Welcome And Guest Introduction

Dr Andrew Greenland 0:00

So, welcome to another episode of Voices in Health and Wellness, where we have honest conversations with clinicians, founders, and innovators who are challenging conventional health care and building new models of care. Today I'm joined by Dr. Ryan Gannon, a family physician, co-founder of Blue Ocean Health, and a strong advocate for direct primary care. Ryan has spent the last several years building a practice outside the traditional insurance system, creating a model that allows for deeper patient relationships, greater physician autonomy, and a stronger focus on prevention and lifestyle medicine. Alongside his clinical work, Ryan is passionate about nutrition, strength training, and helping people take greater ownership of their health. Ryan, welcome to the show. Thank you so much for joining us today.

Dr Ryan Gannon 0:39

Thank you. Appreciate you having me

From Sport To Family Medicine

Dr Ryan Gannon 0:42

on.

Dr Andrew Greenland 0:42

So if we could maybe start at the beginning, um, a bit about your journey, really. So what attracted you into medicine in the first place and why did you choose family medicine?

Dr Ryan Gannon 0:52

Yeah, geez, so I'm I'm definitely not someone who knew that medicine was going to be my path at a young age. Um initially, I think it started because I had a very heavy interest in nutrition and exercise from a young age. Most of my background and uh when I was younger revolved around soccer. So anything that could give me an edge and you know make me a little better, a little quicker, a little stronger was uh that was my thing. And then I ended up you know playing throughout college a little after college, and in college, I met a professor and um became very fond and interested in genetics. So I ended up doing a good amount of research there, and I think that's where my interest in the the hard sciences really took off. Um after that, my path, the the question was really do I pursue something you know towards a graduate degree, maybe a PhD within biology or genetics itself. But I realized I really missed the the people component. Um, and I wanted something that combined that as well as the sciences, and medicine looked like it could be a good fit. So after that, I went as far as I could with soccer and then ultimately decided to you know pursue a path in medicine. Um family medicine itself is in you know, it initially I was actually very much interested in psychiatry, and I'm very fascinated both with uh psychology and you know holding deep conversations and really getting to know people uh on a much deeper level. But I think um uh the well, the other aspect as well is in terms of independence and autonomy, I I kind of I wanted to hang my own uh shingle. And in my mind, psychiatry was kind of the last or one of the few remaining fields of medicine that you could do that. Um in medical school, I met my current now business partner, Dr. Cavalak, and he ended up finding a group of docs who practice uh direct primary care, and we ended up getting introduced to a whole bunch of docs doing this throughout throughout the U.S., a bit more, uh we're currently in Pennsylvania, but a bit more, a bit more south and west. And it was when I got to know them that it that really you know further encouraged me to look into to family medicine. So it was sort of this combination of um the people component, really, to you know, getting to know people on a uh much deeper level, the model of care, um, and the ability to do my own thing. So I think it was kind of these three three things that really push me towards this uh specific model and field in medicine. Thank you.

What Direct Primary Care Means

Dr Andrew Greenland 3:42

Um for those that are the uninitiated, could you explain a little bit about what direct primary care actually is? I mean, it's something which is a bit of an alien concept in the UK, but it should be really helpful if you can give us a sense of what it actually is, what the model is.

Dr Ryan Gannon 3:54

Yeah, yeah, absolutely. Um, you know, at its most basic level, it's a uh membership model in which patients um there's variations in themes, but for us specifically, our patients pay us a low affordable monthly membership that gets us access to a primary care doc. And what that looks like is you know, we're frequently in contact with our patients through uh texts, emails, calls, video visits, and the membership itself covers any in-office visits as well. The reason for it is it allows us as the docs to have much more time with patients. Um, so in the US, currently the average physician appointment is you know, roughly, depending on what you look at, six to fifteen minutes. That's probably being generous. Um, um, you know, for our patients, we spend our shortest appointment um is typically around half an hour. You know, we'll take up to that as needed. When we get to initially uh meet someone and do a medical intake for that first visit, we'll spend up to an hour, sometimes longer. But it really brings in the convenience aspect. Um, it's sort of crazy in my mind that when you look at, you know, in 2026, all businesses generally have moved towards faster, better services. Medicine itself is a service, and it's a little archaic in you know traditional systems that patients are still stuck waiting for appointments for hours on end. If they ever have a question about a lab result, they can't get a hold of their doctor. Um, so the model is meant to really address the access component uh to a primary care doc.

Dr Andrew Greenland 5:33

Thank you for Claire. I find that's really helpful. So, at what point did you realize that the traditional insurance-based model wasn't really the way that you wanted to carry on? Or was it just the fact that you bumped into somebody who you know had better ideas? I just want to get the kind of sense of that decision point.

Dr Ryan Gannon 5:48

In my training during during residency, I think we all, you know, um as you know, from a child, and as you get older, you get the experience of an outpatient practice in general, and it kind of becomes the norm and the expectation. And then both, you know, personally having some family friends who worked as docs and I shadowed them, I got a little bit better of a feel before medical school. And then it wasn't until residency during my training that I felt more of the behind-the-scenes pressures that doctors face and what they go through that you don't necessarily see from the patient side. I I knew just based on myself and personality that if I, you know, were likely to have to practice in a typical outpatient setup, I would have lasted, you know, probably a week, and then I I just couldn't do it long term. Thank

Blue Ocean Health In Practice

Dr Ryan Gannon 6:43

you.

Dr Andrew Greenland 6:43

So tell us a little bit about Blue Ocean Health today. What does it actually look like as a practice after three and a half years? Just give us a sense of you know the operation, as it were.

Dr Ryan Gannon 6:53

Yeah, so we were going on actually um this past July was our fourth year anniversary. Um it's it's been a both fun and interesting journey. You learn a lot about business in general. I mean, by you know, if you're a doc opening this type of practice up, you you might as well have gotten your degree in a small business. Um, but we're up to near nearly 400 plus patients at this point. We still do, you know, as we're we're growing, we still do some uh various jobs on the outside to make the practice work. Um and I would say I'm I you know we previously talked about direct primary care, what that looks like. To expand a little bit about that. Um currently, when I last checked, I think there's at least 2,500, maybe getting close to 3,000 practices like us in the country. So we're starting to see the expansion of primary care within the U.S., I think diverge a little more between traditional outpatient medicine, direct primary care, and then towards the the other extreme, more of a concierge type of level. I think we'll continue to see things split like that. And then the other aspect is um employer, employer-based plans as employers are looking to cut down on insurance costs. Um so with the direct, you know, direct primary care, an interesting aspect is they all tend to have like a unique flavor to them or style, you can say. Um, it depends on the you know, the physician running it, their particular interest. Maybe they have some additional training. So some docs may focus more on specific demographics or populations or or conditions. Um, we're starting to see more specialists, whether it's cardiologists or OBGYN docs, open up similar style practices. I would say for us specifically, we do all the regular, you know, bread and butter family medicine um conditions. I would say where we take a really heavy focus is on lifestyle and preventative medicine, both because, you know, with my background, um, I have a really large interest in patients' habits as a whole. Um, that's something that number one, you never rarely discuss in medical school, but largely makes up the life of someone, their eating habits, their nutrition, their sleep, their understanding of their medical condition, you know, what things should or should not be done with medicine. There's so much that surrounds just a medical visit that that goes into it that you never get to focus about. But that's largely my interest. So for my patients who are interested, which is probably a majority, um, we really heavily review those things on the initial visit, and then periodically throughout the the course of the year we're in contact, you know, in addition to doing, you know, checking all the boxes from a primary care perspective.

Dr Andrew Greenland 9:56

Thank you. And what does the patient membership look like from a patient perspective? I mean, I think you've alluded to some of the things around sort of consultation lengths and everything, but if you look at the whole package, what does it look like on paper for a patient?

Dr Ryan Gannon 10:09

Like what does it consist of or a little bit of all the above? So when you um most direct primary care practices fall within very similar price ranges for us specifically, from zero to 18. Um, so from a newborn just born up to 18 years old is $50 per month. And then we do from 19 to 63 years old is 75 per month, and 64 years old and over is 100 per month. And the way you could think about it is it covers all means of access to us. So, like I mentioned before, all aspects of communication, whether that's phone calls, texts, emails, or video visits, and then the in-office visits. So we don't have an additional per office visit fee or anything like that. So we largely structure it around what a patient needs. Typically, that consists of the initial visit when we're really um diving deep and getting to know someone, so up to an hour of consultation, depending on the person. Sometimes they have something acute going on that we need to address a bit quickly. I'm seeing them within the week or at a minimum, we're touching base by you know, text or a call. Um I have some patients who choose to utilize us purely because of the responsiveness. So maybe someone who is um a higher level, you know, someone within the corporate world or a CEO who is very busy and they need someone who can respond by text or email depending on if they're traveling and how to coordinate things like lab work, etc. Um, so it's it's highly it's it's very much individualized to the per the person, um, you know, their conditions that we're working on or you know, preferences, depending on what that looks like.

How Membership Changes Care

Dr Andrew Greenland 12:00

Thank you. It's really helpful. Trying to build an understanding of how this all works. So, how does the um physician-patient relationship change when you take insurance out of the equation? And so you've been doing this for a number of years now. I just wonder if it kind of changes the frame with the patients themselves.

Dr Ryan Gannon 12:15

Oh my goodness, yeah, in so many ways. I think um a good example is when we started, so you know, four years ago in this past July, we had a handful of patients who followed us from our our training. So we started maybe with a you know group of five to ten patients. And I had previously, you know, taken care of a handful of these individuals who who chose to continue their care with us. And I thought I knew them really well on paper. And then within the following weeks of when we started our direct primary care practice, um, I realized I didn't know them really at all. So the ability to actually sit down with someone and just have a conversation for an extended, uninterrupted period of time, um it really changes the dynamic of your ability to get to know someone and then also the level at which you can deliver medical care. And I'll use like maybe a good example would be anxiety, right? So we all know, you know, if you're you know PCP, we all have um the various medical conditions, we can kind of run through this algorithm, we can plug in some numbers in a calculator, we can administer forms and we can be evidence-based. But for me to sit down with someone, and if I have six to 15 minutes for someone who has anxiety, I have no idea of what's going on in their background life, their stressors, their sleep, their coping skills in general, what does their diet recently look like? Um, do they have other medical conditions? What's their understanding of anxiety as a whole? So you can have someone who um medical therapy is absolutely indicated for someone with anxiety versus someone else who really just needs a therapeutic relationship and to sit down and have a conversation with someone for 30 minutes, and then they're otherwise good. They don't, you know, they don't need um a medical therapy. They that's someone who would do very well with therapy. That that's just one you know example that comes to mind, but it just it provides much more options because of your ability to longitudinally get to know someone over time. Got it.

Dr Andrew Greenland 14:38

I'm building this picture in my head of how it all works. I'm guessing the business model is absolutely key to get right. I mean, from you you've been doing this for a number of years now. So you must have a sense of the the number of people that you need to have in the practice, the kind of the number of staff, how to make the membership work so that it actually covers everything that you do. How do you get that right? It must be a very, very difficult juggling act.

Dr Ryan Gannon 15:01

Um it's I I think it's as complicated as you want to make it. I mean, on one level, you know, you pull out the calculator and you calculate um what would a reasonable comparable you know income or how profitable do you want to be, and then how many patients realistically can you safely or do you want to take care of? So I would say most people um I I think I know myself very well that when I look towards the end of what I want things to look like, if you start with that and then work backwards, you can design what and at least gear things towards building that, right? So a general a general PCP in the US roughly carries, depending on what you look at, anywhere from a minimum of one to two thousand patients up to four or five thousand patients. Um, an average DPC doc, depending on how they set it up, can carry. I've seen parts part-time you know DPC docs have a hundred to a hundred and fifty patients. I've seen established you know DPC providers who carry eight to nine hundred or a thousand patients each. Um, that may be someone who's been operating a practice for 10 or 15 years and really knows those patients well. So I think it uh it when you start with that end structure in mind, and then a business is business, you always have to make the math work. Um, it's less complicated than you would think. And we have a lot of docs or you know, residents in training who reach out and say, How do you do this? And my response is you made it to medical school and residency. Um, you know, you could you could figure it out, the resources are out there. And we're very fortunate in that this has been in place for minimum 15 years by now. So a lot of the docs who have been doing this for a very long time have created uh very useful resources that it's a matter of creating your list, checking the boxes off, you know, forming your LLC, um, you know, making sure what do you want your location to look like? Do you have the structure in place? You check that box, um, making sure you got your patient contracts, everything HIPAA compliant. So we're fortunate in that us when we started all that, you know, all that was in place. But I would say from a business perspective, um, you know, your rent is your largest overhead, making sure you have that covered. And um the beauty is is you don't have to figure it all out at once. I think a lot of you know what business comes down to is not having the fear, just starting, and then you figure those aspects out along the way.

Growth Challenges And Public Awareness

Dr Andrew Greenland 17:47

And obviously you have been building this for a number of years, but what has been the biggest challenge in building the practice, maybe clinically, but also the the business aspects as well? What have you been the key things that have um kept you up at night along the way and things that still keep you up at night?

Dr Ryan Gannon 18:03

The biggest thing by far in our area is just awareness. So um we're in uh you know, in Pennsylvania, what uh which I would say roughly the northeastern US is densely the most medically um from a population perspective. Like the options that patients have are numerous around here. We have very large health systems in place that patients automatically recognize um, you know, the name, they have a specific history that comes to mind. Um, so our our challenge is is education from like a marketing and advertising perspective and and explaining the the benefits of the model. You know, a lot of times we get asked, well, if I have insurance, why would I go this particular route or you know, variations along that theme. If you know, if you go a bit more west or south within the US, it's been established enough that patients, you know, generally already know what they're signing up for, so it's easier from that perspective. Um, I would say that's been our biggest hurdle that we've had to overcome in the years, and then you know, still continues to be the biggest hurdle, is you can never, as a small business, have enough people know who you are. Um, and then outside of that, I would say it's probably all the things that generally come with business. Um, you know, there's never there's never a guarantee. Um patients unfortunately can come and go. We're fortunate that we have a very high retention rate, but um patients move or you know, things happen, financial situations change. Um, so you know, just always making sure that the the numbers work and make sense. But my view is there's no guarantees either way. There's a lot of docs who they go to work for a hospital system, and that hospital system is taken over or goes under, similar in the outpatient practice. So it's a matter of what you're comfortable with, you know, the the risk from either perspective. Thank you.

Dr Andrew Greenland 20:07

So I mean you said it's it's obviously growing and there's uh popularity here. I think you said two or three thousand practices in the country. So there's obviously a need for this, and there's a appetite for this. Where do you see it fitting into the future of American health care?

Dr Ryan Gannon 20:23

I can't predict the future, but I'm I'm hopeful that it'll be one of the main, if not main ways that primary care is practiced. Um I'm very much for options, so I want patients to have as many options as are available. So if someone chooses or wants to purely go through an insurance model, then they can have that ability. Um, I want options between DPC practices. I think you know, the saying that a rising tide raises all ships, I think competition is healthy and brings out the best in within DPC practices, but also within the medical system. So I think if if a patient has the option to choose a primary care doc, apart from just geographically, but someone who they believe that they could connect with on a much better level or you know for a different reason, then I'm I'm all for that.

Dr Andrew Greenland 21:20

Thank you.

Lifestyle Medicine And Strength Training

Dr Andrew Greenland 21:21

Um lifestyle medicine, where did your interest first come from? And um also how did your athletic background shape your perspective on health? Because obviously there's a lifestyle aspect to that as well. So I'm just curious.

Dr Ryan Gannon 21:33

Yeah, like like I mentioned before, I think that's my main that that's my main interest. So it all um started from you know soccer at a at a young age, and I I uh from very early on I would try all sorts of various you know diets and nutrition styles to see if that would help me. I um got into weight training at a at a very young age and to see if I improved my strength or or strength. Could I get an advantage over any any competition? I would say my biggest shift has been as I've grown older, I don't play soccer anymore, but powerlifting has become my thing. So for those who don't know what that is, it's three, it's basically a competition with three main lifts the squat, bench press, and deadlift. So you basically train to become as strong as you can, you know, within a given weight class for those exercises. And it's um both personally really fun for me because I love seeing the income incremental progress that you can get over time. And the other reason that it's really fun too is because for patients who are interested, I can incorporate my knowledge from a new training, um, from a nutrition and a training perspective in you know into their lifestyle. I would I think there's a few things that make me as happy as seeing um, you know, our elderly population or older patients that we care for, and especially um women, whether they're young or older, being in the gym trying to build their strength. Um I think we've come a you know a pretty long way in society to overcome a lot of the stigma that kind of has surrounded uh weightlifting in general. And as the science and the education is put more and more out there, I'm very hopeful that that encompasses a large aspect of primary care. Um, but a lot of that depends on the doc. A lot of docs you know purely want to practice medicine, and that's understandable. But I would hope that they at least have the knowledge of if they have a patient who's interested, they would know who to refer to in their community for you know a patient that that would benefit.

Habit Logs And Realistic Change

Dr Andrew Greenland 23:50

Thank you. And and practically speaking, how are you incorporating these principles into patient care, particularly what you were just saying about the powerlifting? What does it look like to a patient in that kind of consultation?

Dr Ryan Gannon 24:00

So it depends. I mean, as you know, as part of my intake and I'm getting to know someone, very often um, you know, one of the first things we'll do is I'll have a patient record a week of I I basically call them our logs. So a week of their nutrition, they they would not change anything. Um so I want to see exactly it is what they're doing at this current point in their life. So they're writing down to the best of their ability what does their new nutrition and fluid intake consist of. If they are exercising, what does that consistently look like on a weekly basis? Um, the other big one I do as well is sleep. So I created my own very uh in-depth, detailed sleep questionnaire, both to screen for sleep apnea, narcolepsy, and other common conditions, but also just to get an idea of if I have this person, this patient in front of me from a habit perspective, where do they sit? How does this relate to um conditions that we know that they have, what are they at risk for, and how do we improve their health as a whole? Um and it's good in the sense that sometimes I have patients come to me and they'll say, you know, doc, um, I don't care what it is, give me the best nutritious plan and workout plan, and I'll do it. So my response, number one, there is no such thing. Um, and number two, if you're someone who's never stepped foot in a gym, our first goal is to get you walking outside for five minutes consistently daily until we can progress you to a point that number one, we got to make sure you actually enjoy and like what you're doing. Um, and then number two, from a habit perspective, what can we build that's gonna be incorporated into your life and have some benefit in the long term? Thank

Burnout And A Sustainable Career

Dr Ryan Gannon 25:44

you.

Dr Andrew Greenland 25:44

I was gonna ask you a little bit about physician burnout, and I just wanted to get your sense of whether you think it's um an individual issue or a system issue. And has DPC improved your own well-being and satisfaction as a physician? I guess I might know the answer to that, but I prefer to hear it from you.

Dr Ryan Gannon 25:58

Yeah, that's I don't know, that's a loaded question. I suspect it's um it's largely systemic, but obviously you have um you know individuals who have a tolerance or ability to operate within that broken system. Um from the system perspective, I think I think the issue is is uh that you can't most traditional outpatient practices, it's uh it's a volume game. So um in order to be deemed successful, rather than being purely about the care of your patients, is how much can you see, how many patients can you treat over the course of a given day. And you'll always lose in that in that system or that game because it's it's a defined end. You can't um it fails very you know very early on, and then not only that, it becomes dangerous for for patients as well. Um DPC, so I I I you know I have some friends that I think in a typical outpatient setting a very busy day would be 30 to 40 patients. Um, obviously, if we're talking about like an urgent care or an ER, that's different. But on a DPC, I I refer to them as touch points. So I may see um five to ten patients in an office setting, but it's very common to have a touch point with five to ten percent of your patient population. So if that's a text or a call or sending an email about lab results and then schedule a you know, scheduling um, you know, a future visit. So it reduces I in my opinion, I it reduces burnout a lot um by creating the space, not feeling rushed, uh, not dealing with a lot of the headaches and the background noise that you would otherwise have to deal with in a traditional setting. Um but to answer your original question, that that's tough. Largely systemic, I think, but doctors I think are notoriously also very good at um grinding themselves into the ground. So some some games we shouldn't be playing.

Dr Andrew Greenland 28:19

Fair, fair. So, what does um a sustainable medical career look like to you when with your new perspective and this new way of working?

Dr Ryan Gannon 28:27

What was the initial part?

Dr Andrew Greenland 28:29

What does a sustainable medical career look like to you now? How do you view that?

Dr Ryan Gannon 28:36

Sustainable. Um I don't know if I would think of things as sustainable. I would say what does the optimal, most enjoying like career look like in the sense of personal satisfaction and then highest value that I can provide for patients. And for me personally, it's a mix on I don't so we we don't we're not full as a practice. Um, I don't know what that number would look like, but it would come before when I'm if I'm feeling strained where I can't spend the time with patients, um, patients are waiting for us, we're not finishing on time. So when things start to resemble uh like a traditional outpatient setting, I know we're we're already past where I want to be. For me, it's the combination of I'm treating patients to the level that I both should and I know that I'm capable of. Um and then the other couple big components within medicine itself is I still have the ability and the time for personal learning. Um, you know, I'm someone who still very much keeps up with my own regular study schedule on a consistent basis, or listening to podcasts, or you know, reading things I'm interested in or bringing more aspects of things like that to the clinic. Um, and then the the other big component, like any other doc, is you know, I have a life outside of this as well, whether it's at the gym or you know, being involved in my church or or community. Um, and I think that equation is a little different for everyone. You kind of have all those all those buckets and you you get to choose how much of each of them that you want to fill, but it it would resemble something like that for me. Thank

Future Plans And Better Tools

Dr Ryan Gannon 30:23

you.

Dr Andrew Greenland 30:23

Um what are your what excites you most about the future of Blue Ocean Health? If you're thinking ahead of say the next year or so, where would you like um Blue Ocean Health to be? Any particular ambitions or things you're looking out for?

Dr Ryan Gannon 30:36

Yeah, right now um I would say our our season is growth. I would love for us to have our um you know a second location at some point. Um, you know, do we bring on another another doc or two? Currently it's just Dr. Kavalak and myself, so um we don't we're fully capable of still you know providing the services and you know behind the scenes, but at some point you bring on maybe a little bit of ancillary staff to free up a bit more clinic time. Um but I would say our more mediate-term goal within the next year would be you know an additional location and expanding our influence in into the surrounding areas where we practice.

Dr Andrew Greenland 31:23

And if you had a magic wand and you could fix one thing in the practice overnight, what would that be? Or if you can't think of anything in your own practice more perhaps more widely in healthcare generally in our practice, it would be um I would love so the ability um to implement what I would say is like higher level, it's not testing, but um let's just let's just say higher level tools within the practice more systematically.

Dr Ryan Gannon 31:59

So a few examples of that are we have a you know small percentage of patients who wear things like uh Whoop or the Aura Ring. Um so the ability to at more large scale uh systematically um both offer that to patients, but but be able to interpret and go through the data. Um, I would love an in office like VO2, the ability to test VO2 max. Um I would love we partner with a few companies for um in-home sleep testing, but the ability to offer that more freely. So I'm always thinking, what are what are tools um that would be like very high yield and a very high perceived benefit and an actual benefit that we could offer our patients as a whole? So I tend to think of things like it would look something like tools along along those lines. Amazing.

Add-Ons, Costs, And Closing Thoughts

Dr Andrew Greenland 33:01

I suppose the the question is then where does the where does the line come where you're putting all these wonderful things in? And it kind of breaks the model because they become expensive and it's difficult to make them fit within the membership plan, or is there a way around that?

Dr Ryan Gannon 33:17

Yeah, that's that's something we always toy with back and forth. Initially, it's I think as you start to add additional ancillary services, it probably looks like an add-on fee. Um, you know, a VO2, the ability to administer a you know, a VO2 max is not something that we obviously, number one, would do for every patient. Um, but number two, we would have to you know cover the cost for that. Um certain certain things within our practice we we automatically include in the membership, whether you know, if someone comes in, they need a steroid injection for their knee. It's gonna be in our minds, it's silly to charge the you know the cost of for you know the single injection. Um other things, both for us, but generally you'll see comp pretty common across DPC practices, is most tend to have contracts with wholesale pharmaceutical distributors, so they can serve as an in-house pharmacy. And for the top 50 to 100 plus you know medications, um if patients choose to go through us, some of them do you know save a good amount of money there. Sometimes it pays for a portion, if not all, the membership. Um, so there's there's a a couple things or commonalities that you see most DPC practices, but for us in particular, I think it comes from that nutrition and um kind of the training background. I'm always teetering on the edge of a combination of like performance and medicine.

Dr Andrew Greenland 34:50

On that note, Matt Ryan, I'd like to thank you so much for joining us. It's been such an interesting discussion. I think many healthcare professionals listening will really relate to your experience of wanting to practice medicine in a way that feels more aligned with why they went into the profession in the first place. It's been really interesting to hear about the DPC model. I certainly have a better understanding of it, and it's very interesting to hear your focus on lifestyle medicine and how you bring that into your practice. So thank you very much for joining us. It's been great.

Dr Ryan Gannon 35:16

Thanks for having me, I appreciate it.