Dr. Vance Alm

Dr. Vance Alm joins us to discuss his philosophy on life and happiness and his new book "The Doctor's Prescription for What's Ailing America"

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Intro:              00:00          Podcasting from the base of Lake Tahoe, in the Eastern Sierras, comes The Medicine Wheel. We are a group of progressive physicians seeking solutions and enlightenment while surfing the seas of big data and summiting mountains of research. In an effort to make the practice of medicine more personal and medical knowledge more accessible and empower you, the listener to be as healthy as possible. Now, The Medicine Wheel.


Dr. Devlin:         00:30          Welcome again to the medicine wheel. Today, we are blessed to have both myself and Dr. Floyd here today, along with a colleague of ours and someone who, sort of, predates us from the university. Dr. Vance Alm. Thank you so much for joining us here today Vance.


Dr. Vance Alm:      00:46          Pleasure to a company you.


Dr. Devlin:         00:48          Awesome. Great. So I know that you recently wrote a book, but I also have some preliminary questions I want to ask of you before we dive into the very short novel you wrote this past year. Tell me a little bit about how you ended up in the field of medicine. You're like a lot of us and took a unique path to become a physician, and you had a, almost, a prior life before that. Can you talk a little bit about what that was for you?


Dr. Vance Alm:      01:14          So I'm one of those people that's going to be the future. You don't do- you don't just have one profession, you're going to have a series. Anyway, I always wanted to be a doctor because when I was five years old, I watched the guys sew my hand together, that's what I wanted to do. So through my life early on I wanted to be a doctor and so I went through, in high school and everything and I studied all the right things. And then that wonderful twist, I went into the military because I couldn't afford to go to school. And so after a career in the military, then I went to medical school. So a little bit diverse background from the average person going into medical school?


Dr. Devlin:         01:49          Now, tell me a little bit about your career in the military. Cause it was an extensive one, It wasn't just like I did a few years and then came out.


Dr. Vance Alm:      01:55          First one I went in, I went in as an enlisted man so I could get money for college. And then after attending college, paid for through the military, I decided that I wanted to go into medicine and unfortunately I didn't get accepted first. And so I still had to take care of a family and myself. And so I went back into the military as an air force flyer. And so I was a navigator on KC-135s. And so I had the experience traveling around the world and seeing different sites, but also I had the experienced military medicine. Military medicine is different because you don't pay anything and I think that that's a model that we may have to pursue.


Dr. Devlin:         02:33          Great. Great. And I'll move on to this next one. I know Dr. Floyd is sort of chomping at the bit, he has a question for you. What is the most profound lesson that you've learned in your practice and, and, and how many years you've been practicing now? Close to 20, Right?


Dr. Vance Alm:      02:46          So graduated from residency 18 years ago. And so I've been happy and have experienced my own practice with a partner, experienced my own practice. And then I worked for a corporation, didn't like it? So now I'm back to private medicine all by myself. Biggest lesson I think I've learned is, to treat people as people not just as a case or a disease.


Dr. Devlin:         03:10          Yeah. That's excellent.


Dr. Floyd:          03:10          That's a good, good way to put it because where patients are more than just numbers on the paper and a chart number as well.


Dr. Vance Alm:      03:20          One of the things that I've practiced forever is the philosophy of treat other people the way that you would want to be treated. It goes far, especially if you apply it into medicine as well.


Dr. Devlin:         03:31          Yeah, that's true. Kind of give us a flavor of what you do outside the clinic. I know you kind of have a little Marcus Welby practice here in town but what do you have a passion for outside of medicine? I know there's a variety of things. There's two I'd like you to talk about. Number one is The Scottish Games and number two is your love of travel.


Dr. Vance Alm:      03:50          And so my love of travel has expanded greatly because I finally have the means to do it. So as a father, I didn't have that opportunity to travel, although I traveled widely with the military. So I've seen lots of countries around the world and seen a lot of different things. But now I'm getting that age where, "Hmm, how much longer do I have on this planet?" So I've decided to just enjoy life. And so I've had the opportunity to go to Europe a couple of years ago and now I'm traveling around enjoying life. And I missed the first question.


Dr. Devlin:         04:23          Oh, The Scottish Games.


Dr. Vance Alm:      04:24          The Scottish Games. Uh-Oh. Again, my son, he kind of pointed me in that direction by saying it's something that I should at least observe. And they happened to have a game here in Reno, and I decided to try. And so being a rather large guy, I thought, "Well, I'll do okay." And so for my very first one, I got first place. So I thought if I can do that, I may have to stick with it.


Dr. Floyd:          04:50          Wow, that's awesome.


Dr. Devlin:         04:50          Yeah. So, I know there's a lot of photos of you in your office doing a whole wide variety of things. There's another thing that I don't know if you're closeted about or not or you're open to talking about it's not like, you know, anything strange but you like to dress up.


Dr. Vance Alm:      05:04          Yes. So one of the things in life that I tell my patients is to enjoy life, to live life to the fullest, to not just be an innocent bystander, but enjoy and partake. In one of those things involves different costumes. And so I enjoy the Renaissance festival, it's interesting, it's unique, it's something that's quite fun. I enjoy dressing up for steam punk, again, it's interesting, It's fun. I've been a participant in civil war reenactments, again, my love of history has drawn me to that. I've also been a person who dresses up for world war II enactments and it's one of my passions because world war II D-Day, we'll have the 75th anniversary here, this year, is one of the most important things that ever happened for the United States. We established and maintained democracy for the world. We vanquished the fascists and free loving people get to enjoy that.


Dr. Devlin:         05:59          Wonderful. The other curious thing that people may not know about you, cause I know it's been a few years since you've been, is that you actually went and worked at The Burning Man festival.


Dr. Vance Alm:      06:07          Yes.


Dr. Devlin:         06:07          Yeah. Talk to me a little bit about your experiences out there.


Dr. Vance Alm:      06:11          And so, I went to Burning Man for nine years and it started in residency because my- the person that was instructing me was going to be out at burning man providing healthcare out there. I asked if I could come along and see if I would learn anything, from that I learned a great deal. One of the biggest things is that everybody needs to have healthcare at some point. One of the most enjoyable things though, was that at Burning Man you actually get to live and breathe and talk with fellow free thinkers, instead of just the regimen of 'it has to be this way, it has to be that way' people were encouraged to think freely, as evidence by the art, all sorts of different things were encouraged as art, some of them don't appeal to every single person. One of the bad things is that Burning Man changed over the years, it used to be very small and it was a special group of people coming together and it was that hippie group that was coming together. Peace, love and all those wonderful things that we enjoy, that's gotten a little bit tainted now. I think there's a little bit too commercialism, I think that it's gone away from its root but it still embraces the thought of free thinking. We as humans need to remember that, think for ourselves, look at the lessons that are around you, but think for yourselves.


Dr. Floyd:          07:31          Yeah, I was reading Stealing Fire and they talk about Burning Man a lot and about the Silicon Valley bigwigs, a lot of them go out there and they either prove their worth and they come up with different ideas and it goes right along with your lines of free thinking. And I think it encourages people to open their minds and kinda think outside the box. Unfortunately, I've never been there. I'm thinking hopefully next year if Sean will take me.


Dr. Devlin:         07:59          Right, you'll be my date.


Dr. Vance Alm:      08:01          And so, one of the things to remember is don't buy into so some of the hypocrisy that people will say that you have to dress as a liberal, crazy person. Go as you, be yourself, just enjoy the time that's out there, enjoy everything that's available. It's not just one mindset that is supposed to rule. It's think truly free. Enjoy and do whatever you want to.


Dr. Devlin:         08:25          Yeah. There's a bunch of tenants that were outlayed around burning man and they still hold true. And Larry Harvey, unfortunately who passed last year, made some big contributions in complete ownership in an authentic way that is about interconnection, it's about creativity and expression. My experiences there have been diverse and profound over the past 20 years. But what you, what you bring to my mind is that how eclectic and how different every individual is when they go out there and you're right, they can shed the mask that they wear in traditional society and be who they are. And you and I know that we have had peers and colleagues and folks who even taught us that express themselves in a very beautiful and unique way there that we would never have seen if we stayed within I guess polite society settings.


Dr. Vance Alm:      09:15          Yes. It's just a place where you can enjoy being whatever you want to be and some people think very far outside the box and some people think very narrowly, this is how I have to be. Do what you want. Enjoy, be the person that you want to be, not what society, even the Burning Man's side of how you have to be. If you want to dress up as a Knight in shining armor, do it. If you want to be the most liberal person and walk around with nothing on, that's your choice. Do whatever you want to be. It's what we should embrace further for our general society, but we barely often stick to the norms. We think the way people tell us we have to think. Be free. Think for yourself.


Dr. Devlin:         09:57          Yeah, that's good advice.


Dr. Floyd:          09:59          And, let's change this and go to medicine. And you were telling me earlier about your four hypotheses to happiness and that you tell all of your patients and can you go over those again? They were very interesting.


Dr. Vance Alm:      10:13          So some simple things that you can look at and think of these as ways of defeating anxiety or depression. Number one, live your life far too often we're trapped in a role and we don't actually live life. Life is to be lived. You work, you work to live, you don't live to work. So live and enjoy life. If you're doing things that you enjoy, life will be better. You won't be depressed, you won't be anxious. Number two, that can help that exercise. We build up all the apprehension and certain chemicals, adrenaline, when we just sit and we worry about everything that we have to either run away from or fight against, release those chemicals. Go for a walk, do something that's fun and enjoyable. Exercise. If you do something that's aerobic, it tends to have a rhythm to it. When you get into your rhythm, it will create a calming effect. Third on the list, you need to talk to people. We far too often are just typing things down. We're not talking to people. So the social media is great, but you need to talk to people and bounce ideas off of. If you're frustrated with something, if you have a problem and you tell it to somebody, they now have your problem as well. They share your problem and you're now burdened with only half of that problem and usually they're going to try and comfort you and say something like, "Vance, it's going to be okay," but they're also going to give you a suggestion. It may be the worst suggestion that you've ever heard, but often it makes your brain start to think of the possibilities of there are solutions to my problem. And then number four, what are your goals? That's actually a problem I see with the whole country. We don't have goals. We're just meandering through life without goals, without a focus to your life. You're just going to meander and you're going to worry about the inconsequential things instead of worrying about what's really truly important to you. Best place for finding out your goals. Think back to when you were 12 years old, what did you want? Oftentimes that's going to tell you where you should be headed, but don't just think about the goals. "I Want to be rich!" It doesn't work. You need to have something that's really much more fundamental, something that you can actually hold onto and in addition to the goal, what is your plan for life? Without the plan, the goal just remains out there, so come up with the plan. Come up with a goal. What do you want to be? I want her to be a doctor. I waited until I was 37 years old to attain that goal, but I came up with a plan, I worked it and worked it and worked it until it finally would happen, and I made it happen.


Dr. Floyd:          12:51          Awesome. That's great.


Dr. Devlin:         12:52          That's a lot of wisdom. I think that you kind of help us segue into a part of the conversation where we sort of discuss a little bit about your book because you wrote this book I think in, in response to some frustration you felt about how healthcare in general was going. But the other component is, and a lot of people may not know this, you ran for Congress I believe, three separate times. Is this true that you ran?


Dr. Vance Alm:      13:16          It's true.


Dr. Devlin:         13:17          Okay. Well-


Dr. Vance Alm:      13:17          I'm a failed politician.


Dr. Devlin:         13:18          Well, that's- there's worse things than that. So tell, tell me a little bit about how you came to the conclusion that you needed to write a book and also why you thought it was important for you to run for Congress. What changes were you hoping to make?


Dr. Vance Alm:      13:32          The changes that I wanted, I ran three different campaigns and in each of those campaigns I felt there's three main things that every person in American needs, good health, a job, and the education to obtain that job. What are the issues that we talk about all the time in politics? Anything except for those three primary things that will affect every single person. And so there was an opportunity that a previous Senator said that there wasn't going to be a congressional candidate. So I decided I will step up and fill that void. And so that got me interested in politics. And again, I came up with those three things that I felt were important because of my grandchildren, because they have a future that looks quite bleak to me. And so I felt that I needed to address those. And so I looked and looked and began to get more and more frustrated with what I was seeing in regards to the ideas that were out there. Strangely being a staunch Democrat, I'm not a big fan of the affordable care act because being a physician I've seen where it didn't seem to work. And so if that doesn't work, what does work? And rather than reinvent the wheel, I looked at different countries and see what they have to offer. The system that seems to work the best is that we need to have a system, not of government involved health insurance, we need to have government provided healthcare. And so that's what I, my premise in my book is I think that we need to look at how to provide health care and address all of the problems, not just who's going to pay for healthcare. One of the things in my travels was that I asked people, "Well, what do you think of your healthcare?" In that, when I was in Europe, every single person I've talked to felt that their country was providing the best healthcare that they could possibly have. And yet I asked my own patients what they thought of healthcare. "Is Healthcare in America broken?" The answer is, yes. 100% of the people that I asked said that healthcare in America is broken. And if you look at the statistics, it definitely is, we pay too much and we get far too little for the money that we spend. We're suffering, and yet we don't know how to change it. And I decided very quickly that I was going to run again and again until people started to understand that healthcare is a big issue. And it went from three campaigns ago to a non issue. Two campaigns ago began to be an issue and this last campaign, it was the number one issue in America. We have to make some changes in healthcare, and being a doctor, I think that it's my role to be a patient advocate and that I have to make changes in healthcare.


Dr. Devlin:         16:13          Yeah. You know in your book you refer to as this a new solution potentially being referred to as Fed Med. The concept would be that you would have the government pay for and provide medical care as part of- not only a safety net, but basically a, almost like, a right for patients. Talk to me a little bit about that concept and where do you think it's best represented in the world today, your model?


Dr. Vance Alm:      16:43          So, Fed Med, a short term for "federal medicine", federal medical system. It's the concept where instead of having the government provide insurance, the government is actually going to provide healthcare. We already do it in this country. We have military medicine, we have the VA and we have Indian health service. In each case, you're actually providing healthcare, not a promise to get healthcare. I think it's important that we look at this because right now we're on road for the medical industry to bankrupt America. We have to do something now, and this is probably the best choice. We have public education and we have private schools. Why not public healthcare and private hospitals? We can do this and it's just a matter of how do we commit to it. The best example in the world is the UK. They have an awesome system and when I was in England, I asked a young gentlemen, what did he think about his healthcare system? And his response is, "it was f-ing great man." And so, no person that I've talked to in the United States has ever said that we have a great health system. So this is an option that we should look at. Instead of just thinking about who's going to pay for healthcare, we need to have the federal government step in and say, "Hey, we're already paying for a socialized medicine system. Why don't we set up something that's actually going to work for the people?" And we worry about all the millions of people that don't have healthcare. Well, if you have a federal system, everybody's grandfathered in. Well, who's going to pay for it? We're already paying for it in the form of Medicaid and Medicare. Just take those monies and put them into a federal system and also have the private system running alongside for the people that don't think that that's going to provide a good enough health service for them. I think we could do much better with a public health system that doesn't worry about profit. That doesn't worry about do you make enough money to have good insurance, that doesn't worry about, well, I have to do the procedures that are gonna make the most money for me that don't worry about getting a patient in month after month to make sure that the doctor's getting more and more money. We need to look at what's going to worry about, and actually secure, the art of medicine for physicians, so that we look at the health of our patients instead of the money that's going to be generated by the visit. We need to have doctors paid with a salary instead of working for- instead of working for a piecework well, how many hours, how many patients, how many whatever. Did you see? It'll just be, "Is the health of your patient better?" "Yes." That's what we as physicians tried to look for at all times. We try to take care of our patients and yet insurance now is interfering with that. Insurance makes it, well, I can't give you the best medicine. I have to give you this medicine because they think it's appropriate. Well, I can't get you that radiology procedure because they won't allow it. I can't get you that surgical procedure because they won't allow it. It's time for the federal government to step in and say, we want to worry about the health of our people, our citizens, not the cost of what that healthcare provides. And instead of funneling it through for profit, we need to set up a government run system.


Dr. Floyd:          20:06          You bring up a few points and unfortunately America is, we were talking earlier before the show as sick as it's ever been physically, mentally and we're having difficulty accessing healthcare. Why do you think that the system is so broken? What are a couple of the contributing factors, and why do you think that, as a community, we're so sick with increased chronic illness and such?


Dr. Vance Alm:      20:40          A big part of the problem is, is that we worry about everything. Our psychiatric health is really in a poor situation because society has to worry about if nothing else, the cost of their healthcare. If we got rid of that one thing, we might be like Denmark, the happiest country in the world. If we didn't have to worry about our healthcare, am I going to have a job? Do I have the money to get a good education? Do I have a place to stay? If we get rid of some of those cares, we would be healthier psychiatric, psychologically, and we would just be better physically. So part of the problem is that we've emphasized over and over in our country specialty care, over and over, instead of focusing on health, we spoke- we focused on the disease process. Well there you have cancer. Well they have a knee that needs to be replaced. Well they have this and this and this. Instead of looking at the whole person, we focus on just one area. We need to get back to generalists. Canada did well when they converted because they are primarily primary care. They looked at the whole person instead of just the one aspect, that is what we need to return to, but we also have a problem, in that we allowed the hospitals to become more and more important. Instead of just worrying about the physician and the patient, we need to start thinking about how can we curtail some of the excesses that are out there. All of the excesses are profit driven. We in this country are too focused on business, instead of focusing on moral issues, ethical issues, how to treat our fellow being, how to treat everyone as an equal partner in this great endeavor called the United States. We need to look at how can we make it better for everybody instead of how do we make it better for the richest of the population. We need to focus on actually providing good healthcare, and part of that will be preventive medicine. We've gotten away from preventive medicine because it doesn't pay, the focus of the health industry complex, just like the military industrial complex, is that it focuses on more and more profit. We need to get away from that, and again, go back to the focus of the art of medicine to improve the health of every patient.


Dr. Devlin:         23:02          You bring up a really good point. The fact that the healthcare industry is that it's a business and it's in general, it's for-profit, at least those who are holding sort of higher administrative positions, It can be very profitable, even though it may be under a nonprofit moniker. My concern comes from the fact that we have moved so far away from that intimate relationship that takes place between a patient and a physician and almost like a healing relationship that that's been sort of severed here, at least in the United Statesby these third party administrators, whether they be you, like you said, hospitals, insurance companies lawyers. Kind of tell me how your premise of having a fed med may overcome some of these issues, because I see a few problems with fed med, one being a cast system, almost develops. So those people who couldn't afford it, they go to fed med, do they get what? VA style care and then those people that can't afford it, they get more elite care, you know, or higher level care. Talk to me about how you foresee this eventually coming together if you had your way.


Dr. Vance Alm:      24:05          So one of the things that if we did actually pay our physicians a salary instead of worrying about their piecework that they would get, they would do a better job because they would be able to spend the amount of time that they needed. Instead of I need to rush through 20 patients in a day. They can say, "I see each patient for an hour each day that they need the health care." They don't come in for wasteful situations. They come in when they need it. One of the problems with the industry is that we have, as you were saying, not for profits that are being paid as if they're for-profit. A CEO of one of the hospitals in town, not for profit, his salary as the CEO is one point $3 million. I think that's a little excessive. All of the people that are involved with the administration of healthcare, all the people that are checking for your insurance, all the people that are checking to see that you're going to the right person, all the bean counters that are looking at, "Well, do you have the right diagnosis code and did you bill for the correct procedure" that accounts for roughly 24% of the cost of medicine in America. If we were to get rid of that and the supposedly 5% of profit, you've saved 30% off of the cost of healthcare. If we continued to put the amount of money that we currently spend on healthcare by the federal government into a healthcare system, we would have more than enough money to take care of it. If you wanted to address a problem with, well, who's going to pay for the drugs? If you got rid of one aspect of what the pharmaceutical industry spends on healthcare, they spend up to 36% of their budget on marketing. Get rid of that 36% and you now have medicines that cost far less than what the currently costs. If you negotiated prices that are adequate for the pharmaceutical industry with a federal medical system like the VA does, the cost of those pharmaceuticals are gonna go way down. The things that are not addressed by most of healthcare today though are things that are federal system could. Preventive healthcare, It's not profitable so we don't spend money on it. The healthcare insurance companies, they don't want to spend money on that because that's going to be a benefit that another insurance company will get the benefit, that, "Oh, their patients, after they've switched insurance three or four times, they're going to be the beneficiary, not my insurance company, so I'm not going to spend for". We worry about the opiate crisis, another example, and yet nowhere does the current political talk discuss how to really fix that. If you had one system that tracked where everybody was getting their pharmaceuticals from, you'd have it cured. But then there's the illegal source, and yet if you are an addict and you want to get your healthcare, you need to get it now, When you made the decision to come off of opiates, it doesn't exist because current system, we don't have a large enough share of mental healthcare available. A federal system, again, could build on this. One of the interesting things is that people worry about the money and they don't look at what the ultimate results are going to be, and so with healthcare in America, mental healthcare is no longer profitable, so we've withdrawn from it. Rural healthcare is no longer profitable, so we withdrawn from it. Access is not just having the money to go to get that healthcare care, its off the facilities. We also don't have enough physicians in healthcare right now, the reason is, is because healthcare education is over the top.expensive. I just finished paying off some of my school loans, 20 years after I took out those loans and those loans accounted to about the cost of a house, so that is no longer affordable. People don't make their own office because they can't. They can't afford to come out with a debt and then go to work for themselves and assume that for a year or two they're going to make very little money. They have to join into corporate medicine. We need to get away from that model. If you had a federal system that decided to, "Well I will pay for your medical school as long as you come and work for me." Kind of like the military does with pilots, we would have more people getting into healthcare. One of the reasons I really address that is because according to the world health organization, the United States does not have enough physicians for all of the people in the country and we seem to be chasing them away from providing primary care into the specialties because that's where the money is. We need to take both of those things away. We need to have a system that's actually going to provide health care, not healthcare insurance. That piece of paper is pretty worthless. How many patients do you have that are on Medicaid?


Dr. Devlin:         29:04          I-


Dr. Vance Alm:      29:04          You probably don't.


Dr. Devlin:         29:04          Well, I personally, yeah, for sure.


Dr. Vance Alm:      29:07          Probably cause they can't afford to come and see you. I have several Medicaid patients. The problem is they've got this wonderful piece of paper that they then can't go to the right specialist to get care. If you want to send a person on Medicaid to a dermatologist, you have to look outside of the city of Reno sparks. If you want to send them to an orthopedist, it's going to be hard and challenging. Neurology, neurosurgery, countless specialties don't take Medicaid because it doesn't pay enough. Well with the federal system, all those people are going to get adequate care. We're going to have a leveling of the playing field so that everybody's health care is going to be very similar. It's not going to be based on a class system. It's going to be based on everyone has access and you know what? When more than 60% of the people are getting their healthcare from the federal government, they're going to demand their politicians actually provide adequate care. One of the problems that the UK has and why they have a problem is it continually is underfunded. The conservative government there is trying to make changes so it will become, we want a commercial system. Well, commercial systems don't work. We've talked about it already. You don't live as long in the United States compared to countries that have embraced the government system and you have more infant deaths than countries that embraced a government run system. It's time for us to make a change. It's time for us to do the sensible thing.


Dr. Devlin:         30:29          All right, well, it almost sounds like you're back on the campaign trail Vance, but that's cool. I know we see some things eye-to-eye, and other other places we have some differences. We're getting kinda to the end of our time slot here, but I wanted to ask you just if you could sort of put yourself out into the future. What do you think medicine in general is going to look like in the next say 25 to 50 years?


Dr. Vance Alm:      30:50          Medicine is going to end up being much more class driven because as the prices are increasing and the share of the U.S. Economy that has spent on healthcare goes up and up, less and less people are going to be actually involved in getting healthcare. There's going to be more turning to, well, what can I get over the counter? There's gonna be more illegal. There's going to be more setups where someone who is not really qualified to provide your healthcare is going to be providing your health care. People are going to be looking to the internet to find the answers that they can't get from going to a doctor. It's time for us to be patient advocates. We need to step up. We need to make an effort and make sure that politicians start listening to the medical community instead of just going along. We've been silent for far too long. It's time for us to be involved. It's time for us to stand up and yell at our legislators and say, "This is what needs to change" and don't go with just whatever is out there. If I'm not right, then come up with a solution instead of just pointing the finger and saying, "that doesn't work, that doesn't work," come up with your own solution. Write books, write articles, talk to people, talk to everybody you know about how should we have it? Place yourself in the future. Look at the facts that are there and then extrapolate them out. Would this work? And find out if it will, talk to people and find out what are the solutions instead of just pointing the finger at the bad things that are going on.


Dr. Devlin:         32:19          Great, Vance, could you do us a real big favor? Could you show us your book? I know that you have one tucked in there. I think for the viewers and listeners who have an interest in learning more about what Vance is doing, this would be a great resource for you. And the title of it? "The Doctor's Prescription for?"


Dr. Vance Alm:      32:33          The Doctor's Prescription for What's Ailing America. And right now it's how do you get access healthcare? This is just one description of one plan. I hope that there's talk of a hundred different plans on how to fix this, but we need to start talking and we need to make some effort to make some changes. If I'm wrong, I would be happy to admit it, but come up with a realistic plan instead of just promising a plan and then presenting no plan. It's time for us to actually do something about healthcare in America.


Dr. Devlin:         33:05          Great, Vance, thank you. Floyd, did you have any questions before we wrap up?


Dr. Floyd:          33:08          No, I think it's great. I thank you for your time.


Dr. Devlin:         33:11          Yeah, listen, once again, I want to thank to all of our listeners and viewers who check in with us here at The Medicine Wheel. And again, it's been a blessing to have you on Dr. Vance Alm, you've been a mentor of mine for years and it's a pleasure that you've been willing to give some of the time today to us.


Dr. Vance Alm:      33:28          It's been my pleasure and again, think outside the box.


Dr. Devlin:         33:30          Hey, thank you for that.


Dr. Floyd:          33:33          Go out and be healthy.


Dr. Devlin:         33:34          All right, blessings everyone.


Outro:              33:38          The medicine wheel encourages all of our listeners to subscribe to our newsletter and podcast as we continue to explore the world of medicine, bringing you up to date, health and science information. The medicine wheel invites our listeners to email us any news where these stories are topics they wish to explore further and discuss on the podcast. For more information about the medicine wheel, please visit us at our website www.themedicinewheel.com and on Facebook and finally on Twitter and Instagram at the Med Wheel. In an effort to support access to integrative medicine and functional medicine options for those in need, And education for those who need information, please consider donating to project OM Care. 501C3.Org please go to our website, www.the medicinewheel.com to learn more. Thank you again to all our local sponsors, Grateful Gardens, Lighthouse Coffee and Dorinda's chocolates which represent some of the best organic and advertising options in the Reno Tahoe area. Lighthouse coffee shop is a proud sponsor of the Medicine Wheel. We are a family owned and operated local coffee shop. Our goal as a business and a family is to cultivate community wherever we are. All of our coffee is ethically sourced, organic and farm fresh. It's roasted in house daily, guaranteeing you access to the freshest cup of coffee on the planet. We cared deeply for our community and everyone in it. We strive to provide you with the best ingredients and most comfortable environment. Come and enjoy coffee with us. We are family and we would love for you to be part of it. Gerber Medical Clinic is proud to support the medicine wheel and medical education to improve health quality, nurturing the lifestyles of our listening community enhancing wellness for all. Thanks again to Wyred Insights and their talented team for making our podcasting dream possible. In closing, we would like to remind all of our listeners if you have a medical concern or diagnosis, you need to see your personal doctor without delay and if needed, obtain a referral to a specialist. If ever you feel the health issue you have is urgent or an emergency, please call 911 and go to your nearest emergency room. Please do not take any of our positions, commentary or our guests' opinion as medical advice and always seek out medical care from fully licensed and appropriately trained medical professionals in your area. The information shared in this podcast is for general information only and should not be construed as medical advice and understand that no doctor patient relationship is formed. The use of this information and educational materials link to this podcast and website are employed at the user's own risk. The content of this podcast is not meant to be used as a substitute for medical advice, diagnosis, or treatment. This is the medicine wheel. Signing off for this week with reminder to live love, listen and learn.



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