Rebel Healthcare The True Patient Lead Journey Toward Improving Healthcare

Brian Urban:

Yes, this is the Healthcare Rethink podcast. I'm your host, Brian Urban, and today we have someone who has an amazing history in terms of technology, healthcare strategy, and now an author on top of that. Susanna Fox is going to be discussing her book today that just came out recently, Rebel Health: A Field Guide to the Patient-Led Revolution in Medical Care. So excited for this conversation, to dive into the book, and to dive into the person of Susanna as well. Welcome to the show, Susanna Fox.

Susanna Fox:

Thanks for having me.

Brian Urban:

This is going to be, oh man, a ton of fun. We were already having fun before we started the recording here on our little show. And to kick things off, we love to have our audience get to know our guests right off the top. And I actually don't even know quite where to start with you because in terms of your career, you are the Chief Technology Officer of the Health and Human Services in the U.S. federal government, already amazing. And then before that, you were an editor in U.S. News. And there's so many other things in between there as well that I think led to the culmination of your recent writing here, but let's start with just simply Susanna. How did you find your path all the way to becoming an author and through healthcare, through U.S. government? Tell us who you are and how this happened.

Susanna Fox:

Well, there's a few things to know about me. One is that I'm always curious, curious about other people, curious about technology, and I also am opportunistic. I will say that I studied the anthropology undergrad, which actually gives you a license to be professionally curious. And to use a phrase by another one of your guests, it gives you cultural humility. It gives you this sense that, boy, I don't know everything and I'm going to go into this community and learn from other people. What I also saw early on online, just being a pretty early internet user... My dad was an internet user in the 80s when it was really just a text-based opportunity for connection, and what I saw starting back in the nineties is an opportunity for democratization, democratization of data, of access to information. And that's really the through line of my career, whether we're talking about building websites in the 90s. Like you said, I was the editor of the website for USNews.com. I will say I started as an intern and worked my way up to become the editor.

Brian Urban:

That, I would not be able to find, no. Wow.

Susanna Fox:

And then moving on to become a researcher, and I fell in love with the possibility of data and the democratization of power and information in healthcare that the internet has brought to us.

Brian Urban:

Wow, that is a powerful introduction coming into it. And you had so much innovation work. Another portion of your brain when you were at the Pew Research Center, also at Robert Wood Johnson Foundation, everything you did was internet-based at that time. And it was very early on, so I definitely want to understand a little bit more of those days because that's where a lot of the fire started, I think in healthcare tech, what we see today. But Susanna, I want to talk about Rebel Health. I think for all of our listeners in our audience here, they've seen it splashed everywhere on LinkedIn from a lot of other people that are really holding up your work. I'm excited to have a lot of other people get to know the work behind this work. So as I open up the book here, the first thing I see, aside from some of your initial thank yous, a thank you especially to Eric, maybe we can ask about that.

Susanna Fox:

My husband. Yes.

Brian Urban:

I was wondering, just curious.

Susanna Fox:

Shout out.

Brian Urban:

A very lovely way to thank anyone important in your life, as subtle as you did there. Dr. Tom Ferguson, so he was a very influential researcher in terms of medical consumerism, which now is very much a staple into how things are used and understood at a literacy perspective, engagement perspective, modality perspective for individuals across the U.S. in terms of consuming healthcare. So tell us about that relationship. It seemed very, very intimate. It seemed very influential as well to what we start to see in the early parts of this book at least.

Susanna Fox:

Tom Ferguson was a visionary. He was decades ahead of his time. He was somebody who graduated from Yale Medical School and immediately saw the opportunity of helping people to step into their power. And this was in the 70s. This was way before technology even was on the scene. And he did it by becoming the first medical editor of the Whole Earth Catalog. The Whole Earth Catalog was kind of like a paper version of the internet. You could learn new things, you could order all kinds of back to the land camping equipment. And Tom Ferguson, then known as Doc Tom, would teach people about how to take care of their own health. And then when the internet came along, he was immediately drawn to this idea of giving people access to the information and tools that they needed to take care of themselves.

And when we started working together at the Pew Research Center, I was lucky enough to essentially have a one-on-one graduate course with Dr. Ferguson, and he took me under his wing, he introduced me to all of his other radical health friends and I got to learn so much from him. So I didn't have a background in health before I started working at the Pew Research Center and really focused on the intersection of health and technology.

Brian Urban:

So Tom was that person that I guess gave you the turn signal and the fork in the road to go deeper into healthcare. And I think a lot of us are happy that you did because of your influence when you were at HHS. So I think it takes that type of person that is not a healthcare delivery nature to be able to say, "Hey, there's a few things that we could probably do better here," whether it's from an infrastructure perspective, payment perspective, engagement experience, what have you, and that's where you went in a lot of ways. So I was curious of that. And I think the most fascinating thing that I... I'm trying to connect the dots. I don't know if this came from this or not, but OpenNotes was a big project that Geisinger Health system-led that was about transparency from what physicians were capturing in their physician-patient appointments that patients can actually see and have more of a transparent model.

Is that something that stemmed from his work, or is it just a happy the road was being paved and this was because of some of the things that he had done?

Susanna Fox:

It was all part of the same bouquet of things that were flowering, right? So I know one of the people involved, Tom Delbanco, involved in OpenNotes also knew Tom Ferguson, and there's a pretty wide-ranging group of people who, again, back in the 70s and 1980s and 1990s, were looking at the opportunity of giving people, regular consumers, patient survivors, caregivers, access to information and access to clinical notes. And people realized that the more you give people access to that information, the more likely they are to engage. They're more likely to understand their diagnosis. They're more likely to fill their prescription. They're more likely to show up for that screening that you really want them to.

Brian Urban:

I love that. That's truly patients being a part of the patient journey. So I was so curious if that was a part of it. I love how you answered that. It was part of the bouquet of that time in terms of what was happening. That's awesome. So as a part of that, I see the way that you've opened up the book, and you have an amazing story that opens it up about a young woman named Dana Lewis that we're going to get into, but the way that you've identified these rebel health leaders as it's a patient-led field guide. We're talking about your book here, and it very much is from a lot of the, I'd say the stories that you have in here, seeker, networker, solver, champion, and you go through that almost in order throughout the book.

I'm curious of these labels. These come from the stories obviously that you lay out here in the book, but is this something that you've just carried through your experiences and just now kind of put them together on paper in this field guide? Is this something you've collected for many of the years in your experience

Susanna Fox:

Coming up with those archetypes of the patient-led revolution only occurred when I was actually writing the book,

Brian Urban:

Really?

Susanna Fox:

So I was a researcher. I was a formal researcher at the Pew Research Center for 14 years, and then worked at the Robert Wood Johnson Foundation, and then took this crazy helicopter ride to the top of the federal government and worked at HHS, got a really different view of the American healthcare system. And along the way, throughout all of those years, I had done fieldwork in online patient communities. And something that Tom had advised me to do very early on was to spend time with, as he put it, the pioneers on the frontier of healthcare, the cowboys, the hackers, the artists, the rebels, and those are people who are living with rare or life-changing diagnoses because they're always going to be pushing the edges of whatever they are facing. And so I was a keeper of stories. There were thousands of people who had answered my questions and shared their stories with me over the years. I felt a sense of responsibility.

And so in looking back over all 20 years of field notes, some patterns emerged, and I realized that one way to introduce these archetypes, these different types of people to the rest of the world and really to the C-suite of healthcare, I realized that I could describe how people react to a setback or react to a diagnosis. Some people go out on the hunt for information. They're not getting what they need. They may or may not have a diagnosis. They're not getting their questions answered. They go out on the hunt for information and they don't give up. Those are seekers. The second group are networkers. Networkers are the most visible group in the patient-led revolution. They're very active on social media. They're the ones who are forming communities, both online and offline. If they see something that works, they share it with their group. They pool resources and learning community. Those are networkers.

The third group are solvers. Solvers are people who if something isn't working, they can't wait to take it apart and put it back together again. They'll invent a new tool. They attack problems. That describes a solver. And the fourth group, what I love about the writing process for a book is that I didn't even see the champions coming, but in my interviews, in checking my archetypes with people, I conducted an additional 100 interviews with different kinds of people who I think of as rebels in healthcare. And anytime someone talked about being able to take a product to market or getting attention for something important, they named a single person. Like I name Tom Ferguson, they were able to name somebody, a journalist who was able to shine a spotlight on their work or somebody with funding who was able to help them scale their idea, somebody who gave them regulatory guidance. And that's when the archetype of the champion emerged. And each of the four archetypes describes people that you can become if you need to, or you can recruit to your team if you have a specific problem to solve.

Brian Urban:

Wow. And thank you. I was saying labels. Archetypes, obviously more pointed to the words that you use to describe the personalities and characteristics underneath it. That is just so fascinating because those people exist. I was able to really assimilate with a few stories personally, but also connect some of the stories to people I know as well, especially with the rare disease stories that you put into the earlier parts of your book. And I did want to open up on that story with Dana Lewis because I found this right off the bat, very refreshing and very in your face to say, here's what people were struggling with. Even though it was about 2013 where there was a lot of tech being developed and a lot of patient focus, that still wasn't really happening as a big industry thing to carry forward. It was just maybe a buzz at the time, similar to what a lot of things are, maybe continuing with health equity right now.

It's still a bit of a buzz and nothing's being carried forward too much in a programmatic level. But let's start with Dana Lewis. She was a diabetic, young woman, a digital media strategist in her professional career, and she was living quite a far distance from her mother who was consistently worried about her potentially passing away in her sleep in a very common way of passing away for a diabetic that needs insulin, type one diabetic, nocturnal hypoglycemia, which is a very scary thing. And a part of her device would alert her for having more insulin in her treatment, and that alarm wasn't loud enough to wake her up. And she tried a lot of different things herself, was really starting to keep track of her own health in a very rebelistic, kind of gorilla style way, wrote to device manufacturers and said, "Hey, this is not loud enough. What can you do?"

And she got a very blunt response of, "Yes it is, and that's the way it is." But she didn't take that for an answer and she started to drive her own change. So I'll stop there. But the story of this was probably so common for a lot of people struggling with diabetes one and probably a lot of other relative conditions that they were really dependent on a device or some sort of system to get them going to take their medication or their therapy. So tell me about why you started it off with Dana. Lewis here. And I guess is this is the seeker. I would think this is the seeker. Probably a couple other characteristics maybe I can put on top of her, but tell me why this story kicked off the book.

Susanna Fox:

Thank you. I chose to start with Dana's story because it is so emblematic of so many problems in healthcare. Number one, she had a problem that needed to be solved. This is a really scary situation for people with diabetes, and she felt very alone. But she's not alone. There are people who would love to help if only they knew how to gather together. And pre-internet, Dana might have had to give up. But because she is naturally a networker, she was already online, she was already using Twitter to talk with other people with diabetes, she didn't have to give up. She had joined a community and was forming new communities online. And that's one of the messages of the book, that there's always been radical health movements who are demanding change from people who are left out or discriminated against or invisible to the mainstream healthcare system, and the internet allows us to connect with each other.

But another lesson of Dana's story and the story of the continuous glucose monitor alarm that was not loud enough to wake Dana up is that the medical device companies have traditionally seen their customers as the clinicians who write the prescriptions, not the user. Well, let's spin this forward and realize that... So I'll quickly tell that it was patients and caregivers who were able to hack into the continuous glucose monitor, free the data, send it to an Apple watch, share how they did it. Hundreds of people all over the world were able to replicate how one diabetes dad publicly shared how he had done that, and Dana was able to build herself a louder alarm. And what's really cool is that 10 years later, we can now look back and see that that set off a cascade of innovation. Here's my question for the rest of the industry. Where's your blind spot? This medical device company had a blind spot where they didn't understand that Dana was their customer, that they missed out on the opportunity to improve their product because they didn't have a way to listen to Dana.

That describes a lot of different aspects of healthcare that we need to improve.

Brian Urban:

Wow. That is just so powerful of a message to open up the book, and then it kind of continues throughout the book and cascading examples of that. And it makes me think too, looking at that, the way you described it, I didn't quite see it until now, is that the device manufacturers saw the physician as the end customer. They sold it, they got those in the office, they would prescribe it from there to their patients, and that would be it, not the actual user of it. They didn't see the full through view of who's using it, how it's giving feedback and insights being looped for innovation. They did not see that, very short-sighted. Can you imagine if Apple was like that?

Susanna Fox:

Right. Well, they wouldn't be successful.

Brian Urban:

Wouldn't exist.

Susanna Fox:

Right. And you think about who really is the customer and who really is the user, and there are now many more products for people living with insulin requiring diabetes because of this activism, and I'll say because the FDA looked at this. And at first, were a little nervous about patients hacking into their own medical devices, but then they realized this is actually a boon. This is good for patients. And in general... And by the way, this is a bipartisan stance. In general, the federal government believes that patients should have access to data. It's true in medical record data, it's true in terms of device data so far just in device data for diabetes. But let's think more creatively, let's think more openly about how it's going to be a competitive advantage going forward to listen to patient survivors and caregivers. It's going to improve your service, it's going to improve your product, whether you're a startup or a legacy a hundred year old company.

Brian Urban:

It is. And it made me think, and I didn't want to give too much away because the dad in the book and leveraging YouTube, that is amazing how that... It's amazing that it had to be patient-led and the manufacturer was not intuitive enough to understand that it had to be. But as a sidestep, it made me think of Medtronic. Recently, Medtronic released their new pill cam, which was FDA approved, and that, they believe, was a patient-led journey to be able to go from a very large clunky device you physically wear on you as you're swallowing a small pill cam for GI pathology reasons and cancer detection to now a very slim, teeny little thing that goes on your abdomen in a smaller pill. And that transformation probably could have happened a lot faster if they would've started listening to patients and pulling in these stories in a more thoughtful way.

But it's amazing because I saw that reflection actually today thinking about our conversation that we're going to have on your book. So these examples are real and they're continuing to happen. I hope this is a part of the underlying foundation of innovation for a lot of different device, drug, and other therapies that are out there facing patients. I love the way that you opened that book. The one thing that you started to describe a little bit toward the middle ish of the book, not to be too much of a tease for our audience here, is the actual rebel health matrix. So I like the way you put this. This is probably the professor side of your mind that we haven't tapped into, and I'm sure you're maybe already being asked to speak as a guest lecturer at many universities. I would if I was a dean of such a school. And it's a very simple matrix. It is needs met invisible at the bottom and then visible at the top.

And you describe a lot of the different patient-led journeys within this matrix. So was this also part of your experience in your field notes you pulled through or is this something that came naturally in the writing process as well?

Susanna Fox:

Again, this came up only because of writing the book.

Brian Urban:

Wow. Wow.

Susanna Fox:

And if anybody out there is thinking about writing a book, it is a way to bring together all of your evidence. If you're somebody who has... And I know your other authors who've been guests on your show talk about this process where you think, do I really have enough evidence? Do I have enough to say to really make this into a book? Well, try writing an article. That's what I did. I actually wrote an article for Harvard Business Review just to test to see, is this something that's going to resonate with let's say a business oriented audience? And it did. And what I realized is that... And again, this was also a product of the pandemic. So it was MIT Press called me in the summer of 2020 to invite me to consider writing a book about peer-to-peer healthcare. And because I was stuck at home like we all were, I had time to sit down and look at this 20 year base of evidence that I had and start to see it in a new way.

And thank you for noticing the rebel health matrix. I'll say that I designed the book for people who are busy and tired, people who might be experiencing brain fog because they're going through treatment or because they're caregivers, or because they're on planes all the time and in meetings all the time. That describes healthcare executives. So I tried... I open every chapter with a very engaging story, and I close every chapter with a summary box. So a tip for the very busy person, you could look at my book and just read the summary boxes at the end of each chapter and kind of get the gist of the message of the book. But I also really wanted people to come away with some action items and say to themselves, okay, the problem that I'm facing is not visible to mainstream healthcare, and I know that there are a lot of other people like me whose needs are not being met. How do I fight my way out of that quadrant? How do I work with networkers to raise the visibility of this?

So even if our needs are not being met, we can raise the visibility and drag ourselves to the upper quadrant where maybe some journalists will start to notice this issue, or maybe a government agency. Maybe will become visible to a public health entity that will try to help us. Or like people with diabetes did, they realized that they themselves could solve their own problems. And so they were able to drag themselves from needs not met invisible, they were going to drag themselves over into the quadrant where their needs are being met, but it still wasn't visible to the mainstream healthcare system. That's the kind of actions that I really hope people are able to take because they read my book.

Brian Urban:

Yes. And you made it very digestible with those summary boxes, by the way. Your book came on several trips with me, Susanna, to New York City and to Boston, and I came back with more of a download on the second trip. So it was very digestible for anyone who has a busy schedule or who's trying to understand what they can take into action in an immediate fashion from some of the stories that you put into the book in front of the reader. So that is in and of itself, very, very helpful. And something that I thought was fascinating, speaking of, you mentioned brain fog, long COVID, you brought long COVID into the conversation in the book. And also, I thought you made a very interesting comparison. As that is more of an emerging condition, you made that to an emerging disease back in the 1980s to HIV.

And I thought that was a very interesting way of comparing these two because they, in and of itself, were visible from the COVID side, but not long, and then HIV was just very mysterious. It was very concerning, and then it became very cultural specific, and then geographical specific. So it was really interesting how you pulled those two together. And then as I was reading that little section, there was one cool stat that I saw from Rock Health, and then Stanford University was mentioned, about 83% of U.S. adults are tracking their health in some fashion, whether it's on their own accord or it's through a virtual space or it's through an app, et cetera. So I'm curious with that, there's been so many different, I'd say explosions in the healthcare ecosystem in terms of technology, social, care technology as well, that there's a lot of tracking to what someone's doing relative to an activity or to a need.

Are you starting to see that as the newer patient-led avenue that's, I guess formalizing or maybe centralizing the way that patients are sharing data back to a physician or a licensed clinical social worker, things like that? Is that more of a highway that you're seeing that's being developed? Have you started to see those things. And going a little bit outside the book, but have you started to see some of those things?

Susanna Fox:

You're touching on? One of the areas that I led some research, I actually did the first national survey of personal health tracking, actually even before Rock Health. I love that Rock Health has picked it up and they've continued the work. But at the Pew Research Center, I, again, hanging out with people with rare and life-changing diagnoses, in the early 2000s, I saw how they were keeping track of symptoms. And as soon as there was a possibility of using technology for more precision in their tracking, these folks would start to do that in order to help themselves in solving a personal health mystery. And in helping a clinician understand... A clinician is only going to see you once or twice a year if you're lucky, and you have 364 days where the clinician is not seeing you. And if you want to give them a lens on what really is going on with your symptoms, whether it's GI, whether it's neurological, or if you are an athlete and you want to improve, that's another area, of course, where we see a lot of personal science and self-tracking.

When I started doing this work, gosh, 15 years ago, we didn't have the kind of precision tracking, and so I was very interested to ask people, how do you keep track? Do you keep track on paper? And what are you tracking? And I remember one of my favorite things about research, and I commend this to anybody who does market research, always make sure that there's an open text box. Don't limit people to just the multiple choice questions. Always give people a chance to tell you a little story. There were so many people in the open text box when we asked people, "How specifically do you track?" who shared with us that they... Men often have a belt, that they're like, if I can fit this belt around my waist, that I know I'm in good range for my weight, or women talked about having a certain pair of jeans, that if they could fit into those, that they know they're in range.

But since that time, there are so many amazing trackers. You can name your favorite in terms of tracking your sleep, tracking your heart rate. Now we have clinical level tracking of Afib. And so this is an incredible opportunity, and what I would argue is that everybody needs to have some basic skills because I think it's all hands on deck with our health, whether we're talking about your personal health or whether we're talking about a public health emergency. We really need to rely on people to have some sense of how illness is affecting them so that we can find treatments that work for that individual and for us as humans, because we're all in this together.

Brian Urban:

I love this. This, I could easily spend another 30 minutes on, Susanna, because your background is so fascinating. As I'm seeing you share this more and more, your qualitative research that stemmed from Pew, and then very, very likely at the Robert Wood Johnson Foundation applied, I would imagine, as a CTO at HHS, and then into your book here, what a beautiful storyline that I think... For someone that does research on the side like myself, I am not a quantitative analysis mind at all, but I can pull together a lot of great questions for focus groups, it's difficult to be able to build on that and have a really good field book like you've had. So I'm just so dishonored that we've had your voice on our little show here today to compile some of your stories. I do have a couple more questions though before I let you go.

I can't let you go just yet. I did want to talk about one more story in your book that I found personally fascinating that leads into the advocacy world for rare and orphaned disease. And your one story was about Michael Katz. And I found this... I had some goosebumps when I read this because this, in my days back in Walgreens specialty drug, heard so many stories like this, but there was just little that we had our care management team that could make a deeper impact. There's only so much that they could do, and there's a big economic side to it as well. So Michael was diagnosed with a rare disease of myeloma, and he had to start to navigate this by himself, essentially of what you were saying in the story of him. And he joined, and he was with them for a very long time, the International Myeloma Foundation.

And that's a very big foundation, but there's a lot of foundations like that. Cystic fibrosis, there's a foundation for that as well. And it's a rare disease, but it's still becoming more known advocacy for it. He was an advocate and was with that foundation for many decades until he did pass from complications of his cancer. But his advocacy work led to some really cool clinical trials studies that helped millions of people there on after. So he was such a great example of one of your archetypes here. I got to ask, how did you find the story of Michael? This is definitely your research paying off here, but how did you find the story? And also, why did you choose to lift up Michael's story?

Susanna Fox:

Oh, I love... Thank you so much for asking. So I found that story because Dr. Rajkumar, who's also featured as part of the story of Michael Katz, is someone who is a Mayo Clinic oncologist who uses Twitter to be a networker, not only for fellow clinicians, but also with the patient community. He educates people through Twitter. And he shared that story tweet by tweet, and I saw it one day. I saw that he was sharing in memoriam, essentially an ode to Michael Katz and the work that he had done as a patient advocate in helping oncologists to see that they had a blind spot. They were not looking in the right place for where there could be a new innovation in clinical trials and what eventually became standard of care for multiple myeloma. And so I wrote to Dr. Rajkumar and eventually was able to get an interview with him and get his permission to retell the story in my book.

But that's an example of somebody who used Twitter as a storyteller, and I was just lucky enough to see it. One of the reasons why I chose to include it in the book is because it was symbolic of how patients and clinicians can work together to improve science and improve treatment options, where we had a patient networker, a survivor, Michael Katz, who was able to be part of a very broad-based patient community where he was always listening. Where are the pain points in my community? And then we have the champions. We have the group of clinicians who were setting the clinical guidelines, who were looking for opportunities for new clinical trials who invited Katz to be the patient representative. And so he sat in a chair along with researchers, scientists, oncologists as an equal member of this committee.

And I think we need to do that more often. We need to invite patient survivors and caregivers to be equal members of research teams because they know things that the clinician scientists do not. And when Katz said, "Why don't we try reduced dosing?" for this very, very difficult drug, that was really hard to take, but the clinicians all thought that it would be so boring. Because this was an old drug, they thought, "God, really dex dosing, that's going to be what we're going to spend our money on?" But Michael Katz was passionate and he convinced them. Yes, and it actually changed standard of care and is, I believe, one of the most downloaded articles from the Lancet in this area because it was so groundbreaking how they designed the clinical trial with a patient and got such incredible results.

Brian Urban:

Wow. Wow. And then you think about the FDA now requiring clinical trial diversity, but the next step beyond that is having clinical trial partnership and having individuals be more deep seated in the phases of the trials as well, I could see stemming from this. This was just an amazing part. I think truly a nugget in the book because it's not in the beginning, it's not in the end. It's a little bit past the middle, I believe, and it's just very telling of the patient-led side of it that's advancing science, to your point, not just an experience or just simply more attention for an advocacy group for maybe payment assistance, things that are on the economic side. It's more truly about advancing science. So with that, Susanna, we always ask our guests to take a look at a crystal ball or look out five plus years. But for yourself, I'm curious, we don't have to maybe go out that far, what is next for peer-to-peer patient-led healthcare?

What's next? What do you think is going to be picked up in the industry that's going to put application and really help advance science or help advance different aspects of healthcare?

Susanna Fox:

Well, I am a true believer that the future is here. It's just unevenly distributed. There are pockets of peer-to-peer healthcare throughout healthcare. So for device data, we see that diabetes devices are now so much more open to data sharing. How about cardiac devices? How about the devices that people use for sleep apnea? What are the ways that we can empower patients with their device data? So that's one example. Another example that I see is that it's very well established in behavioral health and emotional wellbeing, that people with firsthand experience with depression, anxiety, OCD, serious mental illness, that it's often, a substance use disorder, I could go on, it's very, very well established that a peer, someone who has been there before you can be the best counselor, can be the person to help you in recovery from your eating disorder, from alcoholism, from whatever it is that you're dealing with.

Why don't we spread that? Why don't we make sure that anyone who is dealing with a new diagnosis is not alone? And I'll just say one of the reasons why I wrote my book is to let people know, whatever you're dealing with, you are not alone. There are people who would love to help you if only they knew how to find you.

Brian Urban:

Wow.. Right there, that is, I think the depiction of the archetypes that we all possess in different ways. And if we can't help you, how can we find you? I love, love this book. Highly encourage all of our audience to be able to pick this up. Take something away from it. Put it into your own life. Rebel Health, A Field Guide to the Patient-Led Revolution in Medical Care. Author Susanna Fox, thank you so much for joining our little show here today. This was amazing.

Susanna Fox:

Thanks for having me.

Brian Urban:

And for more exciting insights and excerpts, please visit us at finthrive.com.