Ep 61: From Outrage to Action: Reimagining Healthcare and Prevention with Natalie Davis, MD

In this episode, we talk with a physician whose frustration with the health of Kentuckians — and the way our healthcare system responds to it — became the catalyst for real change. Instead of accepting a system that often waits until patients are critically ill, she began searching for solutions that focus on prevention and early intervention.

That journey led to the creation of Prevent Scripts, an innovative app designed to identify disease risk and support true behavior change through personalized, practical strategies. We discuss why upstream care matters, how small habit changes can lead to meaningful health improvements, and how technology can finally support — not replace — human-centered medicine.

This conversation is about moving from complaint to action, and about empowering patients to take control of their health one small step at a time.

Find out more about Prevent Scripts at www.preventscripts.com

and find Dr. Natalie Davis at NatalieDavismd.com

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specific individual’s medical condition. No information provided in this podcast constitutes medical advice and is not an attempt to practice medicine or to provide specific medical advice, diagnosis or treatment. This podcast does not create a physician- patient relationship and is not a substitute for professional medical advice, diagnosis or treatment. Please do not rely on this podcast for emergency medical treatment. Remember that everyone is different so make sure you consult your own healthcare professional before seeking any new treatment and before you alter, suspend, or initiate a new change in your routine.

Transcript

Ep 61:From Outrage to Action: Reimagining Healthcare and Prevention with Natalie Davis, MD

[00:00:00] 

Before we start today's episode, I would like to quickly read you our podcast disclaimer. The content in this podcast is for general reference and educational purposes only. It is not meant to be complete or exhaustive or to be applicable to any specific individual's medical condition. No information provided in this podcast constitutes medical advice and is not an attempt to practice medicine or to provide specific medical advice, diagnosis, or treatment.

This podcast does not create a physician patient relationship, and it's not a substitute for professional medical advice, diagnosis, or treatment. Please do not rely on this podcast for emergency medical treatment. Remember that everyone is different, so make sure you consult your own healthcare professional before seeking any new treatment, and before you alter, suspend, or initiate a new change in your routine.

Welcome to the starting day. We're your host, Dr. Kitty Dotson and Dr. Sarah Sheets. Two internal medicine doctors who spent years practicing traditional primary care. Over time, we realized something was missing from modern healthcare, a [00:01:00] real understanding of how everyday lifestyle choices impact overall health.

We'll help you cut through the noise of the countless health influencers and their conflicting opinions because no matter who you follow, the basics of lifestyle medicine are at the heart of it all. 

Welcome back to the starting gate. We're your host, Dr. Kitty Dotson 

and Dr. Sarah Schuetz. 

Today we're going to be talking more about actually putting your health goals into action.

So often we see patients who wanna be healthier, but they really struggled to make lasting changes and clinicians feel stuck too, really feeling like they don't have the right tools to help. But today we're gonna talk to a doctor who felt this way and was actually able to turn her frustration.

With healthcare into innovation. 

We're so excited to introduce our guest, Dr. Natalie Davis. She's the Chief Medical Officer for Prevent Scripts, an app designed to help people prevent chronic disease through realistic evidence-based habit change. We're so excited to have her joining us to go [00:02:00] over how this concept came about, as well as what she's learned from developing and being a part of this business.

And just so you all know, she is a Kentucky native. She was a grad of UK College of Medicine and practice for 18 years as a pediatrician split between St. Louis and Kentucky during that time. And because of her experiences and wanting more for her patients, that's where this business was born. Dr.

Davis, can you tell our listeners a little bit more about yourself? 

As you said, I tell people I'm a five generation western Kentucky native, went to med school, 91 to 95 university of Kentucky. And I had some incredible mentors at University of Kentucky. Namely Dr. Nema Desai, who really inspired me to become a pediatrician and inspired me to go to the best children's hospital residency that I could get into.

And so I ended up matching, and [00:03:00] had a incredible, three year residency program at St. Louis Children's Hospital.

So it was a interesting experience and going into ambulatory care as opposed to staying in the big Children's hospital center, I think was really the start of working in care and seeing the shortcomings of our medical system at the same time. 

And what was it that you were noticing that really made you feel like we need a better tool to help patients understand what they need to do, number one, and then actually do it?

I've always been thinking about different approaches

and I think it really may stem from, there's so many things we do in medicine that are just plain dumb, right? All of the things that we do are so dumb. And I can say that with gusto because you guys have [00:04:00] lived that experience as well. Everyone is living that experience with our healthcare system in the United States.

It's a really dumb system. I feel more outrage about our healthcare system than I think the average, doctor or, person working in healthcare does. Righteous anger is another way to put it.

And I just have this inability to just let it slide. And that combined with knowledge of , using technology as a tool to provide better care. So you're trying to find your own work-life balance while you're also trying to make things better for patients,

and you're talking about this outrage.

Can you elaborate a little bit more? What were you just outraged about? 

 Our life expectancy in Kentucky is at the latest count is 73.5. We toggle back and forth between Mississippi [00:05:00] and West Virginia for the worst life expectancy. That is an outrage to me and our patients are really suffering.

And when I came back to Kentucky in the late two thousands, I noticed, having been in St. Louis, I practiced in a very affluent area of St. Louis and lived there for a long time after residency. And I just noticed I didn't recognize people. Everyone has gained 60 pounds or 80 pounds and people were dying suddenly of heart disease, heart attacks and.

At the same time, my doctor friends were saying, Hey, you gotta get back here. We're doing great. And it just didn't sit right with me. 

. in Kentucky. We have no cost containment . We have, three or four or five, major health systems with primarily fee for service, primarily keeping the beds full.[00:06:00] 

We have a smattering of ACOs, a tiny little handful of ACOs who are doing great and doing well in their shared savings. But that is a very small minority of the clinicians practicing in our state. 

Can you just elaborate on what is an a CO and what do you see the benefit? From in that 

well, accountable care organizations sprung from Medicare, right?

And Medicare wants to share in the savings of cost reduction largely for Medicare patients. And, we have great companies like Agilon and Aledade that are helping primary care doctors start and implement the objectives of accountable care, reducing readmissions, reducing ER visits, reducing total cost of care.

All of those things are in that equation. [00:07:00] The problem that I have with the way Accountable care has evolved is that as a pediatrician, my thought is. If you're waiting for a 72-year-old heart failure patient to go home from the hospital and then enlist in chronic disease management, that means you waited too long.

You could have done something when the patient was 53. Our average age of user in the prevent scripts population of our customers is in fact 53. And so keep doing the focus on the downstream patients. Sure. Those chronic patients need help. But the fact that we're focused so much on that and less on the upstream rising risk populations, we implement in patients 13 to 74.

And that to me as a pediatrician, seems like the perfect opportunity to intervene [00:08:00] before patients become that, 38.2% of our population has more than one chronic condition. I 

we, we had this eye-opening experience as well as we recently were presenting to healthcare professionals about primary and secondary prevention of cardiovascular disease.

And the patient we presented was not seen by the audience to be sick. When to kitty and I was like, , this is the opportunity. We need to be intervening. And I think that's something that has evolved over time in a lot of medicine is we are waiting way too late where we could have more influence upstream and actually reduce costs then not waiting till the cost is already started to pile on for a patient and then trying to undo chronic conditions.

Let's prevent 'em before they even happen. 

Yeah. The patient, like that 

money is saved. 

The patient we made up to present was a patient with mildly elevated blood pressure. their A1C was on the verge of [00:09:00] pre-diabetes, but nothing overtly terrible with this patient. And that's where I think we have to take action because within a few years, if you don't take action, they will be overtly hypertensive.

They will be. Further along the pre-diabetes or diabetes range, but that group seemed surprised that was who we brought up as the person to do something about. 

 , Absolutely. And here's where, you don't really know the problems of health systems until you ask what the problems of health systems are.

a lot of these strategy meetings, this is all happening behind closed doors and health systems aren't necessarily forthcoming with what their strategy is. And a lot of the time, the innovation and the artificial intelligence implementations, I hear about within the large health systems are focused on inpatient problems, keeping people from falling out of their beds and, stuff like that.

And all, everything has its place and [00:10:00] time, but. The sheer fact of the pain, suffering, and death that our populations are experiencing as a result is shameful. Shame on us. 

Yeah, totally agree. And I, this is what I love about prevent scripts. So let's talk about this and because this business model of using this app really is focusing on these patients way upstream way early.

So can you explain to our listeners a little bit like what is prevent scripts and when can it be utilized to help prevent chronic conditions? 

 We started in our pilots. To get an understanding in surveying the physicians, one of the things we learned is that providers didn't really know which patients would be open to a conversation about weight and which [00:11:00] patients, it might be taboo.

They might have a BMI of 44, but they just came in to talk about their back pain and they don't want, they're not ready to talk about their weight on this particular day of the interaction. And so one of the things we developed , actually after we, the mobile apps, is a pre-visit survey.

And this is where we start in our ambulatory customers is. Getting an understanding of the patient's self-efficacy, getting an understanding of the patient's stage of change, of course, understanding what are their chronic conditions that they're developing or have developed, including pre-diabetes, pre-hypertension, all of the downstream things, heart disease, NASH, all of the things.

We wanted to also understand diabetes risk. And so this pre-visit survey really creates a robust behavioral profile. We went ahead and threw in social [00:12:00] determinants of health because if someone is sleeping in their car, they're obviously not going to be able to undergo this robust behavior change intervention.

Social determinants is actually the most important first thing you need to take a look at. And then if all of those are okay and the patient is in a contemplative stage or action stage. That is a patient that might be interested to have a conversation about weight and to do something about it right there at the point of care.

And then we color code all of those things for the patient so they can see, Ooh, my diabetes risk, it's red, my weight, it's red and red, my blood pressure, oh, it's in the yellow.

And so we're showing the patient, wow, these are some things you need to be thinking about. As you're here on your physician visit, which could be for a sinus infection or back pain or any of the number of reasons people come in.

And so we work to carve [00:13:00] this behavior change opportunity out. No matter what you came to the clinic for, whether it's an annual wellness visit or a sinus infection, we still have this opportunity to engage and enroll in a behavior change intervention. We help providers streamline and automate both this pre-visit piece and the decision support as well as onboarding of patients into these interventions.

Even after patients leave the clinic, we have a system that continues to engage the patient and we're able to enroll of those patients that are eligible for remote monitoring programs. , Patients are looking for an accountability partner and they don't necessarily have the trust in their payer for their payer to be that accountability partner.

And of course there's, the litany of consumer companies that are out there too, doing all of these interventions. But [00:14:00] patients are able to do an intervention with their provider as the accountability person and then to have their insurance reimbursed for this, they may be, able to just either have no copay or a small copay for it.

 just to summarize that, it sounds like you all have created this app that doctor office visits can use. It's a screening tool to just, like we said, we're thinking about these chronic conditions like. Diabetes, hypertension, and obesity before they may be something you're even taking medicine for.

And this app is able to screen for that, give a red flag and be like, Hey, we need to have this discussion. And it prompts a discussion with their primary care provider, which is who they have the best relationship with when it comes to their health, because that helps people have that connection and they like that person being their accountability 'cause they know the most about their health, which is great.

I love all of that. And then the next part [00:15:00] of this app is what I think is where there's so much power as well, is not only do we screen, so conversations are started in our primary care office, but then there is options to create. Behavior change in very small steps over time. And we know that Kitty and I talk about that is where all the behavioral research shows to create longstanding behavior change is doing this in small increments.

Can you elaborate what you all's research showed and why you invested in telling patients to just do these really small things to get started. 

 Yes. And I did it wrong in my practice. I was the worst offender. I was kitchen sinking. You're there. Okay. You need to, eat more fruit.

You need to eat more vegetables, you need to move more. Here's a handout, a Mediterranean diet. Do all the things you know, and that we were never trained on behavior change in medical school. And I was the worst offender. Luckily, I have a brilliant CEO in our company. My co-founder, Brandi [00:16:00] Harless, who had the foresight to bring in several very accomplished experts.

Dr. Emily Lilo and Dr. Heather McKee were behavior change PhD specialists that helped us in from our very early days, design this platform and how it should work. And I was amazed at that. Level of detail that we were able to get to. But long story short, we have the patient pick their goal. And we focus our goals around the American Heart Association's lifestyle Essential Eight, or the American College of Lifestyle Medicines, lifestyle pillars.

They're all the same thing. American Academy of Family Medicine, we're all of the professional organizations, we're all saying the same thing. American Academy of Pediatrics, we're all on the same team of saying it in different ways, but we're all [00:17:00] saying the same thing. It's the same eight, behaviors that patients need to focus on.

And we let the patient select the behavior as their primary goal. And so in our mobile apps we're tracking, key biometrics there's four. The weight, the blood pressure, the blood sugar. And we added in waist circumference because we found that there were just droves of patients that in fact had metabolic syndrome but weren't.

Actually diagnosed with metabolic syndrome and getting that waist circumference is one of the key pieces of that. And also, patients love to track it. You give them something they'll track it. Check this waist circumference once a month, I'll do it. My doctor says to do it. I will do it.

And so those are the key numbers. And then we're color coding those numbers, red, yellow, green in the mobile apps. And then the core of that program \, we call them my [00:18:00] plans. And so a patient might select, eat less sugar , they might select move more. And so we. Digitized that five, a preventive counseling approach that's endorsed by the United States Preventive Task Force.

So the flow would go with the patient, and this is all automated. They can do this 24 7. We send them a reminder to do a check-in once a week. And so the flow is I want to eat less sugar because I want to. Live longer, but I can't because I have this barrier and that barrier. And my husband's always bringing home Oreos from the store, you know, whatever the thing is in terms of barriers.

And then we have them select a little micro goal that they can stick to for that week. And then they commit to their provider to do their best to make that change. And then once they select their goal, [00:19:00] they're going to get six weeks of customized prevent tips. This is powered by our large language model.

We call her, we call Heri. And so the tips are customized to each individual user and that user's stated barriers. So we're really trying to get the right notification to the right patient at the right time. And. This is the core of how the program works. It takes five minutes in the morning, five minutes in the afternoon.

patients say that they appreciate having the ability to toggle between behaviors. If one particular behavior gets to be impossible and they can't do it because they have strep throat or whatever life, happens, then they can switch to a different goal for a while. And this is often the topic of our coaching [00:20:00] sessions in which our coach is checking in with the patient monthly to see how is it going, what's hard about eating less sugar?

What makes it easier to eat less sugar? What do you wanna try next time? 

Yeah, I love that it keeps prompting to. Try something else and to make the goal small, because otherwise you're just not gonna stick to it. And then if you don't see yourself sticking to one goal it's often that patients then think they can't stick to other goals as well.

So seeing yourself stick to that one small thing usually helps build that momentum to then do the next, 

building that self-efficacy, building that agency. And it's so wonderful to see that it's like a glimmer. Patients are doing it and then once they're doing it, you have we're always walking this fine line of.

, If we irritate them too much, they're gonna fall off the wagon and delete the app and, and never come back to the doctor again. That combined with, just the right amount of nudges at the right time to [00:21:00] help develop that self-efficacy and develop that agency.

And then, this is all Dean Ornish's stuff. When you feel better doing these behavior changes make you feel better in a way that taking a statin does not help you feel better. And so as you feel better, as you are accomplishing your goals, and maybe finally you master drinking more water, you finally get off.

Maybe it takes you eight weeks, but you finally get off the Mountain Dew and you finally master drinking more water, then you can move to something else. And so then you're feeling better. And that feeling good is. Self reinforcing prophecy. 

Yeah, that's something that I've learned a lot in our lifestyle medicine practice that I know I did not do.

In traditional primary care is when we're working on lifestyle change, the majority. If people and providers at [00:22:00] follow up are just looking at that weight, so a patient comes in, they're working on behavior change, they may have lost one pound, their weight may be stable. Never did I go back and say, Hey, with the changes we talked about, are you feeling better though?

That is where the money is because 

If we work on small behavior changes, we work on the habits up front and we start feeling better, then we can progress them. So then eventually we will see the weight go backwards. We will see the blood pressure decrease, but that's not necessarily the thing we should be focusing on upfront.

We need to master a small habit to get that win, and we need to. See how our body's responding because when we recognize that something's making us feel better, the habit loop's gonna stick. But if we don't make that connection in our brain, then we give up on it because we thought we were just doing it for our weight.

And so there's just so much value in that. And again, I didn't [00:23:00] do that in for years, and I'm like, what was I doing?

I think we're also busy all the time too. You're busy in the office when you're with patients. It's hard to get through everything, but just in your life, you're busy.

And most of us don't really set aside. Those five minutes, or even just five minutes a week to reflect on how am I doing 

Giving space, putting space into your life to reflect. And I remember those days, I remember, when I did outpatient peds, outpatient peds is a, it's a slog. You're, you got 40 patients to get through and you'll see 20 patients in the morning and 20 patients in the afternoon.

And plus all of the administrative piece and the, and authorizations and you guys know, I'm just preaching to the choir. All of the dumb things, all of the dumb stupid things that we had to do in practice to keep it going and floating that, is happening across, every medical practice in the country [00:24:00] across every academic medical center in the country.

You add all the, add all of this up, all of the dumb things we do. Taking away the space from, the reflection and the foresight and the, that ability to meet patients where they are. 

Agree. 

Can you Maybe give us an example of really how this has worked for a particular patient?

 Yes. I would love to give you an example. I love this. We have of our. 36,000 patients under contract and the 15,000 patients that we've surveyed, we've able to onboard and bring around 800 patients through these remote monitoring programs. And there's one particular patient that stands out for us that is Jesse, who is a Latino male.

He was an Android user, and Jesse came in and had a weight of 458 pounds. Blood [00:25:00] pressure in the one fifties, over nineties, a pain scale of nine out of 10. And he was seen as a new patient in our customer's clinic, filled out the assessment. He actually filled out the assessment. Several more visits between March and over the summer.

And then in July he decided he was ready. His stage of change moved from pre-contemplative to action and he downloaded the mobile app and he started self-tracking. He started, he picked actually move more as his goal and his big barrier was working in a factory and sort of this inability to have time for exercise.

And so he's first chose that he would park his car further away and walk further to get into work. And he continued tracking, continued with his scale and over [00:26:00] time with a couple of visits throughout the fall, he was able to by that next year. Lose a hundred pounds, normalize his blood pressure, take his pain scale down to zero, and he was able to build on that move more goal.

And towards the end he was, during his work breaks, he was walking around his warehouse, , doing laps on his work breaks, and was able to overcome all of these barriers in his workplace by making these iterative small changes. And we see in aggregate for our population, for folks that are diagnosed with hypertension, we see 12% reduction in blood pressure.

For folks that are diagnosed with diabetes, we see 1.4 reduction in A1C and then we 

equivalent to a medication. 

Yeah, I was gonna say, let's pause. That's the same as [00:27:00] starting a medicine. 

Yeah. Give that some credit there per minute. 

Yes. The A1C reduction, it's let's go back to the case you gave , you guys were talking about that patient, three years before their A1c is nine, right?

You and I, we wanna make these changes when the patient is in this stage one hypertension and their BMI is elevated and they're just maybe their A1C is, toggling up at the very, very beginning of pre-diabetes, but you wait three years, then their A1C is nine, that's what grabs everyone's attention. And so we've had to separate, we have all these cohorts. We have, lots of patients that have hypertension. They're getting these, outstanding blood pressure reductions. We have lots of patients that also have been diagnosed with diabetes. They're getting outstanding A1C reductions.

And then the rest of everyone, you go a little more upstream. When that patient is in their forties or even thirties, the overweight patients that aren't yet diabetic and [00:28:00] hypertensive, 82% of those are seeing a clinically significant amount of weight loss. 

That's excellent.

I love it because it shows so many times. I feel like because of messaging that's out on social media and just things that patients are exposed to, it is felt that the only option is something extreme. to help with their health. Because it's okay, if you don't completely overhaul everything, there's no hope for you.

There's no chance. But this program shows and has the data to back it. That taking a year and just working on small things, these are very small goals and letting them build over a year, you get these dramatic changes. It doesn't require that whole life overhaul to see a difference, 

Patients can do it. We have not given our patients enough credit, this sort of mentality. All the patient lost a follow up, oh, the, patient's not. [00:29:00] Compliant, that's bs and that's shame on us for writing those words in charts because we have not given our patients the opportunity to do this themselves.

And they can it, and they will do it, and in fact, they love doing it. 

They need the right tools and information and I think that's something that it took me a while to realize that, when you just give such, I don't know, superficial information to patients, just eat less, move more, and then they just walk out the door without any guidance on how to create this behavior change that's not actually helpful.

That's not helpful. We really, in something that Kitty and I believe a lot in is like we really need to be doing such a better job at helping with behavior change and being trained as physicians in behavior change and how to do it well. Because that's how we start to improve this entire epidemic.

It's not more [00:30:00] medicines. It's not like we have to actually prevent these things. People having less of these conditions instead of adding more treatments for the conditions. That's not actually getting us in a better spot. That's just getting in a more expensive healthcare system. We've conquered that.

I'm tired of that one. 

These are pretty simple technologies too. We've had these mobile phones for quite a long time.

And we are really just connecting these technologies, right? We're taking the mobile, we're connecting it through Bluetooth to an FDA approved device. We're utilizing, notifications and text messaging and this workforce of digital health utilizing, some. Artificial intelligence that, some LLMs and we have a natural language processing scheduler that where you can just talk to the mobile app now and schedule your next session.

. We see about of our cohort, we see about 65% of visits now are scheduled with the mobile app.

And just talk to the mobile app and schedule your next [00:31:00] session. That's easy. That's just access, shame on us for not providing better access to our patients. Shame on us for making people wait for six months to a year to see a specialist that's crazy pants. It doesn't even make any sense.

 I'm just like, mic drop. It is crazy pants. So with this, because I know it probably hasn't been easy trying to get healthcare systems on board of thinking this way, what strategy has been successful to help them think about, so upstream, right? Because that's not what normal healthcare systems do.

What actually helps a healthcare system be like, oh, why are we not doing this? Make the light bulb. I know we've all had that light bulb, but how are 

you 

converting other people to have that same light bulb as we gotta do this differently. 

I read a really neat article about this.

The advisory board company recently [00:32:00] wrote, and it was a two-sided article. Half of it was talking about helping vendors and technology companies like prevent scripts communicate our value propositions better. But then the other half of it was about advising health systems on.

Providing better support for this kind of innovation. And what has helped prevent scripts is actually going downstream. We started with this sort of idealistic, let's just grab all the patients when they're pre-diabetic, before they're on statins and, taking GLP one drugs and let's just reverse that.

Let's do 80% cost reduction. But we found as we got into market, our primary care customers were saying hey, I've got all these diabetic people. I'm tanking on this quality measure of A1C, and I'm tanking on my hypertension control quality measure. [00:33:00] I'm not gonna get my upside risk bonus. We would really like to have, formal.

 Diabetes, chronic management and hypertension intervention programs. And so our customers really drove us to add those two programs and that are in play now. And so we've just ticked ourselves downstream, we actually have heart failure patients in our program now. And health systems, they, what they need to do is they need to define their problems and then they can maybe build it yourself if you wanna build it yourself, but if you wanna roll out something fast, then you know, buy is an option because it's faster to deploy already built technologies that are proven to work. And on the vendor side, we may make assumptions about problems. You don't know what the [00:34:00] problems are until you go in and ask. And if the number one problem in the health system is reducing readmissions, then they're not thinking about this upstream implementation.

So what we have found worked for us is just continuing to move downstream, keeping our upstream, we still have, all of the revenue and the behavior change from the enrolled patients in the upstream. But we're doing downstream implementations now, even post discharge implementations.

And so we just have to meet the problem, solve the problem as it's stated by the health system, and then go from there. But. One of the big problems we see is, if the readmission reduction is an issue, then there's also this piece of getting that patient back into the primary care doctor after they're discharged is a big problem.

And that's something that, that, a [00:35:00] downstream implementation solves by getting the patient hooked back into their primary care doctor so that they're not bouncing back into the ER after their stay. 

And you're pointing out something that absolutely drove me crazy. , All these measures that you're getting reimbursement for that you just talked about, readmission control of A1C, control of blood pressure and people who already have problems.

Why are we not getting reimbursed for keeping our panel of patients from getting these problems? I have a thousand patients. I have kept 500 of my thousand patients from getting diabetes, hypertension, et cetera. Like, why are we not reimbursing there, instead of, let me get all these patients that ha, that had this condition and control them better.

What 

I know you look at these ACOs, a lot of these accountable care organizations spent so much time gaming risk scores. To make people look sicker so [00:36:00] they can make more money for Medicare. That's the opposite of what my company does.

Yeah. My company actually changes behavior and makes patients better. That's 80% cost reduction. . And as primary care providers, we know that we're the highest value providers, yet we are only making 5% of the money in healthcare.

It's also churn, the payers know, these patients are gonna churn out. They know exactly the period of time at which the statistics are that this patient's gonna churn out and be someone else's problem.

There's a level of upstream that is of less concern from that payer perspective, and that is just, it's just part of the game. It's unfortunate.

 Yeah. What advice do you have for anyone from the doctor to the medical assistant that's rooming the patient that has an idea of this could be better if we did it this way, how would you tell them to even try to put that into action [00:37:00] or take it anywhere?

I think as providers. Moving into positions of leadership , for those that are still working in large practices and large centers, moving into leadership positions where you have the ability to affect change and have some say becoming involved in the innovation ecosystems in a leadership role is a way to dip your toe, into it.

Of course, moving into the professional organizations like obesity medicine and American College of Lifestyle Medicine, those are ways to move the needle, for your populations. Each one of us has to make that decision for themselves. How far they want to go. I'm like the outlier of the outliers, I know that about myself.

But I've been able to find a community of outliers doing these sort of cra we call them moonshots. We're doing these crazy moonshots and, finding a community [00:38:00] of like-minded providers I think is really important. 

 That's why I was glad I found Kitty. 

Oh no, I was glad I found you to there 

because you start thinking, it's 

am I crazy?

Am I out here just all by myself and I've lost my mind and I have all these crazy thoughts. So it is so helpful to find people that are like-minded and wanting to make change. 

Yeah. Absolutely.

You have to move, keep moving into where your passion is. And our team at Prevents Scripts is this amazing, incredible, like-minded team of, behavior change experts and our CEO we have a great operations. Manager David Moore now, and an incredible development team that is, partly in the us, partly in Pakistan.

. And, I never dreamed, when we had this concept that I would be Tony Stark talking to my database, but here I am.

Speaking of that, because you are so involved in the technology world and the healthcare [00:39:00] space what do you think. Patients should be ready for in the future, we'll just say five to 10 years in healthcare, with AI being integrated and all these new tools what are some of the things that you think patients should be embracing for change that's coming?

I am really excited about AI technology that provides transparency of pricing. There are some companies coming down the pike that are so amazing. I really hope the days of these overinflated charges by, healthcare entities, combined with the lack of transparency on the payer side.

I'm really hopeful that is a. Thing of the past. 'cause I feel like there's some amazing technology coming down the pike. There's amazing e-prescribing technology coming down the pike. There's [00:40:00] amazing customization coming down the pike for the microbiome, for example. There's just amazing longevity technologies coming to pass.

Although those are mostly functioning in the consumer space now, they're not getting to the people we know really need this help. But that super convergence of technologies. I really see it happening and I'm just. I'm just optimistic that the future will be better. , We hear a lot written about, the bots for the health systems fighting the bots for the payers.

And we're just in this bot war of nobody wanting to pay and everybody wanting to keep their margin and everybody wanting to keep their profit as is and satisfy their boards and their, create their shareholder value. But I'm optimistic that there are consumer companies and provider [00:41:00] led interventions that are gonna really make a dent.

 , The vision when we started was to, have these kinds of health outcomes. We're talking about and to do that for a million patients, for example. And I keep moving the goalpost, if we could do a million, maybe we could do 10 million. And that is really making a dent.

 That's great. 'cause I, we do get very negative about, oh, the future is, there's only bad things to come. So it's exciting to hear someone who is very involved in technology in the healthcare space to hear that. No. We actually do have some exciting things that are new and fresh and can change healthcare because we do not need to stay in its current pattern 'cause it is not working.

And so I love hearing about innovation.

 Dr. Davis, obviously I think if a patient is listening to this and their provider offers prevent scripts, I think they would be wanting to take advantage of it, hearing everything that you had to [00:42:00] say today. But is there an option for someone to actually use this if their provider doesn't? Use prevent scripts and where do you see prevent scripts going in the future?

So we do have launching a program called Prevent Scripts Direct, where patients that have either been in our programs or a patient that just wants to do a program is able to access prevent scripts directly in a consumer model. And that has been an exciting and exciting launch that we're, is probably gonna come to, into play January.

And the other partnerships that we have that are coming to pass are, partnering with Launch Blue and Invest Blue, the UK innovate team and UK Healthcare. And we're looking forward to customizing an implementation there so that we have more patients in Kentucky having access to the platform.[00:43:00] 

We have a clinical research project with the University of Buffalo Dr. Amanda Ziegler and her team at the Primary Care Research Institute to do a customization for 13 to 17-year-old populations that will be full implementation and investigate three arms. There will be one group of obese teens will get standard of care.

Another group will get prevent scripts and the third arm will get prevent scripts plus a wearable, and we'll be collecting outcomes data and looking into how the interventions affect provider patient relationship. So that's really unique and exciting and. We do have the ability for patients to sign their email up on our website if they're interested in that, that Previn Scripts direct product.

But our preferred methodology is going through primary care clinics because we know that is [00:44:00] where we're going get our best onboarding and where we're gonna get our best adherence to our programs. 

 and then Dr. Davis, one other thing for our listeners that may not be able to have access to this, prevent scripts and are wanting to make some change, what is just, if you had to give a short piece of advice, like how can I get started?

What should I do, what would you tell patients? 

I would say have confidence in your own ability to have agency and have control over your life. Realizing that. You can do these things, you can make change. You can overcome barriers, you can do it. 

I love that. I do too. Yes. 

Little mic drop right there.

Yeah. That's a, something that Sarah and I really always wanna make sure we're reinforcing too, because with [00:45:00] these episodes, our goal is for you to feel in control. Because so many times when you're in a healthcare setting, your health can feel out of your control. And we want you to know that, although occasionally there are times where it is, much of it is in your control and you can do it, you can make a difference 

for, 

and even teenagers can do it.

I think this, as a pediatrician, one of the things that I've found and really struggled with in practice for teenagers, an obese teen. Who has two obese parents feels so helpless. They feel like, how can I do this myself if my parents aren't helping me?

And what we discovered is that, 16, 17, 15-year-old, they can influence the groceries that are bought at the store. They can get their parents to buy some apples. They can do these things for themselves. [00:46:00] And that isn't a uphill battle. But kids can do it. If kid, if a kid can do it, anyone can do it.

Yeah. No, I like that.

 I think that was really inspiring both for patients to, to feel empowered and know that there are tools coming out to help you make little changes and help prevent disease or improve chronic disease that you already have. And also a great time for us in the healthcare field, no matter where your role might be in that, to be inspired by people like you that are taking their frustrations and not just complaining about them, but trying to make a change to, to help the system as a whole.

So hopefully everyone feels inspired today and makes a goal no matter. No matter what that is. 

And if we do have someone that is wanting to just know a little bit more about your business, where could they find more information about prevent scripts? 

I think the best place to look [00:47:00] two places. One is take a look at our website@www.preventsscripts.com to learn more.

And you can drop your email address in there. We'll give you, send you some case studies. You can also learn more at Natalie Davis md.com . 

We'll put that in the show notes so it's easy to access there. And we really appreciate your time and your expertise today, and we're excited Next week we're going to take a little bit of a different path so please join us See you next time.