Marketing Tips for Intimate Treatments - Henry Ramirez, MD, FACOG, OB-GYN

This is Patient Obsessed, the aesthetic practice marketing podcast that explores what makes people choose one doctor or provider over another, in a word, the conversion, the magic moment. I'm Eva Sheie, your host and scrappy problem solver. My name is Eva Sheie and I'm so thrilled to bring you Dr. Henry Ramirez, who is an OBGYN in both Dallas and in southern Oklahoma. He's the founder of several practices and med spas. He's an incredible trainer educator and most importantly is absolutely obsessed with the patient experience, which is why he's here with me today on patient obsessed. So welcome Dr. Ramirez to the podcast.

Thank you so much for having me. I'm looking forward to be able to kind of, I guess sign some knowledge to whatever questions you may have.

I was joking earlier that I was awake from two to 4:00 AM thinking about vaginal rejuvenation marketing, and I've been thinking about it for years, but also especially today because it's such a huge challenge. How do we take these sensitive topics and speak to women with respect without making it seem tacky or cheesy and actually helping them understand why it's important, and I am thrilled that I get to ask you questions about that today because you've thought about that much more than I have.

100%. I think what makes it even more challenging and all the obstacles that we have in a way is just the culture we've built around it. For the most part, most women are silent. They struggle in silence because grandma, great grandma has told them that everything they're experiencing, there's just part of being a woman and they just have to be blessed. So my biggest hope has always has been to be able to get the word across and like you said, to get it across in a way that is honorable to our moms and our daughters and our sisters and our wives, where they feel like they've, someone has really stopped and listened to what's wrong and has a solution more so than just dealing with symptoms, but giving them a solution where they can plan things out and really get back to enjoying their good quality of life that they deserve.

I heard you say something the other day when we were talking about Kegels. You said, for a lot of women, that's a great solution and we need to do them, but in some cases we're just told over and over just do your Kegels and then sent on our way to go home without actually understanding how to do them, but also that they don't necessarily work for everything and we don't even know when they're not working.

Correct. And what I noticed is whenever I start working on pelvic floor rehab or regeneration with my patients, that's the first thing that I realized, and out of 10 patients, nine of them have not been doing their Kegels properly in our standard of care as Ob Gyns. First of all, not to badmouth my colleagues, they're very busy colleagues. They were seeing 40, 50 patients a day. Their time slots are very small, but because of that, it almost seems like pelvic floor takes a backseat when it should absolutely be something that should be in the forefront of what we speak even before a patient gets pregnant. So when I ask my patients, are these, when I have them contract with, let's say with an electric muscles stimulation, and I ask them, are these the muscles you've been contracting when you do your Kegels, maybe one out of 10 will say, oh yeah, these are the ones, but nine out of 10 absolutely has no idea what a Kegel is or has been doing them wrong for a long period of time.

What do you think they think they are when they're doing them wrong?

Well, the instructions that we give them is try to stop your urine at midstream and then use those muscles 10 sets three times a day, or every time you're at a stoplight or you're in a commercial. But what happens is is that they'll end up using abdominal muscles and accessory muscles like thighs and buttocks and really don't focus in on those Kegels. The reason is is because most of them have injured their pelvic floor after a vaginal delivery or after a surgery is kind of when we're telling these instructions, when those muscles are injured, they're really hard to really recruit those muscle fibers because that neural muscular, that mine muscle junction has kind of been diminished because of pain, just like a knee would be diminished because of pain after an injury from a sports accident or anything like that. So that's the problem. The pelvic floor is injured and then we just tell 'em, oh yeah, you guys are great. Just do your Kegels and everything will be back to normal.

This is something I think you do really well that I want to call out is that drawing these analogies to athletes. And so can you tell us some of the things that we would tell athletes every day that apply to the same things we tell women that we don't tell them every day? Do you know what I'm saying?

Yeah, totally. And I mean, I like to start off maybe in a postpartum period once a patient delivers vaginally, we know that there's been a lot of injuries, soft tissue injury, muscle injury, mucosa injury, but our biggest concern when we're talking about pain management for those patients, it's more so is how it's going to affect their breast milk. So we're putting our patients in high dose Motrin or NSAIDs, ibuprofen to relieve their pain, which works really well. But if that was an athlete that was within the first 24 hours of injury, the last thing we really want to do is throw 'em on a high dose NSAID. The rule for an athlete is RICE, rest, ice, compression and elevate. And the reason for that is that we want to control the swelling, but we don't want to knock it out completely because part of that swelling is part of their healing. For our patients, our female patients after the injury, we're completely knocking out a lot of their inflammation. So it shows in their postpartum period that recovery of that muscle and that soft tissue. It's not the same as it is for an athlete that's being treated properly.

Because the NSAIDs are preventing that healing response from taking place.

Exactly. And a lot of that smooth muscle injury, a lot of that soft tissue injury, a lot of that is inflammation is very necessary. We want to control it.

What do you do instead?

Instead of, what I did instead was, I was using IV Tylenol.

IV Tylenol.

Which doesn't knock out all the inflammation, but it really does improve the pain. So for this athlete, we're going to run 'em through rest, ice, compression and elevate. Once we determine whether it's an injury that needs surgery or not, the next thing we do is they go through surgery or actually first prior to going to surgery, we'll do a type of PT. We know that, let's say it's a knee injury, we know that that quad is basically, it's lost it's muscle tone because the brain has stopped firing neuromuscular signals to it. It hurts when it moves. So prior to going to surgery, they always tell us, make sure you keep that quad nice and strong. It's going to make a big difference in your recovery. Then they go to surgery. Then the next thing after surgery that we do is that we make sure we control the swelling, we control all those things, and we start working on those exercises as soon as they healed so that we can get full range of motion and full strength so they can get back to their function and minimize their chances of healing for our injury.

(07:46)
And the pelvic floor after vaginal delivery or surgery is probably 10 times worse than most athletic injuries and none of that,

10?

If not more. I try not to be, I get to a point that I started exaggerating a lot of things and because I want to make a point, but it's a lot higher injury and we don't do those things. So the idea is we put 'em on Motrin, we send them home after a day or two days of being in the hospital at six weeks we see 'em, and what we're looking for is to make sure that the lacerations and things have healed. Most of the times that vagina is gaping open. If I was to ask that patient at that point to Kegel, there's probably absolutely no way that patient's going to be able to kegel. The muscle walls are super weak. So my instruction to that patient at that point is, okay, here's what's going to happen.

(08:35)
It's going to be important. You need to do your Kegels every time you're at a stoplight and every time you see a commercial, which is outdated now, because with Netflix and all those things, there's not very many commercials. So maybe every time you look at TikTok should be the real instruction down. So what ends up happening is this patient goes home, she fails within the first week of trying because she's not feeling anything or she thinks she's tightening her pelvic floor when all along what she's tightening is her abdominal muscles or quad and her buttocks, and it just never really strengthens. That's not the way we treat our athletes. Our athletes, we make sure they're strong objectively, not subjectively, objectively know that they're strong and objectively know that they have full range of motion, that they're capable to performing the job that they're supposed to perform in the athletic world. So why don't we do that for our females? I'm not sure. But I really think now the more I'm seeing papers come out and the more I'm seeing social media and I think people are finally starting to realize, okay, this is important. What have we been thinking?

So zoom out for me a little bit because you developed this for InMode. Am I accurate? Is that

So I developed the Femtite portion of it. I also did a lot. I did most of the research on the FormaV. Whenever I was doing the research on the FormaV in my office, I had a different technology called Interstem, which was EMS. So in my office I demonstrated a lot of the synergies between radio frequency and EMS. So whenever I started speaking of the data, speaking of everything we're doing, we realized that the platform would be best if we can have something that took care of all the tissue and that's in power. So we have an EMS, we have a form of bipolar radio frequency, and now of Morpheus that takes care of the mucosa. I was also the first one to take the Morpheus and demonstrate its safety inside of the vagina. So I wish I could say I developed it and I came up with all the technology. That would've been great. No, but I did understand the technology and put it all together for the benefit of or female's pelvic floor.

So you're tinkering with these things in your office then. Did you go to them or did they discover what you were doing? How did that happen?

A little bit of both. I've always been a part of the cutting edge technology. So prior to InMode, I was into the CO2 technologies and a lot of those reps, and I also spoke about CO2 technologies and the benefit of the pelvic floor in the vagina during those times. So whenever most of those reps from InMode and the high brass from InMode ended up leaving, that company went to InMode They knew me and they searched me out. Honestly, when we bought or MonaLisa or CO2 technology, one of the things that came with it was a monopolar radio frequency, and I understood enough about radio frequency for my occupational therapy days. So I was excited to have it just from a heating perspective. I just wanted to heat things, improve blood flow, improve all those things as patients healed. I understood that.

(11:44)
So I knew that that device that I got with my CO2 laser was limited. It was monopolar, didn't have all the safety things in there. So you almost had having a thermal injury on a patient before you got results, and no one really wants to be known as the doctor goes around burning vaginas. So I was very limited in how I could use that, but the reps for the company knew. So I was very vocal about it. If I could have a bipolar radio frequency, I can make a lot more difference. And voila came in mode, which was all bipolar radio frequency.

You were an occupational therapist before you went to medical school. How did that background inform the way that you were approaching this?

It's interesting when we hear occupational therapy, physical therapy, a lot of folks don't really understand. And I must say that when I went to graduate school for occupational therapy, my whole mentality was, okay, I'm interested in sports and I love psychology, and that's the way I approached occupational therapy, and it really was way more than that. So occupational therapy, when I compare to physical therapy, it's basically a more subjective, holistic approach to a patient. What occupational therapy says in his standard is that man through the use of his hand energizes mind, body and spirit. So to give an example of what would make a difference between occupational therapies and a physical therapist, it's like a physical therapist. If you have a mom that has a stroke and she loses, she loses this function of one side of her body, a physical therapist is going to objectively get in there, work on range of motion, work on strength, and try to get her back to being as functional as possible.

(13:35)
Occupational therapist is going to take the baby and with that baby show that mom how to adapt to be the best mom she can possibly be without being able to use half of her body. And through having that occupation in mind, it organizes the brain's plasticity where that body can function a whole lot better. That's the difference between the two. So whenever I think of occupational therapy on the pelvic floor, I'm thinking of quality of life, I'm thinking of full function, I'm thinking of sexual health. I'm thinking of all those things because those are very important and that's kind of the mindset that I had when I went into medical school. Medical school does a number on you. Medical school makes sure that you absolutely are evidence-based and you're going to be randomized control all these things. So there was a time that I lost my way in seeing my patient as a whole person.

(14:31)
And it wasn't until about 10 years ago that I realized, man, all those things that I learned back in my occupational therapy world is very part of who I am today and is very part of how I need to establish myself with my patients. So what I did, which I think is equivalent to occupational therapy, is that I got a fellowship in integrative medicine. So integrative medicine basically says that each patient's an individual that we have to meet 'em where they're at, that the western way of medicine is good for some things, but it's not everything. And that the eastern ways of medicine that has a lot of things that we absolutely shun, but they work well. But there's some things in there too that can hurt a patient. So why not use the things from all the access that you have to approach a patient? And that's kind of my mindset between integrative medicine and occupational therapy and then my medical mentality is kind of how I approach my patients.

Do you think that your patients find you because something happens to them that makes them see their current medical care differently and start looking for other answers? Is that a way that people typically find you?

I think at this point I get a little bit of that. I honestly still feel, Eva, that I've spent a lot of time educating my patients to what's out there and the possibilities of abnormalities coming down the road. I think a lot of my patients still need a lot of educations to what their options are. So yes and no is the answer to that. There's some, and I don't think it's the majority, I think it's the minority of patients that really are coming to find someone that's really listening, that's looking for alternatives. And I love those patients because open to all those things, but majority of my patients still have absolutely no idea what they're supposed to have, and we are in America. We all still want that quick pill, that quick shot that takes care of everything for 'em.

Are you spending more time with your patients than most doctors or are you just talking faster?

I think I always talk really fast, but a lot of people ask me, do you miss delivering babies? And a part of me does, but a large part of me realizes that now with the amount of time that I have with my patients, that I am actually given a whole lot better care than I ever was when I was doing basically the bread and butter of seeing 50, 60 patients a day, spending minimal time with them, giving them minimal information, trying to write a lot of information with the hopes that they read it. Now I get to really sit down and as well as put together a team to try to reach all the things that this patient needs because I'm in a cosmetic world. I feel like if I were to open just an integrative medicine office that it's hard to manage because most of us are hard to change lifestyles. But now I understand that if I take that same idea and I tie it to results, then patients are more willing to go through that lifestyle change with the idea that the results are going to be much better. So then I get to really dive into what is healthier living? How should you approach things? How should you mitigate stress? Why is nutrition important? Why is sleep important? And all those things, whereas before it was like no one's listening to that, give me a pill.

So you can't do any of this without marketing. So I want to transition a little bit to, you have people in front of you, they had to find you and come to you somehow, and a lot of things have to happen to get them sitting in front of you. So as you sort of moved from the traditional into this new world that you've invented for yourself, which is really remarkable, how did you think about marketing?

Well, I mean I really believe that and to me it's a lot easier to have 10 of your patients try three new things that you're offering than to bring in 30 new patients, especially in the pelvic health world, because my ability of just getting on social media and talking about vaginas and vagina injuries and all those things, it's a thin block of ice that you're dancing on. So I don't do much of that. But what we do very good in our office is that we absolutely capture patients and try to educate 'em as best as possible when they're there.

So you're using the people in front of you.

Most of my marketing is my in-house marketing,

And they have a great experience. And then you encourage them to tell everyone they know and that's easy because they're having a great experience?

Exactly. So the way we capture 'em and we open because we also have to take down the barriers that they have up. A lot of times they're not going to come in and say it on their own. Minimal, if I have 10 patients that are coming in with issues, one of 'em is going to come out and really tell me everything that's wrong. So we like to, in our intake forms, we have just quick questions. How many babies have you had? Are you having any vaginal dryness? Are you able to orgasm? Are you having recurrent bv? Are you having recurrent UTIs? Just simple questions that I know that a lot of times patients forget to talk about or have a hard issue talking about. Are you leaking? Do you feel like you're lax? Do you feel the same? Do you feel like something's wrong with your pelvic floor?

(19:53)
Something is general like that. Whenever they check any of those things off, the next thing on the list is that when she goes in, she looks at it, she brings it up, she talks about her own experience with some of the technology that we have in our office, and then she comes back out and tells me, oh yeah, this patient wants to know more information about these things. So that's a lot easier to go in and basically open the door and open all the conversation to what I have to offer and what things they could be running into in the future and what we can do to prevent it. Then for me to just come in there and say, Hey, how's it going? I know it is your annual, so what's going on? Hey, you want to hear about all the stuff that I have? Because a lot of times they may or may not.

So you still use paper intake forms? And that paper, people really underestimate I think how powerful paper can be.

We do. I'm not a hundred percent excited about still using paper, but it's something that in my main gynecology clinic or cosmetic gynecology clinic, we have not transitioned into full computerized or digital. I've been wanting to, but I've been wanting to for about eight years and it hasn't happened.

The only way you can is if you figure out how that mechanism can be retained between the handoffs and that's super hard to do.

It's the handoff that's the hardest. Yeah, so once I speak to my patients about all the things I have to offer based on the things that they've already checked off and have heard a little bit about. And I give them lists and some alternatives to all of it, then they get to see and speak to someone else about what it costs, what the plan is, what the protocols are, and that makes life a lot easier. There was a time that I was the one who did it all, and as most medical staff or medical practitioners or doctors we're benevolent. So whenever we talk about cost, all a patient has to do is we our eyes a few times. I mean her blink her eyes and just turn her head and I'm going to give her the greatest discount in the world.

So when you are working with doctors, when you're training on these technologies and talking about these things, what kinds of challenges in terms of marketing, do they ask for your advice about what are their common questions when you're doing that?

Yeah. The most common question that I get is how do we get the word across? How do we get the word across? And I mean, what I just spoke about is kind of what comes out is that first you have to start off there and the more people you're able to treat in your office, the more word of mouth you get. And then you have a brand for some most, and then you can kind of put, when I'm marketing pelvic floor onto social media, I call it just hints. I am kind of hint towards things to get people excited to come ask about it, all the things that I would like to show. Sometimes it's just a little too much.

I've done here and there a fair amount of content in this space and in some places we really had fun and took a humor approach, and so we would use pictures like moms jumping on trampolines. You don't have to say anything, cuz if you know, you know.

Yeah, we do a lot of that stuff. A lot of that stuff is done, but still there's still a lot more education involved in there, so you still have to get 'em in. And I also say that you're only as successful as your ability to bring your team with you. I think a lot of us physicians are missing that. They feel like just because we believe in it that everybody else is going to believe in it. So allowing your staff, first of all to try it if they like. I like for all of 'em, it's part of their benefit package. Honestly, in my office, they get to do all of the things that I offer at cost, and I like that because anytime that a patient comes in, they're interested, they can speak from their own experience, they can speak about what it felt like. They can give 'em all the expectations, and it's a lot easier when they're hearing it from someone outside the doctors, just like people get increased blood pressure with the white coat. A lot of people get selective memory with what we tell 'em as well. So I believe that it has to be a repetition and it has to come from more than one person in that office. And if you don't educate your office, you're missing that late.

Have you seen any big missteps? Is there advice you can give us about what not to do?

Well, just like I said, don't buy technology and not train your staff. That's definitely one thing that you don't do. The other thing that you don't do, I've kind of alluded as well, I don't think, I feel like when doctors start speaking about other things other than risk benefits and alternatives and jump into speaking money, I think there's also pitfalls there. Also, I don't think you should go out and basically decrease your prices trying to get in more people, be the cheapest in town. I think when you do that, you end up getting people that really aren't interested. I also don't believe in giving very many things away because part of improvement and results, a portion of it comes from how well is the patient invested and if that patient's not invested into what they're doing, they're not going to do the things that they're going to do to get the best results possible.

(25:25)
So you shouldn't be the cheapest. You shouldn't speak money. You should train your office staff really well to have the same level of passion as you do. And really those really are the three major things that you probably should be. And one last thing that I think is huge when you think of competition, think of competition. Anytime you set your sights on the person across the street, you're going to fail. You're going to fail horribly. Your competition is yourself. Your competition is improving who you are on a daily basis. If you stay true to who you are and what you have to offer is something that you're passionate in that works. You're always going to attract the people that you want to have when you start competing against someone else and trying to be what you're possibly not capable of being because you want to look like someone else's, your competition and things start to become very odd and it just doesn't fit who you're supposed to be.

I'll add one thing about price. From years of research that we did survey patients, which is when people are prepared for prices ahead of time, not specifics, but ranges, then they're twice as likely to move forward when they're in front of you. So what that means is putting price ranges on your website, which is easy, but also training the staff who answer the phone to proactively bring up the price. So they just volunteer the information ahead of time when someone's calling to schedule an appointment or ask questions so that they know what they're expecting and then they self-select. If they don't have the money or they don't have the ability to finance, then they're not on your schedule taking that time.

That makes a lot of sense and that increases your closure rate. There's three things that we talk about whenever we're bringing in someone for a consult. One, we want to make sure that they have, if we're doing whatever case it is, whatever time it's going to be, they're going to be down that they have that downtime period. Number two, they have to have a range of costs so they know that they're going to come in. Number three, we need to make sure that they have that they're candidates, number one, they're BMI, they're not too heavy, things like that. So if we have those things in place, when they come in, they're good candidates and like you said, a larger percentage close when you have that information, so.

So, coming back around, for anyone who's maybe listening and has just acquired an EmpowerRF, what are the first three things that you suggest that they do to get themselves set on the right foot?

I think the first thing you need to do is understand the technology that you have. And then once you understand the technology, then you're going to really understand the need, meaning how many of your patients really are going to benefit from this? Those two things by itself should get you very excited. Cuz that's your third thing, your third thing is to absolutely be excited about what you have, bring your whole staff with you with the excitement, and then be able to speak to your patients about it. So your first marketing to be able to reach as many people as you can. It's going to be like an event. Once you know your information, once you're excited about it, make an event in your office, make a fun event, have some more doors come in, present on the machine, talk about all that you have to offer. Be excited about it, have a small or short time decreased pricing for 'em, and you'd be surprised at how many people you can close and start off your whole process of treating these patients.

Who are you inviting to the event? All current patients?

Especially when I first get technology, I like to invite all my current patients, introduce 'em to my new technology, make 'em excited, and then give them a deal.

It's easy to get caught up in, especially with events. I think in all the stuff that you have to do, most of it you don't have to do. You can hold a simple educational event with simple food and simple invitations and still be very successful.

You can have a Lunch and Learn. It can be as simple as Lunch and Learn, take 30 minutes to introduce it to 'em. You can have a demo if you want, whatever.

And then with something like vaginal rejuvenation where maybe even if you haven't talked about or tried to sell these procedures in the past, a Lunch and Learn where you bring in four or eight really good patients who you know well, who you're not afraid of, and practicing on them the first time to get the marbles out is such a great way to get started.

I think so, I think so.

Does InMode themselves do anything to help out with marketing and are there advantages that come from working with them on something like this?

Yeah, InMode actually does. I think part of what you get with when you buy a platform is access to an actually marketing company that helps you with websites if you need and all those things. And they also InMode has a team, a marketing team that's part of the company that comes in and helps you set up that first event. They kind of let you know what you got to do, how many people you have to have there. Some of them will even help you present that first event, which is very nice.

The rep will come and help you?

Yeah, InMode, does do a lot of help with marketing, and they do. They want you to want to get that platform successful. It makes sense. The more consumables you buy, the better off they are. So they want you to be successful.

It's easy. I used to say when I sold shoes, I had to like the shoes to sell the shoes. When you like the shoes, it's not hard.

Indeed, indeed.

I had a really hard time selling ugly shoes.

That is so true. I mean that comes with technology as well. Whenever, whenever I compare monopolar to bipolar radio frequency, I think you've heard me say this, monopolar, it is not as efficient. It works. It's radio frequency, it works, but it's not as efficient. So it takes a lot longer to get your tissue to the temperature and keep it at that temperature to have the results. Whereas bipolar, all of the radio frequency stays within the tissue that you're treating. So it's more efficient and it's faster. So if I take a staff member and I say, look, spend 45 minutes on this case and we'll get the results. There's going to be plenty of times that they do, but there's going to be a few times that they don't. Then they're going to get variable response from the patients. They're going to stop believing in them because of that.

(32:15)
Their body language tells it, and a lot of times that's what makes that fail. It's the same way as that shoe. You look at that shoe, you imagine yourself with it on. You're like, oh man, this is terrible. I don't want to talk about these shoes. Whereas the bipolar, we're talking about 10 to 15 minutes. They can spend that amount of time every time. They'll get consistent feedback from patients. They'll get the pat on the back from all their patients. They get really happy about doing the procedures, and it does well like the good looking shoes. Right? You feel good when you walk in 'em. It's easy to sell.

Yep. You're embarking on the adventure of building your first online course to help other doctors and two, probably more than doctors for any providers that utilize the Empower RF. And I'm wondering where we can find that online course?

I think what happens in our training when we're talking about the pelvic floor, the amount of time that we're putting towards it, once we buy this platform, it's like half a day. Although as you can see, I can speak really fast and I can get a lot of information done in a half a day. There's a lot of things that are missing. So I thought to be able to record it all and to be able to pin things like anatomy so they can go back and take a deeper dive, look at, okay, what did he say about how to numb these things, look at it and take a deeper dive. I think those things are what's necessary for my colleagues out there to start making the progression successfully towards being experts.

Tell us where your practices are, what the best website is, if we want to learn more about you and what is the best way to reach you if we're interested in anything that you do.

I'm Dr. Henry Ramirez. I have three different clinics. I have a clinic in Ardmore, Oklahoma, Southern Oklahoma Women's Health is the name. I have a clinic in Frisco, Frisco, Texas, and it's called Azure Med Spa and then one in Bentonville, Arkansas, which is Willow Park Rejuvenation. The best way of getting in contact for me for any information is through my email, so H Ramirez @ SOWH obgyn.com. My best website is going to be my Southern Oklahoma website, which is SOKWH.com is the best website that has the most information about all the things that I do. I also have an Instagram, which is a personal Instagram that a lot of my doctors message me in. It's called at LivingWell md. So those are all resources. They're all places. You can absolutely find me.

Thank you for sharing so much wisdom with us today. I really appreciate it.

Thank you, Eva. Appreciate you.

Thanks for listening to Patient Obsessed. From inquiry to appointment and appointment to surgery. The obsession has always been and always will be conversions. For more resources in middle of funnel marketing advice, go to patient obsessed podcast.com. If you're doing something innovative to improve or disrupt the patient experience, we want to hear from you. If you're a doctor or an aesthetic professional and have ever thought about doing your own podcast, you can try podcasting for free. On our Meet the Doctor podcast. Schedule your free recording session at meet the doctor podcast.com and listen to Meet the Doctor on YouTube, apple Podcasts, Spotify, or anywhere you listen to podcasts. I'm Eva Sheie, your host and executive producer. Production support comes from Mary Ellen Clarkson and Hannah Burkhart. Our engineer is Daniel Croeser. Patient Obsessed is a production of The Axis, THE AXIS. io.