Book Cover - Beyond The Walls | Ep. 315

Our guest for this episode is Zeev E. Neuwirth, MD, an advocate for transforming healthcare delivery.

He is a healthcare executive with over 15 years of clinical practice in internal medicine and another 15 years in clinical operations, quality improvement, care redesign and population health. Dr. Neuwirth is also a digital health industry advisor, podcast host and author.

His most recent book released in September 2023 is called Beyond The Walls: Megatrends, Movements and Market Disruptors Transforming American Healthcare. It outlines a three-part strategy for the transformation of American healthcare and documents dozens of examples of the visionary, courageous entrepreneurs and leaders who are transcending the constraints of our legacy past.

Dr. Neuwirth is closely aligned with the Evolution of Medicine’s values, and he has been working to change healthcare from a high level within conventional systems.

Download and listen to the episode to learn more about the following:

  • How digital technology and group visits can improve healthcare
  • The importance of reducing or preventing physician burnout
  • The urgency behind transforming payment models to reduce healthcare expenses
  • Practical strategies for transforming healthcare from within large healthcare systems and “beyond the walls” of those systems
  • And much, much more!


Mitochondrial Support for Post-Infection Syndromes | Ep. 314


Dr. Zeev Neuwirth: But then they actually ask another question, which is not what’s the matter with you, but what matters to you? What’s important to you in your life? Where can you find hope, purpose, and meaning? Where can you find healthful relationships? Let’s talk about that, and then let’s build everything else around that. And then they build the… By the way, this goes into their electronic health record, which is unbelievable. They train their people, they train their teams. And then around that, they say, “Okay, if you could work on one thing right now, like you, what is doable for you today?”

James Maskell: Welcome to the Evolution of Medicine podcast, the place health professionals come to hear from innovators and agitators leading the charge. We cover the latest clinical breakthroughs and health technology, as well as practical tools to help you transform your practice and the health of your community.

This podcast is brought to you by the Lifestyle Matrix Resource Center, who provide a range of options to help you deliver successful, effective functional and integrated medicine. To find out more and to get started, go to goevomed.com/lmrc. That’s goevomed.com/lmrc.

Hello, and welcome to the podcast. This is another in our series of Healthcare: Beyond the Pandemic, and we’re leading into real leaders in traditional healthcare who are showing the way of how doctors and practitioners doing the work of integrative, functional, lifestyle medicine are really leading the way.

This week, we have Dr. Zeev Neuwirth. He is, as you’ll hear, experienced, super-experienced physician, been in medicine for more than 35 years, a real leader in healthcare, and a bit like Robert Pearl. I became familiar with him while following him on LinkedIn, and it turns out he’s a big fan of whole health. He’s a big fan of group visits. He’s a big fan of digital technology—all the things that we talk about here at the Evolution of Medicine, but really playing at a much higher game inside the health systems. And so, I think there’s a lot of great information in here, and it’s also really inspiring to see that health system leaders are really starting to understand that re-humanizing medicine is a huge part, and reversing chronic illnesses is critical. It’s a really great half an hour. Enjoy.

So, a warm welcome to the podcast, Dr. Zeev Neuwirth. Welcome, Doc.

Dr. Zeev Neuwirth: James, such a pleasure to be here. Thank you.

James Maskell: Yeah, so, I’m really excited to connect for many reasons. I think what we’re talking about generally here is healthcare post pandemic: Where are we headed? And when I came across your work—I followed you for a while on LinkedIn and really enjoyed a lot of the interviews that you’ve done with so many seminal leaders. Then when I saw the book, I just thought this is something that I think the integrative, functional, lifestyle medicine community would really like. Come to find out, having read the book now, that this is not a small part of your interest and that you’ve been actually interested in whole health and group visits and many things like that for a long time.

So, I guess where I want to start is you talk at the beginning of your book about matrix moments, moments that you sort of broke free of the matrix of healthcare. And I think for our audience, they all have a matrix moment. In general, it’s something to do with the health of a loved one where they realize that the standard of care couldn’t help, and they just felt morally compelled to go out and find something that could help. And maybe I’d just love you to start with some of your matrix moments and the things that helped you realize that you needed to go beyond the walls.

Dr. Zeev Neuwirth: Yeah. No, James, thank you so much. So, first of all, I do want to say that in all my work and writings, I’m very, very keen on making sure that physicians, nurses, and other providers in our system of healthcare here in the United States and across the country, across the globe, that I’m in absolute awe of the people who are in healthcare. 99.9% of them are incredibly bright, have spent their whole lives and careers devoted to helping other people, true professionals, truly mission-driven. The best group of people in the world are in healthcare, and so, I am absolutely in awe.

And so, anything I say about healthcare is really more about the system than it is about the individuals, or even, quite honestly, a lot of the organizations in it. I think that we’re wrapped up in a system that is so misaligned with what we need to do.

And this is not just opinion. At this point, it’s fact. The system is just unsustainable, and it is totally malaligned with really the needs we have in healthcare. And so, I just want to preface it. I was in healthcare. I’ve been in healthcare for over 35 years. I trained as an internal medicine doctor. I went to University of Pennsylvania, one of the premier medical schools in the country. Loved it. I went to Mount Sinai in New York City and trained internal medicine. I did a research fellowship, and I pursued a career.

I practiced for over 15 years as an internist. I taught internal medicine residents for years as a full-time medical educator and a full-time physician in the hospital and in clinics. And then, I moved into management. And so, I led large groups of physicians and then got into care redesign and process improvement and quality improvement and human-centered design and then strategy and population health and innovation.

And so, I’ve really been in the belly of the beast, if you will, for over three decades. And probably about… now it’s probably… It was 2015 or so, I began to have, as you and I were talking about, these sort of matrix moments. I started to realize I was in meetings and had been in meetings for years, and the meetings were pretty much the same thing. We were talking about the same problems in the same way.

And it was starting to get a little eerie and incredibly frustrating for me to be sitting there year after year with the same solutions being put on the table and not really seeing progress, when you looked at the data and the numbers. And then a couple of things happened that really broke the camel’s back that were really these truly matrix moments where I decided I needed to take the red pill, for those of you who know the movie The Matrix.

And the moments… Really, one moment was—and this is still hard for me to talk about—one moment was my own mother, who was in her early 70s, went in for an elective hip surgery and did not leave the hospital alive. And in a very, very good hospital in New Jersey, right outside of New York City. And it was devastating to my family. It was devastating to me. And here I was… And it was a completely, completely avoidable death. And it hit me on a personal level, but let’s be clear, this wasn’t an exception. Every year, 400,000 to 600,000, 400,000 to 600,000 individuals and their families are devastated the same exact way I was. And I knew those numbers, and I’d been talking about it and thinking about it. But when it hit me, it was devastating.

And then another thing happened actually not too long after that, where one of my best friends, someone I worked closely with and someone who in fact was my primary care doctor—one of the best primary care doctors and brightest I’ve ever met, and one of the nicest human beings I’ve ever met—committed suicide. And again, not an exception.

Every single day, at least one or two doctors commit suicide. We know that burnout in healthcare is close to 50%. Literally one out of every two doctors is disenfranchised, demoralized, burnt out. The same goes for nurses. And that’s not a tipping point. That’s not an exception. When you literally have 40%, 50%, 60%, depending on the specialty, doctors burnt out and nurses burnt out, that tells you something is fundamentally wrong with the system. They’ve begun to call it, the literature they’ve begun to call it…

And by the way, this isn’t about the individuals. I mean, if you make it through medical school and residency, you’re resilient. Let me just tell you something. If you can get through that, you can get through anything. So, it’s not about the individuals. They are strong, powerful individuals. They’re resilient. They know how to cope. This is about a system that is just overwhelming them, and it’s just one sign that we need to change the system.

So, for me, that was 6, 7, 8 years ago, I decided to… Basically, I said, “What we’re doing is not working. I need to go back and do something I’ve been doing before as an innovation officer. I need to go back and talk to the people who are doing something different, who are approaching this dilemma.” And it is a dilemma. It is a complex, adaptive problem. We have to approach this with different conceptual frameworks because the frameworks we’re using are not working.

It doesn’t matter if medical science is amazing and doing amazing things and technology is amazing, but the solution will not come from that alone. And if it would have or could have, it would already have. It’s not about resources. It’s not about science and technology. It’s about fundamentally seeing the problem in a completely different way and approaching it from a different way. And I began to interview these courageous, bold, visionary leaders who were doing that.

Now, I understand that what I was doing was talking to folks who were beyond the walls, these entrepreneurial spirits and people who are literally going beyond the walls conceptually, literally physically, and systemically. And I was doing what we call positive deviance. I was looking for exceptions to the rule where people were actually literally finding success. And that’s the journey I’ve been on for the last eight or 10 years. And I think it’s a very, very powerful approach, because trying to solve the problems, the same problems in the same way is a fool’s errand, and we need to get out of that. And that’s why the book’s called Beyond the Walls.

James Maskell: Yeah, absolutely. And I was just thinking as you were saying that just how many parallels there are in our life. Because I was reading here in the front cover, it says, “This is a collection of heroic journeys with real life characters whose stories encourage and embolden us not to be held hostage to the mindset, behaviors, and inertia of the past. They are intended to ignite the creativity, integrity, and courage of more leaders to go beyond the walls and leverage their potential to contribute to a more humane future for American healthcare.” I would say right now you are talking to a collection of people who have gone beyond the walls. And literally what that means is in most cases, quitting their job, leaving employment, and forging a new path towards practicing in a new way where the goal is self-efficacy for the patient, where the goal is no chronic illness, no dependence on the medical system.

And that’s something that I have seen. And I’ve interviewed so many amazing people as well, just in this world. Maybe you could just share with all of us because I think that you’ll find some resonance here. In your book, you talk about the need for whole health as a movement that is happening, and you talk a lot about the VA, obviously, and the leadership there. I know Tracy Gordet and now Dr. Klinger, there’s a lot of exciting things coming out even this year about the whole health and the effect of whole health on such a system. I was interested to hear that you think that your book is positive because, obviously, there’s a lot of negative that it’s been built around. What is it about the whole health movement that you think is so promising to take us outside the walls or beyond the walls?

Dr. Zeev Neuwirth: Yeah. So, first, kudos to you and your listeners here for being part of this community. I know it’s not easy. In fact, a friend and colleague, Sean Duffy, who’s a serial entrepreneur in healthcare and beyond the walls leader himself. He left… Just to give you a sense, it’s in the book too, Sean… You should read the story. Oh, I know you’ve been reading it, but your listeners.

Sean was in Harvard Medical School and Harvard Business School, he was getting dual degrees, and he realized as a medical student, as a Harvard business student, that the model was bereft, and he left. Can you imagine? He left Harvard Medical School and Harvard Business School to go beyond the walls in his 20s. And he went and he studied technology and digital and behavior change and went a whole different direction, which is really aligned with this whole issue of whole health. And he’s built Omada, which is an amazing company, one of the leading digital health companies in the country. And so, again, just kudos to you and this community.

I would say what’s wonderful about the time we’re in, and I’m so, so hopeful, and yes, I look for the positive because I do think that’s the way out of this dilemma, looking for examples. I think it’s encouraging, it’s inspiring, it’s informing, and it tells you: This is where the resources need to go. And I think at this point, the literature is really clear that the nonclinical factors, whether it’s whole health or contextual health or social determinants of health or wellness, these so-called non-traditional clinical factors. They are the ones. These are the factors that actually create the greatest impact by far. It’s a two to three, one ratio over the clinical factors.

And so, that’s not to negate the clinical factors, that’s not to criticize the clinical factors. That’s just let’s right-size this. If you look at the data, if you look at the literature, clinical care, traditional clinical care has somewhere around a 30% impact, let’s say, just in round numbers. The nonclinical factors that you are all talking about have a 70% to 80% impact. And again, there’s some nuance to that. But if you understand the literature and if you go to the evidence and you go to the data and you go to the outcomes, then we should be spending a lot more energy, a lot more time, a lot more resources, a lot more money, really studying and deploying this.

And so, I have to say, there are pockets that are happening across the country and across the globe. I was shocked to learn that the VA system, the Veteran Affairs system in the US, is one of the most progressive systems I have ever come across. And literally, I just interviewed another luminary from that system. I’m going to post that interview. I’m just shocked. And I think part of the reason it is so forward in its research, in its deployment, in its approach, and its conceptualization—because they do positive deviance in the VA, they look for those exceptions—I think the reason is, though, the payment model.

The payment model is not a fee-for-service, piecemeal, do more stuff, check more boxes, order more tests, do more surgeries. That’s not how the VA works. They get paid a certain amount per veteran per year, and the veterans stay in the veteran’s system, so they’re not jumping from insurance to insurance company. And so, they’ve got this brilliant payment model where they can actually really ask the question: What is the best thing? What is the most optimal type of care we need to deliver for the veterans? Because that’s the way we’re going to use the dollars the best. And so, they’re set up in a beautiful payment model. And by the way, they’re even innovating on their payment model, which is incredible. It really is the test kitchen for healthcare delivery and innovation in healthcare.

And so, they’ve been working on a whole health movement. And I’ll tell you something, I actually was one of the people back in the 1990s, I was in the VA system, and one of the early, early pioneers where we actually began doing this. And what they’ve done with it since then is unbelievable. And so, they’re really shifting the paradigm. They’re starting out with the notion that, you know what? We’re people. We’re not widgets.

So, lowering your blood pressure or lowering your cholesterol, it’s important, but it’s not enough. We’re conscious human beings with spirits, and that spirit and that mind is connected to the body. It’s not like a machine. And by the way, I think we have been so, so off base in healthcare, and I was part of that, by the way. I’ll admit it. I was doing lean process improvement for years, and I thought, “Okay, we can lean ourselves out of this.”

We’re not widgets, we’re not cars, and it doesn’t work that way. And so, you really need to approach the person as a whole person. And by the way, that means changing everything. It’s not just the mindset of the clinicians and their teams. It’s literally all the tools you have there, all the resources, all the processes, protocols, all the automation, all the technology has to be built around, and the payment system, all of it has to be rejiggered around a whole health contextual, whole person movement.

And so, their movement is… What I love about it is they start with purpose and meaning. And we know that purpose and meaning is actually a factor that determines how long you live. And that’s a fact now. That’s what I learned from the scientists there. That’s not just conjecture. That’s a fact. If you don’t have purpose and meaning in your life, your chance of dying this year is so much greater than if you do have purpose and meaning.

I’ve read so many articles now. There was just an article in the New England Journal about this whole thing. They call this something else, but they call it structural intervention, but it was about if your purpose and meaning is not there, everything goes wrong. All of a sudden you’re depressed, you’re anxious, your blood pressure is up, your body stops working. You’re more likely to have bad outcomes, like strokes and heart attacks and trauma and accidents and turn to drugs and alcohol. So, purpose and meaning.

And they start with a simple, simple question which completely changes the whole system. They say to you, this is the fundamental core of it, of course, they ask the question: What’s the problem? What’s the matter with you? Which is kind of a clinical sort of factor. What’s bothering you? Get that, but then they actually ask another question, which is not what’s the matter with you, but: What matters to you?

What’s important to you in your life? Where can you find hope, purpose, and meaning? Where can you find healthful relationships? Let’s talk about that, and then let’s build everything else around that. And then they build the… By the way, this goes into their electronic health record, which is unbelievable. They train their people, they train their teams. And then around that, they say, “Okay, if you could work on one thing right now, like you, what is doable for you today?”

And they have a wheel, a wheel of wellness. Do you want to work on nutrition and diet? Do you want to work on physical activity? Do you want to work on your relationships? Do you want to work on movement? So, do you want to do Tai chi or yoga? Or if you’re in pain, we have modalities, non-traditional, not necessarily clinical modalities to help you with pain, which is obviously a huge problem. Do you want to work on loneliness? What is it that you want to work on?

Now that we understand your meaning and purpose and what matters to you, here’s… And they offer these things. In the VA, they have systems and programs so they’re real. They can actually deliver that to people and then follow up with you. I think that’s just one movement. And I have a whole chapter just on the whole health movement. And by the way, there are other companies I mentioned in that chapter, a company, ZealCare, which I actually tried to get them into a system I was in, and they’re doing the same thing. They come out of years, if not decades, of… This is research we’re talking about. This is not made up out of someone’s head. This is bonafide published peer-reviewed research that all of this is based on.

And I know you talk about groups. Well, ZealCare is using groups for polychronic care. They’re bringing people together online virtually and using coaching and wellness and other modalities and finding great success, because when you bring people together who are dealing with the same things, it’s not just that they’re interacting with one another, they’re actually doing positive deviance. They’re learning from one another. They’re saying, “Hey, this guy over there, he’s figured out how to deal with this. I’m going to do what he does.” I’m far more likely to listen to someone who’s going through the same thing I’m going through than a person standing in front of me with a white coat who has no idea what I’m going through.

And so, I think the power of people, the power of network, the power of community, so, grossly under-recognized and under-leveraged in healthcare delivery. And again, I’m not talking… This isn’t stuff I made up. I used to run group patient visits. As you know, James, we had, when I was up in Boston, the largest group patient visit program in the country. We were running over 50 group patient visit programs in 18 different specialties, from pediatrics to obstetrics and gynecology to rehab to diabetes. And I saw the power of groups. And again, the literature is pretty darn clear that if you bring people together, a lot more positive things happen than when they’re isolated and alone.

James Maskell: Beautiful. I appreciate you sharing that. And yeah, we’re a hundred percent aligned on that, and I’m glad to hear. Someone who’s worked in such a range of really high levels talking like that is a dream come true for me because I believe that’s the case. I’ve seen it. I wrote a book on it as well. So, I definitely feel that that’s where healthcare needs to go, and that’s the best way of whole health integrating into the system. And just one example there. Are we really going to retrain all primary care doctors to really move around people’s meaning and purpose, or can we just get the doctor to prescribe people into a group?

Dr. Zeev Neuwirth: That’s right.

James Maskell: And then that group can facilitate that for them. I’m just thinking about what other ways that we can move forward. Anyway, we’re agreed on that.

Dr. Zeev Neuwirth: I agree. And James, I agree with you. I think the most proximal way is to offer this as another option for providers to refer people into. Like I mentioned ZealCare, but there’s so many others. And even in the VA, the physicians and the teams are trained as far as they need to be trained. They’re not going to be delivering the programs, but they have referrals to people who are trained who can deliver this stuff.

And I actually see it as a wonderful… I have a lot of friends and colleagues who have been boarded in lifestyle medicine. It’s not for everyone. It’s like some people go into cardiology, some people stay into general medicine, some people go into… There are physicians, primary care physicians who want to specialize in lifestyle medicine and integrative medicine, and great. And so, we’ll have some who do that, but everyone else can refer in.

And you don’t necessarily need, as you know very well, you don’t need an MD to do a lot of this. In fact, you don’t need an MD to do most of it, whether it’s health coaches or other folks who get trained in other modalities.

Again, this is important. We are in a crisis right now in terms of healthcare. Healthcare is completely unaffordable, and this isn’t just for the 30 million… By the way, I say just. There are almost 30 million people in the United States who do not have health insurance. There are another hundred million, 41% of the American public are underinsured or are struggling with medical debt. Okay? The vast majority of us in the country, in the United States, cannot afford the American healthcare system. People are making choices. Literally half the people, this was a recent poll, 50% of Americans over the past year skipped or delayed some sort of medication or medical treatment because they could not afford it. 50%.

Okay, this is not a small problem. And the crisis, the lack of nurses and the paucity of primary care doctors and specialists, this is serious. The only people who are going to be able to get it are the top 1% or 2% of the population will be able to pay cash to pay for this stuff. The rest of us are really in trouble. And so, I think in order to actually make healthcare doable for most of us, and I mean most of us, whether here or anywhere else, and quite honestly the same problems are everywhere, if not worse outside of the US, we need to figure out how to leverage other nonclinical, non-MD folks. It is a must do, and it’s a must do like yesterday, not like tomorrow or five years from now.

James Maskell: Absolutely. Yeah. No, I completely agree. I want to make sure that we touch on digital because that’s obviously what you lead with, and the implications of digital lead to hospital at home and some of the other chapters that you speak to. Obviously, one of the things that we’ve done here at the Evolution of Medicine over the last nine years is really talk about some of the ways in which you can take advantage of digital technology. And obviously, the pandemic created a much more wide-ranging ability to integrate with those technologies and many more patients using it. Why do you think digital is such a big potential transformative agent, and where do you think the leverage is for the average doctor trying to reverse chronic illness in technology?

Dr. Zeev Neuwirth: Yeah, so, I’ll dive into that in 10 seconds. First, I just want to step back for a second. I think we are clearly in a digital health revolution in healthcare. It’s already happening. Most people don’t understand it. In fact, I would say there’s no such thing as digital health, because all health is digital at this point. And in the next 3, 5, 7 years, it’ll even be more. So, you will not be able to do anything in healthcare, anything state of the art, up to date, unless it’s actually digitally enabled. And I’ll just make that statement, because I believe it 100%.

But let me just step back for a second. In the book Beyond the Walls, I talk about three major domains. The digital health revolution, the systemic revolution that’s happening in healthcare, which is absolutely critical. If we don’t understand that part, nothing’s going to change. How collaborations, partnerships, platform technologies, and business models, we have to understand that.

But those two are in service of the most important thing, which I think you’re all about, which is humanizing healthcare. And that’s the middle part of the book that we were just spending some time on. Digital and systemic changes are all about the payment models and all the technology. It all has to be in service of humanizing healthcare, making it more customized, more personalized, making it more equitable, more convenient, accessible, making it more efficient.

In terms of digital, I think we’re in for one of the most amazing errors ever, and this is why I’m so hopeful. Digital far from, I think it’s just absolutely ridiculous that people think that somehow digital and technology is going to make healthcare less relational. There could be… Seriously, think about the way we communicate now. I’m able to speak to friends and colleagues that I would never be able to speak to if it wasn’t for the digital revolution. Some of my closest collaborators I’ve never even met in person. And by the way, I don’t even have to be talking to them at the same time. It could be asynchronous communication, which is the majority of the communication. And I feel incredibly close to them. I feel incredibly connected to them. And so, digital…

And then on top of it, you think about this right now physicians, primary care physicians in particular, it takes literally, this is data that was published, 26 hours a day to do the work of a primary care, 26 hours a day to do the work of a primary care physician. I would say you could cut back. In fact, this has been discussed. If you add a digital enablement and a team-based care, you would reduce that down to, and I heard this from a researcher, something like nine hours a day, actually within the scope of reason.

So, digital enablement, when you take… Doctors spend literally hours a day doing menial work, data entry, data retrieval. Technology and digital will take that off their hands. It will automate it for them. It will make them so much more capable. Instead of now we have to… If I need to look something up, look, medical knowledge changes, doubles every 72 days. Medical knowledge doubles every 72 days. There is no human being on the planet that can keep up with medical knowledge even in the most specialized area.

And so, we have machines now, we have technology, we have AI that literally can look up the world’s knowledge in healthcare and medicine and bring it to the doctor and the patient literally within milliseconds. And once we get that into the exam room, literally the doctor and patient… By the way, this is not science fiction. As the doctor or clinician or whatever provider is sitting there with a person and their family as they’re talking, the machinery will be listening in.

We’ll be recording it so I don’t have to spend four to six hours a day typing up my notes, which by the way, that’s what doctors do nowadays, right? Hours a day, literally doing nothing but typing up their notes. And I don’t want to get into how terrible that situation is. It’s bad for doctors. It’s worse for the patients they care for. We don’t have the time to get into it. But could you imagine if the machinery can actually do that in real time? And then even say… And not only include what the provider says, but include what the patient says.

And could you imagine if the machine could prompt the doctor and the patient and say, “Listen, as I’m listening in, here’s what I’m thinking. There’s a question. The patient just said something’s bothering them. Let’s explore that a little bit. Or here’s the latest, up-to-date…. This is what this thing could be. You have this pain or this symptom. Here are the top three things this could be. Here’s my recommendation for the treatment options.” And then the doctor and the patient can say, “Oh, thank you very much, machine. We’ll take it from here. We’ll talk about it, and let’s really contextualize it for you and for what we need to be doing now.”

That is not… And I’m telling you, it’s not even science fiction anymore. It’s literally on the shelf, ready to go. We just need to actually start deploying it. So, then we haven’t even talked about the whole hospital at home movement, the fact that care is moving out of hospitals, out of these centralized buildings and facilities into patients’ homes and treating them. So, if my sugar drops dangerously low, I don’t end up in an ED, someone automatically… The machine actually picks that up, alerts me, alerts my team, something immediately happens.

If I have a question, I’m at a restaurant and I’m trying to eat right, what do I do? Well, technology can actually aid me. In fact, it’s already happening. There are companies like… I’m close to a company called Virta that uses the ketogenic diet. They actually can help people literally, while they’re in a restaurant, figure out what is the most appropriate thing they could order off of that menu.

And again, digital is the great… I call it the great enabler. I don’t think most people have any understanding of how it’s going to revolutionize. And again, not from a technology perspective. I don’t really care about technology. What I care about is people, and I care about those who are caring for people. And this is about humanizing healthcare, and digital is one of the key ways we’re going to do it.

James Maskell: I really want to recommend to everyone in our community that you check out this book because what I see coming through the book is the message that we’ve been sharing here for a long time, but coming from a place that it hasn’t really come from before. We’ve had Dr. Robert Pearl on the show, and he was awesome, and just really talked about how the lifestyle medicine movement, when paired with the right payment model, can take this whole thing forward.

And he had some good ideas about how our doctors and communities can band together to go after contracts where reversing chronic illness can actually be valued appropriately, given how valuable it is to long-term costs. I guess maybe where I’d love to just finish today is that the end of the book, there’s really a call to arms, I think, for your fellow physicians and fellow people in healthcare on really taking the bull by the horns today to create that transformation. Maybe that’s where I’d just love to finish is just what is the message that you have for healthcare professionals who are at different stages of their evolution and are wanting to be part of a future that really takes us where we need to go?

Dr. Zeev Neuwirth: Yeah. It’s actually, James, it’s a call to action, as opposed to a call to arms. But I love that. So, here’s the thing. For years, I’ve been hearing from people, “It’s never the right time to make this change.” That’s all I’ve heard for the last 30 years. When things are going great, people say to me, “Oh, my God, we’re making so much money. Things are going so great. This is definitely not the time to change. This is not the time to get beyond the walls.”

And then when things are going terrible, when we’re not making money, we’re up against the ropes, people are like, “You can’t expect us to change now. We’re just focused on…” And so, the bottom line is this, it’s never a good time to change. And so, that’s where leadership comes in. That’s where true leadership comes in because true leadership understands where we have to go and doesn’t mire itself in the present moment. We have to transcend that.

We are in the dark ages of healthcare delivery. I have lived in the dark ages and worked in the dark ages for the past four decades, no question about it, in terms of healthcare delivery. The data shows it, the outcomes show it, where we are today show it. We’ve been in the dark ages. We’ve been in fiefdoms with these stone walls surrounding us. We need to get beyond those walls in healthcare delivery, and we need leadership to do that.

And to your point, and to the people who are listening here and to this community, you know what it means for those who have gone outside the walls. We need leaders who are courageous and bold. And the thing is, it’s not about taking down the walls. It’s really about making them irrelevant. And so, we need the folks who are in traditional legacy healthcare, those leaders, to lock hands with those who have gone outside the walls and beyond the walls. And that is the way we’re going to transcend the walls.

And that’s a real call to action. And again, we don’t have to wait. We don’t need more research. There are examples of solutions that work, and what we need to do is to do that. There’s a quote, everyone’s pointing fingers at everyone. I just saw something in the news about the insurance companies are now waging war with the hospitals. This is not what we need. We don’t need war.

We need to actually lock hands. JFK, President Kennedy, quoted something in a speech decades ago and he said, “There are no such thing as evil people. There are just good people that let really, really bad things happen. I think we have to stop that.” And I get it. Believe me, the question people are saying, “Well, I get it. I love this. I agree with this, but what can I do? I’m just this or I’m just that.” Everyone says… I’ve talked to CEOs, I’ve talked to people in the C-suite and they say the same thing, “What do you think I can do? I’m just another…”

No, no, no, no, no, whatever… You want to know what to do? Even the most basic, simple step, and obviously, I believe in this, go get the book Beyond the Walls. Find an example, there’s numerous stories in there, and do something. Pick one thing to do. Talk about the book. And not just my book, other books. This all starts, all movements start with a story. They all start with a narrative.

And I think at the bottom of it, James, what I’m doing with this book is actually presenting a counter narrative, and to your point, a powerful, comprehensive counter narrative that is based on reality. And if we all start to sing that song, if we all start to move beyond the walls… We can’t do it alone. There’s no question about it. You will martyr yourself. You will not be able to get beyond the walls alone. We have to do it together, and that’s why I wrote the book, honestly, to form and be part of this beyond the walls movement.

James Maskell: Beautiful. Well, Doc, thanks so much for igniting this for healthcare at large. I know you have a strong influence in really influential people in healthcare. I’m grateful to everyone who’s listening who has gone beyond the walls already and is now supporting patients and doing that.

And, I think, to follow up from what happened in Dr. Pearl’s interview, I just want to reignite that those people that have gone beyond the walls need to get to know each other, connect, and work together, because by singing the same song, as you said there, I think we can really create a significant transformation.

So, check out the book. Here it is, Beyond the Walls. It is Megatrends, Movements, and Market Disruptors. Transforming American Healthcare. Great reading, and actually surprisingly inspiring and positive, given the place that we find ourselves in. So, high recommendation. Doc, thanks so much for being on the podcast. And everyone else, thanks so much for tuning in. This has been another episode of the Evolution of Medicine podcast. I’m your host, James Maskell, and we’ll see you next time.

Thanks for listening to the Evolution of Medicine podcast. Please share this with colleagues who need to hear it. Thanks so much to our sponsors, the Lifestyle Matrix Resource Center. This podcast is really possible because of them. Please visit goevomed.com/lmrc to find out more about their clinical tools, like the Group Visit Toolkit. That’s goevomed.com/lmrc. Thanks so much for listening, and we’ll see you next time.

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