Episode Transcript
[00:00:00] Speaker A: Where entrepreneurs come to grow it's passage to profit with Richard and Elizabeth Gearhart.
[00:00:06] Speaker B: Now it's time for our main guest, Dr. Joseph A. Puma. He is the founder of Soren Medical. What if the most common heart tests people rely on are no longer the best option? So Dr. Puma is going to be talking to us about advanced imaging and AI and how they're transforming heart disease and how it's detected, not necessarily transforming heart disease, but how it's detected.
And this happens often before the symptoms become apparent. Tell us about the new technology and why it's so important.
[00:00:40] Speaker A: Yes. Thanks again, Richard. But you are right, it's transforming. I think you're using the right word. We're in the midst of a great transition, and I'm looking forward to our conversation later about AI in particular.
In our practice, we use AI every day. Probably one of the most beneficial ways AI is functional today is actually in body imaging. And on the coronary side, the heart side, it's as advanced as in any other part of the body. So now we have the capability, if we can get a high quality snapshot of the heart, which we have with the most advanced CT scan in the world, and then reconstruct that and use, we have, a partnership with. Heartflow is the most advanced AI. But what their AI can do is it not only gives us an angiogram of the arteries so we don't have to do an invasive procedure, it can tell us if there's any plaque there and analyze that plaque with such incredible detail on whether it's calcified, hardened plaque, soft plaque, hard, or even plaque that's ready to rupture and cause a heart attack. And then the third part is if there's any plaque or blockage, it can assess with incredible precision if that blockage is severe, what cardiologists call significant or greater than 70% blockage. So why is all of this important?
Because we're now going from historically, all treatment for heart disease has been symptomatic, driven. Okay. And that's unfortunately why many men wake up at 4, you know, when they're in their 40s, at 4 or 5 in the morning, having the heart attack that ultimately kills them. Okay. At this point in the world, that should never happen. What we've done at Soren Medical, and I think the big leaping off point for me is realizing that there's a lot of technology in disparate places. All I really did was have the foresight to put it together in one place, so change the way we approach diagnosing heart disease. And then what we did is work with a small group of researchers around the country through heart flow, where we now and we'll be presenting it next week. If you follow our approach to scanning the heart, applying the AI software and then treating the patient's LDL levels based on a protocol that we developed, we actually, for the first time in the history of the world, can prove we can reduce heart attacks.
[00:03:11] Speaker B: Wow, that's significant.
[00:03:13] Speaker C: So that's huge.
[00:03:14] Speaker A: Well, it's interesting, Elizabeth, because you know, we're in an era now post Covid where nobody trusts anybody.
And you know, it seems like all our friends and family are on the Internet every day looking at wellness and longevity and peptides and all of this stuff, none of which have any proof. But all they're really showing is their anxiety. Because there's only two things we, we can do in medicine, right, is make people feel better or live longer. And I don't think people want to live forever. I think they want to feel as good as they can for as long as they have. But we now have the ability to transform the way we approach heart disease. We can now see it, predict it and treat it before any damage occurs to the heart, before those kind of end stage problems occur. And that's what we've done at SOAR and we've created that, that platform now and the approach, we did it all just blood, sweat and tears in our own financing. And now we're in the process of planning to try and figure out how to scale it and bring it national.
[00:04:16] Speaker C: That's what I was going to ask you is. Well, of course Richard goes and sees you at your office in New York and I should probably do that too because I don't know that my doctor is giving me the greatest advice. But everybody's going to want this, right? So how are they going to get it?
[00:04:32] Speaker A: That's the challenge right now if you go online, you know, there's already companies that do full body MRIs.
And it's not that there's not value in that, but it's not targeted. And so we get finding. It's just like doing when you do mass screenings. The problem with mass screenings are they're costly and it's never really clear who to treat. And so you end up doing lots of additional tests or procedures.
With heart disease, it's the number one killer.
As many people as we think have it, we really don't know what the true denominator is because we've never had a simple scan. Our scan Takes three minutes. The AI process, you know, Richard, you've been through it.
[00:05:13] Speaker B: I was just gonna say it's very quick. Dr. Puma's staff is amazing. They're delightful.
And you go in, it's a few minutes, and in minutes you can see a three dimensional picture of your heart and the surrounding veins and arteries. I had a higher calcium score than I felt like I should have. And the calcium score, really, correct me if I'm wrong, measures the plaque on the veins and the arteries. Right. And that's what causes the blockages, which ultimately leads to the heart attacks.
And by looking at the scan, I could see that the way the plaque was distributed, it wasn't really harmful.
So it reduced my anxiety level because I realized that even though I have this terrible calcium score, it wasn't dangerous or unhealthful.
[00:06:02] Speaker A: So, yeah, that's absolutely right. Even when you take our scan and our approach to the scan with the AI software and then couple it with your lab values, your cholesterol profile. Inflammatory markers. Right. So you're hearing these words, inflammatory markers, things that if you go on wellness websites or longevity websites, these are all the rage, but nobody really knows what to do with them. Right. And, you know, there's these new websites that'll charge you $150 a month subscription fees to get blood tests every three months, and they do all these panels. But what does that really mean? I think the difference between our wellness and longevity platform with the Soren heart scan is the fact that we've coupled it with very clear research.
We have proven efficacy. Efficacy.
[00:06:51] Speaker B: Mm.
[00:06:51] Speaker A: Okay. And so it's personalizing the therapy. Lipid lowering therapy, anti inflammatory therapy, treatment of blockages. It's personalizing it for everyone. So whether you're normal, have mild to moderate disease or severe disease, because every day we see patients come in, even minimal symptoms, and they end up needing bypass surgery, stents. It's pretty remarkable.
[00:07:17] Speaker C: That's what I was going to ask you. So if somebody comes in and you go, wow, you got a lot of this, a lot of these plaques, do you send them to the emergency room or schedule surgery for as soon as possible?
[00:07:27] Speaker A: So we typically. That's a great question. We typically schedule their procedure intervention within 24 hours. As you know, where we have our heart scan and our platform, it's an ambulatory Surgical Center. On February 19, the New York State Department of Health. After we worked to educate them, I founded a society three years ago, the New York Ambulatory Cardiovascular Society. So now New York State, on February 19 approved coronary interventions in ambulatory surgical centers.
So soon you'll be able to have your stents right there, right there. Pacemakers, things like that. Now, nationally, already 26 states approved it, because really, the approval comes from the federal governments, from Medicare, cms, but then each state has. Has their own guidelines and regulations. So there's a great transformation taking place, Richard, right now through innovation, technology.
[00:08:21] Speaker B: And when we talk about trust, I will say that being able to visualize your heart and your circulatory system around it and see the plaques, seeing is believing you can see it. It's a lot different than some theoretical test that has a lot of numbers on it. And I think the visual just reinforces the credibility of the whole process. And there's something fascinating about seeing your own heart. I mean, I think the procedure is great, and I hope that many, many people can eventually take advantage of this on a national and global scale.
[00:08:57] Speaker C: I just wanted to ask you. So will insurance cover it? Does it cost a lot?
[00:09:01] Speaker A: Insurance covers it. Number one, Medicare reimburses about $265 for just a basic heart scan, but also reimburses for the AI software. And that's where really the win is. Right. So you have this technology now that's reimbursable. It just depends on what the indication is. So if you have symptoms, even if it's atypical symptoms that could be your heart, the insurance will cover it. If you're coming in to get it just for prevention and you want to check, your insurance may not cover it, but. But that's where the transition is. Eventually that's all starting to change. And as our research gets out, our data that shows that we reduce heart attacks, you can't go to any of those blood test sites that are doing those blood tests or any of those wellness or longevity, or have any peptide injected into you that can make any true claim that they make you feel better or live longer.
[00:09:57] Speaker C: So, Dr. Puma, we were talking to somebody in the hallway, and they said that somebody that they knew that was a patient of yours was scheduled for open heart surgery in four days. And after he went to you, he didn't have to have it.
[00:10:12] Speaker A: That's correct.
[00:10:13] Speaker C: What happened?
[00:10:14] Speaker A: First of all, this particular person is, you know, typical human being. You know, oftentimes people deny their symptoms. Right? That's. That's not a big surprise. You know the old doctor joke, Doc, it hurts when I go like this. Doctor says, don't go like this.
[00:10:27] Speaker C: All right? So that's what my doctor says.
[00:10:29] Speaker A: To me, that's not medicine.
I don't know what that is. That's more like a Groucho Marx skit. But that's not the way medicine ought to be. But the truth is, when we don't feel well, our body autoregulates, Right? Unless you're having a heart attack, which is this severe, dramatic symptom, symptoms are often subtle. You start getting a little short of breath, can't carry groceries in like you used to, or maybe you're a little more tired. But as we get older, we think we're getting older. So this particular person ignored symptom for quite some time. You know, typical denial, and then found out there was, came in, had a heart scan. But when we did our heart scan, we were able to see in detail, you know, Richard, as you've seen the arteries. We were able to see inside the arteries the level of calcification, and felt that with stents, we could treat all three arteries. And we did. And he's doing amazing. I bumped into his wife actually recently at a.
An event here in the city a couple of weeks ago, and she said, he's doing amazing. Taking his medicine back to normal activity, normal energy level. And what I often hear afterwards, he didn't realize how bad he was feeling.
Now that.
[00:11:44] Speaker B: And he's feeling better now, too.
[00:11:46] Speaker A: Oh, he's feeling amazing now. Now that he's treated, his activity level, energy level is way up.
[00:11:51] Speaker B: Well, that's great.
[00:11:52] Speaker A: Without open heart surgery.
[00:11:53] Speaker B: Without open heart surgery.
[00:11:55] Speaker C: Wow, that's huge.
[00:11:56] Speaker B: So we need to take a commercial break. We'll be right back with more of passage to prophet Richard and Elizabeth Gerhart and also Dr. Joe Puma.
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[00:14:03] Speaker E: Now back to passage to profit. Once again, Richard and Elizabeth Gearhart and
[00:14:08] Speaker C: our special guest, Dr. Joseph Poon, who is just pushing the boundaries of medicine and saving lives.
It has been amazing talking to him, but we're not done talking to him yet. So we were talking during the break about what happened to Lindsey Graham. So he was a senator who just suddenly died unexpectedly. I thought, I mean, I was shocked when I heard it. What happened to him?
[00:14:35] Speaker A: Yeah. Again, I, I didn't treat Lindsey Graham, so I don't want to talk about the specifics, but what the news media reported, is he a dissection or what's called a tear, what you can consider a tear in the major artery in the body, the aorta.
So every time the heart pumps, the pumping chamber of the heart pumps blood through a valve that go and then it goes into an aorta. And think of the aorta as kind of the tree trunk of the body. And every, every other part of the body gets its blood flow from a branch off that aorta. But when that aorta tears, it's a medical emergency and it needs to be recognized quickly and then treated quickly. And the treatment is emergency open heart surgery. Now, the most common cause of those tears is high blood pressure. And oftentimes these patients will have had an acute rapid rise in their blood pressure for some reason.
[00:15:30] Speaker B: Wasn't he just returning from a trip or something? He was like negotiating something with Ukraine or had something to do with the war.
[00:15:37] Speaker A: That's exactly right. But usually these people also have high, you know, will have high blood pressure in general, beyond.
[00:15:43] Speaker B: Yeah, on top of that.
[00:15:45] Speaker A: That's exactly right.
[00:15:46] Speaker B: Right.
[00:15:47] Speaker C: So if. If he had come to your clinic a month before, what would you have done? Would you would have done the scan? Do you think you would have seen it?
[00:15:55] Speaker A: Well, our. Our heart scan, when we do a heart scan for the arteries of the heart, we're capturing the aorta as it comes out of the pumping chamber. And we capture it actually up until about the diaphragm, even below the diaphragm, to be honest, because sometimes we get part of the liver in there. And so you can see what's called the descending aorta, because the aorta starts up here in your chest out of the heart, and will go all the way down to about your belly button before it breaks into two different arteries that go down into the pelvis and into the legs.
[00:16:29] Speaker C: So you would have seen it.
[00:16:30] Speaker A: Yeah, we capture all of that. And if we had any issue or reason to or indication or as we talked earlier, people get full body scans, you would have captured it in a full body scan without question.
[00:16:43] Speaker C: And what would you have told them to do?
[00:16:45] Speaker A: Depending on the size of it and the extent of it, surgery is the treatment for that type of problem. Open heart surgery, where they actually put a graft in. In the aorta there and then replug in the arteries to the heart so that the area that's torn or where there is a tear or if it's gotten dilated, what we call an aneurysm, gotten too enlarged, there's a weak. The wall of the artery when that happens, and that puts you at risk for rupture.
[00:17:11] Speaker B: So you mentioned full body scan. So is the technology that's been developed for the heart scan, is it the Soren scan? Is that what you call.
That's the.
[00:17:20] Speaker A: Yeah, we trademarked it the Soren heart scan.
[00:17:22] Speaker B: And so is that same technology applicable to the whole body?
[00:17:26] Speaker A: The CAT scan angiogram is the AI software is not. The AI software is fundamental just to the heart arteries.
[00:17:35] Speaker B: Got it. So we were talking during the break about other innovations. Maybe we can talk a little bit more about some of the other projects you're working on.
[00:17:44] Speaker A: Yeah, I think one of the biggest issues right now is high blood pressure. And I think that, you know, I think the medical community is starting to question many assumptions. For instance, I think we mentioned it before, when you have high blood pressure, first of all, most of the time, we don't know why people have high blood pressure 95% of the time we develop it. As we age, our arteries get stiffer, but we know it's modulated through the kidneys and the kidney nerves. Okay. That's where the hormones get released that modulate elevated blood pressure. That's number one. Number two, historically we, we give patients medication and if their blood pressure is not controlled, we keep adding more medications. And what we do know today is that all these medications cause side effects.
[00:18:28] Speaker C: Yep.
[00:18:28] Speaker A: And the older we get, the more likely we are to have side effects. In patients with high blood pressure, almost half of them are not compliant with their medicine because of side effects. And so what I think is a great innovation now is we have the ability to treat the nerves. A one time procedure where we put a little catheter or a tube in an artery or vein down near the hip and it takes about 30 or 45 minute treatment in to treat the nerves in the kidneys. Okay. Outpatient procedure. You go home a couple of hours after procedure and slowly over about two or three months, we see blood pressure slowly come down. And so in patients who have severe high blood pressure, difficult to control, A, we're able to get them controlled.
[00:19:21] Speaker C: They.
[00:19:22] Speaker A: But in patients even who have been on three or four different medicines just for high blood pressure, and let's remember, we start getting older, we're on medicine for osteoporosis, cholesterol, blood pressure, a blood
[00:19:34] Speaker B: thinner, throwing a few vitamins on top of it.
[00:19:36] Speaker A: Right. So, you know, I often have patients, Elizabeth, walk in the office with 15, 20 bottles of I don't want to be there. And so this procedure allows us to start cutting back on these pills. And high blood pressure is the most common risk factor for atrial fibrillation, irregular heart rhythms, which increases the risk of stroke by five times. Congestive heart failure. And in fact, in the black community, hypertension, high blood pressure effects on the heart are more common cause of death now than blocked arteries. So I think there's a huge opportunity to educate folks, use this new technology to treat them.
[00:20:17] Speaker D: Right.
[00:20:18] Speaker C: Do you do that in your office?
[00:20:19] Speaker A: Yes.
[00:20:20] Speaker C: The reason I'm asking, asking for a friend.
But seriously, I really am. We have a friend who's healthy, he's not fat, he exercises, he eats well, and his, he tells us his blood pressure is through the roof and there's nothing he can do about it.
[00:20:37] Speaker A: Well, there is something you can do about it, number one. Number two, this treatment now is approved for ambulatory surgical centers so you don't have to go into a hospital, it's outpatient, you know it take the procedure, it tells itself takes about 45 minutes. The recovery is about 2 hours afterwards so about 4 hours of your time. And then you know we tie that actually with other technology where we monitor folks blood pressure, we give them a blood pressure cuff and it's cellular.
So whenever they check it, we assign a nurse to them whenever they check it. It comes to us on a website so we can monitor pressure. So there's lots of ways now to use kind of high tech approach to improving patient care and patients lives.
[00:21:22] Speaker C: So how do people get a hold of you if they want to come and see you?
[00:21:26] Speaker A: You can reach out at Soren Medical S O r I n medicalny.com you can sign up for a heart scan right on the website. It literally asks for just four pieces of information.
We accept insurance. We've tried to take every barrier out of the way. Even if you don't have insurance, if you just let us know. At inforsorenmedicalny.com we take care of everyone that asks us for help. You ask us for help, we help you.
[00:21:54] Speaker C: So you have to support yourself. But I don't get the feeling you're doing this for the money.
[00:21:58] Speaker A: No, I think that at this last stage of my career, I think, you know, you asked the question earlier, what's the kind of, the one thing you kind of. I saw this. You felt it jumping into the water and doing it.
It's been incredibly rewarding. I think we've helped a lot of people and it's, it's been great to see and now we really feel like we're onto something that, that actually.
You used the right word, Richard. Is transforming healthcare. It's transform the way we approach our patients.
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[00:22:38] Speaker A: Learn more at passagetoprofitshow.com.
