Nobody Asks About Ibuprofen (ft. Joel Selanikio)

Healthcare is getting better and smaller simultaneously. What do you mean by that?

We have so much technology that enables us to skip the doctor visit. How do we provide health to people in a world where doctors are not the center of providing health to people? 20 years ago, you had to go to the doctor to get ibuprofen. I've never once had anybody ask me, do you think over-the-counter drugs are gonna replace doctors? Even though the whole purpose of over-the-counter drugs is to do what? Get rid of the doctor. Even though that's what they're for and that's what they do, right? So we really, I think, have a blind spot Welcome to Digital Voices, where healthcare and life science leaders explore the real work behind transformation. This podcast is about people, leadership, and the conversations that move healthcare forward. Now your host, Ed Marx.

Thanks for listening to Digital Voices. I have another great guest and, and it's all about the guests that make Digital Voices top 10 in the world. So thanks for listening. And you will not be disappointed. You'll thoroughly enjoy this podcast, just like the others. I have with me Dr. Joel Selanikio. Joel, welcome to Digital Voices.

Great to be here, Ed.

Joel, you're like a physician, a TED keynote speaker. You speak to boards, uh, you speak to a lot of different health systems. You, your content is fabulous. I've been a longtime follower. That's kind of how we first met. I've been a stalker. Joel, of yours. I love the stuff that you put out. I use some of the material that you put out because it's very well thought and researched. And so I was like, I have to have Joel on the podcast and talk about all these different things. So that's sort of how we first met. But Joel, the most important question in our 30 minutes together, what kind of music do you like to listen to?

You know, so I like to listen to a very wide variety of things, but I have a 5-and-a-half-year-old in the house who is a bit of a musician and plays the piano and the guitar. And he kind of gets on these little jags. So he's currently— he discovered Elton John. And so I'd say for about the last 2 weeks, almost the only music I have listened to is Elton John. Normally, I have a much broader kind of— a much broader reach, but it's Elton John for the foreseeable future.

Him and Bernie Taupin, they wrote some incredible music together.

It's good stuff. I'm being reminded now, I haven't listened to some of this stuff in a long time.

Yeah. And some of those notes are hard to reach. But I love his music for sure. What about life message or mantra? Are there words that sort of guide how you live?

Well, it's funny because my wife and I talk about this all the time, again, in terms of our son. And the thing that I keep trying to hit with him I'm not sure if it's taken root yet, but I sort of feel like it's been my thing, which is be useful. The goal in life is to be useful. How are you happy? You're happy when you feel like you're being useful, whether it's hopefully both to yourself and also to others, right? I mean, I've always been the happiest when it's been a great balance of that. Just is what I'm doing right now, is it useful to folks?

Yeah, I love that. That's a good good frame of mind in everything that we do. So before we jump in, and I, and I'm dying to jump in, trust me, uh, I want to, I want to learn a little bit more about you and about your career, but then we're going to jump into some of the very provocative things that, that you have talked about in terms of where we're headed with healthcare and technology in the future. So, but before we get there, yeah, tell us a little bit about yourself. Like, where did you grow up? Tell us about your upbringing. Oh, sure.

Uh, I mean, I think I had a pretty, uh, pretty unremarkable upbringing. I grew up in suburban Long Island, uh, one of 4 kids. Um, my dad was, uh, my dad had a furniture store. My mom was a housekeeper, uh, or sorry, not housekeeper, homemaker, and then later became a nurse and a social worker. So a little bit of, a little bit of medical something there. Uh, you know, no doctors, uh, in my family or anything like that. But I, um, for some reason, even when I was a little kid, people kept suggesting that somehow I would become a doctor. Uh, they didn't suggest any of the other stuff that I've done, uh, but maybe it was simply that at that time, you know, people thought, well, you know, you do well in school, you're a smart kid, you'll either be a doctor or a lawyer, ideally, you know, that very limited menu of options. But, uh, yeah, so I, you know, went to public school. Went to Haverford College, took some time off, wound up— took some time off, worked in New York after college for what was then Chase Manhattan Bank doing computer stuff. And then for reasons that, to be honest, it was so long ago that I can hardly remember my thought process on it, but I decided to leave the bank and go back to school and do pre-med and medical school. I will say one of the funny things about that to me, one of the really remarkable things is this was at the end of the '80s, and I was thinking, yeah, I know a lot about computers for that time, but now I'm going to medical school, and I guess I'm never going to use or think about computers ever again. I mean, we were just at the cusp of this tidal wave of technology, right? And even immersed in it, I was thinking to myself, well, Now I'm going to be a doctor and of course it's not going to touch my life at all. So, so much, so much for being prescient, right?

I mean, that is pretty interesting. And yeah, how it's all come, come back together now. Was there a particular pivotal moment in your life? Could have been in your youth, could have been what you just described in your adult life where you made this complete career switch that fundamentally changed your trajectory.

I think I've had, I think I've had at least 2. I mean, I, um, I did a pediatric residency at Emory University in Atlanta, and I had no thoughts about getting into public health or international health or anything like that. And Emory happens to be down the street from CDC, and lots of folks in the pediatric world down there are either working part-time for CDC or used to work for CDC, et cetera. And many of them told me, many of them told me when I was in my, I guess, second year of residency, you know, there's a fellowship at CDC called the Epidemic Intelligence Service, the EIS.

Mm-hmm.

you know, you investigate outbreaks all over the world. It's pretty cool. You should— you know, I think you would be good for that. And I still to this day don't know what it was about me because I was just there cranking along doing my peds residency and hardly had time to, to think. And yet, you know, I applied for that, that residency or that, that fellowship at CDC, and that really did completely broaden my mind. I mean, uh, it was indeed, uh, investigating outbreaks all over the world, working on child vaccination and Vietnam or Kenya or that kind of thing. Right after, I mean, you finish residency and you go for a few weeks of training at CDC, and then you are on a plane to Borneo or something like that. That really opened my eyes to something that's become much more important to me now technologically, which is, how do we provide health to people in a world where doctors are not the center of providing health to people? You wouldn't think, right? That public health-related, third world-oriented kind of thing, what's in, you know, does that have in common with, uh, wearables, et cetera, et cetera? But in fact, it is in fact the same thing. You know, how do we provide maximum health to a maximum number of people? And when doctors again are not at the center of that equation, and, uh, poor countries have been that way for a long time because they simply, you know, doctors have never scaled to most of the Earth's population. Probably at least 50%, probably a little bit more than 50% of the world's population will never see a doctor in their life or a nurse. They will never enter a clinic. And of course, we have a quite different situation here. We have healthcare. It's just very expensive. But in both cases, I think we're moving towards that where doctors will be a much less important part of our health moving forward.

Yeah, you're kind of already giving some insight into some of the provocative parts. This is great. So you still see patients, but you also started Future Health.

Well, actually, when I was at CDC, I actually got promoted to work for the HHS Secretary. HHS is the parent organization of CDC and NIH, et cetera. And actually, I quit that job after a couple of years to, with a friend of mine, start a software company called Magpie, which we actually wound up just winding down and selling the technology. But For about 20 years, my main job was running a software company that we produced. I think people nowadays would just call it mobile forms software designed to help public health folks in poor countries to collect better public health data. So I had that whole thing, and that was actually, you know, you were talking about pivotal stuff. That was actually super important to me because I started not really knowing anything at all. about technology except really as a user. I had some ideas, but it put me into contact with Silicon Valley for the first time. I had no business background. I didn't think about being in business, didn't know anything about business models or anything like that. My friend and business partner, Rose Donna, who had been at American Red Cross, we quit our jobs like idiots. We quit our jobs with no revenue stream and started this company. And then basically for 20 years, did pretty well selling the software, which was actually, now that I think about it, was actually the first web-based, the first SaaS software within global health where you didn't have to install it locally on your computer. You used it over the web like you would so many other tools that we have. But what happened with that, which was so, I think, So critical for me was that because I was a doctor who was using mobile technology to do cool things with poor people in poor countries, I got— I started getting invited to a lot of conferences out in Silicon Valley to, to talk to folks, kind of as, you know, the novelty act, right? You know, the entertainment. It's like, oh, isn't this cute? This guy's a doctor and he's using— he's using technology to do this kind of stuff. And I don't think anybody really learned anything from me at these. I mean, I was at conferences. I remember one time I was sitting next to Sergey Brin in a small conference room listening to somebody talk, and I'm just thinking to myself, this is just mind-blowing. I don't think anybody learned anything from me, but I learned an enormous amount from them, which is that there's this whole— there's a whole world of business theory around mobile technology and all the rest of that stuff. Was kind of fundamental. And even though I'm not doing that software building anymore now, and getting back to Future Health, Future Health really is just me having this phenomenal job now. And the phenomenal job is, other than my couple of days a week maybe in the clinic, my full-time job is thinking and writing and researching and talking about these changes that are happening with technology, et cetera. So Future Health is really just— Future Health is me. I don't have a— well, I have an assistant, but I don't have any other staff. And it's really just the organization behind giving talks and making sure the blog runs on time. Right?

Yeah. And we'll put all that information in the show notes too, because I want people to follow you. I follow you on X. And yeah, and there's your whole platform and the things that you put out are really informative. So We're going to jump into maybe, I don't know if we're going to get to all 10, but I have like 10 quotes from you and they're super provocative. And then like, maybe we'll do like a 1-minute sort of a rundown. Like, what, what do you mean by that? So let's, let's see how it works. Healthcare is getting better and smaller simultaneously. What, what does it, what do you mean by that?

Yeah. You know, I think within healthcare, people have this idea that there's all these technologies, like AI is of course the thing everybody's talking about now. And that AI is going to make healthcare better. And, um, and of course, you know, healthcare is still going to be the center of health, right? That's the way people think within healthcare. And they don't seem to realize that AI— I mean, if you look at how much is spent in the consumer sector on technology, it dwarfs what is spent in the healthcare sector. I mean, uh, it's literally true that Apple makes more money on AirPods than healthcare spends on electronic medical record systems.

AirPods. Yeah.

This is not like the prime product of Apple. This is like an afterthought for Apple. If you spend more money on technology, or in the case of Apple, if you're earning more money from technology, if you have more revenue and you can spend it on innovation, you're going to get more innovation where? In the place where the money is being spent, and that's the consumer side. In fact, I think for the last 20 years, you could You could say that technology is really the primary method by which we— information technology is the primary method by which we've all gotten more capabilities, more tools, more ability to do things. That happens much, much faster on the consumer side than on the healthcare side. I mean, if you work in healthcare where we're still using faxes, where we use these horrible— I mean, mediocre at best electronic record systems, it's not hard to imagine that this is the case. Yet, somehow, people think that healthcare will still continue to be the center of this tech world. Healthcare is definitely getting better with AI. I think AI reading films to discover more signal that's buried in those films, fantastic. AI, silly little administrative things like AI helping the health system to send you a text message to remind you to come to the— all the things that— That retail had 20 years ago, healthcare is finally getting through the benefit of this technology. At the same time, we have so much technology that enables us to skip the doctor visit. That's the smaller part, and that's the part I think that healthcare really does not understand. They just don't understand. There was a Gallup poll maybe back earlier this year, and the Gallup poll basically asked people if they used AI for health and if it had ever caused them to skip A doctor visit? And when you ran the numbers of the people who responded and said yes, it wound up calculating out to about 14 million clinic visits per month that people had skipped, had canceled because of something that ChatGPT or some other tool told them. 14 million a month. Healthcare is oblivious to this. So they see the getting better part. They really don't see the smaller part. The smaller part is where we're living.

Yeah. In fact, you have said doctors aren't going away, right? People are always afraid, is AI going to replace doctors? Your statement is, doctors aren't going away, doctor visits are.

Yeah. Well, even the doctors, Ed, I mean, this whole, is AI going to replace doctors thing, it's like, are automobiles going to replace blacksmiths? I did a talk a couple of years ago. And I was like, you know, I'm going to— let me go to Google Maps and see if there's any blacksmiths still around. And I live in D.C., right? So we're surrounded by Maryland and Virginia. They both have huge areas of horse country. There's plenty of blacksmiths around. There's not one blacksmith per 50 people like there was in 1900. No, there's one blacksmith per, you know, 80,000 Americans. So, you know, asking the question, are cars going to replace, you know, replace blacksmiths? end of sentence doesn't make any sense. And neither does saying, is this going to replace doctors? And like, all of them? Another thing that we miss is I talk a lot about over-the-counter drugs, right? And the fact that because of over-the-counter drugs, many clinic visits don't need to happen, right? 20 years ago, you had to go to the doctor to get ibuprofen. You needed the judgment of a physician to get Advil, right? Or Zyrtec or any of these things. And even though the whole purpose of over-the-counter drugs is to do what? Is to get rid of the doctor, right? The whole purpose of over-the-counter drugs is to replace doctors. I have never once— speaking to thousands of people every year, I've never once had anybody ask me. Everybody asks about the AI. Nobody ever says, do you think over-the-counter drugs are going to replace doctors? Even though that's what they're for and that's what they do. Right. So we really, I think, have a blind spot about this stuff.

Yeah. To that point, GLP-1 is eliminating service lines. Talk a little bit about that because that's related to what you just said. And then autonomous vehicles reducing trauma cases.

Yeah. I mean, to me, I sort of separate this into what I think of as the migration of care from the healthcare system to your living room, basically. All the things you can do now, like measure your blood glucose or whatever it is, all these things you can now do, monitoring your health, asking questions, interpreting your labs that you can do sitting on your couch at home. This movement. So the care still happens, but it doesn't happen in the hospital. It doesn't happen in the clinic anymore. So that's the migration. But the second part that I think people are also quite oblivious to, although bariatric surgeons are beginning to understand, is that there are technologies that are eliminating the demand completely. So the care doesn't happen somewhere else. The care doesn't have to happen because the disease is eliminated. In the case of GLP-1s, I don't know if you saw this recently, but in the last few years, for the first time in, I think, 30 years, the obesity rate in the United States is going down. I mean, 30 years of up, up, up, up, up. And the only theory anyone has about this is Ozempic, basically. And bariatric surgery, I think, has decreased in the last few years by 30%. They are shrinking bariatric surgery departments. It's very blatant. But the thing that happens is, even though I talk about that, I'll talk to healthcare CEOs and I'm like, well, what are the other things in your system? What are the other revenue streams in your system that are downstream of obesity, like stents? Like diabetic retinopathy care, like various cancer care, like knee replacements and hip replacements, right? If obesity goes away, this is a huge hit to healthcare revenue. And, you know, I guess GLPs are sort of, you know, pharmaceuticals are healthcare adjacent, so it's not that surprising to us. But another thing is people just don't realize with autonomous vehicles, That when the insurance companies are telling us these get into 90% fewer accidents, literally nobody at the hospital is thinking, gee, I mean, maybe we ought to scale back our plans for that trauma center because now obesity care is a much, much bigger revenue source for healthcare than trauma is. But they're both very significant. They're both in the billions of dollars. And again, folks, I think, are not paying attention to it.

What about the insurance side? So we've, we've been talking a couple things about the provider side, but you have said biggest insurers are getting smaller.

Yeah. I mean, everybody's rethinking, well, what hap— I mean, let's say, let's say that because of things like ChatGPT, and this is super conservative, let's say that if you look at all the healthcare activity that just involves a patient transferring information between the patient and healthcare provider of some kind, right? It's just informational. There's no exam, there's no tests being done, right? That's a big part of healthcare, not just primary care. You know, that's where the surgical PA calls you and says, hey, how are you doing after the surgery, right? If all that stuff is automated or all that stuff moves to the consumer side, what does that mean for the cost of insurance? Like, should we still be paying the same amount for insurance if we're not actually using healthcare? And If insurance coverage goes down because this stuff has migrated, or in the case of the GLPs or autonomous vehicles, because it's just gone, what does that mean to the pool of patients that are going to be basically paying these premiums? Does that mean premiums go up? Does it mean premiums go down? Does it mean coverage becomes more specialized? I'm not an insurance guy. I don't know, but you know that there are implications Again, based on the fact that if you're being insured for something, if you're being insured for fire and the risk of fire goes down by 90% in your house, that's going to play havoc with insurance markets. And I think they're really just coming to grips with this now.

Everyone's saying there's a physician shortage, but what do you think the data is really showing?

And especially when it comes to a lot of these consumer-oriented treatments and protocols that have bypassed Well, you know, I think, first of all, 90% of the time when you see there'll be some quote, a news story about, you know, they're projecting a shortage of 100,000 physicians or something like that, 90% of the time that number gets traced back to a single organization, which is the American Academy of Medical Colleges. Or is it American Association of Medical Colleges?

That's right.

The trade organization of organizations that train doctors. So there's a little bit of a bias issue there. But even CMS, right? CMS does projections too, and they come up with similar conclusions. Here's the flaw in both of their approaches. CMS and AMC, they both basically say, okay, let's look at the demographics. And if the population's getting bigger and everyone continues to use the healthcare system exactly as they did in 1995, then how many doctors will we need and how many doctors are we going to have? And it's like, guys, you're assuming that GLPs have no effect. You're assuming that wearables and iPhones and ChatGPT have no effect, even though we already know that millions of people are turning away from the healthcare system and skipping visits. So, you know, someone needs to go knock on the door at CMS. I, I don't know about, about AAMC. I don't know whether they're sort of set in their ways. I'd like to give them the benefit of the doubt. But somebody needs to knock on the door at CMS and say, I don't think projecting that it's going to be 1995 forever in terms of healthcare is really a valid way of coming up with physician shortages. And then the problem is, if you really want to know, if you're not biased and you don't think things will stay the same, part of the problem is we're not collecting the data that we need. You know, right now, every time I say that healthcare is getting smaller, even with data, like there's a Harvard researcher named Ishani Ganguly. She came up with a study out in 2020, showed a 25% decrease in primary care visits over an 8-year period. And since I've talked to her since then, she said either subsequent data pretty much supports this. 25%. Now, Ed, don't you think if there was a 25% decrease in the sale of light trucks in America, that the head of Toyota would know about it? Right. Don't you think everybody in the automobile industry would talk? It'd be all over the trade papers, et cetera. She comes up with this figure. They looked at millions of insurance claims for insured adults, right? People who had insurance, and comes up with a 25% decrease in primary care visits. I haven't found a primary care provider. I haven't found a CEO. I haven't found a board member. I haven't found anybody who has ever heard of or paid any attention to this study. And so when you think about, like, if demand is going down, as that would suggest, Then what does that mean to these physician projections? The problem is I talk to folks and they say, well, my clinic is busier than ever. And I try to explain to them that the current situation where coastal clinics in big cities are busier than ever might be because demand is up, more and more people trying to get fewer and fewer appointment spots. Or it could be because demand is down because people are leaving and therefore clinics are closing and health systems are consolidating. And we know that's happening. And therefore, there's, you know, the surviving patients population is divided among fewer clinics, so they're all busy. And I don't know, in fact, no one knows which of those is actually the case. Is it demand going up? Is it demand going down? Is it a shortage? Is it not a shortage? We don't know because we're not collecting— no one knows. CMS doesn't know because we're not collecting the data, for example, about Let's say, how many appointment slots are there in general, overall, per specialty? Nobody collects this stuff. I don't mean like the number of doctors. It's very imperfect. You don't know how much time is that doctor spending on actual clinical care, right? How much— they're working 40 hours a week. Well, how much of that is actually in the clinic and available? Not collecting that data. And no one appears to even have identified that we need to be— well, I mean, I talk about it, but it doesn't seem to be widely acknowledged that we don't have enough data to actually answer these super important questions for the healthcare system and the country.

All right. So, Joel, hopefully people have come to some level of realization about some of the trends that we're talking about here. This is really happening. What do you counsel a health system? Let's just take your average hospital health system. What is your counsel? Like, people listening now, they're like, oh yeah, I think I kind of agree. I've seen that. This Joel guy, he's, he's, he's, he's pretty close to what I'm experiencing. So we need to respond, right? So what do you counsel these health systems to respond? Like, what should they be doing today?

Well, I think one thing they should be doing that they are not at all doing is they should be, they should be coming up with best case, worst case, middle case scenarios, right? They should be hedging their bets. Again, I mean, people are like, well, autonomous vehicles, maybe that'll do this or maybe that. They're a long way off, aren't they? My wife just got a Tesla, and I can tell you, they're not a long way off. That Tesla drives me from here to Long Island, and I don't touch the wheel or the pedal the whole time. 250 miles, right? They're not a long way off. But if you think Joel's right, you should develop a plan. I hate to be the worst-case scenario, but yeah, let's assume he's right. Let's come up with a worst-case scenario for what's our staffing, where are we going to put our money, et cetera. Let's come up with a best-case scenario, which is probably that things continue the way they are, becoming more efficient through technology and AI, et cetera, and kind of a midcourse so that we're not constantly making all of our plans based on these, for example, projections that really don't have any basis in fact anymore. They're projections about what would've happened back in 1975. They're not projections about the world that we currently live in. So to me, this is something that you see in many industries, let's say. I mean, with the GLPs, right? Look at the food industry. If you look into what the food industry is doing to respond to GLPs, if you read any trade papers in food, and I kind of did this as research because I wanted to see a parallel case of an industry very much affected by GLPs, right? People don't eat as much if they're on Ozempic. All the trade papers, you can't read an article about Ozempic or GLPs in trade papers for the food industry without the words existential crisis appearing or existential threat appearing in the article. You can't find that in the healthcare press at all. Food companies are already coming up with product lines trying to discern what are the things that people are going to come to us to buy and to eat? What are the things people are going to enjoy? if they're on Ozempic. We need to make portions smaller. Maybe we need to play up the protein and, and increase the protein. They're already doing it. It's in your supermarket. They haven't had any more time to respond to this than healthcare has. But if you ask people in healthcare, what are you doing to respond to the GLPs? They don't have anything to say. They, they basically, the answer is usually nothing. Nothing at all. And I think doctors also, they're like, yeah, it's great. I mean, people will be healthier, And I totally agree with them. People will be healthier, but they're not thinking, they're not putting their budget cap on, they're not putting the revenue cap on and thinking about that. So if I could wave a wand, I'd say, let's have people, let's start wargaming it. Let's start doing best case, worst scenarios. And that I think the people who maybe there are surely people out there doing that now that I haven't met. I think those are the people that are going to fare the best over the course of the next 10 years.

All right, let's end with this. What about on a personal level? So we, you just gave great counsel, like what should you do as a board, as a C-suite? Like how do we respond to what's really happening? But on a, on a, a personal level, like as a leader, like someone again listening and maybe they're like, yeah, I really should know more, or I really should learn more, or I really should adopt something new. Any advice to that listener?

Well, I mean, other than, you know, following your podcast and, and reading, reading the stuff that I put online, I think would be the number one and the number two spots. To me, I think it's kind of hard to advise people to consider their preconceptions.

Yeah.

In healthcare, again, there's this preconception. It's so central and it's so immovable that doctors are going to be the center of everything in the future. Yet, we've lived through all these different industries where, I mean, when I was working at Chase, when I was right out of college, I mean, We still sent— if we wanted to have something in— if we wanted to print something out in multiple fonts and colors, we sent that to a printer. Right? We don't do that anymore. All the experts, so many of the experts have been kind of displaced by technology that lets us do those expert things. The same thing has happened in healthcare. People don't really realize it. And so if I would say the first thing is to recognize that that is the case, that this is part of a of a long tradition. This is part of a 50-year trend of empowering the consumer through this preponderance of spending on consumer technology rather than institutional technology that just advantages the consumer year after year after year. And you need to be basically focused on understanding that when healthcare survives, it will be as a health niche. Emergency care, expensive machines that people can't have in their house, MRI machines, et cetera, surgical procedures, that kind of stuff. That's going to be healthcare, not the going to the doctor and have a chat, because you're going to be having the chat with your phone. Right. That's what I would, I think, advise people.

Yeah, this is great. Well, we just scratched the surface, but it's so thought-provoking. Joel, we covered a lot of ground, everything from Elton John and your upbringing and kind of the formations that have led you to where you are today. And very thoughtful and provocative at the same time, but real. I mean, obviously you're preaching to the choir here with me. What did we miss, or is there anything you want to double down on? I'll give you the last word.

Again, it really gets to what I was saying about these preconceptions people have. Clayton Christensen, Innovator's Dilemma, right? Famous Harvard Business School professor.

He wrote that book Was that 1997?

About how industries get disrupted. And even when they can see the thing that's happening, Kodak actually literally invented digital photography, and yet they got completely blown out of— I mean, Kodak essentially doesn't exist as a company anymore. They saw it, but they couldn't respond to it. And again, to me, I can't say I'm happy about it. I work within healthcare. A lot of people I know, their life is healthcare. But, you know, to me, I think the thing that I think about all the time is just how can I, can I somehow enable health systems to better react to this stuff so that they are, again, the survivors rather than the disrupted?

Yeah, Joe, I'm with you 100%. That's why I do the things that I do as well, because it's going to happen. And I'd rather those of us who are trained in it and understand it have lived it are the ones to guide it. And as, as of right now, it's happening from the outside. Uh, it's being completely disintegrated, but hopefully voices like yours, and there's others out there, uh, people will start to listen and do something before it's too late. Joel, thank you so much for being my guest on Digital Voices.

My pleasure, really. Thank you for listening to Digital Voices. We hope today's conversation sparked ideas, reflection, And connection. Subscribe on YouTube, Apple, and Spotify Podcasts so you don't miss an episode.