#AIS: The Lanby's Tandice Urban on solving healthcare's customer service problem
Chapters
0:0 The Lanby's Tandice Urban breaks down why healthcare has a customer service problem, and how to fix it12:28 Bestie Q&A: changing American's perspective on healthcare, opportunity for DTC health brands, why is medical spend at all-time highs while avg lifespan has flatlined/slightly decreased?
00:00:00.000 | I'm going all in.
00:00:01.780 | We'll let your winners ride.
00:00:04.020 | Rain Man, David Sack.
00:00:06.920 | I'm going all in.
00:00:09.780 | And it's said.
00:00:10.560 | We open sourced it to the fans and they've just gone crazy with it.
00:00:13.660 | Love you guys.
00:00:14.280 | Queen of Kinwa.
00:00:15.920 | I'm going all in.
00:00:17.800 | Please welcome Tandis.
00:00:19.780 | Hi everyone.
00:00:20.500 | Hi everyone.
00:00:26.480 | So what I want to talk about today is the problem that I'm obsessed with,
00:00:31.140 | which is bad customer service and healthcare.
00:00:33.560 | So I'd like to start out by walking you through a day at the doctor's office.
00:00:38.700 | It can look a little bit like this.
00:00:40.980 | You have to start out by making an appointment.
00:00:43.620 | So you call in.
00:00:44.640 | You talk to someone very unpleasant on the phone.
00:00:47.000 | They put you on hold.
00:00:48.880 | You wait.
00:00:50.160 | There's bad hold music.
00:00:51.300 | You're waiting.
00:00:51.900 | You're waiting.
00:00:52.380 | They come back.
00:00:53.520 | You go back and forth a little bit on your calendars.
00:00:56.280 | You get an appointment.
00:00:57.380 | It's in 21 days.
00:00:58.760 | Now it's 21 days later.
00:01:02.340 | You go to the doctor's office.
00:01:04.040 | Someone very unpleasant checks you in at the front desk.
00:01:06.520 | You sit down.
00:01:07.380 | Super depressing waiting room.
00:01:09.200 | Bad wall art.
00:01:10.280 | Very old issues of parenting magazine.
00:01:13.860 | Smells like Purell in there.
00:01:15.900 | That's fine.
00:01:16.940 | This is your hangout for a little bit now.
00:01:18.680 | And now it's maybe 30 or 40 minutes later.
00:01:21.620 | Someone calls you back.
00:01:23.280 | As you may have guessed, they're very unpleasant.
00:01:25.920 | They take you back to the exam room.
00:01:28.220 | It's very small, blab, fluorescent lighting everywhere.
00:01:31.160 | They take your vitals.
00:01:32.240 | They hand you essentially a sheet of printer paper.
00:01:34.460 | They tell you to change into this.
00:01:35.600 | Now you're in sort of a secondary holding chamber.
00:01:39.260 | Except this time you can hear the doctor in the other room.
00:01:42.800 | And they're saying, "Hey, it's so great to see you."
00:01:44.500 | And so you know they're just getting started in there,
00:01:47.000 | even though your appointment was an hour ago at this point.
00:01:50.660 | Pull up your phone.
00:01:52.500 | You start to go through your little question list.
00:01:54.320 | Get up the courage.
00:01:55.880 | Get up the courage to ask everything you came in to ask.
00:01:57.780 | And then finally, the doctor knocks.
00:02:00.800 | Like you could possibly still be changing.
00:02:02.320 | He comes in.
00:02:03.060 | Does a little small talk with you.
00:02:04.480 | He goes and sits down.
00:02:05.640 | Starts asking you some questions.
00:02:07.840 | You're maybe like eight minutes into the appointment at this point.
00:02:10.880 | And you're like, "Okay, also I have some questions."
00:02:12.700 | And you pull up your little question list on your phone.
00:02:15.040 | And you get through maybe like two or three of these questions.
00:02:18.520 | And then the doctor starts to give you a look like, "Let's wrap this up."
00:02:21.840 | And so you wrap it up.
00:02:23.580 | You ask three questions.
00:02:24.840 | The appointment is over.
00:02:25.840 | You go outside.
00:02:26.840 | You check out.
00:02:27.840 | If you're lucky, they'll tell you how much you owe.
00:02:29.840 | If not, you will just find out later in the mail.
00:02:32.840 | So my guess is that maybe many of you in this audience have a concierge doctor.
00:02:38.640 | But most of us have had some iteration of this experience at some point.
00:02:43.240 | There are a lot of terrible things about our healthcare system.
00:02:45.320 | But the one I want to complain about specifically today is why the customer service at the point
00:02:50.100 | at which you're actually consuming the healthcare is so appallingly bad.
00:02:54.900 | And when I refer to customer service,
00:02:55.800 | that's anything that touches the patient experience while you're going to the doctor.
00:03:00.440 | So a long wait time is as much bad customer service as the unfriendly front desk person.
00:03:07.560 | There's this really great quote that I love from Bill Gurley, prolific investor, and my
00:03:13.240 | relationship hall pass.
00:03:15.040 | I didn't know he was going to be here.
00:03:20.800 | The US healthcare market is the least customer centric of any customer service industry.
00:03:25.760 | We are so numb to the pain that we rarely object or complain.
00:03:29.760 | So that's part of what I think is so crazy about this is that we kind of just take it.
00:03:35.660 | And so that got me curious to explore three questions that I want to go through with you
00:03:39.760 | here today.
00:03:40.760 | Number one, why are things so bad?
00:03:42.340 | How did they get this way?
00:03:44.040 | Number two, why should we care that things are so bad?
00:03:46.740 | And number three, what can we do about it?
00:03:48.760 | What's a little something we can do to make it better?
00:03:50.900 | So let's start with why are things so bad?
00:03:53.720 | A big part of this is.
00:03:55.720 | Our customer service problem is really more of a consumer service problem.
00:04:00.540 | And what I mean by that is patients are consuming the healthcare, but they're not exactly the
00:04:04.520 | customer in the traditional free market sense of the term.
00:04:07.600 | So who is the US healthcare system as we know is an employer sponsored model.
00:04:13.060 | This was not very well thought out.
00:04:14.480 | It's more of a World War Two relic that was came from a national mandated wage freeze
00:04:18.660 | in 1942.
00:04:20.400 | And we kind of just kept going with it.
00:04:22.080 | And now today, the doctor is not getting out of bed in the morning for your $15 copay.
00:04:25.680 | They're really making their money off of the major stakeholders in the industry who are
00:04:30.060 | the employers and the insurance companies.
00:04:32.120 | They're the payers.
00:04:33.120 | They're the real customers in this story.
00:04:35.880 | And doctors don't love this either.
00:04:37.080 | By the way, there's major burnout in the medical community.
00:04:40.040 | But when you play this all the way out, you're left with misaligned incentives between physicians
00:04:44.160 | and patients.
00:04:46.800 | Physicians in the traditional fee for service model, which is our predominant model today
00:04:50.060 | where physicians are paid per per patient encounter, they're incentivized by volume.
00:04:55.640 | And not by quality and not by good health outcomes.
00:04:58.200 | So it's no surprise that practices are not designed to cater to the patient.
00:05:02.940 | And once that becomes the norm, it becomes the culture, every doctor's office can get
00:05:05.920 | away with it.
00:05:06.920 | And now you're left with these two really bad stats.
00:05:10.240 | The first one is in primary care, specifically, the average NPS for provider is three.
00:05:17.680 | That is so embarrassing.
00:05:20.480 | Number two, 96% of patient complaints are about the service itself, only 4% are about
00:05:25.600 | the care delivered.
00:05:26.560 | So patients are really noticing how bad the customer service is.
00:05:30.860 | And yet, to go back to our earlier point, patients have this sort of Stockholm syndrome
00:05:35.940 | when it comes to going to the doctor specifically.
00:05:38.060 | We'll request a non-talkative Uber because we don't feel like chatting with the driver
00:05:41.380 | or we'll leave a very scathing Yelp review for a restaurant.
00:05:44.840 | But when it comes to this service, even though we're not an easy to please generation, we
00:05:49.440 | become very submissive.
00:05:51.040 | And it's the most important service across any service industry.
00:05:54.540 | So this is not a good thing.
00:05:55.560 | Why is this happening?
00:05:56.640 | And why should we care that we're having such a bad time at the doctor's office?
00:06:01.320 | It's because bad service is bad for our health.
00:06:05.360 | So good medicine is a partnership between a patient who's coming in with real information
00:06:09.880 | on how they're feeling and then a physician who's coming in with real expertise to bring
00:06:13.720 | to that information.
00:06:15.020 | And they work together.
00:06:16.020 | But if the patient is feeling very anxious and exhausted and the doctor is feeling very
00:06:19.740 | rushed and dismissive, you're left with losing a bunch of really important information
00:06:25.520 | that you need to make nuanced diagnostic and treatment plans.
00:06:29.040 | So to give you an example, doctors are far more likely to prescribe antibiotics in the
00:06:32.920 | afternoon than they are in the morning for the same patient with the same issues because
00:06:37.820 | they're just running late and they're dealing with decision fatigue.
00:06:40.020 | If you leave with anything from this talk, it should be to make morning appointments.
00:06:45.340 | And then patients, on the other hand, know all of this and they've felt this before.
00:06:49.400 | And so what many of them end up doing is deferring treatment altogether.
00:06:53.020 | So patients feel like it's a hassle.
00:06:55.480 | They don't want to take anything out of it.
00:06:56.480 | They will just text their med school friend.
00:06:57.820 | Health care has a patient buy-in problem because they've made the experience of going to the
00:07:02.680 | doctor's office so bad that we only go when we absolutely have to go.
00:07:07.340 | And what do we lose when we go when we only absolutely have to go?
00:07:11.300 | Preventive care.
00:07:12.660 | And preventive care is really the reason it's so bad that we're not going to the doctor's
00:07:16.500 | office.
00:07:17.500 | We lose out on going when things are early.
00:07:19.720 | We lose out on all the upstream, life-saving, cost-saving benefits of prevention.
00:07:25.440 | So I'm going to hit you with three stats on that.
00:07:27.680 | The first one is 40% of annual deaths caused by the top five causes of death in the U.S.
00:07:32.620 | are preventable with good preventive care.
00:07:36.540 | According to the CDC, for whatever that's worth to you, avoidable chronic disease accounts
00:07:40.600 | for 75% of our health care spend.
00:07:44.440 | And finally, on the other hand, patients with a PCP, a primary care doctor, spend 33% less
00:07:49.960 | on health care overall because they're front-loading that spend toward prevention.
00:07:54.740 | So that's our final question.
00:07:55.400 | Is good service bad for our health?
00:07:57.200 | What can we do about it?
00:07:58.440 | The good news is this.
00:08:00.320 | We are starting to see more and more practices shift towards models that incentivize physicians
00:08:04.580 | to care about good customer service.
00:08:06.540 | So there are two models we can use here to change the compensation model to allow physicians
00:08:11.620 | to have time and space to think about service.
00:08:14.640 | So the first one is direct-to-consumer.
00:08:17.240 | So that's making the patient the customer again in this scenario.
00:08:21.580 | And the second one is leveraging value-based care models where they ensure that they're
00:08:25.360 | not only the consumer but the patient.
00:08:26.360 | So we're not just saying, "Hey, we're going to give you a new patient.
00:08:27.360 | We're going to give you a new patient."
00:08:28.360 | We're going to give you a new patient.
00:08:29.360 | We're going to give you a new patient.
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00:12:00.360 | We're going to give you a new patient.
00:12:01.360 | We're going to give you a new patient.
00:12:02.360 | We're going to give you a new patient.
00:12:03.360 | We're going to give you a new patient.
00:12:04.360 | We're going to give you a new patient.
00:12:05.360 | We're going to give you a new patient.
00:12:06.360 | We're going to give you a new patient.
00:12:07.360 | We're going to give you a new patient.
00:12:08.360 | We're going to give you a new patient.
00:12:09.360 | We're going to give you a new patient.
00:12:10.360 | We're going to give you a new patient.
00:12:11.360 | We're going to give you a new patient.
00:12:12.360 | We're going to give you a new patient.
00:12:13.360 | We're going to give you a new patient.
00:12:14.360 | We're going to give you a new patient.
00:12:15.360 | We're going to give you a new patient.
00:12:16.360 | We're going to give you a new patient.
00:12:17.360 | We're going to give you a new patient.
00:12:18.360 | We're going to give you a new patient.
00:12:19.360 | We're going to give you a new patient.
00:12:20.360 | We're going to give you a new patient.
00:12:21.360 | We're going to give you a new patient.
00:12:22.360 | We're going to give you a new patient.
00:12:23.360 | We're going to give you a new patient.
00:12:24.360 | We're going to give you a new patient.
00:12:25.360 | We're going to give you a new patient.
00:12:26.360 | We're going to give you a new patient.
00:12:27.360 | We're going to give you a new patient.
00:12:28.360 | We're going to give you a new patient.
00:12:29.360 | We're going to give you a new patient.
00:12:30.360 | We're going to give you a new patient.
00:12:31.360 | We're going to give you a new patient.
00:12:32.360 | We're going to give you a new patient.
00:12:33.360 | We're going to give you a new patient.
00:12:34.360 | We're going to give you a new patient.
00:12:35.360 | We're going to give you a new patient.
00:12:36.360 | We're going to give you a new patient.
00:12:37.360 | We're going to give you a new patient.
00:12:38.360 | We're going to give you a new patient.
00:12:39.360 | We're going to give you a new patient.
00:12:40.360 | We're going to give you a new patient.
00:12:41.360 | We're going to give you a new patient.
00:12:42.360 | We're going to give you a new patient.
00:12:43.360 | We're going to give you a new patient.
00:12:44.360 | We're going to give you a new patient.
00:12:45.360 | We're going to give you a new patient.
00:12:46.360 | We're going to give you a new patient.
00:12:47.360 | We're going to give you a new patient.
00:12:48.360 | We're going to give you a new patient.
00:12:49.360 | We're going to give you a new patient.
00:12:50.360 | We're going to give you a new patient.
00:12:51.360 | We're going to give you a new patient.
00:12:52.360 | We're going to give you a new patient.
00:12:53.360 | We're going to give you a new patient.
00:12:54.360 | We're going to give you a new patient.
00:12:55.360 | We're going to give you a new patient.
00:12:56.360 | We're going to give you a new patient.
00:12:57.360 | We're going to give you a new patient.
00:12:58.360 | We're going to give you a new patient.
00:12:59.360 | We're going to give you a new patient.
00:13:00.360 | We're going to give you a new patient.
00:13:01.360 | We're going to give you a new patient.
00:13:02.360 | We're going to give you a new patient.
00:13:03.360 | We're going to give you a new patient.
00:13:04.360 | We're going to give you a new patient.
00:13:05.360 | We're going to give you a new patient.
00:13:06.360 | We're going to give you a new patient.
00:13:07.360 | We're going to give you a new patient.
00:13:08.360 | We're going to give you a new patient.
00:13:09.360 | We're going to give you a new patient.
00:13:10.360 | We're going to give you a new patient.
00:13:11.360 | We're going to give you a new patient.
00:13:12.360 | We're going to give you a new patient.
00:13:13.360 | We're going to give you a new patient.
00:13:14.360 | We're going to give you a new patient.
00:13:15.360 | We're going to give you a new patient.
00:13:16.360 | We're going to give you a new patient.
00:13:17.360 | We're going to give you a new patient.
00:13:18.360 | We're going to give you a new patient.
00:13:19.360 | We're going to give you a new patient.
00:13:20.360 | We're going to give you a new patient.
00:13:21.360 | We're going to give you a new patient.
00:13:22.360 | We're going to give you a new patient.
00:13:23.360 | We're going to give you a new patient.
00:13:24.360 | We're going to give you a new patient.
00:13:25.360 | We're going to give you a new patient.
00:13:26.360 | We're going to give you a new patient.
00:13:27.360 | We're going to give you a new patient.
00:13:28.360 | We're going to give you a new patient.
00:13:29.360 | We're going to give you a new patient.
00:13:30.360 | We're going to give you a new patient.
00:13:31.360 | We're going to give you a new patient.
00:13:32.360 | We're going to give you a new patient.
00:13:33.360 | We're going to give you a new patient.
00:13:34.360 | We're going to give you a new patient.
00:13:35.360 | We're going to give you a new patient.
00:13:36.360 | We're going to give you a new patient.
00:13:37.360 | We're going to give you a new patient.
00:13:38.360 | We're going to give you a new patient.
00:13:39.360 | We're going to give you a new patient.
00:13:40.360 | We're going to give you a new patient.
00:13:41.360 | We're going to give you a new patient.
00:13:42.360 | We're going to give you a new patient.
00:13:43.360 | We're going to give you a new patient.
00:13:44.360 | We're going to give you a new patient.
00:13:45.360 | We're going to give you a new patient.
00:13:46.360 | We're going to give you a new patient.
00:13:47.360 | We're going to give you a new patient.
00:13:48.360 | We're going to give you a new patient.
00:13:49.360 | We're going to give you a new patient.
00:13:50.360 | We're going to give you a new patient.
00:13:51.360 | We're going to give you a new patient.
00:13:52.360 | We're going to give you a new patient.
00:13:53.360 | We're going to give you a new patient.
00:13:54.360 | We're going to give you a new patient.
00:13:55.360 | We're going to give you a new patient.
00:13:56.360 | We're going to give you a new patient.
00:13:57.360 | We're going to give you a new patient.
00:13:58.360 | We're going to give you a new patient.
00:13:59.360 | We're going to give you a new patient.
00:14:00.360 | We're going to give you a new patient.
00:14:01.360 | We're going to give you a new patient.
00:14:02.360 | We're going to give you a new patient.
00:14:03.360 | We're going to give you a new patient.
00:14:04.360 | We're going to give you a new patient.
00:14:05.360 | We're going to give you a new patient.
00:14:06.360 | We're going to give you a new patient.
00:14:07.360 | We're going to give you a new patient.
00:14:08.360 | We're going to give you a new patient.
00:14:09.360 | We're going to give you a new patient.
00:14:10.360 | We're going to give you a new patient.
00:14:11.360 | We're going to give you a new patient.
00:14:12.360 | We're going to give you a new patient.
00:14:13.360 | We're going to give you a new patient.
00:14:14.360 | We're going to give you a new patient.
00:14:15.360 | We're going to give you a new patient.
00:14:16.360 | We're going to give you a new patient.
00:14:17.360 | We're going to give you a new patient.
00:14:18.360 | We're going to give you a new patient.
00:14:19.360 | We're going to give you a new patient.
00:14:20.360 | We're going to give you a new patient.
00:14:21.360 | We're going to give you a new patient.
00:14:22.360 | We're going to give you a new patient.
00:14:23.360 | We're going to give you a new patient.
00:14:24.360 | We're going to give you a new patient.
00:14:25.360 | We're going to give you a new patient.
00:14:26.360 | We're going to give you a new patient.
00:14:27.360 | We're going to give you a new patient.
00:14:28.360 | We're going to give you a new patient.
00:14:29.360 | We're going to give you a new patient.
00:14:30.360 | We're going to give you a new patient.
00:14:31.360 | We're going to give you a new patient.
00:14:32.360 | We're going to give you a new patient.
00:14:33.360 | We're going to give you a new patient.
00:14:34.360 | We're going to give you a new patient.
00:14:35.360 | We're going to give you a new patient.
00:14:36.360 | We're going to give you a new patient.
00:14:37.360 | We're going to give you a new patient.
00:14:38.360 | We're going to give you a new patient.
00:14:39.360 | We're going to give you a new patient.
00:14:40.360 | We're going to give you a new patient.
00:14:41.360 | We're going to give you a new patient.
00:14:42.360 | We're going to give you a new patient.
00:14:43.360 | We're going to give you a new patient.
00:14:44.360 | We're going to give you a new patient.
00:14:45.360 | We're going to give you a new patient.
00:14:46.360 | We're going to give you a new patient.
00:14:47.360 | We're going to give you a new patient.
00:14:48.360 | We're going to give you a new patient.
00:14:49.360 | We're going to give you a new patient.
00:14:50.360 | We're going to give you a new patient.
00:14:51.360 | We're going to give you a new patient.
00:14:52.360 | We're going to give you a new patient.
00:14:53.360 | We're going to give you a new patient.
00:14:54.360 | We're going to give you a new patient.
00:14:55.360 | We're going to give you a new patient.
00:14:56.360 | We're going to give you a new patient.
00:14:57.360 | We're going to give you a new patient.
00:14:58.360 | We're going to give you a new patient.
00:14:59.360 | We're going to give you a new patient.
00:15:00.360 | We're going to give you a new patient.
00:15:01.360 | We're going to give you a new patient.
00:15:02.360 | We're going to give you a new patient.
00:15:03.360 | We're going to give you a new patient.
00:15:04.360 | We're going to give you a new patient.
00:15:05.360 | We're going to give you a new patient.
00:15:06.360 | We're going to give you a new patient.
00:15:07.360 | We're going to give you a new patient.
00:15:08.360 | We're going to give you a new patient.
00:15:09.360 | We're going to give you a new patient.
00:15:10.360 | We're going to give you a new patient.
00:15:11.360 | We're going to give you a new patient.
00:15:12.360 | We're going to give you a new patient.
00:15:13.360 | We're going to give you a new patient.
00:15:14.360 | We're going to give you a new patient.
00:15:15.360 | We're going to give you a new patient.
00:15:16.360 | We're going to give you a new patient.
00:15:17.360 | We're going to give you a new patient.
00:15:18.360 | We're going to give you a new patient.
00:15:19.360 | We're going to give you a new patient.
00:15:20.360 | We're going to give you a new patient.
00:15:21.360 | We're going to give you a new patient.
00:15:22.360 | We're going to give you a new patient.
00:15:23.360 | We're going to give you a new patient.
00:15:24.360 | We're going to give you a new patient.
00:15:25.360 | We're going to give you a new patient.
00:15:26.360 | We're going to give you a new patient.
00:15:27.360 | We're going to give you a new patient.
00:15:28.360 | We're going to give you a new patient.
00:15:29.360 | We're going to give you a new patient.
00:15:30.360 | We're going to give you a new patient.
00:15:31.360 | We're going to give you a new patient.
00:15:32.360 | We're going to give you a new patient.
00:15:33.360 | We're going to give you a new patient.
00:15:34.360 | We're going to give you a new patient.
00:15:35.360 | We're going to give you a new patient.
00:15:36.360 | We're going to give you a new patient.
00:15:37.360 | We're going to give you a new patient.
00:15:38.360 | We're going to give you a new patient.
00:15:39.360 | We're going to give you a new patient.
00:15:40.360 | We're going to give you a new patient.
00:15:41.360 | We're going to give you a new patient.
00:15:42.360 | We're going to give you a new patient.
00:15:43.360 | We're going to give you a new patient.
00:15:44.360 | We're going to give you a new patient.
00:15:45.360 | We're going to give you a new patient.
00:15:46.360 | We're going to give you a new patient.
00:15:47.360 | We're going to give you a new patient.
00:15:48.360 | We're going to give you a new patient.
00:15:49.360 | We're going to give you a new patient.
00:15:50.360 | We're going to give you a new patient.
00:15:51.360 | We're going to give you a new patient.
00:15:52.360 | We're going to give you a new patient.
00:15:53.360 | We're going to give you a new patient.
00:15:54.360 | We're going to give you a new patient.
00:15:55.360 | We're going to give you a new patient.
00:15:56.360 | We're going to give you a new patient.
00:15:57.360 | We're going to give you a new patient.
00:15:58.360 | We're going to give you a new patient.
00:15:59.360 | We're going to give you a new patient.
00:16:00.360 | We're going to give you a new patient.
00:16:01.360 | We're going to give you a new patient.
00:16:02.360 | We're going to give you a new patient.
00:16:03.360 | We're going to give you a new patient.
00:16:04.360 | We're going to give you a new patient.
00:16:05.360 | We're going to give you a new patient.
00:16:06.360 | We're going to give you a new patient.
00:16:07.360 | We're going to give you a new patient.
00:16:08.360 | We're going to give you a new patient.
00:16:09.360 | We're going to give you a new patient.
00:16:10.360 | We're going to give you a new patient.
00:16:11.360 | We're going to give you a new patient.
00:16:12.360 | We're going to give you a new patient.
00:16:13.360 | We're going to give you a new patient.
00:16:14.360 | We're going to give you a new patient.
00:16:15.360 | We're going to give you a new patient.
00:16:16.360 | We're going to give you a new patient.
00:16:17.360 | We're going to give you a new patient.
00:16:18.360 | We're going to give you a new patient.
00:16:19.360 | We're going to give you a new patient.
00:16:20.360 | We're going to give you a new patient.
00:16:21.360 | We're going to give you a new patient.
00:16:22.360 | We're going to give you a new patient.
00:16:23.360 | We're going to give you a new patient.
00:16:24.360 | We're going to give you a new patient.
00:16:25.360 | We're going to give you a new patient.
00:16:26.360 | We're going to give you a new patient.
00:16:27.360 | We're going to give you a new patient.
00:16:28.360 | We're going to give you a new patient.
00:16:29.360 | We're going to give you a new patient.
00:16:30.360 | We're going to give you a new patient.
00:16:31.360 | We're going to give you a new patient.
00:16:32.360 | We're going to give you a new patient.
00:16:33.360 | We're going to give you a new patient.
00:16:34.360 | We're going to give you a new patient.
00:16:35.360 | We're going to give you a new patient.
00:16:36.360 | We're going to give you a new patient.
00:16:37.360 | We're going to give you a new patient.
00:16:38.360 | We're going to give you a new patient.
00:16:39.360 | We're going to give you a new patient.
00:16:40.360 | We're going to give you a new patient.
00:16:41.360 | We're going to give you a new patient.
00:16:42.360 | We're going to give you a new patient.
00:16:43.360 | We're going to give you a new patient.
00:16:44.360 | We're going to give you a new patient.
00:16:45.360 | We're going to give you a new patient.
00:16:46.360 | We're going to give you a new patient.
00:16:47.360 | We're going to give you a new patient.
00:16:48.360 | We're going to give you a new patient.
00:16:49.360 | We're going to give you a new patient.
00:16:50.360 | We're going to give you a new patient.
00:16:51.360 | We're going to give you a new patient.
00:16:52.360 | We're going to give you a new patient.
00:16:53.360 | We're going to give you a new patient.
00:16:54.360 | We're going to give you a new patient.
00:16:55.360 | We're going to give you a new patient.
00:16:56.360 | We're going to give you a new patient.
00:16:57.360 | We're going to give you a new patient.
00:16:58.360 | We're going to give you a new patient.
00:16:59.360 | We're going to give you a new patient.
00:17:00.360 | We're going to give you a new patient.
00:17:01.360 | We're going to give you a new patient.
00:17:02.360 | We're going to give you a new patient.
00:17:03.360 | We're going to give you a new patient.
00:17:04.360 | We're going to give you a new patient.
00:17:05.360 | We're going to give you a new patient.
00:17:06.360 | We're going to give you a new patient.
00:17:07.360 | We're going to give you a new patient.
00:17:08.360 | We're going to give you a new patient.
00:17:09.360 | We're going to give you a new patient.
00:17:10.360 | We're going to give you a new patient.
00:17:11.360 | We're going to give you a new patient.
00:17:12.360 | We're going to give you a new patient.
00:17:13.360 | We're going to give you a new patient.
00:17:14.360 | We're going to give you a new patient.
00:17:15.360 | We're going to give you a new patient.
00:17:16.360 | We're going to give you a new patient.
00:17:17.360 | We're going to give you a new patient.
00:17:18.360 | We're going to give you a new patient.
00:17:19.360 | We're going to give you a new patient.
00:17:20.360 | We're going to give you a new patient.
00:17:21.360 | We're going to give you a new patient.
00:17:22.360 | We're going to give you a new patient.
00:17:23.360 | We're going to give you a new patient.
00:17:24.360 | We're going to give you a new patient.
00:17:25.360 | We're going to give you a new patient.
00:17:26.360 | We're going to give you a new patient.
00:17:27.360 | We're going to give you a new patient.
00:17:28.360 | We're going to give you a new patient.
00:17:29.360 | We're going to give you a new patient.
00:17:30.360 | We're going to give you a new patient.
00:17:31.360 | We're going to give you a new patient.
00:17:32.360 | We're going to give you a new patient.
00:17:33.360 | We're going to give you a new patient.
00:17:34.360 | We're going to give you a new patient.
00:17:35.360 | We're going to give you a new patient.
00:17:36.360 | We're going to give you a new patient.
00:17:37.360 | We're going to give you a new patient.
00:17:38.360 | We're going to give you a new patient.
00:17:39.360 | We're going to give you a new patient.
00:17:40.360 | We're going to give you a new patient.
00:17:41.360 | We're going to give you a new patient.
00:17:42.360 | We're going to give you a new patient.
00:17:43.360 | We're going to give you a new patient.
00:17:44.360 | We're going to give you a new patient.
00:17:45.360 | We're going to give you a new patient.
00:17:46.360 | We're going to give you a new patient.
00:17:47.360 | We're going to give you a new patient.
00:17:48.360 | We're going to give you a new patient.
00:17:49.360 | We're going to give you a new patient.
00:17:50.360 | We're going to give you a new patient.
00:17:51.360 | We're going to give you a new patient.
00:17:52.360 | We're going to give you a new patient.
00:17:53.360 | We're going to give you a new patient.
00:17:54.360 | We're going to give you a new patient.
00:17:55.360 | We're going to give you a new patient.
00:17:56.360 | We're going to give you a new patient.
00:17:57.360 | We're going to give you a new patient.
00:17:58.360 | We're going to give you a new patient.
00:17:59.360 | We're going to give you a new patient.
00:18:00.360 | We're going to give you a new patient.
00:18:01.360 | We're going to give you a new patient.
00:18:02.360 | We're going to give you a new patient.
00:18:03.360 | We're going to give you a new patient.
00:18:04.360 | We're going to give you a new patient.
00:18:05.360 | We're going to give you a new patient.
00:18:06.360 | We're going to give you a new patient.
00:18:07.360 | We're going to give you a new patient.
00:18:08.360 | We're going to give you a new patient.
00:18:09.360 | We're going to give you a new patient.
00:18:10.360 | We're going to give you a new patient.
00:18:11.360 | We're going to give you a new patient.
00:18:12.360 | We're going to give you a new patient.
00:18:13.360 | We're going to give you a new patient.
00:18:14.360 | We're going to give you a new patient.
00:18:15.360 | We're going to give you a new patient.
00:18:16.360 | We're going to give you a new patient.
00:18:17.360 | We're going to give you a new patient.
00:18:18.360 | We're going to give you a new patient.
00:18:19.360 | We're going to give you a new patient.
00:18:20.360 | We're going to give you a new patient.
00:18:21.360 | We're going to give you a new patient.
00:18:22.360 | We're going to give you a new patient.
00:18:23.360 | We're going to give you a new patient.
00:18:24.360 | We're going to give you a new patient.
00:18:25.360 | We're going to give you a new patient.
00:18:26.360 | We're going to give you a new patient.
00:18:27.360 | We're going to give you a new patient.
00:18:28.360 | We're going to give you a new patient.
00:18:29.360 | We're going to give you a new patient.
00:18:30.360 | We're going to give you a new patient.
00:18:31.360 | We're going to give you a new patient.
00:18:32.360 | We're going to give you a new patient.
00:18:33.360 | We're going to give you a new patient.
00:18:34.360 | We're going to give you a new patient.
00:18:35.360 | We're going to give you a new patient.
00:18:36.360 | We're going to give you a new patient.
00:18:37.360 | We're going to give you a new patient.
00:18:38.360 | We're going to give you a new patient.
00:18:39.360 | We're going to give you a new patient.
00:18:40.360 | We're going to give you a new patient.
00:18:41.360 | We're going to give you a new patient.
00:18:42.360 | We're going to give you a new patient.
00:18:43.360 | We're going to give you a new patient.
00:18:44.360 | We're going to give you a new patient.
00:18:45.360 | We're going to give you a new patient.
00:18:46.360 | We're going to give you a new patient.
00:18:47.360 | We're going to give you a new patient.
00:18:48.360 | We're going to give you a new patient.
00:18:49.360 | We're going to give you a new patient.
00:18:50.360 | We're going to give you a new patient.
00:18:51.360 | We're going to give you a new patient.
00:18:52.360 | We're going to give you a new patient.
00:18:53.360 | We're going to give you a new patient.
00:18:54.360 | We're going to give you a new patient.
00:18:55.360 | We're going to give you a new patient.
00:18:56.360 | We're going to give you a new patient.
00:18:57.360 | We're going to give you a new patient.
00:18:58.360 | We're going to give you a new patient.
00:18:59.360 | We're going to give you a new patient.
00:19:00.360 | We're going to give you a new patient.
00:19:01.360 | We're going to give you a new patient.
00:19:02.360 | We're going to give you a new patient.
00:19:03.360 | We're going to give you a new patient.
00:19:04.360 | We're going to give you a new patient.
00:19:05.360 | We're going to give you a new patient.
00:19:06.360 | We're going to give you a new patient.
00:19:07.360 | We're going to give you a new patient.
00:19:08.360 | We're going to give you a new patient.
00:19:09.360 | We're going to give you a new patient.
00:19:10.360 | We're going to give you a new patient.
00:19:11.360 | We're going to give you a new patient.
00:19:12.360 | We're going to give you a new patient.
00:19:13.360 | We're going to give you a new patient.
00:19:14.360 | We're going to give you a new patient.
00:19:15.360 | We're going to give you a new patient.
00:19:16.360 | We're going to give you a new patient.
00:19:17.360 | We're going to give you a new patient.
00:19:18.360 | We're going to give you a new patient.
00:19:19.360 | We're going to give you a new patient.
00:19:20.360 | We're going to give you a new patient.
00:19:21.360 | We're going to give you a new patient.
00:19:22.360 | We're going to give you a new patient.
00:19:23.360 | We're going to give you a new patient.
00:19:24.360 | We're going to give you a new patient.
00:19:25.360 | We're going to give you a new patient.
00:19:26.360 | We're going to give you a new patient.
00:19:27.360 | We're going to give you a new patient.
00:19:28.360 | We're going to give you a new patient.
00:19:29.360 | We're going to give you a new patient.
00:19:30.360 | We're going to give you a new patient.
00:19:31.360 | We're going to give you a new patient.
00:19:32.360 | We're going to give you a new patient.
00:19:33.360 | We're going to give you a new patient.
00:19:34.360 | We're going to give you a new patient.
00:19:35.360 | We're going to give you a new patient.
00:19:36.360 | We're going to give you a new patient.
00:19:37.360 | We're going to give you a new patient.
00:19:38.360 | We're going to give you a new patient.
00:19:39.360 | We're going to give you a new patient.
00:19:40.360 | We're going to give you a new patient.
00:19:41.360 | We're going to give you a new patient.
00:19:42.360 | We're going to give you a new patient.
00:19:43.360 | We're going to give you a new patient.
00:19:44.360 | We're going to give you a new patient.
00:19:45.360 | We're going to give you a new patient.
00:19:46.360 | We're going to give you a new patient.
00:19:47.360 | We're going to give you a new patient.
00:19:48.360 | We're going to give you a new patient.
00:19:49.360 | We're going to give you a new patient.
00:19:50.360 | We're going to give you a new patient.
00:19:51.360 | We're going to give you a new patient.
00:19:52.360 | We're going to give you a new patient.
00:19:53.360 | We're going to give you a new patient.
00:19:54.360 | We're going to give you a new patient.
00:19:55.360 | We're going to give you a new patient.
00:19:56.360 | We're going to give you a new patient.
00:19:57.360 | We're going to give you a new patient.
00:19:58.360 | We're going to give you a new patient.
00:19:59.360 | We're going to give you a new patient.
00:20:00.360 | We're going to give you a new patient.
00:20:01.360 | We're going to give you a new patient.
00:20:02.360 | We're going to give you a new patient.
00:20:03.360 | We're going to give you a new patient.
00:20:04.360 | We're going to give you a new patient.
00:20:05.360 | We're going to give you a new patient.
00:20:06.360 | We're going to give you a new patient.
00:20:07.360 | We're going to give you a new patient.
00:20:08.360 | We're going to give you a new patient.
00:20:09.360 | We're going to give you a new patient.
00:20:10.360 | We're going to give you a new patient.
00:20:11.360 | We're going to give you a new patient.
00:20:12.360 | We're going to give you a new patient.
00:20:13.360 | We're going to give you a new patient.
00:20:14.360 | We're going to give you a new patient.
00:20:15.360 | We're going to give you a new patient.
00:20:16.360 | We're going to give you a new patient.
00:20:17.360 | We're going to give you a new patient.
00:20:18.360 | We're going to give you a new patient.
00:20:19.360 | We're going to give you a new patient.
00:20:20.360 | We're going to give you a new patient.
00:20:21.360 | We're going to give you a new patient.
00:20:22.360 | We're going to give you a new patient.
00:20:23.360 | We're going to give you a new patient.
00:20:24.360 | We're going to give you a new patient.
00:20:25.360 | We're going to give you a new patient.
00:20:26.360 | We're going to give you a new patient.
00:20:27.360 | We're going to give you a new patient.
00:20:28.360 | We're going to give you a new patient.
00:20:29.360 | We're going to give you a new patient.
00:20:30.360 | We're going to give you a new patient.
00:20:31.360 | We're going to give you a new patient.
00:20:32.360 | We're going to give you a new patient.
00:20:33.360 | We're going to give you a new patient.
00:20:34.360 | We're going to give you a new patient.
00:20:35.360 | We're going to give you a new patient.
00:20:36.360 | We're going to give you a new patient.
00:20:37.360 | We're going to give you a new patient.
00:20:38.360 | We're going to give you a new patient.
00:20:39.360 | We're going to give you a new patient.
00:20:40.360 | We're going to give you a new patient.
00:20:41.360 | We're going to give you a new patient.
00:20:42.360 | We're going to give you a new patient.
00:20:43.360 | We're going to give you a new patient.
00:20:44.360 | We're going to give you a new patient.
00:20:45.360 | We're going to give you a new patient.
00:20:46.360 | We're going to give you a new patient.
00:20:47.360 | We're going to give you a new patient.
00:20:48.360 | We're going to give you a new patient.
00:20:49.360 | We're going to give you a new patient.
00:20:50.360 | We're going to give you a new patient.
00:20:51.360 | We're going to give you a new patient.
00:20:52.360 | We're going to give you a new patient.
00:20:53.360 | We're going to give you a new patient.
00:20:54.360 | We're going to give you a new patient.
00:20:55.360 | We're going to give you a new patient.
00:20:56.360 | We're going to give you a new patient.
00:20:57.360 | We're going to give you a new patient.
00:20:58.360 | We're going to give you a new patient.
00:20:59.360 | We're going to give you a new patient.
00:21:00.360 | We're going to give you a new patient.
00:21:01.360 | We're going to give you a new patient.
00:21:02.360 | We're going to give you a new patient.
00:21:03.360 | We're going to give you a new patient.
00:21:04.360 | We're going to give you a new patient.
00:21:05.360 | We're going to give you a new patient.
00:21:06.360 | We're going to give you a new patient.
00:21:07.360 | We're going to give you a new patient.
00:21:08.360 | We're going to give you a new patient.
00:21:09.360 | We're going to give you a new patient.
00:21:10.360 | We're going to give you a new patient.
00:21:11.360 | We're going to give you a new patient.
00:21:12.360 | We're going to give you a new patient.
00:21:13.360 | We're going to give you a new patient.
00:21:14.360 | We're going to give you a new patient.
00:21:15.360 | We're going to give you a new patient.
00:21:16.360 | We're going to give you a new patient.
00:21:17.360 | We're going to give you a new patient.
00:21:18.360 | We're going to give you a new patient.
00:21:19.360 | We're going to give you a new patient.
00:21:20.360 | We're going to give you a new patient.
00:21:21.360 | We're going to give you a new patient.
00:21:22.360 | We're going to give you a new patient.
00:21:23.360 | We're going to give you a new patient.
00:21:24.360 | We're going to give you a new patient.
00:21:25.360 | We're going to give you a new patient.
00:21:26.360 | We're going to give you a new patient.
00:21:27.360 | We're going to give you a new patient.
00:21:28.360 | We're going to give you a new patient.
00:21:29.360 | We're going to give you a new patient.
00:21:30.360 | We're going to give you a new patient.
00:21:31.360 | We're going to give you a new patient.
00:21:32.360 | We're going to give you a new patient.
00:21:33.360 | We're going to give you a new patient.
00:21:34.360 | We're going to give you a new patient.
00:21:35.360 | We're going to give you a new patient.
00:21:36.360 | We're going to give you a new patient.
00:21:37.360 | We're going to give you a new patient.
00:21:38.360 | We're going to give you a new patient.
00:21:39.360 | We're going to give you a new patient.
00:21:40.360 | We're going to give you a new patient.
00:21:41.360 | We're going to give you a new patient.
00:21:42.360 | We're going to give you a new patient.
00:21:43.360 | We're going to give you a new patient.
00:21:44.360 | We're going to give you a new patient.
00:21:45.360 | We're going to give you a new patient.
00:21:46.360 | We're going to give you a new patient.
00:21:47.360 | We're going to give you a new patient.
00:21:48.360 | We're going to give you a new patient.
00:21:49.360 | We're going to give you a new patient.
00:21:50.360 | We're going to give you a new patient.
00:21:51.360 | We're going to give you a new patient.
00:21:52.360 | We're going to give you a new patient.
00:21:53.360 | We're going to give you a new patient.
00:21:54.360 | We're going to give you a new patient.
00:21:55.360 | We're going to give you a new patient.
00:21:56.360 | We're going to give you a new patient.
00:21:57.360 | We're going to give you a new patient.
00:21:58.360 | We're going to give you a new patient.
00:21:59.360 | We're going to give you a new patient.
00:22:00.360 | We're going to give you a new patient.
00:22:01.360 | We're going to give you a new patient.
00:22:02.360 | We're going to give you a new patient.
00:22:03.360 | We're going to give you a new patient.
00:22:04.360 | We're going to give you a new patient.
00:22:05.360 | We're going to give you a new patient.
00:22:06.360 | We're going to give you a new patient.
00:22:07.360 | We're going to give you a new patient.
00:22:08.360 | We're going to give you a new patient.
00:22:09.360 | We're going to give you a new patient.
00:22:10.360 | We're going to give you a new patient.
00:22:11.360 | We're going to give you a new patient.
00:22:12.360 | We're going to give you a new patient.
00:22:13.360 | We're going to give you a new patient.
00:22:14.360 | We're going to give you a new patient.
00:22:15.360 | We're going to give you a new patient.
00:22:16.360 | We're going to give you a new patient.
00:22:17.360 | We're going to give you a new patient.
00:22:18.360 | We're going to give you a new patient.
00:22:19.360 | We're going to give you a new patient.
00:22:20.360 | We're going to give you a new patient.
00:22:21.360 | We're going to give you a new patient.
00:22:22.360 | We're going to give you a new patient.
00:22:23.360 | We're going to give you a new patient.
00:22:24.360 | We're going to give you a new patient.
00:22:25.360 | We're going to give you a new patient.
00:22:26.360 | We're going to give you a new patient.
00:22:27.360 | We're going to give you a new patient.
00:22:28.360 | We're going to give you a new patient.
00:22:29.360 | We're going to give you a new patient.
00:22:30.360 | We're going to give you a new patient.
00:22:31.360 | We're going to give you a new patient.
00:22:32.360 | We're going to give you a new patient.
00:22:33.360 | We're going to give you a new patient.
00:22:34.360 | We're going to give you a new patient.
00:22:35.360 | We're going to give you a new patient.
00:22:36.360 | We're going to give you a new patient.
00:22:37.360 | We're going to give you a new patient.
00:22:38.360 | We're going to give you a new patient.
00:22:39.360 | We're going to give you a new patient.
00:22:40.360 | We're going to give you a new patient.
00:22:41.360 | We're going to give you a new patient.
00:22:42.360 | We're going to give you a new patient.
00:22:43.360 | We're going to give you a new patient.
00:22:44.360 | We're going to give you a new patient.
00:22:45.360 | We're going to give you a new patient.
00:22:46.360 | We're going to give you a new patient.
00:22:47.360 | We're going to give you a new patient.
00:22:48.360 | We're going to give you a new patient.
00:22:49.360 | We're going to give you a new patient.
00:22:50.360 | We're going to give you a new patient.
00:22:51.360 | We're going to give you a new patient.
00:22:52.360 | We're going to give you a new patient.
00:22:53.360 | We're going to give you a new patient.
00:22:54.360 | We're going to give you a new patient.
00:22:55.360 | We're going to give you a new patient.
00:22:56.360 | We're going to give you a new patient.
00:22:57.360 | We're going to give you a new patient.
00:22:58.360 | We're going to give you a new patient.
00:22:59.360 | We're going to give you a new patient.
00:23:00.360 | We're going to give you a new patient.
00:23:01.360 | We're going to give you a new patient.
00:23:02.360 | We're going to give you a new patient.
00:23:03.360 | We're going to give you a new patient.
00:23:04.360 | We're going to give you a new patient.
00:23:05.360 | We're going to give you a new patient.
00:23:06.360 | We're going to give you a new patient.
00:23:07.360 | We're going to give you a new patient.
00:23:08.360 | We're going to give you a new patient.
00:23:09.360 | We're going to give you a new patient.
00:23:10.360 | We're going to give you a new patient.
00:23:11.360 | We're going to give you a new patient.
00:23:12.360 | We're going to give you a new patient.
00:23:13.360 | We're going to give you a new patient.
00:23:14.360 | We're going to give you a new patient.
00:23:15.360 | We're going to give you a new patient.
00:23:16.360 | We're going to give you a new patient.
00:23:17.360 | We're going to give you a new patient.
00:23:18.360 | We're going to give you a new patient.
00:23:19.360 | We're going to give you a new patient.
00:23:20.360 | We're going to give you a new patient.
00:23:21.360 | We're going to give you a new patient.
00:23:22.360 | We're going to give you a new patient.
00:23:23.360 | We're going to give you a new patient.
00:23:24.360 | That's the most important thing.