain. That's not to sort of disparage most of the people. Actually, most of the folks on the science tableI like, and I respect, say many of them, maybe not most, but many of them, I like and respect, but it isthe case that there was it was they weren't the right group of people. They weren't representativeOntarians he was like, ten guys and two women, I think, I don't know many of them white, they weren'trepresentative socio economically, racially diverse, anything. They didn't have the right expertise onthere. I would have liked to see some like frontline nurses on there to say ‘listen, this stuff is silly' orsome frontline, whoever just some frontline folks to be say ‘listen, none of the stuff that you're sayingmakes any sense whatsoever'. And luckily, there was some reason, voices on there, but they were theminority. But luckily, they prevailed, or we would have had outdoor masking and even tougherlockdowns. I don't know how folks really; it was really close. I think we fortunately had thatrepresentation, but that should have never even happened, we should have had public health Ontario,being its agency and making recommendations to the ministry and to the government. There shouldhave never been a science table. Then second thing, I just want to say I've we've talked about thisforever and I do think we should talk about this more, not in the context of like this, this podcast, but isalso just absolutely the role of the media. I do want to say that, like historically, media had to do a lot ofwork, they had to go to universities or hospitals and ask for the right expert, and then the media orcomms team, ‘you should really talk to Zain Chagla' Because he has good example, you know, it givesgood expertise on this or you start to like, I don't know, like Dr. so and so for this or that, and they puttogether the right person, they organize the time and then they talk. Now you know that it was reallylike the story I think was more organically developed on based on what the experts had to say. Nowyou've got reporters, for people who are not from Ontario, there's a sports reporter in the city ofToronto that I looked historically, I can't see that they've ever done anything in public health suddenlybecame like the COVID reporter in the city of Toronto, for a major newspaper. It's like this person hasnot a clue of what they're talking about, just like has no clue they've never trained in. I don't disparagetheir sports reporter like why should they? but they became the voice of like public health for like theaverage person. It just it set us up where that person just had a story and then just found whateverpeople on Twitter that they could to like back up their story irrespective to drive controversy, to driveanger towards the government based on sort of political leanings. Even if maybe my political leaningsare aligned with that person, it's a relevant because it's not about politics, it's about public health. So Ithink the media, we have to think about, like, how do we manage the media's need for clicks and profit,you know, during this time, in with, like, their role as like, the responsible are an important part of like,you know, social functioning, in terms of the free press. So, I, there's no easy answers to that. But I'll justsay, I think there was a fundamentally important role that the media played here. And I have to say, itdidn't play out positively, in most places.KK: I gotta say, like, this is gonna be naive talk. But we're in a pandemic, there had to be so many of ushad a sense of duty, like, I was surprised at the lack of sense of duty, to be honest with you. Even if youare about your cliques, ask yourself, is this is this about the greater good here? Is this really gonna get usfurther ahead? I've said this a few times on my platform, I would have a balance of a mess. The balancedmessage on was usually one specific network that would bail on the interview. They would literally bailon the interview because my message might not be as fearful. What the actual f you know what I mean?Like it's crazy.(?) I will say there were some good reporters. I don't want to say that that you know, there were someincredible folks. I was talking to someone the other day, I won't mention who but I think the mark of thegood reporter was, you know, they have a story, they want to talk about it. They contacted us. And theysaid, what time can we talk this week, right? They didn't say I need to get this filed in three hours. If yousay you need to get this filed in three hours, the expert you're gonna go to is the one that's available inthe next three hours, right? They wanted to hear an opinion, they wanted to get multiple opinions onthe table, but they would carve out the time so that everyone could give their story or, what theiropinion was or what evidence they presented. They made sure it rotated around the experts rather thanthe story rotating around being filed. I think it's important and, you know, you can get a sense of certainthings that are on the need to be filed this day, or even on the 24/7 news cycle, where they may not beas well researched, they're they're a single opinion. They're quoting a Twitter tweet. Now, I think insome of these media platforms, you can just embed that Twitter tweet, you don't even have to, youknow, quote it in that sense, you just basically take a screenshot of it basically. Versus again, thosearticles where I think there was there more thought, and I think there were some great reporters inCanada, that really did go above and beyond. Health reporters, particularly that really did try to presenta picture that was well researched, and evidence based, you know, with what's available, but therecertainly are these issues and it's not a COVID specific issue, but with media ad reporting, in that sense.Yeah, it's and it's important to say like, it's not actually just the reporter, it's the editors, its editorialteams, like I had said, OTR discussions with reporters very early on, I've tried to stay away from themedia, because I think the folks who have done it, I've done it well. But it was interesting, because BobSargent, who sadly passed away, an internal medicine physician, and an amazing mentor to manyclinicians in Toronto. Put me in touch with a couple of reporters. He's like, you know, you're a publichealth person, you should really talk to these reports. We had this; can we talk to you privately? It wasso weird. This was summer of 2020. So, we had a very private discussion where I said ‘Listen, I haveconcerns about lockdowns for like, these reasons' I think it's reasoned, because it's not it, I've got noconspiracy to drive, like, I've got no, there's no angle in any of it. So, but it was just fascinating. So, theywere like we might be able to come back to you, and maybe we'll try to do a story around it. Then theycame back and said, we're not going to be able to pursue it. I said that's fine. It's no problem. It just sortof showed that I think, similar as academics, and clinicians, and all of us have been under pressure basedon everything from like CPSO complaints, the complaints to our employers, to whatever to just saw, youknow, the standard attacks on Twitter. I think there was also a lot of pressure on reporters based on thiswhole structure, and of it. So I think, I don't mean to disparage anybody, but I do think the point thatyou made is really important one is. I'll just say, in our own house, you know, my wife and I both werelike talking at the beginning of this and being like, what do we want to know that we did during thistime? So, my wife worked in person, as a clinician alter her practice all throughout her pregnancy? Shenever didn't go, you know, she did call she did all of that, obviously, I have done the work I've done interms of both clinically and vaccine related testing. But this just idea of like, what do you want toremember about the time that you would like what you did when s**t hit the fan? And, you know,because first, it'll happen again, but just also, I think it's important to sort of, to be able to reflect andthink positively about what you did. Anyways,KK: I hear you both, part of it, too, for me, I'll just straight up honesty. In some ways, I'm just pissed, I'mpissed that a lot of the efforts that were that a lot of people put into to try and get a good message outthere. The backlash. Now people reflecting saying, ‘Oh, I guess you did, you know, many of you do tohad a good point about lockdowns not working out'. I know it may be childish in some way, but it's just,you know, a lot of us have gone through a lot to just try and create a balanced approach. I think therewas a little bit of edge in this voice, but I think it comes with a bit of a bit of reason to have a bit of edge.I think in terms of the next couple questions here are areas to focus on. A lot of people in terms of like,decisions regarding mandates, boosters, and so forth, like we talk a lot about it on public health, it's thedata that helps drive decisions, right. That's really what you would think it should be all about. So, one ofthe many questions that were thrown to us, when we announced that this was happening was, the needfor like, almost like universal boosters, and Sumon, I'll put you on the spot there, at this stage in thepandemic, where I'm gonna timestamp this for people on audio, we're on January 10th, 2023. There aresome questions that we get, who really needs to push through to we all need boosters? What's yourthoughts on that?SC: So, I think that one of the things that I said this, as Zain makes fun of me throughout the pandemic, Icame up with catchphrases, and my one for immunity is the way that we've conceptualized immunity inNorth America. I think a lot of this has to do with an actual graphic from the CDC, which likens immunityto an iPhone or a battery, iPhone battery. So, iPhone immunity, where you have to constantly berecharging and updating. I think that has kind of bled into the messaging. That's what we think of it. Iremember back in I think it was October of 2021, where they were also starting to talk about the thirddose. The third dose, I think that at that time, we knew that for the higher risk people, it was probablythe people who would benefit the most from it. We had Ontario data from it was I think, was ISIS.There's vaccine efficacy against hospitalization, over 96% in Ontario in health care workers 99%, if you'reless than seventy-seven years of age, yet this went out, and everybody felt like they had to get thebooster. So, I think that the first thing that bothered me about that is that there wasn't a kind ofstratified look at the risk level and who needs it? So now we're in 2023. I think that one of the big thingsapart from what I said, you know, who's at higher risk, there's still this problem where people think thatevery six months, I need to recharge my immunity, which certainly isn't true. There wasn't a recognitionthat being exposed to COVID itself is providing you a very robust immunity against severe disease, whichis kind of it's coming out now. We've been we've all been talking about it for a long time. And you know,the other thing is that the disease itself has changed. I think that I heard this awesome expression, thefirst pass effect. So, when the COVID first came through a completely immune naive population, ofcourse, we saw death and morbidity, we saw all the other bad stuff, the rare stuff that COVIDencephalitis COVID GB GBS tons of ECMO, like 40-year old's dying. With each subsequent wave asimmunity started to accrue in the population, that didn't happen. Now we're at a different variant. Andthe thing is, do we even need to be doing widespread vaccination when you're with current variant, andyou can't be thinking about what we saw in 2021. So, putting that now, all together, we have as Zanementioned, seroprevalence, about almost 100%, you have people that are well protected against severedisease, most of the population, you have a variant that absolutely can make people sick. And yes, it cankill people. But for those of us who work on the front line, that looks very different on the on the frontlines. So, I really think that we should take a step back and say, number one: I don't think that thebooster is needed for everybody. I think number two: there are under a certain age, probably 55 andhealthy, who probably don't need any further vaccination, or at least until we have more data. Numberthree: before we make a widespread recommendation for the population. We have time now we're notin the emergency phase anymore. I really hope that we get more RCT data over the long term to seewho is it that needs the vaccine, if at all. And you know, who benefits from it. And let's continue toaccrue this data with time.KK: Thanks Sumon. Zain, are you on the along the same lines assume on in terms of who needs boostersand who doesn't?ZC: Yeah, I mean, I think number one: is the recognition that prior infection and hybrid immunityprobably are incredibly adequate. Again, people like Paul Offit, and we're not just talking about youknow, experts like us. These are people that are sitting on the FDA Advisory Committee, a man thatactually made vaccines in the United States, you know, that talks about the limitations of boosters andprobably three doses being you know, The peak of the series for most people, and even then, you know,two plus infection probably is enough is three or even one plus infection, the data may suggest maybe isas high as three. Yeah, I think, again, this is one of these things that gets diluted as it starts going downthe chain, if you actually look at the Nazi guidance for, you know, bi-Vaillant vaccines, it's actuallyincorporates a ‘should' and a ‘can consider' in all of this, so they talked about vulnerable individuals,elderly individuals should get a booster where there may be some benefits in that population, the restof the population can consider a booster in that sense, right. And I think as the boosters came out, andagain, you know, people started jumping on them, it came to everyone needs their booster. Andunfortunately, the messaging in the United States is perpetuated that quite a bit with this iPhonecharging thing, Biden tweeting that everyone over the age of six months needs a booster. Again, wereally do have to reflect on the population that we're going at. Ultimately, again, if you start pressing theissue too much in the wrong populations, you know, the uptake is, is showing itself, right, the peoplewho wanted their bi-Vaillant vaccine got it. Thankfully the right populations are being incentivized,especially in the elderly, and the very elderly, and the high risk. Uptake in most other populations hasbeen relatively low. So, people are making their decisions based on based on what they know. Again,they feel that that hesitation and what is this going to benefit me? and I think as Sumon said, theconfidence is going to be restored when we have better data. We're in a phase now where we can docluster randomized RCTs in low-risk populations and show it If you want the vaccine, you enter into acluster randomized RCT, if you're in a low-risk population, match you one to one with placebo. You wecan tell you if you got, you know, what your prognosis was at the end of the day, and that information isgoing to be important for us. I don't think that policy of boosting twice a year, or once a year is gonnaget people on the bus, every booster seems like people are getting off the bus more and more. So, wereally do have to have compelling information. Now, as we're bringing these out to start saying, youknow, is this a necessity? especially in low-risk populations? How much of a necessity is that? How muchdo you quantify it in that sense? And again, recognizing that, that people are being infected? Now, thatadds another twist in that sense.KK: Yeah, and we'll talk a little bit about public trust in a bit here. But Stef, you were among someauthors that did an essay on the booster mandates for university students. As we've both alluded toZain, and Sumon there's this need to be stratified. From an RCT booster point of view that we're not wellestablished here. When Stef's group looked at university mandates and potential harm, when we'redoing an actual cost benefit ratio there, their conclusion was that there's more room for harm thanbenefits. So, Stef I want you to speak to that paper a bit.SB: Sure. So, I will say this, I don't actually have much to add other than what Zain and Sumon said. Runa vaccine program we are offering, you know, doses as it makes sense for folks who are particularlyimmunocompromised, multiple comorbidities and remain at risk for serious consequences related toCOVID-19. We'll continue doing that. And that will, you know, get integrated, by the way into like, sortof a vaccine preventable disease program, so offering, shingles, Pneumovax, influenza COVID. And alsowe want to do a broader in terms of other hepatitis vaccines, etc. That aside, so this, this isn't about, youknow, that it was really interesting being called antivax by folks who have never gotten close to avaccine, other than being pricked by one. Having delivered literally 1000s of doses of vaccine, so it'salmost it's a joke, right? but it's an effective thing of like shutting down conversation. That aside, I thinkthere's a few things at play one as it related to that paper. I find it really interesting, particularly foryoung people, when people are like, listen, yes, they had a little bit of like, inflammation of their heart,but it's self-resolving and self-limiting, and they're gonna be fine. You don't know that. Maybe sure we'llsee what happens with these folks twenty years later. The reality is for younger men, particularly, thishappens to be a very gender dynamic. For younger men, particularly, there seems to be a dynamicwhere they are at risk of myocarditis. I don't know whether that's a controversy in any other era for anyother disease, this would not be a controversy would just be more of a factual statement, the data wereclearer in I'd say, probably April, May 2021. I think there's lots of things we could have done, we couldhave done one dose series for people who had been previously infected, we could have stopped at two.There are a million different versions of what we could have done, none of which we actually did. In thecontext of mandating boosters now for young people, including at my institution, you were mandated toget a booster, or you would no longer be working. So obviously, I got one. There's a real dynamic ofwhat is it your goal at that point? because probably about 1011 months into the vaccine programbecame increasingly clear. You can still get COVID. Nobody's surprised by that. That was clear even fromthe data. By the way, wasn't even studied. I mean, Pfizer, the way if you just look at the Pfizer, Moderna,trials, none and look to see whether you got COVID or not, they were just looking at symptomaticdisease. That aside, I think that it just became this clear thing where for younger men, one or two doseswas plenty and it seems to be that as you accumulate doses for those folks, particularly, it's alsoimportant, if somebody had a bad myocarditis, they're not even getting a third dose. So, you're alreadyselecting out, you know, some of these folks, but you are starting to see increased levels of harm, as itrelated to hospitalization. That what we basically did, there was a very simple analysis of looking ataverted hospitalization, either way, many people say that's the wrong metric. You can pick whatevermetric you want. That's the metric we picked when terms of hospitalization related to side effects of thevaccine versus benefits. What it just showed was that for people under the age of 30, you just don't seea benefit at that point, as compared to harm that's totally in fundamentally different. We weren't talkingabout the primary series, and we weren't talking about older folks. So indeed, I think, you know, thatwas that was I don't know why it was it was particularly controversial. We it was a follow up piece tomandates in general. I'll just say like, I've been running this vaccine program, I don't think mandateshave made my life easier at all. I know, there's like this common narrative of like mandates, you know,mandates work mandates work. I think at some point, and I'll just say our own study of this is like we'rereally going to have to ask two questions. One: what it mandates really get us in terms of a burdenCOVID-19, morbidity, mortality? and two: this is an important one for me. What if we caught ourselvesin terms of how much pressure we put on people, as it relates to vaccines right now, in general? Thevery common narrative that I'm getting is they're like, oh, the anti Vax is the anti Vax folks are winning.And people don't want their standard vaccines, and we're getting less uptake of like, MMR andstandard, you know, kind of childhood vaccines, I have a different opinion. I really do at least I believesome proportion of this, I don't know what proportion, it's some proportion, it's just like people beingpushed so hard, about COVID-19 vaccines that they literally don't want to be approached about anyvaccine in general. So, I just think that with in public health, there's always a cost. Part of the decisionmaking in public health as it relates to clinical medicine too. It's like you give a medication, theadvantage and then you know, the disadvantages, side effects of that medication. In public health, thereare side effects of our decisions that are sometimes anticipated and sometimes avoidable, sometimescan't be anticipated and sometimes can't be avoided. You have to kind of really give thought to each ofthem before you enact this policy or you might cost more health outcomes, then then you're actuallygaining by implementing it.KK: Yeah, number one: What was spooky to me is like even mentioning, I was afraid even to use a termmyocarditis at times. The worst part is, as you said, stuff, it's young folk that were alluding to, and for usto not be able to say, let's look at the harm and benefit in a group that's low risk was baffling. It reallywas baffling that and I'm glad we're at least more open to that now. Certainly, that's why I thought thatthe paper that you guys put together was so important because it's in the medical literature that we'reshowing, objectively what the cost benefit of some of these approaches are. Sumon: when you think ofmandates and public trust, that Stef was kind of alluding to like, every decision that we madethroughout this thing. Also has a downside, also has a cost, as Stef was mentioning. Where do you thinkwe are? In terms of the public trust? Talking about how the childhood vaccines are lower. I don't knowwhat influenza vaccine rates are like now, I wouldn't be surprised if they're the same standard, but whoknows them where they're at, currently. Based on your perspective, what do you think the public trust isright now?SC: Yeah, as physicians, we obviously still do have a lot of trust in the people we take care of. People arestill coming to see us. I wish they didn't have to because everyone was healthy but that's not the case. Ido think that over the last two and a half, we're coming up on three years, I guess right now, that peoplethat we have burned a lot of trust, I think that mandates were part of it. I do think that some of it wasunavoidable. It's just that there's a lot of uncertainty. There was back and forth. I think that one thingthat were that concern me on social media was that a lot of professionals are airing their dirty laundry tothe public. You could see these in fights, that doesn't, that's not really a good thing. We saw peoplebeing very derisive towards people who were not listening to the public health rules. You know what Imean? There's a lot of that kind of talk of othering. Yeah, I think that that certainly overtime, erodedpublic trust, that will take a long time to get back, if we do get it back. I think that the bottom line is that,I get that there are times that we have to do certain things, when you have a unknown pathogen comingat you, when you don't really know much about it. I do think that you want to do the greatest good forthe, for the population or again, you always must remember as Stefan alludes to the cost of what you'redoing. I do think that we could have done that much early on. For example, Ontario, we were lockeddown in some areas, Ontario, GTA, we were locked down in some regard for almost a year and a half. Ifyou guys remember, there was that debate on opening bars and restaurants before schools. It's just like,I remember shaking my head is, look, I get it, I know you guys are talking about people are going to beeating a burger before kids can go to school, that might ruin everything. But the problem is, is that youmust remember that restaurant is owned by someone that small gym is someone's livelihood, you'remoralizing over what this is, but in the end, it's the way somebody puts food on the table. For a yearand a half, we didn't let especially small businesses do that. I'm no economist, but I had many familymembers and friends who are impacted by this. Two of my friends unfortunately, committed suicideover this. So, you know, we had a lot of impact outside of the of the things that we did that hurt people,and certainly the trust will have to be regained over the long term.KK: It's gonna take work. I think, for me, honestly, it's, it's just about being transparent. I honestly, I putmyself in some in the shoes of the public and I just want to hear the truth. If we're not sure aboutsomething, that's okay. We're gonna weigh the evidence and this is our suggestion. This is why we'resaying this, could we be wrong? Yes, we could be wrong but this is what we think is the best pathforward, and people could get behind that. I honestly feel like people could get behind that showing alittle bit of vulnerability and saying ‘you know, we're not know it alls here' but this is what our beststrategy is based on our viewpoint on the best strategy based on the data that we have in front of usand just be open. Allowing for open dialogue and not squash it not have that dichotomous thinking ofyou're on one side, you're on the other. You're anti vax, you're pro vax, stop with the labels. You know,it's just it got crazy, and just was not a safe environment for dialogue. And how are you supposed to he'ssupposed to advance.SB: Yeah, I do want to say something given this this is this idea of our swan song. I think there was thissort of feeling like, you know, people were like ‘you gotta act hard, you gotta move fast' So I thinkeverybody on this, you guys all know I travel a lot. I like to think of myself as a traveler. In the early2020's I did like a COVID tour, I was in Japan in February, then I was in Thailand, and everywhere Ilanded, there were like, COVID here, COVID here, COVID here. Then finally, I like got home at the end ofFebruary, and I was supposed to be home for like four days, and then take off. Obviously things got shutdown. It was like obvious like COVID was the whole world had COVID by, February, there may have beena time to shut down this pandemic in September 2019. Do you know what I mean? by November 2019,we had cases. They've already seen some and Canadian Blood Services done some showing someserological evidence already at that time. There was no shutting it down. This thing's gonna suck. Thereality is promising that you can eliminate this thing by like, enacting these really like arbitrary that canonly be described as arbitrary. Shutting the border to voluntary travel, but not to truckers. Everythingfelt so arbitrary. So, when you talk about trust, if you can't explain it, if you're a good person do it. If youdon't do it, your white supremacist. Kwadwo you were part of a group that was called ‘Urgency ofNormal' you are a white supremacist. It's so ridiculous. You know what I mean? It creates this dynamicwhere you can't have any meaningful conversation. So, I really worry, unless we can start having somereally meaningful conversations, not just with folks that we agree with. Obviously, I deeply respect whateach of you have done throughout this pandemic, not just actually about what you say, but really whatyou've done. Put yourselves out there with your families in front of this thing. That aside, if we can't dothat, we will be no better off. We will go right back. People will be like ‘Oh, next pandemic, well, let'sjust get ready to lock down' but did we accomplish anything in our lock downs? I actually don't think wedid. I really don't think we got anything positive out our lock downs, and I might be alone in that. I mightbe wrong, butut that said it needs to be investigated and in a really meaningful way to answer that,before it becomes assume that acting hard and acting fast and all these b******t slogans are the truthand they'd become the truth and they become fact. All without any really meaningful evidencesupporting them.KK: I gotta say, I'll get you Sumon next here, but I gotta say the idea of abandoning logic, I think that'sthat's a key point there. Think about what we're doing in restaurants, folks. Okay, you would literallywear your mask to sit down, take off that bloody thing. Eat, chat, smooch even, I mean, and then put itback on and go in the bathroom and think this is meaningful. Where's the logic there? You're on a plane,you're gonna drink something, you're on a six hour flight, you know what I'm saying.(?) During the lockdown, by the way, you're sending like 20 Uber drivers to stand point. If you ever wentand picked up food, you would see these folks. It'd be like crowding the busy restaurants all like standingin there, like arguing which orders theirs, you know what I mean? then like people waiting for the foodto show up.KK: I mean, that's the other point. The part that people forget with the lockdowns, tons of people willwork. I'm in Ottawa, where 70% are, could stay home, right? That's a unique city. That's why we werevery sheltered from this bad boy.(?) Aren't they still fighting going back to the office?KK: Oh, my God. Folks, I'm sorry. Yeah, it's like 70% could stay home, but you're in GTA your area. That'sa lot of essential workers. You don't have that option. So, how's this lockdown? Really looking at the bigpicture? Anyway, sorry. Sumon you're gonna hit it up.SC: We just wanted to add one anecdote. I just think it kind of talks about all this is that, you know therewas a time when this thing started going to 2020. Stefan, I think you and I met online around that time.You put a couple of seeds after I was reading stuff, like you know about the idea of, you know, risktransfer risk being downloaded to other people. That's sort of kind of think of a you know, what, like,you know, a people that are working in the manufacturing industry, you're not going to receive them alot unless you live in a place like Brampton or northwest Toronto, where the manufacturing hub of, ofOntario and in many cases, central eastern Canada is right. So, I remember in, I was already starting touse this doing anything. And when I was in, I guess it would have been the second wave when it was itwas pretty bad one, I just kept seeing factory worker after factory worker, but then the thing that stuckout was tons of Amazon workers. So, I asked one of them, tell me something like, why are there so manyAmazon workers? Like are you guys? Is there a lot of sick people working that kind of thing? Inretrospect, it was very naive question. What that one woman told me that her face is burned into mymemory, she told me she goes, ‘Look, you know, every time a lockdown is called, or something happenslike that, what ends up happening is that the orders triple. So, then we end up working double and tripleshifts, and we all get COVID' That was just a light went off. I was like, excuse my language, guys, but holys**t, we're basically taking all this risk for people that can like what was it called a ‘laptop class' that canstay home and order all this stuff. Meanwhile, all that risk was going down to all these people, and I wasseeing it one, after another, after another, after another. I'm not sure if you guys saw that much, but Iwas in Mississauga, that's the hardest, Peele where the manufacturing industry is every single peanutfactory, the sheet metal, I just saw all of them. That I think was the kind of thing that turned me andrealize that we what we'll be doing. I'll shut up.ZC: Yeah, I would say I mean, I think Stefan and Sumon make great points. You know, I think that thatwas very apparent at the beginning. The other thing I would say is 2021 to 2022. Things like vaccinationand public health measures fell along political lines. That was a huge mistake. It was devastating. Iremember back to the first snap election in 2021. Initially great video of all the political partiesencouraging vaccination and putting their differences aside. Then all of a sudden, it became mudslingingabout how much public health measure you're willing to do, how much you're willing to invest in, andit's not a Canadian phenomenon. We saw this in the United States with the Biden and Trump campaignsand the contrast between the two, and then really aligning public health views to political views, andthen, you know, really making it very uncomfortable for certain people to then express counter viewswithout being considered an alternative party. It's something we need to reflect on I think we havepublic health and public health messengers and people that are agnostic to political views but are reallythere to support the health of their populations, from a health from a societal from an emotional fromthe aspects of good health in that sense. You really can't involve politics into that, because all of asudden, then you start getting counter current messaging, and you start getting people being pushed,and you start new aligning values to views and you start saying, right and left based on what peopleconsider, where again, the science doesn't necessarily follow political direction. It was a really bigmistake, and it still is pervasive. We saw every election that happened between 2021 to 2022 is publichealth and public health messaging was embedded in each one of those and it caused more harm thangood. I think it's a big lesson from this, this is that you can be proactive for effective public healthinterventions as an individual in that society that has a role, but you can't stick it on campaigns. It reallymakes it hard to deescalate measures at that point when your campaign and your identity is tied tocertain public health measures in that sense.KK: Amen. I am cognizant of the time and so I'm gonna try to rapid fire a little bit? I think, there's only acouple points that people hit up on that we haven't touched on. There was a push for mass mandates inthe last couple months because of of RSV and influenza that was happening. It still is happening in,especially in our extreme ages, really young and really old. Any viewpoint on that, I'll leave it open toalmost to throw down.(?) I think mass mandates have been useless. I don't expect to ever folks to agree with me, it's like it's aninteresting dynamic, right? When you go and you saw folks who were on the buses, I take the bus to theairport. Our subway in Toronto just for folks only starts at like, 5:50am. So, before that, you gotta jumpon buses. So the construction workers on the bus who were wearing masks during the when the maskmandates were on taking this what's called, it's like the construction line, because it goes down Bloorare basically and takes all the construction workers from Scarborough, before the subway line, get todowntown to do all the construction and build all the stuff that you know, is being built right now.Everyone is wearing this useless cloth mask. It's like probably the one thing that the anti-maskers who Ithink I probably am one at this point. The pro-maskers and all maskers can agree on is that cloth masksare useless. That's what 100% of these folks are wearing. They're wearing these reusable cloth masksthat are like barely on their face often blow their nose. So, to me, it's not so much about like, what couldthis intervention achieve, if done perfectly like saying the study you were involved with the help lead,it's like everybody's like, but all of them got COVID outside of the health care system, they didn't get itwhen they're wearing their N95. That's like, but that's the point, like public health interventions live ordie or succeed or fail in the real world. I was seeing the real world, I would love to take a photo but Idon't think these folks have been friendly to me taking a photo of them, but it was 100%, cloth masks ofall these folks in the morning all crowded, like we're literally like person to person on this bus. It's like aperfect, you know, vehicle for massive transmission. I just I just sort of put that forward of like, that'swhat a mask mandate does to me. I think to the person sitting at home calling for them, they are justimagining, they're like ‘Oh but the government should do this'. But they didn't. The government shouldbe handing out in N95's. How are you going to police them wearing a N95's and how are you gettingthem? It would be so hard to make a massive program work. I would say it's like if you gave me millionsand millions and millions of dollars, for me to design a mass program, I don't know, maybe I could pull itoff you really with an endless budget. But for what? So, I just think that like as these programs went outin the real world, I think they did nothing but burn people's energy. You know because some people itjust turns out don't like wearing a mask. Shocking to other folks. They just don't like wearing a mask.Last thing I'll say is that just as they play it out in the real world, I think we're functionally useless, otherthan burning people's energy. I'm a fervent anti masker at this point because it's just an insult to publichealth. To me everything I've trained in and everything I've worked towards, just saying these two wordsmask mandate, as the fix. That is an insult to the very thing that I want to spend my life doing .ZC: Yeah, I mean, three points, one: you know, masks are still important in clinical settings. I think we allunderstand that. We've been doing them before we've been continuing to do them. So I you know,that's one piece. Second: I mean, to go with the point that was raised here, you know, the best study wehave is Bangladesh, right? 10% relative risk reduction. It's interesting when you read the Bangladeshstudy, because with community kind of people that pump up masking that are really trying to educateand probably are also there to mask compliance. Mask's compliance people, you get to 54% compliance,when those people leave compliance drops significantly. Right. You know, I think you have to just lookaround and see what happened in this last few months, regardless of the messaging. Maybe it's thecommunities I'm in, but I didn't see mass compliance change significantly, maybe about 5%. In thecontext of the last couple of months. You must understand the value of this public health intervention,Bangladesh has actually a nice insight, not only into what we think the community based optimalmasking efficacy is, but also the fact that you really have to continue to enforce, enforce, enforce,enforce, in order to get to that even 10%. Without that enforcement, you're not getting anywhere inthat sense. That probably spells that it's probably a very poor long term public health intervention in thecontext that you really must pump it week by week by week by week in order to actually get compliancethat may actually then give you the effects that you see in a cluster randomized control trial. Again, youknow, the world we live in is showing that people don't want to mask normally. Some people can, i

Solving Healthcare is a podcast series launched in September 2019 by the Resource Optimization Network. Led by Dr. Kwadwo Kyeremanteng, a palliative care & intensive care doctor based in Ottawa, these podcasts will feature interviews and discussions on the topic of improving healthcare delivery in Canada. Underpinned by the values of cost-effectiveness, dignity, and justice, these podcasts will challenge the status quo, leaving no stone unturned as we explore gaps, assumptions, and different perspectives in the pursuit of finding solutions to problems in Canada's healthcare systemNote, views expressed belong to the host only.

I'll just say this - you're not going to want to miss this episode. If one of your goals is to take your long-term health into your own hands and create a lifestyle that fosters sustainable weight loss, fitness and health, this is for you. We have the host of Solving Healthcare - a podcast series launched in September 2019 by the Resource Optimization Network. Led by Dr. Kwadwo Kyeremanteng, a palliative care & intensive care doctor based in Ottawa. His podcasts feature interviews and discussions on the topic of improving healthcare delivery in Canada. I also have my Dr. Jen Crichton, MD, family doctor and someone else who's passionate about preventative care and making our world a fitter and healthier place. She also happens to be my sister-in-law! We talk about our health care system, what we can do to help, how we can better take care of our long-term health, and why it's our responsibility to prioritize our health for the sake of relieving our overworked and overwhelmed healthcare system here in Canada. --- Send in a voice message: https://anchor.fm/fgb-podcast/message

Welcome to Protecting Your Nest with Dr. Tony Hampton. Dr. Kwadwo Kyeremanteng works in the Intensive Care Unit (ICU) at the Ottawa Hospital. His research focuses on making the ICU more efficient and improving access to palliative care services.  To achieve this, he founded the Resource Optimization Network, a multidisciplinary research group working to reduce health spending in this area without compromising care. He is also a speaker, author, and host of the Solving Healthcare podcast. In their discussion, Drs. Tony and Kyeremanteng talk about racial issues in modern society, how to promote acceptance of ethnic and racial diversity in society, the need for a greater understanding of and emphasis on lifestyle intervention with patients, how to solve physician burnout, the benefits of fasting, personalizing your diet to make it work for you, and getting more people of color involved in the low-carb movement. Thank you for listening to Protecting Your Nest. For additional resources and information, please see the links below.    Links:   Dr. Kwadwo Kyeremanteng: Twitter Website   Dr. Tony Hampton: Book Website Instagram Account Facebook Page LinkedIn Account Youtube Account Advocate Aurora Healthcare Profile Dr. Hampton's Low Carb Corner (Diet Doctor) Dr. Tony Hampton's Diet Doctor Author Page   Dr. Hampton's patient handout

Hi friends! Dr. Kwadwo Kyeremanteng is a critical care and palliative care physician at The Ottawa Hospital. Dr. Kyeremanteng cares for the sickest of the sick patients in the intensive care unit (ICU). We talk all about how to solve healthcare and keto on today's episode! As a researcher, he is interested in using ICU resources more efficiently and improving access to palliative care in the ICU. To help do this, he founded the Resource Optimization Network, a multidisciplinary research group working to reduce health spending in this area without compromising care. In September 2019 Dr. Kyeremanteng launched his ever-growing podcast “Solving Healthcare with Kwadwo Kyeremanteng” these podcasts feature interviews and discussions on the topic of improving healthcare delivery in Canada. Underpinned by the values of cost-effectiveness, dignity, and justice, these podcasts will challenge the status quo, leaving no stone unturned as we explore gaps, assumptions, and different perspectives in the pursuit of finding solutions to problems in Canada's healthcare system. Subscribe to Dr. Kwadwo's solving healthcare newsletter and visit the website here: https://drkwadwo.ca/ Link to join the facebook group for the podcast: https://www.facebook.com/groups/2017506024952802/ Follow Vanessa on instagram to see her meals, recipes, informative posts and much more! Click here @ketogenicgirl Try the Higher Protein Keto Meal Plans & Coaching: https://www.ketogenicgirl.com Special thank you to Fast Keto sponsors: Magnesium Breakthrough by BiOptimizers Right now for the ENTIRE month of November, the makers of Magnesium Breakthrough (BiOptimizers) are having a Black Friday Cyber Monday BLOWOUT sale on their best selling Magnesium. All month long you will get 10% off with my unique code plus access to over $200 in free gifts, including books, and more of their best in class products to sample.  So go to www.magbreakthrough.com/fastketo now to get your exclusive 10% discount, plus taccess to over $200 in free gifts, including books, and more of their best in class products to sample.  VISIT www.magbreakthrough.com/fastketo and use the code FASTKETO for 10% off any order! - This episode is brought to you by ButcherBox™ ! They make sure their members are taken care of! This holiday, ButcherBox is proud to give new members Free Steaks for a Year. Just go to ButcherBox.com/FASTKETO to sign up. That's ButcherBox.com/FASTKETO to receive Free Steaks for a Year in your first box! - Prior to beginning a ketogenic diet you should undergo a health screening with your physician to confirm that a ketogenic diet is suitable for you and to rule out any conditions and contraindications that may pose risks or are incompatible with a ketogenic diet, including by way of example: conditions affecting the kidneys, liver or pancreas; muscular dystrophy; pregnancy; breast-feeding; being underweight; eating disorders; any health condition that requires a special diet [other conditions or contraindications]; hypoglycemia; or type 1 diabetes. A ketogenic diet may or may not be appropriate if you have type 2 diabetes, so you must consult with your physician if you have this condition. Anyone under the age of 18 should consult with their physician and their parents or legal guardian before beginning such a diet]. Use of Ketogenic Girl videos are subject to the Ketogenicgirl.com Terms of Use and Medical Disclaimer. All rights reserved. If you do not agree with these terms, do not listen to, or view any Ketogenic Girl podcasts or videos.

The Solving Healthcare podcast hosted by Kwadwo Kyeremanteng has launched medical podcasting in Canada into a whole new level. Dr. K is an intensivist based out of Ottawa, and his podcast, solving healthcare, has been a tremendous source of excellent information on COVID, medicine, exercise, nutrition, and so much more. As if he wasn't busy enough, Dr. K has now also created the Solving Wellness platform, an online website and community that is targeted at wellness for healthcare workers. It was an absolute pleasure to throw down with Dr. K. We talk about our shared Edmontonian heritage, his work with the Solving Healthcare podcast, and the Solving Wellness platform. We are excited to announce that Cold Steel listeners can receive a free membership on the Solving Wellness platform if you go to the solving wellness website: www.drkwadwo.ca/solvingwellness and enter promo code: coldsteel. There are only 10 free memberships, so hurry to join! Remaining listeners can still get a 15% discount on their membership fees at Solving Wellness if you use promo code coldsteel15. Twitter: Dr. K: https://twitter.com/kwadwo777?s=20 Solving Healthcare podcast: https://twitter.com/KwadCast?s=20 1. Solving Healthcare podcast: https://drkwadwo.ca/ 2. Solving Wellness: www.drkwadwo.ca/solvingwellness 3. Resource Optimization Network: https://www.resourceoptimizationnetwork.com/ 4. Pareto Principle: https://en.wikipedia.org/wiki/Pareto_principle 5. Suicide and self-harm in adult survivors of critical illness: population based cohort study: https://pubmed.ncbi.nlm.nih.gov/33952509/

Our 3rd most downloaded episode this year was Episode 168 – Pizza & Beer, Hockey, Covid-19 with Dr. Kyeremanteng Meet Dr. Kwadwo Kyeremanteng. He comes from north of the border and is a physician formally trained in critical care medicine and palliative care. His research focuses on making the ICU more efficient and improving access to palliative care services. To achieve this, he founded the Resource Optimization Network, a multidisciplinary research group working to reduce health spending in this area without compromising care. Dr. K, as he is fondly called, is a leading contributor helping the department to achieve its vision of shaping the future of Medicine. Recently, he joined the physician podcast family with his popular show Solving Healthcare.  Solving Healthcare is a podcast series featuring interviews and discussions on topics related to improving healthcare delivery in Canada based on the values of cost-effectiveness, dignity and justice in healthcare. I gotta give him props, my man has been busy pumping out great content around Covid-19 and I definitely recommend you all subscribe to his podcast. Dr. Kwadwo is on the hotseat today so we can learn more about him, why he started his show, and what are the differences in responses to Covid 19 between the US and Canada.    Transcription: (coming soon)   Resources: Solving Healthcare Podcast This episode is sponsored by Provider Solutions & Development. Experts in holistic career coaching – check them out at www.psdrecruit.org/docsoutsidethebox

Resource Optimization Network: https://www.resourceoptimizationnetwork.com/ (https://www.resourceoptimizationnetwork.com/) Solving Healthcare: https://drkwadwo.ca/ (https://drkwadwo.ca) Facebook & Instagram: @kwadcast Dr. Kwadwo Kyeremanteng (pronounced Kwajo) is an Assistant Professor in the Division of Palliative Care and Critical Care Medicine at the University of Ottawa. He also has research positions with Ottawa Hospital Research Institute (OHRI) & Institut du-savoir Montfort as a Senior Clinician Investigator. Dr. Kyeremanteng clinical practices are with critical care and palliative care both at The Ottawa Hospital & Montfort Hospital. Dr. Kyeremanteng was born and raised in Edmonton where he did his medical school (University of Alberta, completed in 2005). He and his wife then moved to Ottawa where he did his Internal Medicine residency training (University of Ottawa, completed in 2008). Dr. Kyeremanteng continued his studies by pursuing a joint two-year fellowship program in Palliative Care Medicine and Critical Care Medicine (University of Ottawa, completed in June 2010). Dr. Kyeremanteng's academic interests are in end of life in the palliative care and critical care settings, and integration of Palliative Care in the Intensive Care Unit. As well as health services research and cost evaluations. More information regarding his current research interests and projects can be found https://www.researchgate.net/profile/Kwadwo_Kyeremanteng (here). This podcast uses the following third-party services for analysis: Chartable - https://chartable.com/privacy

As you learn more, and more, and more about disease, prevention is the key.  Why get sick in the first place? Don't get sick!  Why are we going to wait until you're end-stage or sick as a dog before we try and provide you with help?  No.  Let's be smarter with our minds, resources and approaches.  It just doesn't make sense when you think about it, really.  A lot of times we're just putting Band-Aids on [things].  Let's get to the root cause and, really, stop you from entering the door.” - Dr. Kwadwo Kyeremanteng Dr. Kwadwo Kyeremanteng is a palliative care & intensive care doctor based in Ottawa, Canada.  As a physician treating critically ill patients, he brings an enthusiasm and passion to the idea of keeping patients out of the hospital in the first place by using lifestyle to prevent disease. On his podcast, Solving Healthcare, Dr. Kyeremanteng features interviews and discussions on the topic of improving healthcare delivery.  He is also the founder of the Resource Optimization Network, a multidisciplinary research group working to reduce health spending, make the ICU more efficient, and improve access to palliative care services. Dr. Kyeremanteng was one of only two Black students in his medical school class, and as one of the few Black doctors practicing in his hospital today, he is keenly aware of the demographic imbalance in medicine and the resulting challenges Black individuals must overcome to have the same opportunities as their peers.  He's recently launched a healthcare mentorship program to help Black students bridge this gap. Dr. Kyermanteng's role in the ICU has put him at the forefront of caring for acutely ill COVID-19 patients, and his experience as a palliative doctor gives him a unique perspective on the challenges facing these patients and their families. I was excited to hear from Dr. Kyeremanteng on all of these hot topics, and more.  We covered a lot of ground in the conversation, from how intensive care medicine and palliative care medicine go hand-in-hand, to the lessons he's learned from spending time with patients near the end of their lives, to what actions we can start taking now to be anti-racist. *Photo courtesy of Michelle Dickie In this episode we discuss: His background and how he came to practice medicine Why he chose to specialize in both intensive care and palliative medicine The overlay between palliative medicine and ICU care The difference between ICU care, palliative care, and hospice care Lessons Dr. Kyeremanteng has learned from spending time with patients at the end of their lives How he developed his passion for disease prevention Observations Dr. Kyeremantang has had caring for acute patients during COVID Patterns he's noticed in patients who thrive after leaving the ICU Ways Dr. Kyeremanteng helps patients nurture a positive mindset His experiences with racism both as a child and in medicine Dr. Kyeremanteng's youth mentorship program Lessons he hopes to instill in his three sons The advice he would give to people to live their life to their fullest Dr. Kyeremanteng's advice to people concerned about COVID-19 Actions he would love to see his white colleagues take to fight racism Three things Dr. Kyeremanteng does on a regular basis that have the biggest positive impact on his health One thing he struggles to implement that could have a big impact on his health What a healthy life looks like to Dr. Kyeremanteng You can follow Dr. Kyeremanteng on his website, Solving Healthcare, his podcast, and on social media: Instagram, Facebook, and Twitter. Links: Palliative care: Earlier is better Systemic Racism, How to Create Change and More with Dr. Chika Oriuwa Easy Strength with Dan John The 4-Hour Work Week, Tim Ferriss The 80/20 Principle, Richard Koch Related episodes: Ep 147 – Cancer, Racism, and Speaking Up with Deb Cordner Carson Ep 149 – The Science of Spontaneous Healing with Dr. Jeffrey Rediger Ep 164 – Boosting Immunity and Reducing COVID Risk with Dr. Aseem Malhotra If you like this episode, please subscribe to Pursuing Health on iTunes and give it a rating. I'd love to hear your feedback in the comments below and on social media using the hashtag #PursuingHealth. I look forward to bringing you future episodes with inspiring individuals and ideas about health every other Tuesday. Disclaimer: This podcast is for general information only, and does not provide medical advice. We recommend that you seek assistance from your personal physician for any health conditions or concerns. This post was originally published on November 3, 2020.

Low Carb & Ketogenic Approaches to Health:Solving Healthcare and the Resource Optimization Network present our first virtual summit!Purchase the recorded summit:https://solvinghealthcare.ca/lowcarbTrulocal.caShop for clean, locally sourced meat products online and make fewer trips to the grocery store.Go to trulocal.ca and use promo code “SOLVINGHEALTHCARE25” to get $25 off your first order!Kim Sutton: http://solvinghealthcare.ca/kimsuttonCharityHelp children in need in our community. Check out our charitable initiative,Bridges Over Barriers:https://www.educationfoundationottawa.ca/students-in-crisis/bridges-over-barriers/MerchandiseShop our Solving Healthcare merchandise and help support our community! All proceeds will be going to Give A Milehttps://solving-healthcare.myshopify.com/NewsletterHave you signed up for our newsletter yet? Keep track of everything going on at Solving Healthcare by subscribing at the link below:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=124e477919WebinarsSubscribe to our expert-led, interactive webinar series:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=ed860b52f9Catch up on our previous webinars on our Youtube channel:https://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videosHow to subscribe to the podcast:Solvinghealthcare.caMake sure to subscribe to the Solving Healthcare podcast! You can find us on Apple Podcasts, Spotify, iHeart Radio, Castbox or Simplecast. Links to each platform can be found below:solvinghealthcare.ca/podcastSocial platforms:Twitter https://twitter.com/kwadcastInstagram https://www.instagram.com/kwadcast/Youtubehttps://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videos

Low Carb & Ketogenic Approaches to Health:Solving Healthcare and the Resource Optimization Network present our first virtual summit!Purchase the recorded summit:https://solvinghealthcare.ca/lowcarbTrulocal.caShop for clean, locally sourced meat products online and make fewer trips to the grocery store.Go to trulocal.ca and use promo code “SOLVINGHEALTHCARE25” to get $25 off your first order!Kim Sutton: http://solvinghealthcare.ca/kimsuttonCharityHelp children in need in our community. Check out our charitable initiative,Bridges Over Barriers:https://www.educationfoundationottawa.ca/students-in-crisis/bridges-over-barriers/MerchandiseShop our Solving Healthcare merchandise and help support our community! All proceeds will be going to Give A Milehttps://solving-healthcare.myshopify.com/NewsletterHave you signed up for our newsletter yet? Keep track of everything going on at Solving Healthcare by subscribing at the link below:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=124e477919WebinarsSubscribe to our expert-led, interactive webinar series:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=ed860b52f9Catch up on our previous webinars on our Youtube channel:https://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videosHow to subscribe to the podcast:Solvinghealthcare.caMake sure to subscribe to the Solving Healthcare podcast! You can find us on Apple Podcasts, Spotify, iHeart Radio, Castbox or Simplecast. Links to each platform can be found below:solvinghealthcare.ca/podcastSocial platforms:Twitter https://twitter.com/kwadcastInstagram https://www.instagram.com/kwadcast/Youtubehttps://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videos

Low Carb & Ketogenic Approaches to Health:Solving Healthcare and the Resource Optimization Network present our first virtual summit!Purchase the recorded summit:https://solvinghealthcare.ca/lowcarbTrulocal.caShop for clean, locally sourced meat products online and make fewer trips to the grocery store.Go to trulocal.ca and use promo code “SOLVINGHEALTHCARE25” to get $25 off your first order!Kim Sutton: http://solvinghealthcare.ca/kimsuttonCharityHelp children in need in our community. Check out our charitable initiative,Bridges Over Barriers:https://www.educationfoundationottawa.ca/students-in-crisis/bridges-over-barriers/MerchandiseShop our Solving Healthcare merchandise and help support our community! All proceeds will be going to Give A Milehttps://solving-healthcare.myshopify.com/NewsletterHave you signed up for our newsletter yet? Keep track of everything going on at Solving Healthcare by subscribing at the link below:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=124e477919WebinarsSubscribe to our expert-led, interactive webinar series:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=ed860b52f9Catch up on our previous webinars on our Youtube channel:https://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videosHow to subscribe to the podcast:Solvinghealthcare.caMake sure to subscribe to the Solving Healthcare podcast! You can find us on Apple Podcasts, Spotify, iHeart Radio, Castbox or Simplecast. Links to each platform can be found below:solvinghealthcare.ca/podcastSocial platforms:Twitter https://twitter.com/kwadcastInstagram https://www.instagram.com/kwadcast/Youtubehttps://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videos

SPONSORSCOVID-19: How to Manage Stress and Build Resiliencesolvinghealthcare.ca/resilienceLow Carb & Ketogenic Approaches to Health:Solving Healthcare and the Resource Optimization Network present our first virtual summit!Purchase the recorded summit:https://solvinghealthcare.ca/lowcarbKim Sutton: http://solvinghealthcare.ca/kimsuttonCharityHelp children in need in our community. Check out our charitable initiative,Bridges Over Barriers:https://www.educationfoundationottawa.ca/students-in-crisis/bridges-over-barriers/MerchandiseShop our Solving Healthcare merchandise and help support our community! All proceeds will be going to Give A Milehttps://solving-healthcare.myshopify.com/NewsletterHave you signed up for our newsletter yet? Keep track of everything going on at Solving Healthcare by subscribing at the link below:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=124e477919WebinarsSubscribe to our expert-led, interactive webinar series:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=ed860b52f9Catch up on our previous webinars on our Youtube channel:https://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videosHow to subscribe to the podcast:Solvinghealthcare.caMake sure to subscribe to the Solving Healthcare podcast! You can find us on Apple Podcasts, Spotify, iHeart Radio, Castbox or Simplecast. Links to each platform can be found below:solvinghealthcare.ca/podcastSocial platforms:Twitter https://twitter.com/kwadcastInstagram https://www.instagram.com/kwadcast/Youtubehttps://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videos

SPONSORSCOVID-19: How to Manage Stress and Build Resiliencesolvinghealthcare.ca/resilienceLow Carb & Ketogenic Approaches to Health:Solving Healthcare and the Resource Optimization Network present our first virtual summit!Purchase the recorded summit:https://solvinghealthcare.ca/lowcarbKim Sutton: http://solvinghealthcare.ca/kimsuttonCharityHelp children in need in our community. Check out our charitable initiative,Bridges Over Barriers:https://www.educationfoundationottawa.ca/students-in-crisis/bridges-over-barriers/MerchandiseShop our Solving Healthcare merchandise and help support our community! All proceeds will be going to Give A Milehttps://solving-healthcare.myshopify.com/NewsletterHave you signed up for our newsletter yet? Keep track of everything going on at Solving Healthcare by subscribing at the link below:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=124e477919WebinarsSubscribe to our expert-led, interactive webinar series:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=ed860b52f9Catch up on our previous webinars on our Youtube channel:https://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videosHow to subscribe to the podcast:Solvinghealthcare.caMake sure to subscribe to the Solving Healthcare podcast! You can find us on Apple Podcasts, Spotify, iHeart Radio, Castbox or Simplecast. Links to each platform can be found below:solvinghealthcare.ca/podcastSocial platforms:Twitter https://twitter.com/kwadcastInstagram https://www.instagram.com/kwadcast/Youtubehttps://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videos

SPONSORSCOVID-19: How to Manage Stress and Build Resiliencesolvinghealthcare.ca/resilienceLow Carb & Ketogenic Approaches to Health:Solving Healthcare and the Resource Optimization Network present our first virtual summit!Purchase the recorded summit:https://solvinghealthcare.ca/lowcarbKim Sutton: http://solvinghealthcare.ca/kimsuttonCharityHelp children in need in our community. Check out our charitable initiative,Bridges Over Barriers:https://www.educationfoundationottawa.ca/students-in-crisis/bridges-over-barriers/MerchandiseShop our Solving Healthcare merchandise and help support our community! All proceeds will be going to Give A Milehttps://solving-healthcare.myshopify.com/NewsletterHave you signed up for our newsletter yet? Keep track of everything going on at Solving Healthcare by subscribing at the link below:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=124e477919WebinarsSubscribe to our expert-led, interactive webinar series:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=ed860b52f9Catch up on our previous webinars on our Youtube channel:https://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videosHow to subscribe to the podcast:Solvinghealthcare.caMake sure to subscribe to the Solving Healthcare podcast! You can find us on Apple Podcasts, Spotify, iHeart Radio, Castbox or Simplecast. Links to each platform can be found below:solvinghealthcare.ca/podcastSocial platforms:Twitter https://twitter.com/kwadcastInstagram https://www.instagram.com/kwadcast/Youtubehttps://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videos

SPONSORSCOVID-19: How to Manage Stress and Build Resiliencesolvinghealthcare.ca/resilienceLow Carb & Ketogenic Approaches to Health:Solving Healthcare and the Resource Optimization Network present our first virtual summit!Purchase the recorded summit:https://solvinghealthcare.ca/lowcarb*Kim Sutton:  *http://solvinghealthcare.ca/kimsuttonCharityHelp children in need in our community. Check out our charitable initiative,Bridges Over Barriers:https://www.educationfoundationottawa.ca/students-in-crisis/bridges-over-barriers/MerchandiseShop our Solving Healthcare merchandise and help support our community! All proceeds will be going to Give A Milehttps://solving-healthcare.myshopify.com/NewsletterHave you signed up for our newsletter yet? Keep track of everything going on at Solving Healthcare by subscribing at the link below:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=124e477919WebinarsSubscribe to our expert-led, interactive webinar series:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=ed860b52f9Catch up on our previous webinars on our Youtube channel:https://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videosHow to subscribe to the podcast:Solvinghealthcare.caMake sure to subscribe to the Solving Healthcare podcast! You can find us on Apple Podcasts, Spotify, iHeart Radio, Castbox or Simplecast. Links to each platform can be found below:solvinghealthcare.ca/podcastSocial platforms:Twitter https://twitter.com/kwadcastInstagram https://www.instagram.com/kwadcast/Youtubehttps://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videos

SPONSORSTrulocal.caShop for clean, locally sourced meat products online and make fewer trips to the grocery store.Go to trulocal.ca and use promo code “SOLVINGHEALTHCARE25” to get $25 off your first order!Low Carb & Ketogenic Approaches to Health:Solving Healthcare and the Resource Optimization Network present our first virtual summit!Purchase the recorded summit:https://solvinghealthcare.ca/lowcarb Kim Sutton:  http://solvinghealthcare.ca/kimsuttonCharityHelp children in need in our community. Check out our charitable initiative,Bridges Over Barriers:https://www.educationfoundationottawa.ca/students-in-crisis/bridges-over-barriers/MerchandiseShop our Solving Healthcare merchandise and help support our community! All proceeds will be going to Give A Milehttps://solving-healthcare.myshopify.com/NewsletterHave you signed up for our newsletter yet? Keep track of everything going on at Solving Healthcare by subscribing at the link below:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=124e477919 WebinarsSubscribe to our expert-led, interactive webinar series:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=ed860b52f9Catch up on our previous webinars on our Youtube channel:https://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videosHow to subscribe to the podcast:Solvinghealthcare.caMake sure to subscribe to the Solving Healthcare podcast! You can find us on Apple Podcasts, Spotify, iHeart Radio, Castbox or Simplecast. Links to each platform can be found below:solvinghealthcare.ca/podcastSocial platforms:Twitter https://twitter.com/kwadcastInstagram https://www.instagram.com/kwadcast/Youtubehttps://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videos

Low Carb & Ketogenic Approaches to Health:Solving Healthcare and the Resource Optimization Network present our first virtual summit!Purchase the recorded summit:https://solvinghealthcare.ca/lowcarbKim Sutton:  http://solvinghealthcare.ca/kimsuttonCharityHelp children in need in our community. Check out our charitable initiative,Bridges Over Barriers:https://www.educationfoundationottawa.ca/students-in-crisis/bridges-over-barriers/MerchandiseShop our Solving Healthcare merchandise and help support our community! All proceeds will be going to Give A Milehttps://solving-healthcare.myshopify.com/NewsletterHave you signed up for our newsletter yet? Keep track of everything going on at Solving Healthcare by subscribing at the link below:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=124e477919 WebinarsSubscribe to our expert-led, interactive webinar series:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=ed860b52f9Catch up on our previous webinars on our Youtube channel:https://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videosHow to subscribe to the podcast:Solvinghealthcare.caMake sure to subscribe to the Solving Healthcare podcast! You can find us on Apple Podcasts, Spotify, iHeart Radio, Castbox or Simplecast. Links to each platform can be found below:solvinghealthcare.ca/podcastSocial platforms:Twitter https://twitter.com/kwadcastInstagram https://www.instagram.com/kwadcast/Youtubehttps://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videos

SponsorsLow Carb & Ketogenic Approaches to Health:Solving Healthcare and the Resource Optimization Network present our first virtual summit!Purchase the recorded summit:https://solvinghealthcare.ca/lowcarbKim Sutton:  http://solvinghealthcare.ca/kimsuttonCharityHelp children in need in our community. Check out our charitable initiative,Bridges Over Barriers:https://www.educationfoundationottawa.ca/students-in-crisis/bridges-over-barriers/MerchandiseShop our Solving Healthcare merchandise and help support our community! All proceeds will be going to Give A Milehttps://solving-healthcare.myshopify.com/NewsletterHave you signed up for our newsletter yet? Keep track of everything going on at Solving Healthcare by subscribing at the link below:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=124e477919 WebinarsSubscribe to our expert-led, interactive webinar series:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=ed860b52f9Catch up on our previous webinars on our Youtube channel:https://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videosHow to subscribe to the podcast:Solvinghealthcare.caMake sure to subscribe to the Solving Healthcare podcast! You can find us on Apple Podcasts, Spotify, iHeart Radio, Castbox or Simplecast. Links to each platform can be found below:solvinghealthcare.ca/podcastSocial platforms:Twitter https://twitter.com/kwadcastInstagram https://www.instagram.com/kwadcast/Youtubehttps://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videosShow notes by Michael Pratte

SponsorsLow Carb & Ketogenic Approaches to Health:Solving Healthcare and the Resource Optimization Network present our first virtual summit!Purchase the recorded summit:https://solvinghealthcare.ca/lowcarbKim Sutton:  http://solvinghealthcare.ca/kimsuttonCharityHelp children in need in our community. Check out our charitable initiative,Bridges Over Barriers:https://www.educationfoundationottawa.ca/students-in-crisis/bridges-over-barriers/MerchandiseShop our Solving Healthcare merchandise and help support our community! All proceeds will be going to Give A Milehttps://solving-healthcare.myshopify.com/NewsletterHave you signed up for our newsletter yet? Keep track of everything going on at Solving Healthcare by subscribing at the link below:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=124e477919 WebinarsSubscribe to our expert-led, interactive webinar series:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=ed860b52f9Catch up on our previous webinars on our Youtube channel:https://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videosHow to subscribe to the podcast:Solvinghealthcare.caMake sure to subscribe to the Solving Healthcare podcast! You can find us on Apple Podcasts, Spotify, iHeart Radio, Castbox or Simplecast. Links to each platform can be found below:solvinghealthcare.ca/podcastSocial platforms:Twitter https://twitter.com/kwadcastInstagram https://www.instagram.com/kwadcast/Youtubehttps://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videos

SponsorsLow Carb & Ketogenic Approaches to Health:Solving Healthcare and the Resource Optimization Network present our first virtual summit!Purchase the recorded summit:https://solvinghealthcare.ca/lowcarbKim Sutton:  http://solvinghealthcare.ca/kimsuttonCharityHelp children in need in our community. Check out our charitable initiative,Bridges Over Barriers:https://www.educationfoundationottawa.ca/students-in-crisis/bridges-over-barriers/MerchandiseShop our Solving Healthcare merchandise and help support our community! All proceeds will be going to Give A Milehttps://solving-healthcare.myshopify.com/NewsletterHave you signed up for our newsletter yet? Keep track of everything going on at Solving Healthcare by subscribing at the link below:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=124e477919 WebinarsSubscribe to our expert-led, interactive webinar series:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=ed860b52f9Catch up on our previous webinars on our Youtube channel:https://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videosHow to subscribe to the podcast:Solvinghealthcare.caMake sure to subscribe to the Solving Healthcare podcast! You can find us on Apple Podcasts, Spotify, iHeart Radio, Castbox or Simplecast. Links to each platform can be found below:solvinghealthcare.ca/podcastSocial platforms:Twitter https://twitter.com/kwadcastInstagram https://www.instagram.com/kwadcast/Youtubehttps://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videos

SponsorsLow Carb & Ketogenic Approaches to Health:Solving Healthcare and the Resource Optimization Network present our first virtual summit!Purchase the recorded summit:https://solvinghealthcare.ca/lowcarbKim Sutton:  http://solvinghealthcare.ca/kimsuttonCharityHelp children in need in our community. Check out our charitable initiative,Bridges Over Barriers:https://www.educationfoundationottawa.ca/students-in-crisis/bridges-over-barriers/MerchandiseShop our Solving Healthcare merchandise and help support our community! All proceeds will be going to Give A Milehttps://solving-healthcare.myshopify.com/NewsletterHave you signed up for our newsletter yet? Keep track of everything going on at Solving Healthcare by subscribing at the link below:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=124e477919 WebinarsSubscribe to our expert-led, interactive webinar series:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=ed860b52f9Catch up on our previous webinars on our Youtube channel:https://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videosHow to subscribe to the podcast:Solvinghealthcare.caMake sure to subscribe to the Solving Healthcare podcast! You can find us on Apple Podcasts, Spotify, iHeart Radio, Castbox or Simplecast. Links to each platform can be found below:solvinghealthcare.ca/podcastSocial platforms:Twitter https://twitter.com/kwadcastInstagram https://www.instagram.com/kwadcast/Youtubehttps://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videos

SponsorsLow Carb & Ketogenic Approaches to Health:Solving Healthcare and the Resource Optimization Network present our first virtual summit!Purchase the recorded summit:https://solvinghealthcare.ca/lowcarbKim Sutton:  http://solvinghealthcare.ca/kimsuttonCharityHelp children in need in our community. Check out our charitable initiative,Bridges Over Barriers:https://www.educationfoundationottawa.ca/students-in-crisis/bridges-over-barriers/MerchandiseShop our Solving Healthcare merchandise and help support our community! All proceeds will be going to Give A Milehttps://solving-healthcare.myshopify.com/NewsletterHave you signed up for our newsletter yet? Keep track of everything going on at Solving Healthcare by subscribing at the link below:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=124e477919 WebinarsSubscribe to our expert-led, interactive webinar series:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=ed860b52f9Catch up on our previous webinars on our Youtube channel:https://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videosHow to subscribe to the podcast:Solvinghealthcare.caMake sure to subscribe to the Solving Healthcare podcast! You can find us on Apple Podcasts, Spotify, iHeart Radio, Castbox or Simplecast. Links to each platform can be found below:solvinghealthcare.ca/podcastSocial platforms:Twitter https://twitter.com/kwadcastInstagram https://www.instagram.com/kwadcast/Youtubehttps://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videos

SponsorsLow Carb & Ketogenic Approaches to Health:Solving Healthcare and the Resource Optimization Network present our first virtual summit!Purchase the recorded summit:https://solvinghealthcare.ca/lowcarbKim Sutton:  http://solvinghealthcare.ca/kimsuttonCharityHelp children in need in our community. Check out our charitable initiative,Bridges Over Barriers:https://www.educationfoundationottawa.ca/students-in-crisis/bridges-over-barriers/MerchandiseShop our Solving Healthcare merchandise and help support our community! All proceeds will be going to Give A Milehttps://solving-healthcare.myshopify.com/NewsletterHave you signed up for our newsletter yet? Keep track of everything going on at Solving Healthcare by subscribing at the link below:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=124e477919 WebinarsSubscribe to our expert-led, interactive webinar series:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=ed860b52f9Catch up on our previous webinars on our Youtube channel:https://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videosHow to subscribe to the podcast:Solvinghealthcare.caMake sure to subscribe to the Solving Healthcare podcast! You can find us on Apple Podcasts, Spotify, iHeart Radio, Castbox or Simplecast. Links to each platform can be found below:solvinghealthcare.ca/podcastSocial platforms:Twitter https://twitter.com/kwadcastInstagram https://www.instagram.com/kwadcast/Youtubehttps://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videos

SponsorsLow Carb & Ketogenic Approaches to Health:Solving Healthcare and the Resource Optimization Network present our first virtual summit!Purchase the recorded summit:https://solvinghealthcare.ca/lowcarbKim Sutton:  http://solvinghealthcare.ca/kimsuttonCharityHelp children in need in our community. Check out our charitable initiative,Bridges Over Barriers:https://www.educationfoundationottawa.ca/students-in-crisis/bridges-over-barriers/MerchandiseShop our Solving Healthcare merchandise and help support our community! All proceeds will be going to Give A Milehttps://solving-healthcare.myshopify.com/NewsletterHave you signed up for our newsletter yet? Keep track of everything going on at Solving Healthcare by subscribing at the link below:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=124e477919 WebinarsSubscribe to our expert-led, interactive webinar series:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=ed860b52f9Catch up on our previous webinars on our Youtube channel:https://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videosHow to subscribe to the podcast:Solvinghealthcare.caMake sure to subscribe to the Solving Healthcare podcast! You can find us on Apple Podcasts, Spotify, iHeart Radio, Castbox or Simplecast. Links to each platform can be found below:solvinghealthcare.ca/podcastSocial platforms:Twitter https://twitter.com/kwadcastInstagram https://www.instagram.com/kwadcast/Youtubehttps://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videos 

SponsorsLow Carb & Ketogenic Approaches to Health:Solving Healthcare and the Resource Optimization Network present our first virtual summit!Aug 9th, 330PM ESThttps://drkwadwo.ca/low-carb-ketogenic-approaches-to-health/Kim Sutton:  http://solvinghealthcare.ca/kimsuttonCharityHelp children in need in our community. Check out our charitable initiative,Bridges Over Barriers:https://www.educationfoundationottawa.ca/students-in-crisis/bridges-over-barriers/MerchandiseShop our Solving Healthcare merchandise and help support our community! All proceeds will be going to Give A Milehttps://solving-healthcare.myshopify.com/NewsletterHave you signed up for our newsletter yet? Keep track of everything going on at Solving Healthcare by subscribing at the link below:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=124e477919 WebinarsSubscribe to our expert-led, interactive webinar series:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=ed860b52f9Catch up on our previous webinars on our Youtube channel:https://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videosHow to subscribe to the podcast:Solvinghealthcare.caMake sure to subscribe to the Solving Healthcare podcast! You can find us on Apple Podcasts, Spotify, iHeart Radio, Castbox or Simplecast. Links to each platform can be found below:solvinghealthcare.ca/podcastSocial platforms:Twitter https://twitter.com/kwadcastInstagram https://www.instagram.com/kwadcast/Youtubehttps://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videos Outro by 12-year-old Mason Hartwick, Power Chords

SponsorsLow Carb & Ketogenic Approaches to Health:Solving Healthcare and the Resource Optimization Network present our first virtual summit!Aug 9th, 330PM ESThttps://drkwadwo.ca/low-carb-ketogenic-approaches-to-health/ Kim Sutton:  http://solvinghealthcare.ca/kimsuttonCharityHelp children in need in our community. Check out our charitable initiative,Bridges Over Barriers:https://www.educationfoundationottawa.ca/students-in-crisis/bridges-over-barriers/MerchandiseShop our Solving Healthcare merchandise and help support our community! All proceeds will be going to Give A Milehttps://solving-healthcare.myshopify.com/NewsletterHave you signed up for our newsletter yet? Keep track of everything going on at Solving Healthcare by subscribing at the link below:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=124e477919 WebinarsSubscribe to our expert-led, interactive webinar series:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=ed860b52f9Catch up on our previous webinars on our Youtube channel:https://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videosHow to subscribe to the podcast:Solvinghealthcare.caMake sure to subscribe to the Solving Healthcare podcast! You can find us on Apple Podcasts, Spotify, iHeart Radio, Castbox or Simplecast. Links to each platform can be found below:solvinghealthcare.ca/podcastSocial platforms:Twitter https://twitter.com/kwadcastInstagram https://www.instagram.com/kwadcast/Youtubehttps://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videos

SponsorsLow Carb & Ketogenic Approaches to Health:Solving Healthcare and the Resource Optimization Network present our first virtual summit!Aug 9th, 330PM ESThttps://drkwadwo.ca/low-carb-ketogenic-approaches-to-health/ Kim Sutton:  http://solvinghealthcare.ca/kimsuttonCharityHelp children in need in our community. Check out our charitable initiative,Bridges Over Barriers:https://www.educationfoundationottawa.ca/students-in-crisis/bridges-over-barriers/MerchandiseShop our Solving Healthcare merchandise and help support our community! All proceeds will be going to Give A Milehttps://solving-healthcare.myshopify.com/NewsletterHave you signed up for our newsletter yet? Keep track of everything going on at Solving Healthcare by subscribing at the link below:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=124e477919 WebinarsSubscribe to our expert-led, interactive webinar series:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=ed860b52f9Catch up on our previous webinars on our Youtube channel:https://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videosHow to subscribe to the podcast:Solvinghealthcare.caMake sure to subscribe to the Solving Healthcare podcast! You can find us on Apple Podcasts, Spotify, iHeart Radio, Castbox or Simplecast. Links to each platform can be found below:solvinghealthcare.ca/podcastSocial platforms:Twitter https://twitter.com/kwadcastInstagram https://www.instagram.com/kwadcast/Youtubehttps://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videos

SponsorsLow Carb & Ketogenic Approaches to Health:Solving Healthcare and the Resource Optimization Network present our first virtual summit!https://drkwadwo.ca/low-carb-ketogenic-approaches-to-health/ Kim Sutton:  http://solvinghealthcare.ca/kimsuttonCharityHelp children in need in our community. Check out our charitable initiative,Bridges Over Barriers:https://donate.micharity.com/education-foundation-of-ottawa/3796079647/donate?campaign=33MerchandiseShop our Solving Healthcare merchandise and help support our community! All proceeds will be going to Give A Milehttps://solving-healthcare.myshopify.com/NewsletterHave you signed up for our newsletter yet? Keep track of everything going on at Solving Healthcare by subscribing at the link below:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=124e477919 WebinarsSubscribe to our expert-led, interactive webinar series:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=ed860b52f9Catch up on our previous webinars on our Youtube channel:https://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videosHow to subscribe to the podcast:Solvinghealthcare.caMake sure to subscribe to the Solving Healthcare podcast! You can find us on Apple Podcasts, Spotify, iHeart Radio, Castbox or Simplecast. Links to each platform can be found below:solvinghealthcare.ca/podcastSocial platforms:Twitter https://twitter.com/kwadcastInstagram https://www.instagram.com/kwadcast/Youtubehttps://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videos

SponsorsLow Carb & Ketogenic Approaches to Health:Solving Healthcare and the Resource Optimization Network present our first virtual summit!https://drkwadwo.ca/low-carb-ketogenic-approaches-to-health/ Kim Sutton:  http://solvinghealthcare.ca/kimsuttonCharityHelp children in need in our community. Check out our charitable initiative,Bridges Over Barriers:https://donate.micharity.com/education-foundation-of-ottawa/3796079647/donate?campaign=33MerchandiseShop our Solving Healthcare merchandise and help support our community! All proceeds will be going to Bridges Over Barriershttps://solving-healthcare.myshopify.com/NewsletterHave you signed up for our newsletter yet? Keep track of everything going on at Solving Healthcare by subscribing at the link below:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=124e477919 WebinarsSubscribe to our expert-led, interactive webinar series:https://resourceoptimizationnetwork.us19.list-manage.com/subscribe?u=45cbdf2bcb2b4aaebef54a196&id=ed860b52f9Catch up on our previous webinars on our Youtube channel:https://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videosHow to subscribe to the podcast:Solvinghealthcare.caMake sure to subscribe to the Solving Healthcare podcast! You can find us on Apple Podcasts, Spotify, iHeart Radio, Castbox or Simplecast. Links to each platform can be found below:solvinghealthcare.ca/podcastSocial platforms:Twitter https://twitter.com/kwadcastInstagram https://www.instagram.com/kwadcast/Youtubehttps://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w/videos

Dr. K. is a founder of Resource Optimization Network, a multidisciplinary research group working to reduce health spending in Canada without compromising care. He is also the host of the "Solving Healthcare Podcast" series featuring interviews and discussions on topics related to improving healthcare delivery in Canada based on the values of cost-effectiveness, dignity, and justice in healthcare. Working for more than eight years in the Intensive Care Unit (ICU) at the Ottawa Hospital, he shares his challenging experience as a medical doctor physically, mentally, and emotionally. He also tackles the health issues of medical professionals, including depression and suicidal cases. Thus his years of experience, he shares some grateful tips on how to achieve a work-life balance. When asked about his life without becoming a physician, he said, he would be a teacher.

What’s good everyone, Meet Dr. Kwadwo Kyeremanteng. He comes from north of the border and is a physician formally trained in critical care medicine and palliative care. His research focuses on making the ICU more efficient and improving access to palliative care services. To achieve this, he founded the Resource Optimization Network, a multidisciplinary research group working to reduce health spending in this area without compromising care. Dr. K, as he is fondly called, is a leading contributor helping the department to achieve its vision of shaping the future of Medicine. Recently, he joined the physician podcast family with his popular show Solving Healthcare.  Solving Healthcare is a podcast series featuring interviews and discussions on topics related to improving healthcare delivery in Canada based on the values of cost-effectiveness, dignity, and justice in healthcare. I gotta give him props, my man has been busy pumping out great content around Covid-19 and I definitely recommend you all subscribe to his podcast. Dr. Kwadwo is on the hot seat today so we can learn more about him, why he started his show, and what are the differences in responses to COVID 19 between the US and Canada.    Resources: Solving Healthcare Podcast

Dr. Kwadwo Kyeremanteng is the founder of the Resource Optimization Network and a critical care and palliative care physician. He is also the host of the Solving Healthcare Podcast. He is also Canadian, so we discuss the Canadian Healthcare System, which, on its surface, looks like a comprehensive, all encompassing, federally administered single-payor system, like what some of the democrats are discussing in the US. We discuss why this is not the case, and get into some of the details about what isn’t covered, how it is more of a provincial system and what are the differences in provinces. We discuss how the money flows through the system and how private insurance can play a role in some ancillary services. And true to the name of his podcast, at the end, we solve healthcare. Dr. Kyeremanteng was born and raised in Edmonton where he did his medical school at the University of Alberta. He and his wife then moved to Ottawa where he did his Internal Medicine residency training at the University of Ottawa followed by a two-year fellowship program in Palliative Care and Critical Care. He stayed after his training and is now an Assistant Professor in the Division of Palliative Care and Critical Care Medicine. He also has research positions with Ottawa Hospital Research Institute (OHRI) & Institut du-savoir Montfort as a Senior Clinician Investigator. His academic interests include the integration of Palliative Care in the Intensive Care Unit as well as health services research and cost evaluations. More information regarding his current research interests and projects can be found here. Find this and all episodes on your favorite podcast platform at PhysiciansGuidetoDoctoring.com Please be sure to leave a five-star review, a nice comment and SHARE!!!

This week’s guest is Dr. Kwadwo, Kyeremanteng, an Intensive Care Unit and Palliative Care Physician as well as an associate scientist in the Clinical Epidemiology Program at the Ottawa Hospital. Kwadwo is also an assistant professor at the University of Ottawa and the Founder of the Resource Optimization Network, a multidisciplinary research group working to reduce health spending without compromising health care.  Somehow, between all this Dr. Kyeremanteng also manages to host his own podcast called Solving Health Care which I STRONGLY URGE YOU to check out. On it, he discusses current issues facing the health care world with expert health care professionals. This has been my go-to source of all information related to the coronavirus pandemic. During this episode, we talk about his journey, COVID-19 and the things we can do to help prevent the spread, as well as his personal mindset/diet/and fitness rituals. Enjoy this episode and just remember, it’s not that deep! @KwadCasthttps://www.resourceoptimizationnetwork.com/ @ItsNotThatDeepPodcasthttps://www.itsnotthatdeeppodcast.com

On this episode: Kwadwo Kyeremanteng, a Critical Care & Palliative Doctor and host of the podcast, Solving Healthcare, comes on Life in Red to talk what it's like to be a doctor, being around the end of life process, issues in the Canadian healthcare system and his ideas on how to solve them. You can follow the Solving Healthcare podcast: Facebook, Twitter & Instagram: @Kwadcast And everywhere you get podcasts! Solving Healthcare is a podcast series launched in September 2019 by the Resource Optimization Network. Led by Dr. Kwadwo Kyeremanteng, a palliative care & intensive care doctor based in Ottawa, these podcasts will feature interviews and discussions on the topic of improving healthcare delivery in Canada. Underpinned by the values of cost-effectiveness, dignity, and justice, these podcasts will challenge the status quo, leaving no stone unturned as we explore gaps, assumptions, and different perspectives in the pursuit of finding solutions to problems in Canada’s healthcare system Note, views expressed belong to the host only.

Sign up today: http://betterhelp.com/solvinghealthcareand use Discount code “solvinghealthcare"Critical Levels:http://www.criticallevels.ca Resource Optimization Network website: www.resourceoptimizationnetwork.com/Follow us on twitter & Instagram: @KwadcastLike our Facebook page:https://www.facebook.com/kwadcast/YouTube:https://www.youtube.com/channel/UCLmdmYzLnJeAFPufDy1ti8w   Transcript:Kwadwo : 00:00 Yo, y'all wanted more of André Picard. We are delivering. We're talking cannabis. We're talking PharmaCare. We're talking medical assistance in dying. We're talking privatization of healthcare. Episode 14 with André Picard. Let's go.Kwadwo: 00:18 Welcome to Solving Healthcare. I'm Dr. Kwadwo Kyeremanteng. I'm an ICU and Palliative Care physician here in Ottawa and the founder of Resource Optimization Network. We are on a mission to transform healthcare in Canada. I'm going to talk with physicians, nurses, administrators, patients and their families, because inefficiencies, overwork and overcrowding affects us all. I believe it's time for a better health care system that's more cost effective, dignified and just for everyone involved.Kwadwo : 00:53 Thanks for tuning in everybody. We are super excited about this episode with André Picard. We cover a lot. We cover some of the questions that we saw on social media, on Twitter and on Facebook, but what I want you guys to really take away from this episode is how a lack of clear objectives and goals within our healthcare system really can impair care, and impair resource utilization. I think that was a huge eye-opening point that André and I get to talk about here in this episode amongst the other things, but it's a real eye-opener. Every other area within business, healthcare, your own health, your career goals, you, all of us have clear goals and objectives, but what are our goals in healthcare? Is it to reduce infant mortality? Is it to improve on mental health services? What are our objectives? These are the real questions we should be asking ourselves.Kwadwo : 01:56 Okay. Before getting into the show, I want to tell you about our sponsors, Betterhelp.com As I said, I love these guys. They are online counseling service that provides accessible, affordable, and convenient counseling services that are readily available by a video chat, via telephone, via text messaging, and they cater to your needs, whether it's teen counseling, whether it's marriage counseling, whether it's health care providers, addressing compassion fatigue. They're fantastic. So if you guys are looking to sign up, use promo code Solving Healthcare, and you'll get a 10% discount on their services. Our other sponsor today is The Podcast Critical Levels. This is hosted by my boy Zach Cantor and this show's awesome. It's about paramedicine and the issues around paramedicine, but they also dive into issues that involve us all. Specifically, he had a great episode with Dr. Zemek about childhood concussions, which as a father of three boys that are involved in hockey, I was completely engaged in. It was a great conversation.Kwadwo : 03:08 This guy's going to be a star, so you guys are game, listen to him on iTunes, Spotify, or Stitcher, anywhere you could listen to podcasts and, it's a guaranteed gamer man. Good job Zach. Lastly, I want to give a shout out to the Department of Medicine at the Ottawa Hospital. These guys have supported this show tremendously. I want to give a shout out to Abhilash, Sandra, D D, Tracy, you guys are amazing. They've assisted with marketing, on updated website on the Department of Medicine page. I'll leave links to that on the show notes. It is proper, but yeah, love you guys for all the support and uh, appreciate it. All right, let's dive into it. André Picard, the author of "Matters of Life and Death." And you heard him on Episode 13. Amazing journalist, 40 years of experience and he really delivers on this episode. We talk about it all and I can't wait for you guys to listen to it. So we're just going to dive into it. Enjoy Episode 14.Kwadwo : 04:14 So I touched a bit on universal healthcare and in how, I'm not sure in Canada we can truly say that we have universal healthcare. I'm wondering if you had any thoughts in terms of privatization. You know this is coming up a lot in terms of ways of making healthcare more sustainable, dealing with wait times and so forth. What are your thoughts in terms of privatization?André Picard: 04:40 Well let me start with the universality part of the puzzle. So we have, in Canada we have this notion that we have a universal system, but we have the least universal universal healthcare system in the world. I think once you put it in those terms, you go, "Oh hold on. Is that true?" Because we cover hospitals and we cover physicians a 100%, we cover very little of everything else. We cover about 45% of drugs publicly. Well, 30% of home care, uh, 30- 35% of long-term care, 6% of dental care. We're all over the map and it's irrational. So we don't have a universal healthcare system. So that's the first part of the puzzle. I always said, I like to use the analogy of a basket. So we have this Medicare basket of services. Right now we have a basket that's very narrow and very deep. It's hospitals and physicians.André Picard: 05:29 We pay for all of it, even though some of it probably shouldn't be paid for. And then the other stuff we don't cover near enough. So I think we need to make this basket a lot wider and a bit shallower. So we cover a lot more, but we give some people some responsibility for the rest. So that brings us to the, the second part of the privatization talk. And I think a lot of the talk about privatization in Canada, the way to shut down any discussion about healthcare is to say, "Oh, you're going to privatize, we're going to be like the U. S." Well, I think that's it. I think that's nonsense. I think it's a false dichotomy. I think the reality is every, no health system can cover 100% of everything for everyone all the time. So we're going to have some private healthcare,. We have to realize that from the outset.André Picard: 06:18 So the question is not will we have private healthcare? The question is where do we have it, how do we regulate it, and how do we make sure that everyone gets the essential care that they need at an affordable price? So that's, you have to have these philosophical parameters and then how we deliver the care. To me, it doesn't really matter. I don't care if it's delivered by a privately, publicly a mixture. What matters is that people get the care and that it's accessible and that it's affordable. So that that's my philosophy. I get some grief for that, but I think that's how we have to have the discussion about privatization. It's not black and white. It's about how do we regulate it, how do we ensure that it's delivered fairly and comprehensively, et cetera. I think in Canada, the problem we have is we have a badly administered public health care and badly regulated private health care. So we kind of have the worst of both worlds. A lot European countries have a lot of private health care, but it's very strictly regulated. It's not a free for all the way it is here. So there's different ways to, to have get that balanced right. And again, you've got me on my pet topic.Kwadwo : 07:27 That's part of my game. It's interesting because actually I've never heard it framed that way is that we're the, how'd you put it, in terms of universal healthcare, we're the...André Picard: 07:36 ...the least universal in healthcare.Kwadwo : 07:39 Yeah, I like that. And I mean cause it's often people forget that they're like, oh we don't have any private health care in Canada. But you know, if I go see a physiotherapist I'm paying out of pocket. And it's true. It's like where do we want to put our private resources? I mean, well some of the topics that come up or worries I hear people mention is like resource drain where like some of the best surgeons or physicians or whatever, allied health professionals, would just strictly go into the private sector. But it's kind of like you mentioned if you regular, if you're like anything that you're going to do that's semi new or complicated will take some nuance. And so yeah, you know, maybe you need to restrict how much time physicians could spend in the private sector. Maybe that's a solution, but certainly to think that we can't have any element of private healthcare in 2020 or beyond I think is a bit ignorant at this point.André Picard: 08:41 Well, you're right. It's about setting parameters. So if you look at a country like France, a many doctors practice in the public system and the private system, but there's strict regulations. So if you want to work in the private for every hour you give to the private system, you have to give an hour to the public system. So that's, that's a way of getting some balance there. It's not a, you know, it's not an either or. In Canada you can opt in many provinces, not all, but in many provinces you can opt out of the public system and then you can charge whatever you want. There's no limit. I'm not sure that's a good system. Now very few doctors do because our Medicare system is actually very generous for doctors and it's a good system, very little bureaucracy compared to systems like the U. S. So there's the greatest beneficiaries of Medicare have been physicians. We shouldn't forget that.Kwadwo : 09:27 Yeah. I feel like it's so taboo, but we need to go there and I, I don't know what, will make us go there. What I'm getting at is what is our breaking point? Because baby boomers, are getting to prime time, health care, utilization, age, you know, we keep saying that we can't keep this up in terms of healthcare delivery and spending. So what's next? Like what do you see? What's going to happen in Canada in your, in your humble opinion?André Picard: 10:00 Well, you know, I think that we have to realize that healthcare is really important to us. Uh, we have to find a way of delivering it. And as I said before, we obsess a lot too much about the cost. Do we spend too much on healthcare? I am often asked that question and I always give the same glib response.André Picard: 10:16 I always say, I have no idea because I don't know what we're trying to achieve. So we just spend, you know, we spend the way we spend, we don't have any set public health goals in Canada. So unless you have goals, it's hard to save for we're getting, achieving what we're trying to do. So I think that's, we have to do some basic stuff.Kwadwo : 10:34 What kind of goals would you have us, would you have in mind?André Picard: 10:38 Yeah. So I look to many countries do this. So you look to a country like Sweden. So Sweden publicly publishes every year a list of its public health goals. So for example, I take one in Canada and Canada, we have an abysmally the high rate of child mortality compared to most of the world. So I would say in Canada, we want to bring our rate of child mortality from three per thousand to two per thousand.André Picard: 11:05 That would be a public health goal for me. And then we find out a way to do that and we spend the money that's necessary to do it. So that that's how you have, goals and then you work to achieve them. People often get uncomfortable when I say, "You know, we have to treat it more like a business." And that's what a business does. A business says, here's the goals for the year. Often those goals are related to profit, but we don't have, that doesn't have to be the goal in healthcare. The target, the goal can be, you know, we're going to ensure that our child poverty rate falls by X percentage points or that, the cesarean delivery is going to be less disparate from one end of the country to the other. So there's all kinds of goals you can set once you have goals. It's easier, I think, to, to figure out how to spend appropriately.Kwadwo : 11:48 You know where you're trying to go. You have purpose.Kwadwo : 11:53 Yeah. It's funny cause you always hear on a lot of whatever endeavors that you, you, you go on that, you know, you need to set goals and, and write them down or discuss them, be clear on what your objectives are. And it's funny if you asked me what, you know, what are the goals are Canadian healthcare system, that's not an easy question. Yeah. To make Canadians healthier or whatever. But is that really specific enough? Is that like, what does that actually mean? You know? Yeah. No, that's a, that's a great point.André Picard: 12:25 When I, when I do talk to, I often ask the audience, I say, what, what is the statement of purpose of Canadian Medicare? So we spend a quarter of a trillion dollars every year or $256 billion on healthcare. What is its purpose? So I often ask that to audiences and the question, the answer is always silence. So I tell them, you're right, we don't have any, you're all right. You don't just answer nothing. And when you put it in those terms, I think people go, "Wow, we spend all this money and we don't, what's the purpose of it?"Kwadwo : 12:54 Yeah, wow.Kwadwo : 12:56 I'm actually speechless because yeah, what really is our goals, you know? Yeah. I mean it's, even if you think about it in, in specific niches, like you know, when I'm in ICU, I know my goals are clear. When I'm in the Palliative Care, my goals are clear. You know, when they, when we look at a system level, it's not clear at all. You know, we might have a bunch of issues but we're not prioritizing them. We're just blanketly throwing money in and dealing with fires. Wow.André Picard: 13:29 And Palliative Care is a really good example. You know, you have very specific goals once the patient is there, but whatever. What are our goals as society to ensure that the right patients get there? In Canada between 17 and 35% of people who should have palliative care get it. We do a terrible job of ensuring people are treated well at end of life. And you know, I can't, it's hard to imagine something that's more important than alleviating people's pain at the end of life to not see them die a horrible death. And we just haven't, we don't have goals. We don't have, we haven't made that a priority. You know, again, it's the Canadian classic thing. Once you're in power, you know, you're in palliative care, we have fabulous Palliative Care. So many people are denied access to that, that it's criminal.Kwadwo : 14:16 Yeah, and the thing that people may or may not realize is even when it studied the benefits of early Palliative Care, like there's a study out, it's almost 10 years old now that it was stage four cancer patients got either early Palliative Care or just standard care up to the discretion of their team. And the patients that got early Palliative Care, not only were their symptoms improved, but they actually lived longer, ironically. And so, yeah, I mean you're definitely preaching to the choir in terms of Palliative Care resources. I mean, you know, when you, when you look at trying to improve the experience for the family, for the patient, making sure that the, you know, they're not suffering and you know, even from a resource point of view like the patients are less likely to occupy acute care beds as a result. It's just a, it is a bit mind boggling that this is not emphasized more.André Picard: 15:12 Yeah. And it's a reminder. What you're saying is reminder. I don't, I don't think we lack money. I don't think there's any lack of money in our system, we're one of the biggest healthcare spenders in the world. But I think it's how the money is allocated, is the problem. We don't spend smartly. We don't get value for money.Kwadwo : 15:27 This is, this is my, I mean, this is like my mission, Andre. It's like I see it day in, day out us putting in money into interventions that have no benefit. Even, there's a simple, this is a very simple example, but you know, I think it clarifies things you could have if someone comes into the ICU when they're, they need to be resuscitated with IV fluids. There's normal saline that you've, we've all seen that costs maybe a $1 .30 and then there's some more sophisticated fluids that cost about $50 to $60 for the same amount of volume.Kwadwo : 16:03 So 60 times a price with no, like if you could study it through the union, there was no additional benefit for you getting that fluid. You know, and we, we spent thousands on it and if there's no reason for it. You could have an oral antibiotic that's just as effective as an IV antibiotic, but people will still order the IV one because it makes it feel better. Throwing away money just cause, you know, for lack of understanding or just because of a lack of lack of a will to change, it's just, it's all over the place. And then instead we could be putting it into places that matter. That's a, this is, I don't know if this is what drives me nuts. You know, I see my physio-therapist position gets cut , I see my social worker position get cut, things that actually are going to make a difference into the patient experience and improving care.Kwadwo : 16:56 I'm going to have to cut these positions. Yeah. It's crazy to me.André Picard: 17:00 Yeah. And you remind me of, I remember visiting a unit for girls with eating disorders at a hospital and they had cut the psychological care so they were no longer getting psychological care. So what was the result is they ended up spending many more months in hospital. I had great, a tremendous cost, way more money than it costs to fund a psychologist. A different budget, et cetera. It's just a lot of irrational stuff like that happens and it just, it actually costs more money, not less. I know people, 90 year olds with dementia and cancer are getting a hip transplant. What's the good of that?Kwadwo : 17:36 Absolutely. It's and stuff that has been studied and we know are unlikely to benefit and we still offer it. And you know, I mean when you give that example of arguably who might be the most valuable person in an eating disorder ward, I would think it would be the psychologist. Wow.Kwadwo : 17:56 That reminds me, we did get a bunch of questions on Twitter when we were doing this show and, and one of them, you're a popular man. One question that like really stuck with me and, and I don't think there's an easy answer to this, is how do we break the cycle of these four year,Kwadwo : 18:18 cycles where governments are in power. And so they, the budgets are reflective of that. So there's so much sort short, shortsighted, you know, budget, budget, intervention cuts because we got to balance the budgets despite the fact that some of these cuts are gonna make things worse in the long run. Is there a solution to this problem?André Picard: 18:38 Well, again, yeah, I think there is a solution and again, we can learn from looking at other jurisdictions. I think one of the things that distinguishes Canada is the level of political micromanagement. So there's way too much interference from that. The Health Minister's office reacts to what's on the front page of a newspaper. That's how our system runs. It's like I always call our health ministers, firefighters instead of fire prevention officers, that's what they should be doing. They should be setting the philosophical goals, as I talked about before. These are the goals that we want to achieve and we should have professional administrators running the system so that, that's what I see when I go to countries in Europe, like the Netherlands and France, they're professionally managed. They're run like a business. And the government essentially keeps their nose out of it, and the public doesn't want their noses in it. So I think it's really to let the managers manage.Kwadwo : 19:30 Mmm.André Picard: 19:30 One of the worst jobs in Canada has to be a healthcare administrator because you have all this responsibility and you have no power and you're constantly second guessed by politicians. It's a terrible position to be in. So what do they do? They just cover their butts. They try and not make waves and we just go along, you know, try and keep quiet and nobody wants to catch the attention of the Ministry of Health because it's always going to be bad news. So I think it's this professionalization, that we have to aim for. And it's weird cause we don't do it in any other part of our government. You know, the Transport Minister doesn't call and tell the airport what flight should be going out. And that's, that's how it works in healthcare. It's absurd. So I think that problem is easily solvable, but it's going to take some, some political guts for people to say, listen, hands off, I'm going to let the, you know, Ontario Health. So, you know, say take Ontario Health, this new system, theoretically you should be able to do that. That should be an independent entity. Government gives them their allocation of money, go for it, run it that it should be run that that's how a system works in most countries and that's how it should work here.Kwadwo : 20:42 Have you seen a province, the healthcare system that works better than others?André Picard: 20:47 That's when I traveled around the country. I always know that's going to be the first question when I do a talk. I'm obsessed in Canada. Are we the worst or are we just sort of in the middle? That's everybody wants to be in a major of Canadians. So I think, I think the answer to it is we don't know cause we don't measure things very well. I think anecdotally we know that every province does some stuff really well. So we all have areas of excellence. I often describe Canadian Medicare as "islands of excellence in a sea of mediocrity". We have a lot of mediocrity. We have that but have a lot of great stuff. So New Brunswick has tremendous paramedicine. Manitoba has really good homecare. Quebec has really good primary care with CLSC's.BC has a really good handle on its drug program. So there's all of these provinces that do things well.André Picard: 21:37 And the frustrating things for me is we don't learn from each other and copy each other. We do quite the opposite. We always try to reinvent the wheel. But to get back to your initial question, who does it best overall? I'll just go with my gut feeling cause again, there's no measures, but I think these days, I think it varies. I think Alberta used to have by far the best health system, sort of a pioneered the regionalization model, and it does it really well. It allowed the regions to, to run in the way we talked about, you know, you're the boss and you run it and the government keeps its hands out and until the government started meddling again, that worked really, really well. So I think Alberta was a leader for a long time. I think now probably Saskatchewan. Saskatchewan is a really good size, but a million really good size too to run a system.André Picard: 22:26 Ontario is kind of a dog's breakfast. They're trying to fix this with a reorganization, but it's really the most disorganized system as a result. I think one of the ones with the, with the worst outcomes, unfortunately. I don't think there's a best and I don't think there's a worst, but there's a lot of good and there's a lot of bad overall. Unfortunately.Kwadwo : 22:45 No, I can appreciate your answer. I'm originally from Alberta and one of the things that was taking place before I left was single electronic medical health record. You know, they had this, I'm forgetting the name off the top of my head, but you know, taking the bull by the horns and saying, you know, this is ridiculous. We should all be under one system and oh it should, all hospital charts should be able to speak to each other to a certain extent.Kwadwo : 23:15 And this was, I mean this was in 2005 when I left, so yeah, I do. I could, I could see where you're coming from. And yeah, at the time they still had the like a health authorities is what they would call them. Like which pretty much had as you described, a free reign. Relatively speaking to, to work in the way that was most effective for their community. It's a really good point you bring up though. It's, you know, a little bit more independence for some of these administrators to, you know, to try and do the right thing for their, for the community and to be able to get to their needs. Yeah, I mean that's a, that's a fair point and that you don't hear about every day, but yeah, certainly in Ontario this is what we're attempting. All right. I'm going to ask you a bit of a controversial one too.Kwadwo : 24:02 Is there a party that you feel like since you've been doing this for 40 plus years, it seems to do a better job of this than others?André Picard: 24:11 Well, you know, the, I think one of the biggest problems in Canadian politics is that there's very little difference between the parties, violent agreement on, you know, essentially the status quo. And that's, to me, it's always frustrating to me during election campaigns, there's very little discussion of healthcare because there's no disagreement. Everybody sort of has this, well, Medicare is great and we don't want to talk about it attitude. NDP, Conservative, Liberal, all the same approach. And I think a lot of it goes back to there's a famous quote to attributed to Joey Smallwood, who is the premier of Newfoundland, one of the Fathers of Confederation. He once said that, "I've never had a discussion about healthcare that didn't lose me votes." To this day, politicians feel like that...André Picard: 24:56 You start talking about healthcare and it becomes a losing proposition because you can never satisfy everyone. So the parties kind of agreed to to say nothing. We have these little discussions around the edges occasionally because there's never any serious talk of performing healthcare regardless of the party. So short answer, no, there's not one that's better than the other. What we do know is that the lesser a party's chances of being elected, the more bold their promises are for healthcare. So that, that's the sad reality.Kwadwo : 25:24 Fair enough. Okay. I'm going to touch on a few more questions that some of the our friends were, were asking. So in terms of new cannabis legislation, what's your, your overall opinion on our approach?André Picard: 25:43 Yeah, so I've been long a proponent of, I, don't believe that, you know, drugs should be regulated the way they are now.André Picard: 25:51 I'm a big believer in, legalization of all drugs because I believe people are going to use them and we have to make it safe for them to use, and educate them, et cetera. So that's my premise that I operate from. Lots of people don't like that view, but I have a very libertarian view about drugs and I think it's viewed from a public health perspective, that that's the most rational approach. Now when we take cannabis, I think that legalization of cannabis was long overdue. We started discussing this in the 1970s with the Lyddane Report and finally two years ago we got around to legalization. Now what's happened since then? I think it's been kind of a bust in a bust economically, socially, medically because we've replaced this criminalization with a whole bunch of stupid regulations. There's way more laws about cannabis use now than there were before it was legalized.André Picard: 26:45 So it's kind of a, we've undermined what we were trying to do. From the business perspective, that's the story that gets the most attention in Canada is our cannabis companies are all going bust, because they're, the sales are not what they expected. We could have built an industry here that export it, its knowledge around the world, but, there's so much red tape and regulation that we've denied ourselves that, right. So, and I think we've kind of messed up this good idea. We've get it done it very, very badly unfortunately. So the reality is what the reality is, a lot of people still buy on the black market. The government stores have a product, but they have long wait lines. You know, there's the Canadian way. We wait for everything. We even wait for in line outside to buy our pot. So I think it's kind of been a huge disappointment, unfortunately.Kwadwo : 27:35 Yeah. It's, um, I do hear you about the, from a like a public help perspective on legalization cause certainly, you know, putting somebody in jail or putting them in a spot where they can't have a job based on a substance that people are going to use anyway. It seems, you know, um, not right. But my concern personally is the use, especially amongst the youth. Like I think there's some detrimental affects that maybe we're not appreciating. Like I know we see a little bit more psychosis in lead adolescence, early adult age. I just kind of wish it was studied a bit more before we're like, hey, you know, let's just throw it out to the world, but you know, I, do hear from the public health side for sure.André Picard: 28:27 You know the youth, the youth issue, whether it's cannabis, whether it's vaping, whether it's tobacco, that's a particularly challenging one.André Picard: 28:34 And those things are all illegal. It's always been illegal for young people. Probably always will be. And that's not the issue. That's not the way we're going to deal with that demographic. We have to, we have to teach them. Uh, we have to recognize that they're young people, so they're going to be risk taking. They're going to be experimenting and we have to deal with that reality instead of being moralistic about it and saying, "Oh, we've got to ban, vaping, we've got to ban cannabis." They're going to use it. So let's make sure that when they do they do it safely, uh, they do it rationally as much as possible for a teenager to do anything rationally. I think we just have to be much more pragmatic about this stuff. I think that's, to me, that's the big lesson I've learned about writing about public health for a long time is. ..André Picard: 29:15 You really have to put your opinions aside and be very pragmatic about this stuff and realize it's going to happen. So how do we make it as safe as possible? How do we reduce harm? Harm reduction has to be the driving force of our, our public policies. And the worst thing for harm reduction is, is prohibition. Prohibition is always failed regardless of the substance.Kwadwo : 29:37 Yeah. Fair enough. I guess it's always the question, which I guess we don't know. It's just, you know, what is that safe level? What is a, what is the amount or the approach that, you know, is truly reducing harm. But yeah, a lot of questions in terms of, you know, the approach. How about, another question that came up was regarding PharmaCare. I think you've, you've written a bit about PharmaCare and Canada. Oh, any thoughts on that?André Picard: 30:07 Yeah, so an issue we've written a lot about because it, it actually did get debated politically.André Picard: 30:12 Again, I think PharmaCare is necessary. We need to, you know, we're the only developed country aside from the U.S. that doesn't include drug coverage and our, and our universal health plan. So that's something that's needed to be fixed for 50 years. So we have to do that. So we've done it to a certain extent, but we've done it in a very haphazard way. So we have 102 public drug programs in Canada. We have to make some sense of that. We need some, some more centralization, more logic. But I think the really important thing that's lost in the PharmaCare debate is we have to define what we mean by PharmaCare. So we have a lot of people talking about, you know, we need this single universal system. Sure. That's one way of doing it to be, it's not necessarily that way, but the most important thing is what are we going to cover for who and why?André Picard: 31:02 So how are we going to get value for money, uh, for our drugs? And I think the way to do it is not to copy what we've done with, with the physicians and hospitals, we've covered those 100% and it doesn't work. We've had a lot of waste. We have a lot of, stuff that's not done because we spend too much in those areas. I think we have to be careful not to repeat the mistakes we've made earlier. I think we have to be a little smarter to decide what we're going to cover and that, that to me is the essence of the debate. There's no question that we should cover. Drugs are really important. If we're going to have universal healthcare, but universality doesn't mean covering every product for every person all the time. Ensuring that everyone has the essentials in an affordable way and those are different things .Kwadwo : 31:49 That certainly was one of the few healthcare related topics that came up during this past election.Kwadwo : 31:57 And that was a, it's funny, those are my exact thoughts when it came up, I'm like, what is, what does that actually, what does formal care actually mean? Like what are we actually debating here?André Picard: 32:09 Yeah, there was no, there was no real debate. There were a bunch of platitudes that were uttered, but that wasn't debate because they, the parties never defined what they meant. You know, they said, we're going to bring in, in this program, but what exactly is the program going to be? And then, the fact that the Federal parties were debating this, neglecting the fact that ultimately it's up to the provinces, that that was a big problem as well.Kwadwo : 32:32 Excellent. Excellent. So, okay, André, what are your thoughts on medical assistance in dying?André Picard: 32:38 Yeah. So another issue that we took a long time to deal with. So I started covering that issue in the early eighties.André Picard: 32:45 Then it got a lot of steam with the, in the early nineties with Sue Rodriguez kind of died off for awhile and then came back. So that again, we finally brought in this legislation to give people more choice at the end of life to minimize their suffering. So I think that was a really big important piece of legislation. Now the problem was that the legislation was, was flawed and it was inadequate and we, we've got to fix it. So we're at that point now. In fact, a new public consultations have just started about expanding the MAID legislation. So that's going to happen. The court has ordered it, but it's always frustrating with these issues, how slowly we go, how cautious the politicians are. Thank God we have an activist court in Canada. Or we, we'd have much worse health care. Of course, it forced us to do stuff that we know we should do, but politicians are too, too wimpy to do on their own.André Picard: 33:37 So I read the important issue. I think we have to recognize it. Very few people are ever going to get an assisted death. That's going to be one, 2% very tiny percentage. But I think it's a really important philosophical point, a theoretical point that people have choice that end of life. I think that's what's most important about this debate is giving patients more control. And I think that we're going to see that now we're going to see the really tough ones. Does that apply to people with dementia? Does it apply to people with mental illness? Does it apply to children? There's some really, really tough debates coming. But again, I, I stay in my bubble about being pragmatic. I think we have to give people options and then we have to ensure at the same time that there are protections. So that these things aren't abused.Kwadwo : 34:22 So basically what I'm hearing is we can't use this slippery slope argument as a reason not to implement this. People deserve to have that choice in terms of, how they want to end their life.André Picard: 34:37 I don't know how many times I've said in my columns that not every slope is slippery, but I think we actually remember that, that that's kind of a banal argument. Not every slope is slippery there is, we have to have buffers in place to ensure there aren't abuses, but that doesn't mean denying people rights to want them. No one should be forced to take, to have an assisted death when they don't want to. No one should be choosing assisted death for lack of alternatives like lack of Palliative Care, lack of long-term care. That's unacceptable. Not no one should be denied and assisted death who wants it?André Picard: 35:11 Who's making a rational choice? We can do all those three things at once. They are not mutually exclusive.Kwadwo : 35:19 Exactly. In your book "Matters of Life and Death" you touch on transgender issues. Where do you see some of these issues in 2020?André Picard: 35:30 Well, I think it's just an example of what we talked about at the outset, it's an evolution. You know, it's a new patient group, a new demographic that's standing up and being heard, and that the health system has to adjust. This notion of treating gay men was unthinkable in the 70s and 80s, no, they're a bunch of perverts, and we hear a lot of that same when you're around a long time, you start to hear these echoes and we hear that now about transgender, Oh, we can't possibly do that. We can't use different pronouns. Oh, the language has always been the same, but the things evolve.André Picard: 36:03 Language evolves. Medicine has to evolve and I think this is these developments are good. They challenge us, they force us to think differently. Unfortunately, there are abuses or wrongs that happen along the way that forces us to deal with this, but I think it's, it's a very positive development that we're talking about. Like gender fluidity, that the gender is a social construct. I think these are really important things for physicians and few for future physicians to think about and to talk about. And how do they treat their patients well regardless of their gender or how they identify.Kwadwo : 36:38 Super important topic and definitely one for a future episode. André, what about the wait times we're seeing overall whether in emerge or if you're waiting for a hip. Do you see any solutions in the near future?André Picard: 36:55 Yes. So again, I think wait times is the systemic issue.André Picard: 36:58 So it's about creating more flow in the system. It's about breaking the bottlenecks. You know, as we talked about earlier, at the long rates in our emergency rooms have very little to do with emergency care, right? They're all about bottlenecks. It's about inability to admit people, inability to, to get people out of hospital. We have this perversity in Canada called the ALC patients, (alternate level of care) patients who live in hospitals. I've done stories about this. I met a patient who's been living in a hospital for 10 years because there's no alternative for them. This makes no sense. It makes no sense from a business perspective and makes no sense from a patient care perspective. Ethically, all these things are wrong and we have to fix them. But you know, in some provinces, one third of all hospital beds, are ALC patients. They are people who have been discharged but have nowhere to go.André Picard: 37:51 So these are, this is how you deal with wait times is you deal with things across the spectrum. No easy solution. It can't be overnight, but we have to correct the errors we've made of of bad planning. You know, we all, we hear often and over and over again, Oh well,it's the aging boomers. You know, that's what's overwhelming our system. We've known about the boomers for 60 years. No surprise here. It's just a bad planning, lack of foresight. And we have to fix it.Kwadwo: 38:20 Agreed. But what can we do now? Like if I'm, you know, the Minister of Health or I'm a lead for a health authority and I got these tons of ALC patients, what can we do?André Picard: 38:33 Well, I think, again, if look at it and say from a business perspective, what do you do in a business if you have this problem? You have a mixture of carrots and sticks.André Picard: 38:42 So you start punishing hospitals that have ALC patients. Why did patients, you know, that perversity is that hospitals actually like having ALC patients because they require less nursing care. They're understaffed on nursing. They get paid the same amount of money, require less care. So it's actually a good thing for them, which is wrong. It shouldn't be a good thing. So you have to punish them financially. And that will solve the problem pretty quickly. They'll get them elsewhere. We have to incentivize people to have more long-term care homes. Most of our long-term care homes are private businesses and we have to ask ourselves why people don't go into this business. That's because the rates suck , it's because there's way too much regulations. We have to make it easier for people to provide spaces for people who need it. And then we have to deal with the other pieces of the puzzle, which is home care.André Picard: 39:30 I think we've, put far too many resources into people getting home care just to get them out of hospital quicker from short-term surgery and we haven't invested enough in the chronic part of the puzzle. So again, from a business point of view, way cheaper to care for those ALC patients in their homes costs a fraction of the cost. So take that money and use it differently. And if you don't do that, then you're going to be punished. So the carrot and stick approach, all this stuff is solvable. And I know it's solvable because I see, I don't see these problems in other countries around the world.Kwadwo: 40:05 Interesting. We kind of talked a bit about how to create change in healthcare and you do bring up the carrot and the stick. And I mean money talks. One of my main incentives to do research around costs is because that's the language that that's a change language.Kwadwo : 40:24 That's the language of administrators, of politicians. So if you could show a financial benefit for any intervention, like that's when things actually start to move. And so withholding funds so that change can occur. You know, I think it can go a long way, but certainly just sticking with the status quo is not good enough.André Picard: 40:48 But I would add the proviso that if you're going to have carrots and you're going to have sticks. People have to have accountability and they also have to have power. So you can't punish a hospital for having ALC patients, but not giving them the power to resolve it. I think, again, when you have a regionalization is supposed to be the solution to this, right? So the way a regionalization is supposed to work is that they should say, here's our overall budget. We're not spending it well by having these people living in hospitals, we should spend it on home care or we should spend it on long-term care facilities. So you have to have the power to move that money around and that that's how the issue will get resolved. Ultimately give people, accountability and power to fix things.Kwadwo: 41:29 I love it. You know, trusting in the people that you've invested into, trying to make the healthcare system better.André Picard: 41:36 We pay healthcare administrators a lot of money, let them administer.Kwadwo : 41:40 Mmm, no, that's, that's a great point, André. One thing I like to do is always end on a positive note and allow our guests to talk about a story or a time where they've felt that your job has had a big impact in general. And you did give this story earlierKwadwo : 42:00 about, um, you know, the AIDS patient in Toronto, but is there an any other time where you felt that you covering health care and being as engaged as you have been, that you've really made a difference?André Picard: 42:16 I think there's all those little stories like we talked about, you know, the one patient who, who got better care because of your story, little policy changes. Those are always moving. But to me there, to me, there are two big things in my career that stand out. I wrote for a long time about the tainted blood tragedy. So this came out of my coverage of AIDS. I started covering, you know, there were four groups who were infected with AIDS and one of them was always forgotten. This little group of hemophiliac and transfusion patients. So we started focusing on them and this became, this became a huge story. It became an exposure of one of the worst, probably the worst public health scandal in Canadian history. About 30,000 people were infected with HIV and hepatitis, not because of mismanagement of the blood system, because of lying to people because et cetera.André Picard: 43:06 I have a whole book length version of this rant, but, that issue that the tainted blood issue I think is one of my proudest moments because it really did bring relief to a lot of people. There was more than $5 billion in compensation paid out. Ultimately, our drug regulation system changed profoundly as a result of that. And I'm not taking credit for that solely, but we did get the ball rolling. So I think that's really important story in my, my legacy, if I could put it that way. And there's another one very similar, but on a smaller scale that a very touching one was a work that I did with my colleague on the, thalidomide survivors. So there's a group of five people who are affected by thalidomide in the 1950s, sixties, left with, you know, missing limbs, et cetera.André Picard: 43:54 Those folks live the long time suffering in poverty. And we came back to that a few years ago and wrote about these forgotten survivors. And again, the result was a quite a large compensation package. People getting their lives back, people who are forgotten, you know, we got to tell their story. And there's a lot of, a lot of touching, touching stories as a journalist to hear from that and when you actually change people's lives. So those are two of the biggies for me. But all the little ones day to day, you know, they, they keep you going.Kwadwo : 44:27 Yeah, no, I got to tell you, André, it's truly is a privilege to be able to have this conversation with you. And I could truly echo the amazing, inspiring work that you've done over the years that has impacted Canadians and people worldwide and given people a voice, increasing awareness on many health care related issues. And I got to tell you, I learned a ton today. You know, I got no political, no policy, game. I'm not educated from that front, but the things we talked about today was super eye-opening, especially like the silo stuff and the regionalization aspect of, of things like the way you framed it. And it's just, I don't know, there's a lot to digest and a lot to think about, but, you know, I'm hoping my listeners are feeling similar to me and feeling pretty inspired and I'm truly grateful that you took some time to do this and I hope to have you on again.André Picard: 45:30 A pleasure. And you know, I always remind people, you know, I, my job is to sort of summarize and to translate all this. I meet all these brilliant people and my job is sort of steal their ideas and make them pithy and accessible to the public. So I can't forget that I know nothing. I learned all this stuff from other people and I think my only skill is really being able to boil stuff down and simplify it and hopefully communicate it in a way that people can understand and act on.Kwadwo : 45:55 Yeah. Well I'll tell you it's working. Awesome. André, thank you so much. There's going to be links to all your books, your Twitter handle, everything in the show notes and, thanks again for doing this.André Picard: 46:07 Thank you. I look forward to it.Kwadwo: 46:09 Thank you. Thank you so much for listening to Episode 14 with André Picard. I hope you all enjoyed it. If you guys want to follow him on Twitter, it's @picardonhealth. If you want to follow or support this show on Facebook, on Twitter, on Instagram at Kwadcast, you could send comments to Kwadcast99@gmail.com and please let us know how we're doing. 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