Your Health GPS | Episode 1 – Introduction
With Ralph Snyderman & Ellie Siebeneck
Ellie Siebeneck: Welcome to Your Health GPS, Paving the road for a healthier life. I'm Ellie Siebeneck, and I couldn't be more excited to kick this podcast off with you, alongside my co-host, Dr. Ralph Snyderman. He's the Chancellor Emeritus of Health Affairs here at Duke University, a James B Duke Professor of Medicine, and the founder and executive director for the Center of Personalized Health Care here at Duke. Together, we're here to explore how personalized health care can empower you to take control of your well-being. And we hope this to be the first of many podcasts. I'm so excited to kick off this journey with you. Dr. Snyderman.
Dr. Snyderman: Ellie, I feel that way. It's exciting to be doing this with you. This is such an important project, and I can't think of anybody I'd rather be talking to at this time than you.
Ellie Siebeneck: Awesome. So, before we really dive into the heart of today's episode, I have to ask, why this podcast of all the things that you could be doing, why did you feel it's so important to start Your Health GPS?
Dr. Snyderman: Well, I've spent my entire professional career in medicine and improving health is what I've always wanted to do. It's really my main mission. When I think about the importance of health, and what I'm thinking right now is that I've had the opportunity to talk many, many times to many, many groups about health, because I've been involved in it for such a long time. When I speak to CEOs of large organizations, I've been asked to speak to the CEO roundtable about health. And I remember coming into this room, there were 40 executives at some of the largest corporations in the country, and they wanted to hear about healthcare. I said to them, what I'd like you to do for me is just to think for a moment. And I’d say the same thing to the entire audience, think for a moment in your own mind, what are the top three or four most important things in your life? Take a moment, think about it. What are they? The answer usually is my partner, my family, sometimes my religion, my profession. Those are the main things that people generally say. And I said, Well, let's reflect on that for a moment. If these are the main things that you want out of your life, how would you be able to appreciate them if you didn't have your health? And by health, I mean your physical health, your mental health, your well-being. We tend to take it for granted. The other thing that I used to tell these executives, and I remember the chairman of General Motors and various other places, Do you have a strategic plan for your business? Of course, that's my main job—a strategic plan. Do you have a strategic plan for your health? I mean, if your health is your most important resource, or at least a fundamental resource, wouldn't you want to be able to plan to make sure that you get the best out of it? So that, Ellie, is why I'm so excited about working with you for these podcasts.
Ellie Siebeneck: Yeah, no, that's such a powerful way to start out the podcast. And it's so true. I feel like, you know, speaking for myself, personally, I always take my health for granted until something goes wrong. And I think you know, for me, that's definitely one of the main reasons why I think this podcast is so important.
Dr. Snyderman: You know what I think we should do before we jump into the details, is let all our friends out there get to know who they're talking with or at least who is talking to each other, who they're listening to. So, Ellie, why don't you say a bit about you and how you got to this point where we're doing a podcast on health?
Ellie Siebeneck: Yeah, of course. I grew up in Saratoga Springs, New York, which is upstate, north of New York City, and from a very young age, I wanted to be a doctor. So that dream led me to attend Duke University, where I double majored in Biology and evolutionary anthropology, with a minor in Chemistry. And during my junior year, I took this course on “Transforming US Healthcare”, taught by none other than Dr. Ralph Snyderman, which completely changed my perspective. It exposed me to the policy side of healthcare, the business side of healthcare. It also made me realize that healthcare is not just about treating patients, it's also about shaping systems and strategies. So now I'm a master's student at Duke’s Fuqua School of Business, preparing to start my career in Philadelphia after graduation, where I'm hoping to combine my passions for healthcare and business in meaningful ways. Throughout my journey, I've been lucky enough to work closely with Dr. Snyderman here at his Center for Personalized Health Care, which I feel like has only deepened my passion for this field, and hopefully I'm going to have the opportunity to share it with you all through this podcast.
Dr. Snyderman: Well, it's really been a pleasure for me. I remember seeing you for the first time in the class that I mentored. And you seemed, you know, when you speak to an audience, I always look at everybody, look them in the eye, and I get cues as to whether people are interested, not interested, try to be moving faster, slower. And I noticed that you were paying attention, and I thought that that was a very good sign, and it's been a joy to follow you on your journey from that point to this very moment.
Ellie Siebeneck: Yeah, and thank you so much, Dr. Snyderman, for everything you've done for me. I know you're a mentor to so many, and I feel so blessed to you know been able to work with you these past few years and hoping to continue that onward. But I think one of the things that I was most interested in through your talks in these classes was your story and how you got to this point. So I guess before, you know, diving into some of the questions that we're hoping to tackle today, I'd love for you to just share your journey, your career path, with the audience, you've had such an incredible and inspiring career, from leading Duke's health system to founding the Center Personalized Health Care here at Duke. So, you know, we’d love for you to just get into that a little bit and share maybe what inspired you along the way to achieve all the success that you have.
Dr. Snyderman: Well, thank you for that question, Ellie, and I suspect many of the people who are listening to this will be students, individuals who are thinking, what do they want from their career, from their profession? So let me go quickly through mine, because hopefully there are some lessons that people could learn. At the age of 12 for very, very personal reasons, with a dear loved one who was very, very ill, was very concerned about it, seeing her in the hospital, just wanting so much for her to be able to survive and to become part of the family again, seeing the physicians go into her room as we were sitting so nervous, and then coming out and walking to us and explaining what her condition was and the good news she was going to be leaving the hospital and have some more years of health. It gave me that feeling that this is what I want to do for my life. You know, what they did for me was so important and so powerful. I wish I had the capability of doing that for other people.
So, that set me in a deep motivation of a specific area, similar to your health, or to you, you know, health, health care. I wanted to be a physician. I had a path through college going, and then finally was accepted to medical school. It was not easy to get into medical school. I just got in by the skin of my teeth. But thank God I was accepted to medical school. When I was accepted to medical school, I'm thinking I want to impact people's health. Being a physician is very, very powerful, very important, one person to another person. You never want to substitute that. But I thought if I did research, which I seem to enjoy, not only could I help one person, I could help many people. So, I decided to be a research physician. I had my clinical training at Duke, and then it was during the Vietnam War and for my military service, went to Bethesda, Maryland, and went to the National Institutes of Health and did research for about three and a half years. I loved it. I loved doing research, research in inflammation. I was then recruited back to Duke in the Department of Medicine and spent 15 years as a physician scientist and as a clinician, the head of the Rheumatology Division at Duke so I had this beautiful combination of a research laboratory, NIH grants, seeing patients and leading a small clinical division. Life was good.
But somehow, after 15 years, I felt, gee, I've been doing the same thing again and again and again, and it was the time of the development of genetic engineering, a big revolution, to some degree, is a little bit like AI now, it's going to change the world. And the number one company that was leading this area was a company called Genentech. And lo and behold, they asked me to come there, to work in Genentech. And I remember speaking to the President, and I said, you know, what do you want me to do in Genentech, I've never done anything. He said, anything you want, you designed a job. You tell us what you want, what you think you wanted to do, and that's what you'll do. So, I left Duke, moved the family out to the West Coast, San Francisco, which I always had this dream of San Francisco. And never, ever in a million years, thought that I would come back to Duke. I had been at Duke. I loved it. I was gone and moved into something else.
Two and a half years later, short period of time, I was loving what I was doing at Genentech in San Francisco, I got a call, telephone call from a person on the search committee for the next chancellor and really paid attention to it. Who happened to be my closest friend when I was at Duke, and I recall him saying, sit down. I want you to write down exactly the date, the time this call is going to change your life. What are you talking about? He said, Duke needs you to come back as Chancellor. Not do you want to apply for the job, this and that we want you; the search committee wants you to come back as Chancellor. It was preposterous, but my younger son, who grew up in Durham, loved Duke. He was a Cameron crazy then, and he still is. He wanted to go to Duke, badly. He was going to go to Berkeley, which is not a bad place, but for whatever reason, I came back to Duke as Chancellor. I barely knew what a Chancellor was, what it meant, and quite frankly, I still don't exactly know what it means. But for a period of 15 and a half years I started out mainly, initially focused on the academic mission, School of Medicine, the faculty, research, clinical research, very, very important things.
And then, because healthcare was changing so rapidly, we ended up understanding that for Duke to continue to be a high impact organization and to actually be able to survive in a new form of healthcare reimbursement, we needed to create a health system. So, we created the Duke University Health System, which is one of the first comprehensive healthcare delivery systems run by an academic medical institution. It was such a new thing that Time Magazine sent their entire editorial team here for and did a total addition on the Health System at Duke.
Ellie Siebeneck: That's such an inspiring story, and every time I hear it, I am more and more inspired. We could honestly do a whole podcast just on Dr. Snyderman's story and how much success he's had and just how involved he's been in not only the Duke Health Care System, but in health care around the world. So, you know, all of that being said, what kind of led you to found the Center for Personalized Health Care. And this idea of personalized health care, you know, as we've talked about, some is really transforming medicine, and how is that kind of different from the traditional model, and why do you think that's so powerful?
Dr. Snyderman: Well, that's a great question, Ellie. I'm really glad you posed that to me, because in the evolution of my career, I talked about the creation of the Duke University Health System. Three or four years after we started the health system, we actually cared for or we had 2 million patient visits in the previous year. It was an amazing number, and I would present the progress of the Medical Center and Health System to the Duke University Board every year. One year, I thought I'd talk to them more about clinical things, so I looked at the 2000 patient visits we had just to see what kind of patients are we taking care of, and what was astounding to me is that the vast majority of patients that we saw were for individuals that had an event, a negative event, of a disease that they already had. So, if they had diabetes, the diabetes would flare up and they would have some consequence of diabetes. Or if they had asthma, the asthma would be getting worse. But whatever it was, it tended to be for underlying disease that had already occurred. As I looked at this, I thought that was very interesting information.
The other thing was, at this time, medicine was opening up tremendously because the human genome had just been sequenced. The whole human genome was sequenced for the first time. Why was that so important and exciting? Because the genome is one factor that provides a roadmap of the individual's health. It is really like having a bit of the holy grail. It's a predictive tool. So, I started thinking that we're dealing with events that occurred years before. That's the way healthcare was delivered. Essentially, was looking back something happened, it evolved, and then you had an event, and we tried to find it and fix it. Very, very important. But if you have the capability of predicting an individual's health from where they are now, you could turn around 180 degrees and say we're going to have a health plan for that person, a personal health plan. So, the concept of a new form of medicine that would be proactive, personalized and predictive. And then also, since so much would involve what the individual would do, it would be participatory. So, we came up with this whole new form of healthcare that has many, many different names, personalized healthcare. Some people called it P4 medicine, but that came up from that time, and really from that time on to this very moment my professional career has been in how do we transmit this knowledge to individuals, because it is one of the biggest revolutions that one could think of in improving life.
Ellie Siebeneck: That's so awesome. And I love how you really took, I feel like there are physicians out there that just treat every patient very formulaic, like a disease. And I love how you sort of have this holistic approach, in a sense of treating the patient as a patient. You know, like you said, every patient is different. People are going to have different things that motivate them, that inspire them, that they want to improve their health for. So, I think that shows what sets you apart from other physicians -- caring so much about the individual and not just the disease that they have. You know, I know we talked a little bit about this, but just curious, you know, as we've said, health often seems to sort of take a back seat until there's a problem. And, you know, with the research out there and these emerging findings, why do you think that is, and I guess my question is, how can you sort of shift from more of a reactive mindset to more of a proactive mindset?
Dr. Snyderman: Well, one of the things that you bring up is the question of, you know, why is it that people don't take this more seriously. Or, what if you ask somebody about their health, you know, what are you doing about your health? The answer very frequently is, well, you know, I have a physician, and I get a checkup every year, or I have health insurance, so if anything happens to me, I'll go to the doctor. That's important to realize, that's important, but one of the biggest mistakes, which is sometimes subliminal, people don't think about it, but what they do is delegate their health to their doctor and to the health system and their health insurance. How do you take care of your health? Well, I have health insurance that takes care of my health, so that means that you are delegating your health to some other entity—that is a fallacy. That's one of the biggest fallacies. If you think about health and disease, virtually some diseases are very heavily driven by one's genetics. But fortunately, that's quite a small number. The most common diseases are very heavily driven by what the individual does, their behaviors, their environment, their lifestyles. The genetics have a role, but the biggest role is the individual's own behaviors. So, what I have been working on is taking all of the things that we talked about now, you know, knowing that health evolves over time, diseases evolve over time, genetics play a role, different roles for different diseases, but the greatest impact is what the individual does, their environment, their behaviors. Think about a whole new way of practicing medicine.
Ellie Siebeneck: As you mentioned at the beginning of the podcast, where would someone be without their health? You know, they wouldn't even have the opportunity to have their family, to have their religion, to have their profession, without their health. I know you talked about, sort of some of those lifestyle behaviors, but what would you say are some of the most essential factors to maintain long-term well-being?
Dr. Snyderman: Well, I love that question, and I think it's worth thinking about, and I think it's worth for everybody that's listening to this to think about it. But you know what I would say is one of the first things is the idea of having the awareness that health is a very important resource
Ellie Siebeneck: How do you, you know, obviously, the research is there, but how do you really make that known to the people out there, to our audience, to our society as a whole. How do we really convey that message?
Dr. Snyderman: Well, you know, again, that's a perfect question. And to me, and we hadn't discussed this before, I think this podcast and I give you credit for it, because you're the one who said, why don't we do a podcast? And I said, What's a podcast? And you explain to me what a podcast is, but being able to communicate to people, to have them think and to be aware about it. So, the general awareness of health as an important resource and national issue is extremely important. You know what I would say is independent of any thought about politics, administration, whatever. One of the things that I'm encouraged about is the fact that the new administration has indicated that dealing with the problem of chronic diseases is one of the number one priorities, and the focus is going to be on lifestyle changes. So, I think having people be aware of it is very, very important, that's critically important. So, if we talk about what can people do. Given the fact that if you look at the proportion of factors that determine whether one has a healthy life, as we've already said, most of it is what one does their environment, some things they could control, some things they can't, but they can control an awful lot. Most important, be aware of it. Be aware of it. You know this as well as I do, if not more, that being a student, a graduate student, a undergraduate student, you are so involved in this exam, that exam, running here, running there, this appointment, that appointment, you lose sight of everything around you. It's the awareness you know life is going by. Are you there? Are you appreciating it, being able to do that at least, setting a expectation of yourself that you're going to spend some time being aware of that. I'm Ellie; I'm doing all these things, but I am part of something much bigger. And my health is very important, my well-being, my mindset, is very important, so that awareness is number one. And if individuals could, in a sense, give themselves the discipline that in each day I'm going to spend at least five or 10 minutes, maybe mindfully thinking what's really important in my life? You just give yourself a little bit of time. That would be a wonderful thing.
And then from that, the things that you could control, the main things that you could control, the factor that's probably the most determinative factor is what you eat. Now you could approach this, let's say two ways. One, what are all the things that I should eat that are best things in the world for me? It's very, very complicated. I don't say you shouldn't do it, but it's very, very difficult. The other, which is much easier, what are the things I shouldn't be eating? You know, what are the things I should avoid? Just, just avoiding the things. Just start with no processed foods. Just, avoiding the things. And we'll do a podcast on this, or, you know, more, but choosing a diet that is a healthy diet without going overboard, is very, very important.
The other thing, and I'd like to be personal about this, is exercise. In many ways, my life transformed back when I was on the faculty, when my closest friend was a long-distance runner; anybody at Duke hopefully heard the name Bob Lefkowitz because he was our first Nobel laureate. He and I were recruited to Duke at the same time. Very good friends, and he was a runner, and it took him five years to convince me to go out and start to run, and I ended up doing it. And I learned how beneficial it was. I mean, it totally changed my life. I felt so much better. I actually looked better. I could eat more. It did so much for me, but the thing that it changed, and it changed my life from that day to this day, and that's been many, many years, every day, no matter what I do-- when I was Chancellor for Health Affairs, even during the most difficult times, I exercise that day, no matter what, but I set that aside, and I was going to spend an hour doing exercise. I'm not saying anybody needs to do that much, but set it as a priority. Set it as a priority, and so you have diet, exercise, stress, extremely important. Stress reduction is extremely important. I think those are some of the main things. And then, in a way, it's related to diet and exercise.
Think about those things that are really harmful to you. You know, we think about processed foods, right? You want to avoid them. But cigarette smoking, you definitely want to avoid it. Alcohol, anything other than moderation, you know, overdoing, binging, very, very unhealthy, so avoid all the real bad things. And with that, we'll get back to it. You know, hopefully in the podcast, we'll cover all these things, but those would be kind of a survey of what to be thinking about.
Ellie Siebeneck: Yeah, that's all so good and so true. And you know, as a student, as an undergrad student at Duke, and now as a Master's student at Duke, I can definitely attest to; it can be tough to balance everything, like you said, academics, you know, work, internships, spending time with friends, exercising, all of that.
Dr. Snyderman: Well, let me ask. Let me jump in. How do you do it? Because you and I have known each other now for quite a number of years. It's really been a joy to see this part of your journey, and how you came in thinking one thing, and then you switched to something else, and you really found yourself in your direction. You're healthy, you're just went skiing. You did double diamond moguls in Park City and stuff. How do you do it?
Ellie Siebeneck: I think the biggest thing for me, and I know you touched on this, is balance. And I'm very fortunate that from a very young age, my mom really instilled this in me and my siblings, but it's all about everything in moderation, right? I have a huge sweet tooth, and I love having a little piece of candy. But you can't do it all the time. So I think for me, whether it's academics, internship experience, spending time with family and friends, exercise, spending time outdoors - I try to do a little bit of each of those things every day. I try to get outside and go for a walk in Duke Gardens. I try to spend some time with my friends, going out to dinner, spend some time on my schoolwork, my studies, so that way I never get too overwhelmed, and I feel like I am able to sustain these habits that I'm beginning to develop.
And I think, at least for me, through the work that we've been doing together, I've become increasingly passionate about this idea of trying to develop and instill these healthy habits in middle school, high school, college age students that are living on their own for the first time, and that are developing these routines, these habits. Because obviously, right now, a lot of people, sort of college-age students, are, for the most part, pretty healthy. But again, as you were talking about earlier, trying to take a more proactive approach instead of a reactive approach. If we are able, as middle school, high school, college age students, to develop these healthier habits from a younger age, the idea is, hopefully that in the long run, we'll be able to not only reduce the chronic disease epidemic and save health care costs that are straining our nation today, but also for an individual to be able to live a healthier and a higher quality of life in the years to come.
So, I think, for me, it's all about balance, and making sure that you are able to develop behaviors that you're able to sustain. It's not some ridiculous diet, it's not some ridiculous exercise regimen - everything in moderation, but developing those behaviors from an early age so that you're able to hopefully keep those throughout your life and ultimately end up living a healthier and higher quality of life down the road.
Dr. Snyderman: That is so important, and I see it in you, and it obviously works. And there's a couple of things that you said that I think are particularly meaningful. One is the conscious recognition that there are certain things you're going to be doing every day. It isn't a rigid, necessarily type of thing, but you're going to allocate time for various things. I would consider that part of mindfulness. It's something that you're thinking. The other is that there is a planning element there. So, it's a combination of an intention and then a plan to make it happen.
And one of the things that you and I have been working on, which I'm sure we'll get to in much more detail in subsequent podcasts, is again, getting back to how do you get this to be more part of the national consciousness? This plan to promote your own health? How do you help people do it right? Because you're highly motivated. I'm motivated. But most people are not motivated. It's just natural. You don't think about it. You're not motivated. So, the idea of the support systems - one is the general concept of what we're trying to do, and then the support systems to do it.
Ellie Siebeneck: That's awesome. And I guess tying it back to this personalized health plan idea, I know one of the concepts you've emphasized throughout some of your work is this health enabling roadmap. I'm curious how, as we've touched on, as technological advancements like AI and digital tools, as well as advancements in genomic research are becoming more integrated into healthcare, how do you think these innovations can help people more effectively manage their health? And how does this tie into this idea of a health enabling roadmap, personalized health plan that you've been talking about?
Dr. Snyderman: I think that's the center of most of the things that have driven us to want to do this, because we're both very excited about this series of podcasts. I'd like to start with the concept of a personal health plan, just for a moment, talking as a physician, the way I would envision it, as part of a new, enlightened form of healthcare. As a physician, what I want to impart to the individuals I have the privilege of caring for is a personal health plan or roadmap for them to lead the healthiest possible life. So, as a physician, how would I do it? And then how do you change it into what the individual could do?
Number one, I want to evaluate the person's current health. Just do a comprehensive evaluation of where they are now in their life journey. What is the nature of their health right now? There are many ways to do that. What's very important, if it's going to be a roadmap or strategic plan, what are the potential risks that the person has, and what are the potential benefits, strengths that they have to lead the best possible healthy life. The risks, based on genetics, family history, current state of health, current habits, could include major chronic diseases: metabolic obesity, diabetes, pulmonary disease, certain forms of cancer, cardiovascular disease, mental illness. So, you could start doing a risk assessment. What are the main risks that this person has?
The other thing you would do is a strength assessment - what are the factors that they have going for them? Based on that, starting where you are now, you put together a plan over the next year, based on these risks. If there's a family history of cardiovascular disease, early heart attack, you would focus very very heavily on diet, avoiding things that raise lipids, and so on. Or if there were other problems, you would focus on that. You identify specific goals with the individual. “Ellie, what you need to do is slow down. You’re working too hard. Keep doing what you’re doing in moderation.” What you do is create an assessment, and then goals, which are identified by both the individual and the physician. And then how do you monitor those goals? What is the plan? How are you going to do it? You have a plan. And then over time you track it, see how you're doing, and for certain things, you may need ongoing support, encouragement, information.
That gets to your question of digital technologies and AI. As you and I know because we talk about it a lot, there has never been a time as good as it is right now to start developing ways to provide people with tools to enable them to have a personal health plan and the support they need to be able to fulfill their goals. These would be digital technologies with AI, depending on the individual needs - having chatbots to interact with, even virtual assistants, and these are being developed right now. One of the things we're going to talk about over the evolution of these podcasts is how we go from the concepts to make them actionable to each individual and as a governmental policy for improving the nation's health.
Ellie Siebeneck: That's awesome. I feel like technology has already evolved so much, even in the last couple of years since I've been in college. I have to imagine that if it continues to advance at this rate, that before we know it, if it hasn't already, it's being integrated into every industry, healthcare obviously being one of them. Just as you pointed out, these capabilities and advancements in technology and genomic research feel like they're really allowing people to better take control of their health, which will hopefully help them long term.
As we're getting to the end of the podcast, I know we touched on this a bit, but to address the audience - a lot of young adults, especially students like myself, struggle to balance health with school and life's challenges. We talked about lifestyle behaviors important in implementing a healthier lifestyle, but it can be overwhelming. If you had to give one key piece of advice for building sustainable healthy habits or taking that first step on the road to a healthier future, what would that be and how would you advise implementing them into their lives?
Dr. Snyderman: I think the most important thing, it seems trivial, but may be the most important and with intention may be the easiest - is the awareness of the importance of health in everything else the person does, to give it value over the long term over anything else. Now, if you have an exam and have to cram, that transcends things. But to have the awareness underneath it that your health is a running clock, and it's doing well; it’s either working for you or against you. One thing I'd like to do is have a session on mindfulness meditation, because the awareness of one's health and environment is so fleeting. Life goes by so quickly if you're not paying attention, and it becomes much less meaningful. If there is one thing I would do to start, it would be to find 10 minutes every day in a peaceful place to contemplate and get into your breath. Think about what's really important to you in the long run - your partner, your family, your religion, your profession - but don't forget the foundation is your health.
What I'm really hoping we'll do is provide a roadmap for all listeners to easily and joyfully take control of their health. The title of this podcast, which we worked on together, came to me during the lectures of the course you took - creating a personal health plan that is a roadmap for your health. I was thinking, if I were going 100 miles away and driving, I'd punch directions into my GPS to get a specific road plan. What we are doing together is trying to make popular the concept of a roadmap for health - making it available and easy for people to create a roadmap for their own health and develop a means to support people in their roadmap, their GPS for their health plan.
Ellie Siebeneck: That's so good and helpful. I love that analogy of the roadmap. Sometimes the concept of a personalized health plan can be complex for people, so I love an analogy people can relate to - like putting directions into a GPS to get from point A to point B.
I hope this podcast will help lay out a roadmap that our audience, listeners, and followers can follow to achieve the healthiest and highest quality of life they can. For me, this has been a fantastic conversation. I've learned a lot, and I'm hoping to continue this in future episodes we'll be filming.
Dr. Snyderman, thank you so much for sharing your insights, your story, your passion for personalized healthcare, and some practical first steps that our audience can take to begin their road to a healthier lifestyle.
Dr. Snyderman: This has been an awful lot of fun. I've enjoyed this, and I hope it's going to be useful to people. I know you'll be providing information for people to contact us, give comments about what works, what doesn't work, what they want to hear more or less of, and ideas for podcasts. I'd also like to recognize Cindy Mitchell, who was the manager, producer, director, motivator - none of this would happen without her. Thank you. This is going to be a very exciting journey.
Ellie Siebeneck: I'm very excited. Big thanks to Cindy for making script edits and getting all the information about how to record a podcast, which I didn't know before coming here.
Thanks to our listeners. As Dr. Snyderman said, thanks for tuning in to your Health GPS. If you enjoyed this episode, make sure to subscribe, share with a friend, give us a like. We'd love to hear from you - what did you like or not like about this podcast? What topics would you like us to cover? Who would you like us to bring on the podcast?
In the comment section, please feel free to reach out with any comments, concerns, insights at Personalized-Health@dm.duke.edu.. Looking forward to hearing from you, but remember, your health journey starts now. Thanks for listening, and we'll see you next time.