The Future of Fertility and What Every Entrepreneur Can Learn from It with Dr. Steven Palter and Joe Polish

One, just talk about health care, getting women pregnant, fertility, what you do, how you do it, things that will be really helpful. And then the other is how you've actually built such a big following. How can you be a domino for someone else? The Joe Polish Show. Any problem in the world can be solved with the right genius network. I am here with my friend, Dr. Steven Poulter.

It's a pleasure to be here, Joe.

In my home we got this interesting little setup of how my video guys have set this up.

So I think we've been planning this for 10 years. This interview.

Yeah, exactly. So I'm just going to do the official bio of who you are. So. Dr. Steven Palter is the founder and medical director of Gold Coast IVF in Woodbury, New York. He is internationally recognized as a leader in the field of fertility treatment. As a member of the Yale faculty, he was the clinical chief reproductive endocrinology. In endocrinology, he's known as a technical innovator who performed the world's first high definition in 4K endoscopic surgery. Since 2001, Dr. Poulter's clinic in New York has helped thousands of patients achieve their dreams of parenthood. His clinical practice and research focus on infertility. He's taught over 100 invited lectureships and courses, has over 80 publications and abstracts, mentored trainees from over a dozen nations, and has been invited to lecture and perform surgery around the world. He's led the largest online fertility physician education program using his patented Lodestone platform for over 10,000 practitioners. He has combined these two capabilities to reach patients on social media. With an audience of over 600,000 followers and 550 million views, his videos consistently go viral with over 1 million views on multiple social platforms. He's also the creator of the Palter Method, a system for people to take charge of their health and heal the root cause of their infertility so they can get pregnant. Now, his mission is to change the future of of fertility one baby at a time. You can find him on TikTok, Instagram, Facebook and YouTube at. Steven S T E V E N Palter P A L T E R M D well, okay, so I want to do a couple of things here with you too, because I want to just talk about getting women pregnant, fertility, what you do, how you do it, things that will be really helpful to anyone that's listening here. It may be helpful. And the other is healthcare, and then the other is how you've actually built such a big following because a lot of People that would watch me be part of Genius Network listen to the marketing stuff that I do on my marketing podcast they're interested in. If you got a message in a business, how do you tell people about it? How do you get it out? So we'll talk about all these things, so stay tuned.

But when we circle back to that, so many of the lessons about communicating and solving people's problems and education are things that I actually learned from your marketing world and then said how we use this to solve problems.

Yeah. Which is great. And you've done a fantastic job because you educate millions of people now all over the world as a result of it, which is pretty cool. So you mentioned a few things that are potential indirect causes of this. And we now live in this modern world where people are glued to a screen. I've always liked thinking about it. We're more connected electronically and digitally than ever before in human history, but we're more disconnected as humans. And when you're talking about creation of life, there's how people live their lives. I don't know if you think often, are people built for this sort of lifestyle? I mean, are they built this way and reproductively?

Absolutely not. This is not the way it's supposed to be. But, I mean, in caveman times, you'd be pregnant at 18 or 16. As soon as soon as a woman was going through puberty, and you'd be dead by 30.

Oh, I got to ask you a question you're talking about because. Just because you mentioned cavemen, and I can't remember if it's from the book Sperm wars or which book it was, but supposedly, if you go back to. What do you call it?

The Neanderthals and the CRO Magnons.

Exactly. That a woman would be having multiple men or whatever these species species were at the time, basically having orgasms. And that sperms were, like, had claws and they would fight each other in order to see who can impregnate a woman. That there were, like. It was called sperm wars. Right.

Do you know why your penis is mushroom shaped? Did anyone ever ask you that before? No. No. So because other animals, it actually acts like a suction cup. So when the first animal will mate, the second male will come, and it'll actually suck out the sperm of the other one and replace it with theirs. So lower species, they actually look like little suction cups.

Well, now they're actually looking at social media clips. I mean, I could just see.

I have clips.

Your penis is shaped like a mushroom.

I actually made that Video. Okay, that one went viral.

Okay, so explain the plumbing of a man and woman and how this actually. And go.

So most of it. So this is actually a huge misconception. So that's, you know, everyone focuses on that, and everyone thinks. I got to tell you, I have probably half a dozen videos that just, like in five seconds will say you've been having sex for two years and using pull out. You think you're. You think you're on the money. You're just infertile. And everyone thinks it's just the timing. It's plumbing and it's timing. So this is a key thing about reproduction in humans. It's pretty inefficient. But the egg lives for one day. Sperm lives for five days. So if you have sex once or twice a week, two or three times in a month, you'll hit the fertile period. If you look at the root causes. So one third of infertility is due to the woman. One third is the man, one third is combined. So that's the basics. And, you know, all the different parts of the system can go wrong. So the woman may not release the egg. The egg may not be good. The egg and sperm may not meet. The sperm may not good the hormones. But then you got the whole world of toxins, the environment, genetics changes how well those things work. And the key things, you know, age is huge. So for the man, doesn't matter. You can be Tony Randall. You know, you could be 90 and have a baby. It's okay. Sperm goes down a little as you get older, but not much.

But the potency of it, it's. It's. It's. It's less production, but no, not much.

Men remain pretty fertile. And you have, like, some autism. May go up as the man gets older, but, like, the decline is. Is a small amount. A woman, she's born with all the. So a man makes sperm every day, and it lasts. It takes it 90 days from the day it starts growing to the day it leaves. So if you're gonna stop smoking, it's gonna be in your body for 90 days. Wow. So for a woman, she's born with all the eggs she'll ever have, millions of them, and they start to deplete from the. From even before birth. And when she's 20, 80% of those eggs are genetically intact. At 35, half of those eggs are genetically damaged, and they will not cause a pregnancy or a healthy baby. And by 40, it's 80% are off.

And when you're saying women are getting pregnant later in life, or at least trying to. What has been the biggest cause of that?

Well, it's the double edged sword of the women's rights movement. It was, you can have it all, but your ovary doesn't care. The ovaries got a clock that's ticking so you can have it all. But if you're secure as a CEO and now you're 43 and you come to me, it's not a lot. You know, we've lost 80% of our potential. So the revolution in this was telling we can now freeze eggs. So women, if you're, it's the recommendation is if you're going to be 35 and you haven't given birth, we can in two weeks take your eggs, freeze them and give you fertility insurance.

I've not done an interview like this before, right? I've done all kinds of, I've done over 2, 000 interviews with people on all kinds of random subjects. But I could see people doing a search and like, you know, how do I help myself get pregnant if they stumble across this conversation? What are some recommendations that you would give to couples?

So there's so much misinformation out there and so much, you know, both from doctors and people preying on them. You know, it's, these are the most, one of the reasons I went into this field is these are the most desperate for help people where you can literally change their life in one procedure. So you can tell someone they got cancer, they may not take the drugs, heart attack, they won't stop smoking. I could tell this woman 10 things and she's going to follow 10 of them. They are so motivated and I couldn't stand not solving problems. Like I love the biology. I love surgery, like fixing things. I was like, diabetes, like no one's getting better. Heart disease, no one's getting better here. It's like it's a fix. So that's what I love about it. So when they're searching for it, the first thing is knowing when you have a problem. And we have just such simple guidelines. It's if you're under 35, you just had random sex for a year. Trying means there's no condoms, no birth control pills. So you just tried for, you just had sex randomly for a year. Let me say, let's say if you're 18 and you told your mom, don't worry mom, we're not, we're not trying, he's just pulling out. You know, we'd call you like you call you pregnant. And so now they're like, oh, you know, I'm not trying. So under 35, you had sex for a year, you're not pregnant, seek help over 35, six months. Or if you have risk factors and the doctors miss this all the time, you don't have to wait a year, two years, you've had risk factors. Risk factors. Severe pain, irregular periods, heavy periods, someone had cancer, someone's got diabetes, you know, erection, ejaculatory problems in the male. Go seek help right away. Those are just, like, such basic guidelines. But we'll see people with these things that the doctors miss it, and they'll try for years and not realize, just seek help. And so you can use one of those ovulation kits for one or two months. You know, if you're ovulating, you know, you hit the time, and then you got to get. We do really basic evaluation. Like, in two weeks, I can get to, like, 80% of the cause.

Well, okay, so, you know, in my life, as, you know, my partner, she's a vaginal plastic surgeon.

Right.

So I've sat through numerous conversations about all kinds of stuff. I'm going to ask you just some basic questions. Yeah. For the men that are watching out there, why does a woman have a period?

Okay, so the. The reproductive system in one minute. So there's a woman is born with all the eggs she'll ever have, and every month, a group of them somehow become ready to respond to hormones, and a whole group of them start growing, and all of them die off except for one. And so as they grow, they make estrogen and the lining of the uterus, the womb. I say it's like your backyard. The grass is growing and getting ready for the party. The grass is growing. The lining of the womb grows, and fertilization is supposed to occur right in the middle of the month. And a woman actually has a little burst of testosterone right around the time of ovulation, makes her libido go up. So that's why a lot of teenagers, the first time they gave in and had sex was when they were most fertile and they got pregnant. Hmm. Because you're more ready to have sex when you're most fertile. So the egg fertilizes and it implants, and it then makes hormones that sustains the pregnancy. That's the pregnancy hormone that you do a pregnancy test work. If you're not pregnant, the ovary stops making hormones and the whole system sheds. And so the lining of the uterus comes out to prepare for another one. Other animals don't necessarily don't have cycles like this. So you're growing that lining of the uterus to get ready for the baby, and if it's not there, you shed it and you start it all all over again.

Gotcha. All right, so there you go. We're going to go to a little sexual education here. First, this, this makes me think, for some reason this pops into my mind because you said when a woman is most likely, when she's most fertile, she's most likely to have sex. And I.

It might have been in general, like.

In general, I want to ask you this because I. And I'm trying to think which book it was that I read this in years ago, where the time that a woman is most likely to cheat or have an affair is when she is also in the period when she's most likely.

Yeah, it's the same thing. It's the same thing.

So here's another thing I wanted to. So I have a body worker therapist, and she's in the woo woo realm. Like she's. What would you call it? She's an intuitive. And we'll have these very fascinating conversations. And she's a total character. She made a comment to me a couple months ago and me and my partner, we both go see her. She's really, she's a great therapist and body worker, not a psychologist or anything like that. So she said that she had three different female clients that were taking testosterone, that had been faithful to their husbands their whole life, but they cheated when they were taking testosterone. And she said that all these women communicated to her like they're having a moral dilemma because they're like, I never would have had an affair in my husband. I don't know what's going on.

Well, it's the same effect on men and women. The guys get super horny when they're taking it. That's what testosterone does.

Right. And we have so many people taking hormones, men and women, today. So how is that impacting all of this?

So this is. It's not wrong. You know, there's a big backlash against birth control because birth control suppresses all these hormones. So it shuts that off. A lot of women lose their libido when they're on birth control pills. It's got other benefits. It can prevent uterine cancer, but it definitely affects it. And not only that, but plastics act like estrogens in the body and they're endocrine disruptors. So plastics, phthalates, bpa, all that garbage that's everywhere. It's in every body system. Like we find it. You do a testicular biopsy. There's plastic in there.

Wow.

You biopsy the placenta, it's there. And cosmetics, like the three big, three big ones that we tell women to watch for is number one, plastic water bottles. Number two, heating stuff in the microwave in the plastic, and number cosmetics and lotions. And women wear more products. They sell more. You know, corporations sell products to women. Man, you know, whatever bar of soap uses it, you know, between his legs, under his arms and on his head. A woman's got 30 of them. They've got all those things have plastics, endocrine disruptors. Well, if a person come in, she'll blood tests sometimes, and I'll say, this is like 100 fold what it should be. And I'll say, what new cosmetic did you get? And she's like, oh, I got this youth serum from Japan. And it's just all hormones.

Wow.

Wow.

Okay. So, yeah, this is, this is quite fascinating to think about. With that much toxic soup that's floating around, what the hell is going to happen? Do you see getting better, worse? I mean, what.

It's, it's getting much worse. It's getting much worse. I mean, but it's everything. Like, if you want to have, you know, a perspective on fertility, you don't have to be sophisticated. Just look at weight, obesity, diabetes and heart disease. So all these are metabolic disorders from a bad environment. I say it's not, you're not. You know, patients sometimes misunderstand and say, oh, I caused it, you didn't cause it. You're living in an American system with toxic environments, diets, and lifestyle. No one's moving. We're eating packaged processed foods and the average weight, you know, 50% of kids are obese. It didn't happen before. So if you look at the number one cause of infertility in America now, I don't know if you guess what it is, but it's a disorder called polycystic ovarian syndrome that's directly related to metabolism, weight and diet. So just like you get pre diabetic pco, I call it diabetes of the ovary. And it is the number one cause of infertility. So when I started so in the 1900, it was unheard of. Not described. Not described. Then it was 5% of the population, 10%, it's 15. Now it's going to be 20. So it went from zero to almost 20% of the population, general population. And it's from over nutrition of addictive processed foods.

Yeah, I mean, what, you know, because as we were talking earlier, before recording, you know, go check out seed oil.com S-E-E-D oil.com there. So I have a friend, Dr. Kate Shanahan, and she wrote this amazing book called Dark Calories about the Hateful Eight. You know, the word seed oil is interesting because not all oils made from seeds are bad, but there are.

And you can make them rancid if you overcook them and how you heat them and how you attract them. Right?

Yeah. And there's this. I believe, like in that book, there were things that I learned that I never read in any other health books. And I've read over a thousand books and I have a lot of doctors and a lot of clients and a lot of nutritionists and all kinds of fascinating stuff related to it. But 70% of the average American's diet is processed food. Now, 70% and 40% of the caloric intake of the average American's diet is fats. And out of that 40% of caloric intake, 80% of that is vegetable oil and toxic seed oils and how they're processed and that sort of thing. And the human body is not designed for that. So we're now living in this world where we are the environment, the food, everything.

So that is the number one cause of infertility going up right now is that same as diabetes, same as heart disease. That meaning the toxic diet and, you know, carbohydrates, processed oils, overnutrition, obesity, insulin resistance is the core of all, all of our modern illnesses. That's why Ozempic works for all these diseases, because you just lose weight. If you have a gastric bypass and you lose weight and you stop eating this crap and you decrease your body weight, insulin resistance goes down. So you're going to find it helps heart disease, it helps sleep apnea, it helps infertility, it helps all these things. But, you know, if you lost the weight and stopped eating badly, it's not that Ozempic's the miracle drug, right? It's just the fix that you'll be on for the rest of your life. But if you can do it with a lifestyle, it'll have the same effect.

Which of course I'm always going to vouch for. Do it with the lifestyle, because the moment you have any sort of quote unquote shortcut and you maintain a bad environment, bad food, bad whatever, you're just training yourself mentally, physically, emotionally, that this is.

Yeah, but people need. But they need help. Like just you work with, with addicts. I mean, These people, you know, people, I've been there. It's food addiction. You know, we're overweight because we overeat. But what happens is, you know, corporate medicine, you have five minutes with your doctor. So the person comes to see. The fertility doctor made a video about this today. You know, woman stabs doctor after giving her fertility advice. What does he say? Eat less, move more. See you next month. So if you walk in and you've been overweight your whole weight life and you're 100 pounds overweight, and the doctor says, lose weight, eat less, move more. Yeah, thanks, genius. Like, I don't know how to do it. So we have to give them the tools to cut that, cut that addiction and transform their life. They don't know how to do it. And so the Ozempic is the easier, more profitable fix.

Yeah, I mean, I'm so torn on this whole subject too, because, I mean, I've had lots of conversations with you offline about as relates to addiction. And certainly there's applications. These are all tools in the toolbox. The question is when to use it, how to use it, and when do you enable someone in such a manner to where you know what's worse? Right, right.

So I think it's the last tool. But if it's a life vest and the person's £300 and they're going to be dead, throw them the life vest. It's better than nothing, like gastric bypass, the same way. But, you know, all the programs I'm developing now are working on trying to get people access to those lifestyle programs to reverse it and not need to come see me. Like, the big innovation in infertility is in vitro fertilization. So we take the egg out, we join it to the sperm, and now we can genetically test it, know if it's normal, we put it back in. So most people who want to get pregnant can get pregnant with that technology. Now, success rates used to be 15%. They could be as high as 70%. Now we can screen the embryo for 500 genetic diseases. If you have a genetic disease in your family, we can eradicate it from your bloodline, but not everybody needs that. And it's really expensive, like 10 to $30,000. So I've had people who will come to me, they said, you know, I failed for five years. I've been trying to get pregnant for five years. I failed IVF three times. And I test them and I see they've got this metabolic problem. And we put them on a lifestyle reset program. This woman Made a video. She followed my program and got pregnant in the prep for her ivf because we reverse the root cause. Now that takes a lot of time, a lot of effort, and it's not a profit making like an IVF is. So what I'm trying to enable is solutions where, you know, I can see 500 people, 200 people a year. But if I could teach people online how to do these metabolic resets, you know, we could reach 100,000 people, reach a million people.

And is that what you're focused on right now?

Yeah, so I do both. You know, I have. The way I look at it is I've always had the tip of the pyramid. We have a boutique, ultra high tech. You know, I'm known as the guy that solves the problems when people can't figure it out. You've been trying to get pregnant, you failed for 10 years in five countries. They fly in to see me and I figure out what's been missed or we do it better or with better technology. I'm a problem solver. Like I'll, I'll go into detail. I'll go through 500 pages of records and find things that were overlooked and then we fix it. So that's my boutique. But then I said, well, wait a minute, I was teaching about this stuff and I realized that lifestyle is such a part of it, and I developed a program that can reset it. What if I could reach, you know, a hundred thousand or million people online with a really low cost solution that no one else can do because they can't reach enough people. But I have a big enough audience to do it now. What a bigger impact. I mean, my mission is to get people pregnant and I got to keep the doors open. But if I can reach a million people instead of 200, what a, what a life changing.

One of the things you've come up with recently. You know, there's, there's maga, you know, make America great again. Then my buddy Bobby Kennedy, make America healthy again. And you have mafa.

Mafa, Make America fertile again. And you know, there's enormous. There's such an overlap between that movement and what I teach and what I do with my patients. Because so much of medicine has become a procedure and a band aid for the disease. And that's from. Because the system's broken. That's what people get paid for and that's what innovation that drives companies and that's. Patients want quick fixes. Right. But that's not getting at the root cause of the problem. And just like Diabetes is escalating. Metabolic disease is escalating. Infertility is also going exponential. So when I started, it was, you know, 1 in 11 couples, 1 in 10 couples, we're at 1 in 6 couples now have infertility. Can you imagine that? I mean, this was unheard of, you know, 100 years ago. Why? The core things that are increasing, number one is obesity and metabolic disease. Number two is women are waiting longer to get pregnant. And you're born, woman's born with all the eggs she'll ever have and they become damaged as they sit in the body and they don't work. And then there's smoking and sexually transmitted illnesses. So if you look at them, which of these are the lifestyle?

So, well, smoking's probably gone down, smoking transmitters have gone up. Or is it about the same?

About the same. It's about the same. But, you know, smoking has been replaced with vaping. And we've got plastics and we've got environmental toxins that all disrupt the reproductive system in men and women. But the number one thing that's, that's going up is obesity. Obesity and metabolic disease. And that core root of it we can reverse.

So. So for guys that are taking testosterone as an example, because huge issue, what advice would you recommend or give? What are the pros and cons of this?

Yeah, I just did an interview. Wall Street Journal interviewed me about this and I saw a guy this week who's a WWE pro wrestler. And so it's funny, I joke that when the guys are on testosterone, I make the diagnosis when they walk through the door, if they have to come through the door sideways and they're, you know, I say, you know, how much do you lift? If it's over a thousand pounds, you're, you're there. So testosterone replacement therapy is a lifesaver for some, but is one of the most abused drugs in America now, because, you know, if I gave you cocaine or, or methamphetamine, you're going to feel good, you're going to have energy, you're going to be awake, you're going to feel like you can conquer the world. So testosterone goes down as you get older and if you give someone testosterone, they're going to feel like they're 18, right? You're going to be strong, you're going to be aggressive, you're going to have all the libido. So more so the difference is like going to physiologic or going up here. So when you make those levels go high, men love it. So there's all these mills just churning it out online to anyone. But men are completely different than women. You give woman a birth control pill, you shut off her ovulation or reproductive system, and one month later she comes back. The man, since the, since the testicle produces sperm every day, responds differently. So when you give him testosterone, he shuts off his own testosterone production and he shuts off sperm production and it sterilizes him. And none of these mills talk about this to these guys. And then they'll. 80% of them can recover. 20% will never recover. They'll be permanently sterile.

Interesting.

And it could take a year to recover. Now there's ways, but.

But some will never recover.

Yeah. Some will never seen. See it all the time. And the number. So when I was at Yale, so I was, I was teaching at Yale and it was like late 90s, I would see one guy with testosterone induced sterility every couple months. It could be three or five a week now. A week. So these we can get around it. We have to give them injectable hormones. We have to get them off of it. And these guys are smart. I mean, they're like pharmacists. They know how to manipulate all stuff. But there's a very tight balance. The body's very tightly regulated. And when you go above that system shut down.

I should probably point out that the reason we have that this is actually a nest. That was my partner as her mother gave me that from Malaysia, painted it. It's beautiful. But that's a nest. I thought it would be appropriate to kind of put.

When I have patients who come for me from other countries, I. They always give me a fertility symbol from their country. Really? It's like I have them on my desk. I've like a. You know, like Ghana and Egypt and they're cool. That's cool.

You probably see some.

These are like ancient, ancient motifs, you know, going back thousands of years of like, what's a fertility. Yeah.

And the cultural stuff you must see across the board is.

Oh yeah, oh, we. So we had this woman. So it's funny, you know, you talk about the woo woo. So we're ultra high tech. Like we're, you know, we're sequencing genes, we're manipulating the very essence of life. You know, we look at this. But I've seen shit happen that you can't explain. Like we had this woman, she was from some rural part of India. And the mother comes in and she says, we're about to transfer the embryo. She says, you can't do this right now. Because there's this sign, and the angel of death is passing overhead at this time of. Of life, you know, the day. And we said. I said, well, when would it be gone? She's like, in, like, half an hour. And I said to the embryologist, someone's like, well, how'd you convince her to do the transfer? I'm like, fuck, no, we waited half an hour. You know, we said, well, we're waiting half an hour. We said a little prayer with her. We put the embryo, and she got pregnant. But there's these cultural things interesting. That are part of life. We had another woman, very religious. Um, and she was older. She must have been late 40s. I mean, our oldest pregnancy is 55. Wow. Postmenopausal women with an egg donor. So she was older woman, and she's using an egg donor. So she's, like, practically menopausal, this woman. And she's lived in a building her whole life, and she's never been pregnant. And she goes in the building and she said, there's a guy who's, like, crazy. He's supposed to be the seer in the building, and he gets in the elevator with her, and he says, you got two babies in you. She was pregnant with twins. And, like, she'd lived in that building for 20 years not being pregnant. So, like, the stuff you see that you just say, like.

Well, did you say you're manipulating the essence of life?

We're assisting. So. So a rabbi gave me a. Gave me a. You know, people say, you're playing God. You know, I don't want to do this. Oh, so this is. So this is like mug on my soap opera. A lot of videos about this. People say, I don't want to do this. Or they get criticized by their family and their friends because they say, you're playing God. It's against God's will for you to be pregnant. If it's going to happen, it's going to happen. So they're. They're wretchedly devastated. So I feel like if you had a heart attack, would you say it's God's will that your artery close? So if your fallopian tube closed, why is your fallopian tube got this ethical moral judgment on it that your fallopian tube doesn't. It's not. I said, we actually can't change biology at all. We're not that good. We cannot create anything that doesn't exist in the universe, the cosmos, God, whatever you call it. But we understand the process, and we can assist it. So this rabbi gave me a sculpture that said, you know, they say in the Talmud that, you know, there's three people in every, in every birth. The mother, the father and hashem or God. And he says, but God sends emissary, emissaries to help, and that's what you are. So I say to people, you know, I just, I don't create biology, I just understand it and I assist the natural process.

Wow, that's good. Well, you've had to learn to address every aspect of this now. So there's something, I want to get your take on this too, because it kind of goes into a different delivery system. So the line of pill for an ill, you know.

Oh yeah, I see a lot of medical procedures. Oh yeah.

Pill and a procedure and now it's injections, it's all that.

So it's like the subscription model of your, of your razor blades. If you, if you need to stay on it forever. Yeah, Better. Yeah.

So how do you, how do you navigate this healthcare system? Because let's go back.

It's, it is, you know, people ask me, what's the, we had a big meeting. We had like a, we had a meeting in the office and they were saying, like, what bothers you the most? And for years everyone would say, you know, miscarriage is what bothers me. Me when you get there and it doesn't work. And I said, getting up there is the health care system because it is so divisive and designed, it's so dysfunctional and it's just getting worse because the doctors start off good, they want to heal people, they want to get better. They may not be educated in everything, but now they've got this system where everything's got a third party. It's an insurance company dictating what they can, can't do. I've got staff in my office. They spend full time just trying to get approvals for things and navigate what you can and can't do. And now when you went for, most practices were owned by the doctor. More than 50% now are owned by private equity or VC. And they just want to extract profit, grow it and flip it. So that doctor patient relationship has been, is being destroyed. Not because the doctor's bad, but they're drowning. Like the number of doctors who say, I would never want my kid to go into medicine is at an all time high. And it's not on the medicine side, it's on the corporate side. So then you come up with this fix. So you have five minutes to see the patient and they you know, I have luxury. I spent an hour with a new patient. Other people, they get five minutes. And so you have these fixes in our system. And everyone wants a solution. And so the doctors. And yeah, if you're in a procedural thing, they get paid for procedures. That's not good. But on the patient side, everyone wants a pill and a quick fix. You know, everyone wants. Everyone wants a solution. So these forces, when combined together, are so dysfunctional. So that's why when I talk about mafa, make America fertile again. It's the same as, you know, the health, like what you were telling me with Maha, it's like it's a re. We have to have complete reimagination of what it takes to be healthy. Healthcare as opposed to disease treatment.

Yes. Because it certainly is not healthcare. I mean, Kate Shanahan writes about this in her book. I think at the time when the book was written, like 18% plus of the GDP of America is health care. 5.4% is like food, 3% military, which I know Trump wants to increase, and less than 1% tech. So almost $1 of every $5 going to health care. You just follow the money. You can see so much of how it's.

Well, but you've got corporations now running healthcare. So that's why when someone gets shot in the street, why people are celebrating that the CEO of a healthcare company is shot, because you know, this isn't your doctor taking care of you, deciding what's best for you and you in a partnership with him. You know, that's why. That's why the corporations, the first thing they want to do is change the name. It's not your doctor, it's your provider, and you're a customer. We're not taking care. Yeah. And you're all fungible. So, like, when I started, there was like, you would. You would die for your patient. Like you were there.

Fungible. Go back to that.

Yeah. So, like, because you can replace anyone with anyone. It's just whoever's on that shift. It's like your McDonald's worker. When I started, you know, come in Friday, you had a sick patient. You didn't go home till Monday. We work. I work. I've worked 80 hour. I've worked from Friday when I was a trainee, 6am Friday to 6pm Monday without a break because you just were. You had to be there to take care of them and to learn everything.

And now, like, with no sleep.

Yeah. You hallucinate by the end. It's not good.

And so what advice would you Give to doctors, someone going to medical school, someone considering it, someone that's already there because you've been at this game for a long time. And we certainly need these people and we need ones that do not get corrupted. We need people that, you know, I.

Was on the tenure, you know, the academic track at Yale. I was supposed to move up. I got. They would take me aside, like, here's how the games played. I had grants and I was supposed to move up the ladder. And I finally said, you know, and this was a while ago, and I just said, I don't want this. And I just walked away and opened my own center where I had complete control. But I was able to carve out a niche where we don't need to play by that game. There's a backlash. There's more and more people going to fee for service, concierge medicine, where they can provide that relationship. But that's not a majority of doctors and it's not a majority of patients. Pendulums are going to swing like there's going to be some massive recorrection with this, like the housing bubble. This is just the dissatisfaction and the waste in this system is so astronomical. But I, you know, high school kids will talk to me and they say, I say, like 16 years from now, when you're done, I can't imagine what healthcare is going to look like.

How's AI going to change this? Because there are.

So as I got a video, I did a project where I took. So I love finding things that are missed. So there's like one common error that's made on an X ray that makes people not get. It's a kind of tubal blockage that makes IVF and a lot of IVF. Doctors don't look for it because it takes time and they're not interested. They do two or three cycles instead of looking for why it didn't work, or they read the report and the report says it's normal. So I get the pictures and it's not normal. It was misread. So I find that all the time. And I put those videos up in my social media and I'll get dozens of women say, oh my God, I looked at my picture. It's what you said. I showed it to my Doctor and after 10 failures in like three years, you fixed me. Never even saw me. So I took three of those cases and I dropped them into Chat GPT and I made a custom prompt. ChatGPT got all three of them right.

Wow.

Now I've seen it make horrible Mistakes. You know what we were talking about with. When you were sending me the thing with your eye, I'm like, it's missing. It's giving you, like, the. The insignificant one and missing the big one. Yeah. So what the AI is going to do is it's going to filter. It's going to allow you to have access to all the information to eliminate the endless memorization. And then you should process it. And that's like. I'm like, that's the promise. Oh, my God. Like, I don't have to gather the. Instead of me reading 500 pages, it'll summarize it and give me, like, triage. And then I process it and select it. But here's where corporations going. So about one third of the people who need IVF in America are getting it.

One third?

Like, one third. And it's really expensive. It's an access problem. So there's a lot of corporations trying to fix it. And what they say is, we'll just have AI you'll just. The AI will take your history and we'll take someone who's not really trained to do your procedure. And we'll have one doctor supervise a thousand cases where the AI will do it and the nurse will do it. And the paramedical person, that's not. Well, we're not there yet. You know, Waymo shouldn't be your surgeon. You're like, waymo's great until someone jumps in front of it.

What is AI Currently doing that is an improvement? Where do you think this is going to go? I'd love to get some of your predictions on what's going to happen with it.

Where AI is doing really now is pattern recognitions, like X rays, things under microscopes, things where it's just endless visual data. It can process it and find it. AI is really not good in our health care system at mining data from medical records because it's garbage in, garbage out. So, like, everyone's cutting and pasting the medical records and the information's wrong. But it will be good in. When there's 100 things going on at once, and it can generate the lab. Look at the labs, and it'll give alerts. Don't miss this. That happens all the time. Health care errors where they can't. People are so sick and so complex, and someone in the hospital is taking care of 100 people instead of two. So they'll have. It'll fl. It'll. It'll say alert. You know, you're on this med. You're on this. This Think of this. So it's like it's the tree, it's not the decision maker, but it's, it's coming up with, it's filtering the information and coming up with it. Or for rare things where people aren't thinking of it, it may process that and lead you in the right direction.

You know what I think is really useful? So if you're, let's say you're going and seeing a doctor and you're sick or you're disoriented or you had an accident and there's all this stuff being communicated, but your nervous system is overridden, you can't comprehend any of it. I mean, just simply to record that.

Oh yeah.

And have it explain what's going on, what, you know, what's being shared, recording.

What the doctor tells you, your instructions. People can't process it.

Exactly.

Yeah.

I mean I had, I have a friend who's a doctor who's recommending some supplements and all this different stuff. And my brain can't keep track of all that. But I'll record that conversation now. Say, what did he say? What are the actions that need to be take? What? And it just makes things a thousand times easier.

So there's so much processing and summarizing information.

How many surgeries have you done? Do you have any idea?

Thousands.

Thousands. When, when are the robots going to be able to assist you or do it completely?

So I was involved in some of the first robotic surgery. So when I was at Yale, that's one of the things we worked on and we were trying to do it remotely. Telescope was developed by DARPA where the idea was on the battlefield, someone would be here and the surgeon would be there or in space. So at first it just mimicked my movements and I gave a lecture. God, it must have been the 1990s. About next it's going to have all the data and it's going to start to do the process and you draw. So this is avionics, it's all mapping what's being done with space and airplanes. If you can do those complex movements, you would. It is totally possible that you could take a 3D scan of the body with a MRI, high resolution. It makes a 3D map of the body and then the robots doing portions of it. And in neurosurgery and orthopedics some phase of that already exists.

Didn't you do like a very big live stream surgery on how many years ago?

Yeah, a lot of them. So that's when I first started. So I've always kind of taken technology from outside of medicine, and communication education was a big part of it. So I did big live surgeries where we were teaching people how to do procedures. And so we did that with live surgery. And then I started running live interactive seminars and mining what people were talking about so that the audience could affect the speakers. And we get the wisdom of 10,000 people in the audience. So, yeah, I've done both.

What's the biggest one you've ever done.

For a discussion or surgery?

Surgery.

Well, surgery, you could have, you know, five or six thousand people watching. It was one patient. Yeah, one patient.

And what. What sort of patient agrees to do.

A surgery less so. It's crazy. Like, I'm. When. When I was at Yale, we would developed a surgery, and it was the person who's, like, going to be the first one, and one of my patients couldn't be the first one. And she was really mad at me. Like, what do you mean? I'm second. I wanted to be first. Wow. And we actually developed a way to do surgery with the patient awake.

What kind of surgery?

Like intern. We put a telescope through the belly button and we looked if there was disease and we could actually treat it. And so we did it with her way. Because I used microscopic instruments, I found something being used for something else. And I said to the company, if you give me this, I could find a way to get it in the body, and we could do with the patient awake and not have to pay for anesthesia in the operating room. So we did live surgery where there'd be a thousand people watching and the patient would be awake talking to the audience and say, oh, no, I do feel that. Oh, no, this hurts. And we said, you know, the patient's part of the team.

Wow. Wow, that's pretty wild. Well, so the point. Yeah, I can see all the different. Different perspectives that people have about this.

Because one person, I'd be like, you know, some people, like, no way. I want to be number thousand other people are fighting to be number one.

Right.

Interesting.

Some people are like, there's no way in hell I'm going to be. How.

How does.

How do you handle the concentration of the sort of stress of situations that you're under? Because my partner, she used to be a trauma surgeon, so she's seen everything, you know, gunshot wounds, stabbings. And I've had discussions with her of how do you keep a. How do you not lose your mind right when you're in the middle of this chaos? And what's interesting is a Lot of people that are the best at it, it actually is calming to them.

Yeah, you go into the zone, you're just completely, you know, time slows down, you're just, you know, tunnel vision. You don't see it just totally. And you've rehearsed, you know what to do, you know exactly what you're going to do. But it's intense, like it's over and you could, you know, you're exhausted, you wiped out. Right, Right. Yeah.

So fascinating. Well, okay, so what other things have I not asked you about?

Social media.

Okay, so before we jump into social media then let's talk about just the, the ability for people that are married and monogamous and like just the whole, I mean not to go into a whole infidelity conversation or non monogamy or sleeping around or whatever. What advice would you give? Because you mentioned sexually transmitted diseases and I think it would be maybe helpful to give a perspective for men and women about how to. When you're younger and you're filled with hormones or you know, you're in a different sort of state and there's so much lack of socialization with young people compared to when no technology existed. And I have a bit of fear and apprehension of what AI is brilliant and is amazing and so many things that can now be done with it looking five to ten years from now where people, they don't learn how to talk to each other, they don't learn how to be intimate. And since so much of my addiction recovery work, especially in the world of sexual addiction, you know, I've always liked this definition that was given to me by an 80 year old man who devotes his life to helping people to have sexual addictions. He said intimacy is a mutual exploration of a shared safe place. Abuse is anything that takes away the safe place. And addictions are what we do when we don't have a safe place. And so a lot of people don't feel safe in the world. So therefore they don't develop intimate relationships. They're not intimate with themselves. And I'm not just talking sexual, I'm talking the ability to connect with other people. And so much about being a human is connection. And there's so many forces that prevent real connection with your body, mentally, physically, emotionally, socially. And there's a hell of a lot like I know young people that they don't know how to talk to other people and they consume enormous amounts of porn and there's just all kinds of forces that are not really assisting in men and women coming together. And I think in a big part, the postponement of when they're going to get married, when they're going to. There's so many factors at play here. And so that's a big, complicated, jumbled bunch of stuff I just threw at you. So it would almost be. What did you see? So many men and women, what advice would you give them to just like, look, if you go this path or this path or just. Any suggestions.

I love that quote of yours when you did it. I have three boys. One's in high school, one's in college, and one's in grad school. And I shared that with them because I think it was really remarkable. And I hear from them sort of what relationships are like at different stages. Yeah, for fertility, it's. The biology is pretty simple, like chlamydia, gonorrhea cause infertility, HPV causes cervical cancer. That's just the parts. So those are, you know, protect yourself, condoms sort of thing. But then when you talk about family building, you know, reproduction is more than just getting a pregnancy. It's a lot of time we spend trying to help people figure out what do they want. Do you want to be a parent? Do you want to be a single parent? 50% of kids are born in a single family now. So we see women using donor.

50%.

Yeah, we see. And divorce rates are 50%. So, you know, we see women using donor sperm, we see men using donor eggs. And there's so much uncertainty and confusion about the relationship part of it. So obviously, the healthier you are in a healthy, loving relationship. It's like, you know, sleep, sleep, exercise, eat well, feel loved, you know, cortisol, getting rid of all that stuff helps you. And it's strange. There's been a swing back to a lot of people wanting to get. There's like this weird thing where suddenly we're seeing people in their 20s, want to get married, buy a house and have a kid. Whereas, you know, when my time was like, you're 35, you got to work on your career, everyone. So there's this pendulum swinging back and forth. But you're right, the isolation and AI and computers is wreaking havoc on relationships and families. And the same thing with the parents and the kids. Once the kids. So our parents, our patients, it's amazing. We have reunion. We call it our family reunion. We've had 600 people come up to 20 years later to celebrate their families. Like, 600 people who are done with us come back to celebrate and they say that they're the best parents ever because they went through this, it brought them, this tragedy, brought them together. And so not everyone makes it. There are people who get divorced in the middle of fertility treatment because it, the cracks in the system come out.

Right, Right.

But if you go through it something really hard, sometimes it makes you really strong and the priorities get reset and they realize we can do this together. So I think the key is human connection is at risk with this system.

I totally agree.

I totally agree.

And no, thank you. And that's really good to hear. And what I would suggest also to especially to young people is awkward as it is for most people and how I think convenience is great and convenience is not so great because it's a double edged sword. It's like that saying from the 1800s, if you invent a ship, you invent a shipwreck. Right. So if you invent AI, you're going to invent all of the negative sides of it in the same way that we're going to talk about social media. And I could argue both sides. What it does for, you know, depression, what it can do for, you know, just addictive behaviors and how it's a dopamine cash register and all of the negative sides. You're also reaching a ton of people. So we're going to come to that in a moment. What I would say is I have a friend, he was here earlier for lunch and I'm going to do an interview with him a little bit later. Mark Young, he's a CPG expert. So he's an expert. And right now, as we do this sitting here in 2025, in America, 80% of food and clothes and different things that are purchased are still purchased retail. Whereas a lot of people, most young people, they're not going out shopping, they're buying a lot of stuff online. But there is a huge amount of 80% of people still buy things retail. And there's a lot of ways I can go, quote unquote shopping without having to leave the house. You know, I can do it from my phone, but I will go out and interact because I do not want to lose human connection.

One of my kids, you know, he wants to go to a store and touch it. He wants to get an out, a CD where he can touch it and have it in his hand. And he wants to be there in person with someone, one and another one's happy and he's online with his friends. It's two different worlds.

Totally, totally. Yeah. So, so I guess that could lead to dating advice and all this Stuff. But that'll be for. I don't know, that'll be for another time. No, that'll be for another episode. So let's talk about how you have blown up social media, because now you're one of the most viewed doctors in the world.

So, you know, I'm an. I'm an accidental influencer, you know, uh, so it's funny, I had taught doctors and I had been running large seminars where we were figuring out problems that they didn't know how to solve. And I would have these large discussions and mine the information from the audience to come up with an answer. And in one hour, our system was able to take 80% of doctors and say, we'll make a change in how we practice because we were solving their problems. And. And I thought social media was for, like, cute girls to dance. And I was like, I'm too old, bald and fat to be on social media. And so then I had patients that were coming in, and they were telling me things that just made no sense. Like, where did you live? I would give them advice, and they would do something completely opposite. Say, well, I follow this influencer. And he told me to do this. And I just got angry. Like, what do you mean, influence? Like, what is this? You go to TikTok for your medical advice? Like, yeah. And then I had a few patients that were influencers. One had a reality TV show, another one had a couple million followers. One was a celebrity. And they're like, you need to do this. You're angry at the misinformation, and you can communicate the right information. And I said, but they're not looking for that. And someone said to me, no matter who you are, if you've got a solution or a message and you're authentic, you've got an audience, you know, like, you don't have to be cute, blonde and dance. And I was like, okay. So, like, you know, I research stuff, but I'm a quick. So I made a video that day, and it got, you know, thousands of views. And I showed it to someone. We were at Strategic Coaching, and I showed it to someone who? Mark La Chance, who runs a TikTok agency. I said, do you ever hear this thing called TikTok? He says, did you know I run a TikTok agency? And he says, you got it. Do this. Just do this. And within a month, I had viral videos with, you know, millions of views, right? And the core principle, I'll tell you, you know, and I'm not just blowing smoke up your butt. Like, I learned Stuff. I went to your first I love marketing live event. Yeah. And I listened to your I love marketing podcasts. And what I was amazed at with this education based marketing in the direct response world, you are educating people and getting them to do action. So it's like I had thought marketing and selling was like convincing people to buy something and you're hurting them. It's like, what if you're solving their problems? But I never had the reach. Like I was. Like I had. There was a point where we had the highest success rate in the United States and I had the. But I just had no reach. Like, how does anyone know all the stake but no sizzle? I don't have any reach. I said, wow, what if I could reach a really big audience? So I simply like, who do I want to serve? Who do I want to be a hero to? And it was these couples and what are the problems? And this applies literally to anyone in any, any area of endeavor, any field, any industry. You, if you're an expert in what you do, people come to you with their problems and you'll see patterns of what they need. And if you can simplify the solution to answer that problem and give them the information, like what's the Spiel you give 100 times that? Everyone in your office hears you through the walls. They could recite it when you do it. And what's the mistake? You see everyone in your industry making that. When you see it, you say, aha. They're just doing this. And where do you see people making the wrong decisions? So like our example is we have IVF and we have a low cost treatment called artificial insemination. And it's really cheap, but for some people it's got like a 1% success rate or 5% success with patients. The doctor says, patient, which one do you want? You want the $20,000 one or the $2,000 one? Which one do you want? Well, you never gave her information to make the decision and she'll do five of those and she paid more money.

Right.

So you explain to them what is the problem and what is the solution. So then I started just saying that. But there's a language to learn. So that's what's different with social media. So social media has a language and I was fascinated by it. There's patterns, there's memes, there's trends. And you learn that. Like you learn a language. So you basically take your solution, you learn the pattern and you adopt it. So I'll watch videos that, you know, 20 year old kids make that hit, and I will apply that trend to my solution. And you also know where people are desperately hurting. So at your, at your event, you know, I heard Evan Pagan, I heard Cialdini, I heard Carlton. You know, you can tell the story that's in that they're suffering better than they can and the salt is in the wound. And then you show them the solution. So can you deliver that in 60 seconds?

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