Why CGM Access Breaks After the Prescription

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0:00 I mean, our theory and premise, I mean, the the long-term vision. I truly believe within 10 years, uh AI will be prescribing, say, 80% of the low-level conditions. I don't think it's really necessary when someone has, you know, the cold and, you know, do they need a $500 visit to get the same, you know, Tessalon Pearls and nasal spray that they give every person that comes in In MedTech, the difference between a good quarter and a great one isn't always the product. It's the friction standing in the way. Broken sales cycles, misaligned teams, deals that stall at the finish line. Every leader feels it, and the best ones know how to remove it. Welcome to Zero Friction, the podcast where we go inside the minds of MedTech's top commercial leaders to uncover the real barriers they face, the decisions they make, and the systems they build to keep the revenue moving.

I'm your host, Terry Coutsolioutsos. Let's remove some friction. Well, welcome to Zero Friction, a podcast which is designed to really understand where there's friction with regards to patient services and patient value, as well as owners, founders, and commercial leaders that are designing these programs, and are finding friction areas on in their own businesses and what they do to sort of work their way out of them. Today, I've got a great guest, Scott Hozebin, who is the founder and CEO of DirectCare AI, which is really designed to take friction out of the patient pathway with regards to the patients who are in need of diabetic care. So, Scott, I'd love to have you kind of dig in a little bit and tell us a little bit about yourself and your personal journey, and then how, you know, Direct Care actually came to be, and what was the mission and the intent behind the company.

Yeah, no, I'd love to, and thanks for having me, Terry. Appreciate the time. It's the most fascinating topic, right, is healthcare. And, you know, that's the formation of our company is, you know, Direct Care. Just it's in the name. You know, a little about me, it's the last 25 years been in bringing new to market medical, originally pharmaceuticals, and then medical technology and services. You know, started in pharmaceuticals, you know, it did 4 zero to billion dollar products over there, which I always find fascinating how quickly pharmaceuticals can move. You know, then went into the medical device space with a company called Dexcom, where they made continuous glucose monitors and you know, it was in the, you know, first 40 people employed there, so. And that was a long journey. You know, that took 10 years to make it to a billion dollars.

2:33 So, you could do, you know, 2 years in a pharmaceutical company, you know, 10 years to get to a billion in, you know, medical device. You know, and during that time, really just super focused on patients with diabetes and and the challenges that they go through in the disconnected care process. You know, we were always thinking, "Why is it this difficult to get these continuous glucose monitors?" At first were cash, then we got insurance, but even with insurance, half the time it goes through a pharmacy channel, half the time it's going through the durable medical equipment.

Patients don't know where it's going, physicians don't. I work there and half the time I don't know. I've got to check a a spreadsheet to see where where it's supposed to go. So, it seemed quite unfair that you have, you know, patients and physicians that are supposed to just innately know these types of things. And then, you know, there isn't as much help getting the, you know, the device started once they get it. And then, one of the bigger things to me that stuck out was, "Okay, we made this device that's collecting 24/7 data. Why isn't anybody using it to make proactive interventions to help people?" You're getting this steady stream of data. And if you go to the best endocrinologist in the country, they might look at it for 30 seconds, couple minutes every 3 months. So, you have this waterfall of clinically meaningful data and it's barely being utilized. It's it's, you know, patients are looking at it. It's um but clinically as clinician side, not as often as you would like. And there's

A series of codes for chronic care management, remote patient monitoring that came out and some companies that I was doing some consulting for were scaling in this and took over as chief commercial officer for there for a while and really identified some of the points of friction as you mentioned that was going to keep them from scaling. You know, one of the benefits of being through these sort of always going from zero to to a billion is is you know, not looking at what are you doing today, but how are you going to do 10, 100x of this at scale. So, you know, needed some more institutional partnerships that we made to have more physicians, more payer contracts, more health coaches, more device ordering, so we could integrate a basically a intake team, a physician team, device ordering team, and a health coaching team in one digitally digitally connected environment. So that a patient could talk to, you know, one entry point and make it all the way through.

Yeah, what a concept creating a patient-centric concept so that they can, you know, whether it's at the beginning of their journey or during their journey or at the end of their journey with your particular product or service that you've got that fully scoped and landscaped around them where especially I'm sure with some of your patients that are elderly, maybe not technologically advanced and, you know, are challenged with, you know, kind of putting points A and B together sometimes having that ecosystem is probably very supportive for them.

5:21 Yeah, 100%. I mean, the majority and we have multiple areas that, you know, would are are always bringing as much care as direct as possible to the patients. You know, I I talk a lot about the diabetes side and those patients are they're I'd say our average patient is probably 75 years old. You have really one clear connection pathway, which is the phone. You know, they don't work well with, you know, you're often talking with technologists and they say, "Well, it'll be easy. Someone will hit a QR code and then they'll tap in this widget and and that's, you know, isn't going to work at all." It's difficult even for them to click a text link sometimes. The We do a lot of hand-holding that's to get them through the process. It I would say the number one call is the the there's a lost password on, say, their CGM app and it might be a 40-minute call just to help them recover a password.

And that's where, you know, in the system the physicians don't have the bandwidth to do it. There's not enough margins for the the DME providers and the manufacturers. So, it's really nice to be able to offer sort of that gap in longitudinal care between the visits and the provision of the device. If those things aren't done, the care's probably not getting delivered the right way, either. So, that's, you know, that's the you know, we get all these advancements in health care and health care delivery and, you know, at-home health and telehealth and virtual health. And if we can't deliver the health, it really doesn't doesn't matter. We have to figure out on the other side, what are those easy buttons that those patients need to have? So, so what have you done to sort of make the easy button for these I mean, is it basically it's fingers and toes and get on the phone and talking with people? Is that Is that Yeah, yeah.

It just like you're saying. I mean, there's, you know, we we use AI and a lot of technology in the back end to make because I think that's one of the challenges in health care, right? Is all these disparate systems. You know, we we don't have some one national interconnected database where everything flows, right? So, you know, on the digitally on the back and we we've had to make customized intake forms that, you know, through series of tags and triggers go to our data warehouse and then that feeds the EHR and populates that so that the physicians don't have to go and map data over. So, everything is pre-mapped for them. It automatically carries that information into a remote patient monitoring software platform and then that data goes into a device ordering platform. So, all of that stuff is happening, you know, on the technology side, but when it comes to patient contact, there's a human that gets on the phone. We We use We do have a, you know, AI voice agents as well

That would you can use, but for for 90% of the conversations, you know, it's like you said, someone's getting on the phone and they're calling the patient. And they're calling a lot of times. Like those are, you know, areas where someone might use AI and and, you know, identifying when that patient tends to pick up more often than others to call during that time, you know, calling multiple If you know, you know, there's a lot of technology around the dialing system to to make it more efficient.

8:14 That's right. I think it's it's not extremely There's so much technology just to get a hold of people. It seems unfair that any normal brick-and-mortar practice could could institute these types of thing. You know, I was seeing funny this brought up the whole calling syndrome is like there's there's a lot of people I was just listening to a guy His name's Jeb Blount. He's a big like sales guru, prospecting guy. And he's actually talking about how AI and the the outbound calling systems today that people are sooner or later just not going to pick up the phone anymore because there's just so much outbound calling getting done. They just look at it. They know it's a robo call or some kind of AI call. And nobody's going to use the phone anymore. And then we're going to be stuck with now what do we do, right? Especially with the patients in that that senior demographic that are, you know, probably 70 75 years of age. They're They're not quite equipped to handle the the mobile aspects of the

Technology you're using people that are engaging them every day, you know, by calling and having that voice live interaction, which is so supportive. Hopefully that doesn't, you know, hopefully AI doesn't burn that bridge for you when people aren't picking the phone up anymore. Yeah, it's it's interesting. I'm on a like a national council for aging that we're we've been working through guidelines on aging in place. And we were we're talking about something similar the other day and how the age group and the medium that you're contacting them matters a lot, you know?

So, I think, you know, even now it's already burned. You know, for So, if the the chances of someone just calling me and me picking up a an unknown number is zero. I've never It's probably 10 years since I've picked up a phone number that isn't already pre-programmed. Right? Where the seniors, they're they're better at that, right? They're the you know, the text messages are more difficult. They're they're skeptical of them. It's not a human voice. So, it's interesting and I'm and I'm, you know, 51. So, it's you know, I'll be the senior soon. So, I think you know, with with my demographic, you know, Gen X, I think you know, maybe you'll end up with more text messaging cuz and they'll screen that way just because of what you're saying with all the robo calling and all of those types of things, you know. Yeah, it's just really interesting how everything kind of shifts and you know, going back to the whole sales call thing again, I don't you know, just that's who

I deal with most of the time, but they actually said if you know, if you're ever a prospect who never knocked on doors and you know, my first job was I used to knock on physician doors selling like lab testing in Chicago, like door after door after door and half the battle was just getting in the door. Yep. And what Jeb Blount was saying, it's amazing now that like when you start knocking on doors and you walk into offices today, they welcome you in. They're actually starving for the human connection. So, there's a part of what you're doing that I think is really nailing it on the head is that you're blending technology on the back side to create efficiencies and scaling and scalability operationally, but you're still focused on the human side. Uh on the front face of the company and I think that's going to really go a long way and that's just where I think everything has been is that it's all AI,

11:20 It's all artificial, it's all virtual and people are starving for human connection and it sounds like you're providing that in a really valuable meaningful way. Yeah. No, no, and I like again, I think it's different demographics crave different things. So, I you know, if you look at our you know, cash pay offerings where we we do other sort of chronic conditions, testosterone replacement therapy, hormone replacement therapy, ED, hair loss, you know, that those demographics are younger. And those folks want to they want to do a a text-based intake form, take my credit card, and just you know, you know, like for testosterone replacement, they still they they go, they get blood labs with a human. Obviously, we don't you know, humans got to take the blood lab, but then they do a you know, a face-to-face things that are delivered to your house, you put on your shoulder, yeah, and and you drop the blood in an envelope, and then you send it back again. So, I mean,

There's actually, you know, there's a non-human aspect to that as well these days. It's crazy. 100%. Yeah, we we use the TASSO device for you know, folks that are more than 50 mi away from a blood lab cuz you're still you know, those work for for at least for testosterone, there's certain labs that it it doesn't pull as accurate as would love. So, it's you know, we sort of reserve it for after you know, if there's there's there isn't cuz we do have you know, folks that are live remotely. But like we said, it's it's amazing. Every aspect is getting turned into a remote possibility.

Well, it's just it's just funny where the world the world's going and you know, with the millennial age group demographic becoming a bigger part of that purchasing population, you know, they're the biggest fan of the asynchronous relationship of anybody. I mean, they're they're you know, they don't want any humans involved with anything. And so, you know, you'll see more of that I think happening over time that you know, we'll just have to be careful with it because there are parts of our health care system that still need people to engage.

Yeah. No, I I I mean, our theory and premise, I mean, the the long-term vision, I I truly believe within 10 years AI will be prescribing say 80% of the low-level conditions. I I don't think it's really necessary when someone has, you know, the cold and, you know, do they need a $500 visit to get the same, you know, Tessalon pearls and nasal spray that they give every person that comes in with the same. I don't even then I I think people have you know, a right like people talk about rights. I mean, if there is we have an ability. It's it's not even in the future. You could do it now. It's really we're held back from legislation, but you know, for a lot of low-level conditions if someone even says it it is crazy to me that someone has a right to go get alcohol or marijuana or any of these other things that we we say have known negative effects, but I can't go get high blood pressure medicine like an

14:08 ARB. You know, I I think someone you know, there should be that's where I think there's that safety level that comes in with AI that, you know, downstream could it be, you know, for some low-level conditions, you know, a $5 encounter that someone could get health care versus there's a lot that are avoiding health care at this point. You know, so when it comes to safety, you know, when you're blocking care, how many people that aren't getting care are getting hurt from not doing anything? Well, or just, you know, and again, you think about like our health care economy today where it used to be you know, you and I grew up in a corporate environment and we were you know, we had great health care plans that cost us, you know, very little percentage of our salary, right? Out of pocket. And then, you know, over time, you know, our coverage ever since like the mid '90s and legislation and Obamacare and all that stuff, all of a sudden like deductibles

Went up and care levels went down and the gap, you know, that you're writing a check for in the middle of all that became bigger and bigger and bigger. And then today's environment, you have these kids and they have these, you know, low low premium plans with, you know, an eight or nine thousand dollar deductible. So you're every time pretty much you're going to the doctor, you're you're stroking a check for two, three, four, five hundred dollars. Great result for a fraction of the cost and a fraction of the time and a fraction of the, you know, resistance to go get things done and waiting weeks for appointments. And I think that's where the whole thing is really changing and I think you're spot-on and and how you're positioning care where it's you're making it easy, you're making it affordable, and you're providing a high level of service. So, and then the other part is is I just was on watching TV the other night and it made my head snap. I was listening to an advertisement where

You could actually buy an urgent care box that actually had pharmaceuticals in it. Like, so you don't even need a prescription anymore. Like, you literally it's like a telehealth kind of survey, I'm sure, but you literally get an urgent care box for your home that has, you know, basic, you know, low-grade pharmaceuticals for colds and things like that. So, it's the world's coming. I mean, what you just mentioned, there's ways to go do that already, which is kind of crazy. Yeah. No, it's in it's it's as you say, I've seen that, you know, and I I you know, but that's where you'll you will have this evolution, right? You know, because in the same you could have you'll have two sides of the coin.

You're going to have someone that's going to go and someone's will get in trouble for that and someone else will lobby to say, "Hey, someone has a right for that." You know, where is the the line? I mean, that's for, you know, policy makers to decide, but there I to to say that there is no valid argument on both sides is, you know, is crazy. So, what what what does the service look like today? Um, you know, what are the service offerings and what what what lane are you trying to fill? And then, where is DirectCare AI going tomorrow?

16:54 And tell me a little bit about what the future of that looks like. Yeah, so you know, we went live in November. We've helped out 7,000 folks, you know, obtain their CGM and coordinate them with our distributors that work with their payers. We keep, you know, 1,200 of those patients are in our chronic care management program where we do continuous following and help them with their if their alerts are high, low, and, you know, care coordination. Then, we we've just recently launched all of our cash pay offerings, you know, so all of that focus was in in our insurance based programs and that's you know, largely cuz it's a 20-year passion of of you know, trying to solve this one problem, right? How do it seems crazy to me that people who have diabetes and it's this hard to get their continuous glucose monitor. I still, you know, struggle to comprehend how it could be 25 years out and only 20% of the folks that take insulin are qualified for getting a CGM with their

Insurance or using a CGM in something that reduces ER visits by 40 to 80%. Yeah, I mean it seems the outcomes are so pronounced, you know, with with these CGMs. It's just it's got to be where everybody's on one. So what why is it so hard to get it from 20%? Like to me that would be something that you know, that 20% would be the number that would be on the other side of the equation where you know, I you know, I And then you have to go off on a a side tangent, but I'll give you the the numbers. It's you know, so even what I find interesting in working with durable medical equipment companies, 50% of the people that contact them and from an advertisement saying I'd like to get a continuous glucose monitor and that DME reaches out to their their clinician, only 50% of the time does the clinician ever even write back the prescription because they don't get paid to to go and write a script. They don't get paid to write a

What what they call an SWO or you know, think of it like the DME script. A lot of them aren't aware of what it is, so they go, "I'm not dealing with that." So you have something that's you're just showing someone their blood sugar numbers and half the people just say, "I I'm not giving you that." No, doesn't doesn't It's crazy. So then of of those 50 10% of the patients that get the order, get the order and then never order it the second time because no one helped them get it started. So they send all these elderly people these devices and say, "Good luck. Hit the QR code.

Watch a YouTube video and you'll be fine." Well, that doesn't exactly fly right for everyone. So, then you have another third of those patients by the end of the first year if they're on Medicare, will fall off of their continuous glucose monitor by the end of the year because no one's there to hold their hand when they don't know where to order from, they don't know how to restart a sensor, they lost, you know, something. And you know, there's no longitudinal support for the device. It's really watch a YouTube video, ask someone for help. It's really minimal.

19:44 So, that's where, you know, just really focused on and we'll stay focused on on that. But, as we, you know, go in and and a lot of the other popular offerings because it's it's honestly like they're they're sort of sub passions. It's I don't know if you've seen in the news, it's it's almost like a in a conspiracy movie. The the government has come out and said, "Hey, I know for 20 years we said testosterone therapy is really dangerous and bad and it causes all these cardiovascular Well, we misinterpreted the study and especially in women. And and in men, it doesn't cause all these cardiovascular effects that we're saying. This was misinterpreted." So, you have and then estrogen, they come out with a whole another press release. "Hey, this the study was misinterpreted." So, so from a hormone perspective, it's fascinating to me to have and then generations of people that have been basically withheld a medication that we now find out is wildly beneficial. I mean, I don't know

If you saw in like women the reduction in like UTIs for women taking estrogen is massive. Crazy. Yeah. You know, so the biohacking industry is like a $100 billion business in the US, whether it's, you know, prescribed or unprescribed supplements, whether it's peptides or hormone therapy or GLPs, any of that kind of that biohacking stuff. That's a $100 billion a year business just in the US. It's huge. And it's probably a fraction of what it should be, right? I mean, it's There's so many people that I think we're you know, we we're moving away from this concept of like only if necessary. You know, like you know, you only deserve anything that's going to keep you from dying to hey, maybe people can take things that make them feel well and and you know, improve their quality of life.

And I I I think that's a a really neat evolution and support it wholly. I mean, it's So, we we have the you know, hormone replacement therapy for women, testosterone replacement therapy for men, ED, hair loss. We have all If you wanted to do your own blood labs, you can go on there and and do, you know, request panels and then we have doctors that interpret those panels. So, you don't have to wait. We have we have like a pharmacy discount card. So, if you do get a prescription from a traditional physician or us and you go to CVS, you can check It actually checks nine different programs and finds the lowest cash pay price. How cool is that? Like I'll have to definitely like tap into that myself.

Just personally, that's just something that, you know, It's easy. You know, you know, the goal is to map, you know, in long-term vision, like I said, is you know, we we've just been approved for insurance, you know, and we're we have some agents coming on for that. You know, the goal is can we map as as many health care offerings in one place and then unite that with a social application. So, we have an app in the app stores where you can ask a health question and the AI gives you an instant answer and then other folks can put in their two cents.

22:41 And then it connects to our what you'd call like the health store or your website for the different offerings. That's really cool. Like AI and, you know, getting medical insights from AI is really and I've used a couple platforms that myself just cuz I'm I connect with him, I connect with my Garmin. I like every day I'm, you know, total body analysis and and it's really interesting and I connect with this other thing called Sava. And what I've been actually really finding what's really interesting Gemini for those people out there is a really interesting very positive AI motivating uplifting kind of AI when it comes to your health.

So, I've just kind of discovered that in the last couple weeks. Cuz I use I use AI every day for like, you know, food intake and nutritional kind of balance like what I'm eating and I really think for you and you really did well with your calorie burn and your diet was fabulous today and you can afford, you know, an extra scoop of berries and you can start. So, it's just really kind of an interesting thing how the whole world is moving around AI and and medical insights and medical care and it's becoming real world everyday stuff and like DirectCare AI is going to be right in the middle of all that.

That's that's an exciting place to be. Yeah, I think you know, Gemini I don't know if you saw there was a really interesting paper around analysis of like rating frontier models versus specialized models. So, like Gemini versus like open evidence. And Gemini actually performed extremely well. It actually outperformed open evidence in in like health questions. You know, there's areas so it's it's opened up a lot of interest I think, you know, even on the using these frontier models in medical applications. But but even beyond the informational part, I would just say the way they deliver the info is very inspirational and positive. Like it's a very like it's a cool energy that it's delivering. Not just great insights and great info, but the energy that it brings it it's not like any other AI that I've worked with and I work with a lot of AI models in my business everyday. And I've just found Gemini to be a really superior personal coach with my health. It's really been

Kind of a fun experience in the last couple weeks working with it. Yeah, I think it's amazing. I I I personally I use chat GPT with I you know, I have one of the scales that with the bioimpedance that checks and it tracks all my metrics and I load that in and say okay, like, you know, where are we? I'm trying to get to, you know, It's crazy, right? Yeah. You know, I I want to be, you know, 10%. I'm at 14% body fat. What do I do and to, you know, lose no muscle and you have this sort of conversation. I mean, it's it's really fascinating. I mean, it's That was one of the genesis of even creating a basic health question or face was, you know, I found it's nearly I think it's like 8%. There's 120 million health questions a day asked online in the United States.

25:30 I think it's 8% of chat GPT's traffic. None of them actually connect to to care. So, we have this this organic existing behavior But with with the with the dead end. Yeah, with the dead end. So, it's like, you know, long-term goal of the company is can I connect, you know, the two things together? Can I connect this user behavior asking questions online to then be able to give, you know, some sort of care that that leads to if if they're interested. So, tell us you know, you've had a great journey building a unique business model. What have been some of the biggest challenges for you bringing DirectCare AI to market and like what's been sort of, you know, it's growing great and it looks like you got a really solid foundation, but what's been some of the challenges, you know, for Yeah, with DirectCare AI, I would say, you know, you have a lot of things. I I can I'll walk through them, you know, from beginning to end. You know, initially,

Anytime you're trying to connect disparate systems, and if you're doing it on a small and you're working with small partners, you can move fast. Now, you're working with large hundred million plus dollar a year companies and you want to partner, you know, it takes a really long time. So, that's where I think, you know, we we had a major advantage because I'm very fortunate for a very strong ecosystem of of leaders to reach out to. I mean, there were contracts that would have taken a year that took a month because it's But even then, it's it's long. You know, because you can make the contract in a month and then it goes to legal team, their legal team, my legal team.

Nothing's ever fast when it's going over to the legal teams. So, those, you know, that's one whole piece, right? You're going to multiple companies, making contracts. You get the contracts and now you've got to you've get someone hand you APIs. So, you know, that's your that's your doorway to connect my digital environment to your digital environment. And now the development team has to go in place. So, you've got, you know, creating you know, I I I say everything nowadays runs on contracts and APIs and you know, connecting that is is really complicated.

By the way. Yeah. Yeah. I mean, it's you know, on the positive, I think you can be really innovative in health care. There's Lego blocks, they're all out there, but to assemble them, it's contracts and APIs. And putting that together, okay, that's step one. Now getting it to work properly from and and every every new connection adds a new possible failure. So, when you're taking A and B and now you add C, something new could go wrong with the connection from A to B. So, you know, going and then testing those things and now you've got A, B, C, D and E and F. You know, so we've got every one of those is a new connection, new contract, new testing environment.

28:14 So, you know, I would say that is one of the most complicated things. I you know, hands But this is being dependent upon attorneys and data architecture. That's a pretty scary framework, right? Yeah. And I I'd say from there you're and now you're asking entities that operate in a certain way, you know, which is another difficulty. If you're trying to create anything new, there's friction, right? You're asking, you know, sort of conveyor belts or companies that operate in one specific way to make a slight shift here and a slight shift here because you're leveraging their large ecosystem to do good and at the end of the day their ecosystem is larger and doing something else. So now you have to get and you're trying to get process improvements and you know, different standards that are important to us that you know, like we we like to focus a lot on NCQA standards, HEDIS ratings and things like that. So now you're trying to incorporate new frameworks into these

Large entities as a small entity. You know, making any kind of shift is very hard. And then you have you know, outside of that it's you have you're do any shift in health care is extremely difficult for people to understand it, what's going on. You know, so that every every point of anything new is is its own friction point. Friction and inertia and and you know, you're bringing change and that that always takes, you know, must have a lot of great change leadership on your team in terms of being able to implement all these things and build systems around it because that's that's the name of the game what you just described there is this all change and transformation and coming in into somebody else's ecosystem and just shifting just a little bit and can just throw the whole balance off of their practice, right?

Yeah, I mean it's you could have Let me say you could have the cure for death and it would take you five years to get it implemented in any health care system. It's you know, it's very difficult to change the conveyor belt. You know, and so you have to you know, one have thick skin because you know, you get a lot of no's and you have to be comfortable making people feel uncomfortable by showing them a better way and and sort of being firm in that, you know, that's in any new medication, any new device, it's it's really saying like hey, this is what's best for patients. Let's you know, going back to standards and reasons and you know, and finding what's what's everybody's motivator because everybody has different motivators in the system and navigating that's you know, it's own learning. Well, that's a big job. I mean, and like I said, you must have a lot of people really skilled that that because that's a You know, I don't know how many

Practices you've I forget the original conversation, how many practices and partnerships you've incorporated into your business. That's got to be a big part of what you do every day. Yeah, I mean, we we've mostly focused on the direct-to-consumer. You know, we work with some physician groups that have an interest in just referring patients cuz they're quite honestly overburdened. In endocrinology, they're they're really you know, it's it's its own tangent for me. You know, it's they're overburdened. It's not fair. They don't They don't get good compensation. Endos make less than primary care. They're obvious And they're specialty. You have Really? Wow.

31:16 Yeah, they Yeah, there's 30 million patients with diabetes, 5,000 practicing endos. Most endos have, you know, 1,000, maybe 2,000 people. So, you know, you're short. You know, each endo would need to have 4,000-5,000 more patients per practice to even remotely have everyone go to them. And then imagine you're you're making less money than primary care doctor. It's really It's And they're much more complex diseases and and visits. So, you know, they they need help. You know, they So, you know, if we can then go prescribe the continuous glucose monitor, help the person get started, deal with the paperwork, the insurance, the device, you know, you know, durable medical equipment companies, you know, it takes a lot of burden off of some of those folks. So, you'll where they'll refer directly to us.

So, you're taking friction away from a lot of the ecosystem, not just the patient. So, you're you're removing friction from the patient, you're removing friction from endocrinology, you're removing friction from your DME companies. I mean, you're really kind of elevating a lot of, you know, smooth and efficiency for these other these other elements. And And you're finding a way where it fits into your business model really well. Exactly. I mean, that's the At the end of the day, right? There's no margin, there's no mission. So, you Can Can you do these things? I think that's one of the the major problems in most healthcare discussions is is people come up with all the what we should do without thinking of the reimbursement environments, you know, because they're the the margins are extremely thin. I think all of health care, you know, even you know, I I people like to beat up on the insurance company, but you you know, they're they're operating at you'll see

7% margins and no one you know, and they're an evil guy the no one's supposed to make money in health care yet. You can have Microsoft with 70% margins and no one cares. It's fine, you know, it Right. So it's for some reason everyone is is you know, is working really hard and there really aren't giant margins. There there are in certain specialties for sure. But in general, you know, especially with support and support for the elderly, it you have to have a passion for it. There's no honestly no business reason. If you're just about the money, it doesn't make sense. You should go health go sell hats on Shopify because it's it's very hard to work with with elderly patients with complicated diseases and very slim margins. Well, good stuff, Scott. What's this kind of closing up thing? Do you want to leave any closing thoughts for the the program and the audience a little bit?

Yeah, you know, happy to talk to you. Happy to talk through all these things and appreciate what you're doing and looking through all of the different areas of friction throughout health care. I think that's you know, everything that we're we're trying to do right is is map as many health care offerings in one place so that it's as convenient as direct as possible. I mean, that's the name of the you know, DirectCare AI. So we want to use AI all the time. I think you're going to see over the next 5-10 years where there's just a lot of places where AI is going to make much more efficient health care.

34:11 Well, and you got to have a model that can deliver it, too. So AI is going to support it and put build infrastructure around it, but it takes the innovation of commercial leaders like yourself and having DirectCare AI be at the forefront of you know, where people are again, I think your model plays very well in today's marketplace where people are are choosing lower insurance premiums because they see little value the insurance policy other than the catastrophic. And then everything left in the middle is with your credit card in your wallet, right? And and you're and you're building yourself and your infrastructure around that, which is amazing. So, congratulations to you and the team and appreciate everything you do.

Thank you. Thank you, Scott. That's a wrap on Zero Friction, the show built around one simple idea. Remove the barriers and the revenue will follow. If today's conversation was valuable, please subscribe and share it with somebody who needs to hear it. That's how we will grow this community. I'm Terry Coutsolioutsos, a revenue architect powered by AI. Come find me at my website, myrevx.com, and let's talk about what friction is costing you and your organization. Until next time, keep removing the barriers and keep the revenue flowing.