May 22, 2024 • 26 mins
The U.S. finally has a strategy to compete with China… will it work? Why is ‘hold music’ so annoying and how can companies make it better? Jim Keany, Co-Director of the Emergency Room at Mission Hospital in Mission Viejo, joins The Bill Handel Show for 'Medical News'! Dr. Keany talks with Bill about vegetarian diets, a gene test that could be the first step towards precision medicine for obesit and how new biomarkers could lead to early Alzheimers diagnosis.
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Episode Transcript
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(00:01):
You're listening to bill handle on demandfrom KFI AM six forty. You are
listening to the bill handle. Showto us all that buy AM six forty
bill handle. Here it is aWednesday morning, May twenty two. Last
(00:21):
week, the President announced new tariffsagainst China. One hundred percent tariff,
Chinese evs coming into the country,semiconductors, various electronic goods. Boy,
that means a lot, doesn't it. It means nothing. We don't buy
Chinese evs and the chips that arethe tariffs have increased because China really is
(00:47):
the world market at this point forchips. All right, Well, we
don't buy chips directly from China.You know what we buy. We buy
cars, we buy appliances that aremanufactured all over the world. And guess
what they have chips from China.So all of that means very very little.
And so what is going on?What do these tariffs mean? Well,
(01:08):
they don't mean anything in terms ofeconomics. But man, they are
part of a strategy and a statementby the President and the US looking at
China as a real enemy economically.So the tariffs are part of an economic
strategy. This is what we're toldby US economists. It is one of
(01:30):
actually four pieces, three but four. They're trying for number one subsidies to
build technology manufacturing here in the UnitedStates. That's really what this is about.
The second is to make sure thatif Chinese import imports do come in,
we want to tax the hell outof them because what that means is
(01:53):
that we're simply going to do moremore manufacturing here. That's all part of
it, because the US spend billionsand billions of dollars in research and subsidies
grants to build, particularly chip manufacturingfacilities, and then restrictions on access to
money technology know how to help theChinese and finally trying to figure all this
(02:17):
out and out this and having ourallies be part of this. And at
this point, no, and hereis the problem with the US and China.
China has a unified system of strategy. The US never has, doesn't
even have a name. You havea unified strategy to create industry businesses.
(02:42):
Japan did that and does that.Certainly China does. And China can turn
on a dime. For example,what China has done it became a world
market leader in manufacturing by incredibly cheaplabor, good quality and government subsidies across
the board not exploded. They becamethe world manufacturing facility. And then as
(03:04):
the economy grew in China and amiddle class grew, you know, not
so much anymore. Labor became moreexpensive, it became more sophisticated, it
was harder, and so that decrease. Well, guess what China's decided to
now increase that once again the manufacturingcenter of the world, particularly in the
world of high tech chips, etcetera. Why, Well, because labor
(03:27):
is still cheap, cheaper, butthey're at the top of the heat when
it comes to robotics, they're rightup. They're a world power, and
they subsidize. They want to breakinto a market, they subsidize. The
US doesn't do that for the mostpart. I mean it does a little
bit. It's starting to do moreand realizing that unfortunately, protective tariffs is
(03:50):
the way it goes. And theseare countries that believe, and we believe
in market systems of free, openmarket that's how we operate. That's the
basis of a capital system. Lotsof competition, consumer wins, certainly businesses
(04:11):
win. Well, what do youdo when you're competing against the country like
China, that the government is willingto plow tons of money in and subsidize
a given sector, be it cars, be it solar panels, steal.
And that was the original issue.They subsidized, steal and virtually destroyed the
(04:31):
American steel manufacturing sector. So we'regoing to see more and more of that.
And here is the irony. WhenTrump in fact passed tariffs and pulled
US out of treaties with China,Biden went berserk, How dare you do
that? And now that Biden hasbecome president, he's doubled down on what
(04:55):
Trump did, sort of leaving outthe fact that Trump really called it early
on China is no friend. Butthen again, Biden doesn't think Vladimir Putin
is a friend, and Trump thinksPutin is the greatest things in slice bread.
We know your time is valuable.Thank you for holding someone will be
with you as soon as possible.Yeah, you've heard that a few times.
(05:20):
Bill Handle here Wednesday, May twentytwo. A survey was recently done
as to what is the worst Okay, you know, stepping on dog poop,
you know, not good? Allright, going to the dentist,
you know, what's worse than that, according to the survey, waiting on
(05:45):
hold for customer support. Hi,you get the recording. Hello, thank
you for calling. All of ouroperators are busy right now. Your call
is very important to us. No, it's not. You don't care.
This is customer support. This costsyou money, all right. So now
(06:09):
you're on hold and you get tohold music. And I don't know what
is more obnoxious than hold music,especially if you're on a loop. Oh
yeah, and especially you're waiting.Yesterday, I had to call Kaiser.
I had an appointment. I wasgonna have a telemedicine appointment, and I
had to call back and it waseighteen minutes on hold, listening to the
(06:31):
same crap. Why is the musicso bad? Because if you look at
music, for example, in supermarketsand on elevators in lobbies, you know
that's science, I mean that's realscience. In the morning it's more energetic,
and supermarkets people buy more. Inthe afternoon it's more mellow, where
(06:54):
people spend more time. All ofthis to macimize, maximize purchasing in elevators
and office building, same thing.You're more productive based on the music,
and this is true. How abouthold music don't care. You want to
know why because the people who puthold music on the phone aren't music people.
(07:16):
They're not be able to study this. It's a guy who's head of
it that's set up a phone systemand he throws phone music on there,
puts hold music. And why isit all crap? Because it's all public
domain. You're never gonna hear Beyonce. You're never gonna hear anybody. You're
not Bandanna. You're just not gonnahear it. Why because it costs money
(07:36):
and they're not willing to spend money, which is so bizarre because this is
the connection between a customer. Youstrive. These companies strive for customer service
and then already they're gonna wait.The customer is gonna wait because the staff
for customer service is gonna be reallimited because there's no money in customer service.
(07:59):
That's an spence. Selling is aprofit sales, folks. And by
the way, how long do youwait when you're trying to call and buy
something? Press three for purchasing boop, You're not going to put a vehicle
put on hold for eighteen minutes?Hi, can I help you? Nope?
(08:22):
It is a whole different world atyou. Let me give me a
little bit of the history of holdmusic, and it's really fascinating. Goes
back to nineteen sixty two. Therewasn't hold music before nineteen sixty two.
And there was someone it called andthey were waiting right, and there was
an exposed telephone wire. This wasat a factory. And what it did
(08:46):
is people that were put on holdgot to hear this music from a neighboring
radio station. That the music leakedonto the signal the wire that went onto
the phone, and all of asudden, people who are on hold were
listening to music. And so thefactory's owner, a guy named Alfred Levy,
(09:11):
bright Guy, patented the telephone holdprogram system, And in his application
for the patent he wrote, andthis is brilliant that the originator of the
call, where he or she hearsnothing, can believe that the connection has
(09:33):
been broken. And the original purposeof the invention was meant to prevent dead
air, not to provide an alternative, a pleasant alternative, which of course
has not become pleasant anymore. It'sabsolutely debilitating. It is so bad.
And here's the case in point nineteenninety eight, Opus number one. Probably
(09:54):
the most used song in the entiregenre. Composed in nineteen eighty nine by
a teenager, recorded on four tracktape by a buddy who later went on
to design phone systems, and sohe put that on that and it was
an early early one. Cisco PhoneSystems, one of the largest phone systems
(10:18):
in the world, that five minutesof tape is the default hold music for
more than a hundred million phone systemsaround the world. They listened to that
crap, No beiance, no AndreoBacelli. What you hear is songs you've
(10:41):
either never heard of or really cheapinstrumental versions of popular songs that have gone
to the public domain. Opus numberone, by the way, is so
iconic. It has such a fanfollowing that it was even featured in a
Super Bowl commercial last year. Andit's out there in the public domain.
(11:03):
And the other reason why it's notso important it sounds like crap anyway,
you know, why would they engineer, why would they even go into a
studio supposed to doing it in agarage, because music sounds like crap on
the telephone highly compressed signal, andeven if it's selected and mixed to maintain
integrity, like it is in supermarketsbecause they have good speakers, you know
(11:30):
what, doesn't mean everybody's gonna likeit. And there's a whole scientific approach
to this in terms of how musicaffects our moods, how music effects our
cognitive abilities, how music helps thestore owner sell more product. I mean,
(11:50):
they're literally study after study done onthis, because I mean, can
you imagine retail sales in the UnitedStates, how big that is. If
you're a supermarket, if you're aVaughn's, for example, or an Albertson's,
how many people go through that supermarketin a given year you want people
to buy. If you're a departmentstore, how many people go through that
(12:13):
store you want people to buy.So a couple of rules. One,
don't loop it, especially if you'reon hold for a long time. Try
to make it a little bit different. Here's what works. You know,
Apple does this, and that isyou can choose your hold music. You
know, press one for jazz,press two for country. That's kind of
(12:37):
neat, And the other one,which is kind of neat too, which
I like, is you can holdor you can give us a phone number,
we'll call you back. And thatusually happens within ten or fifteen minutes.
The other one I really like iswait time is approximately ten minutes or
(12:58):
less or eight minutes or less.That's easy to do. That I'll buy.
Other than your call is very importantto us, hang on the line,
and the first available representative, we'lltalk to you. I got that
for eighteen minutes yesterday, which iswhy there is now a broken window at
my house because the phone went throughit. Now it's time for Jim Keeney,
(13:26):
and we do this every Wednesday withour medical news. Good morning Jim,
Good morning Bill. All right,we have a few things to cover,
just a fun one and this wasthe last on the heat. But
I thought of this, and alot of it has to do with reducing
the risk of diseases in certain nameof disease here and that is some vegetarian
(13:48):
diets. And here is I'm readingthe headline here, certain vegetarian diets reduce
a risk of cancer, heart disease, and death. You would think obesity
would be part of that too,because it's so boring. People just don't
eat very much of it. No, So it's an interesting study you sent
me because it's a it's what dothey call an umbrella study. So an
(14:11):
umbrella study takes all these studies fromthe past twenty years and then just dumps
them all together. So there's someadvantages to that, there's some disadvantages to
that. I mean, you getthis bird's eye view of what the overall
research seems to say. But ofcourse every study has a different methodology on
how they did it. There's certainbiases that they'll even warn you about at
(14:33):
the end of the study that say, hey, this was this was only
done in you know, people underthree feet tall from you know, northeast
Europe. Well does that really applyto us? You know, you lose
all that kind of data when youget an umbrella study. But I mean,
overall, the results aren't too surprising, right that that you eat healthy,
you avoid too much meat, protein, and you'll do better. But
(14:58):
you know, you can be avegetarian or even a vegan and eat highly
processed food. So that's the onewarning is you know you've got to still
eat healthy. Let me ask yousomething about these studies, and we mentioned
these before, studies of studies thatwere done, studies of many studies,
and I would think that AI usedin this category would be the end all
(15:20):
be all because AI could look atevery study ever done on a given disease
or syndrome and figure out correlations andcome up with these hypotheses where you don't
even need people to write these anymore. No true. And you know,
there have been studies to look atlike markers for AI writing, which is
(15:43):
hard to find. It's really hardto detect reliably. But they estimate that
something like ten percent of peer reviewedresearch has been written at least in some
sections by AI, So I meanit's being used. The problem again,
like I said, you have inherentbiases always in all data, and to
understand those and so that doesn't negatea study. It's just you need to
(16:07):
understand what those are, so youknow the limitations of what the answer you
got, and that gets lost whenyou add that when you aggregate them altogether.
The aggregation can be complex, andwhen you use different methods to look
at one thing versus another, thenmaybe also the different method comes with a
different you know, maybe a differentlevel of normal versus abnormal. So suddenly
(16:29):
you don't know, you know whatin one study what they call normal,
another study they might call abnormal becauseof how they aggregated the data. So
it's hard. It's very hard.But so who can figure out if you're
looking at typically how many studies,two hundred studies is that common in a
a in a given disease? Doesthat work maybe like ten sentinel studies that
(16:53):
really identify Okay, So with thatyou're putting together how do you read bias?
Well, who's experien that one biasis more legitimate than the other.
A good article will identify the bias, right, They'll identify where the weaknesses
are in the study because either theynotice that too many people in the study
(17:15):
arm or smokers versus non smokers.They'll notice that, you know, because
you can never get in the realworld, you can't get a perfect set
of data, and so you haveto, you know, scientifically, we
identify the data as weakness so wecan understand what we're learning in the context
of that weakness. Hey, justone quick question before we take a break,
(17:36):
and that just occurred to me.So you've got as you describe two
kinds of studies. You have theinitial study, the primary study, and
then a correlation of studies and thestudy is then made and then it is
published. Is there a difference interms of the reputation. I mean,
is an initial study just considered bigger, better, more important than the study
of the studies. I'm just curiousabout that one. Yes, yeah,
(17:59):
absolutely so if you're a professor andyou need to publish or perish, you've
heard that term. Sure, that'swhere they earn their reputation. If you're
only doing these kind of aggregate studies, you're not going to get a good
reputation. And in some places it'sa point system, and you're not going
to earn a lot of points forpublishing aggregate studies. You definitely earn a
lot more for prospective meaning you saywhat's going to happen beforehand, you give
(18:22):
a hypothesis, then you actively lookat a group double blinded, so neither
you nor the people in the studyknow who's actually getting the treatment. And
then and it's randomized. And sowhen you have all those elements, that's
like a holy grail of studies,and that's definitely gets the highest respect and
it really is a better understanding ofhow something's going to react in the real
(18:44):
world. All right, that helpsexplain it, Jim obesity, because obviously
that's we suffer so much for we'regetting fatter and fatter, and we now
have the miracle and that's in quotedrugs. We have no idea of side
effects long term that now there's agene test and we're going in that direction
anyway across the board. Would youtalk about that for a moment, sure?
(19:07):
So, I mean, what you'retalking about specifically, is there has
been a gene identified that or notan a gene, but a pattern of
genes that has been identified. Youcan get a sample taken and it would
tell you the likelihood of ozembic orthose type of drugs GLP one drugs working
for you. Because some people takeit and it works great. Other people
take it and barely have any weightloss. And this market identifies what they
(19:32):
call a hungry gut, and ifthe gut is hungry, then it works.
If the gut is a not hungrygut, then Ozempic's not going to
work for you. But overall,I mean this is an example of kind
of personalized medicine. There's a lotof features to personalized medicine. One of
them can be a genetic analysis wheregenes will tell you and identify which drugs
are likely to work for you,which is great because every drug has side
(19:55):
effects, and if you can avoidthose side effects because it's a waste of
time not going to help you,then that's a huge advantage alone. But
then you can look at Okay,maybe a specific dose, maybe you know,
half the normal dose would work forme, Maybe triple the normal dose
would work for me and have nobad effects. You know that those are
the kind of things that we're goingto get in the future as we personalize
medicine. A couple questions about simplecost simply cost, and that is the
(20:22):
gene test. I'm assuming that couldbe pretty pricey. And the other thing
about these drugs like ozimpic will goV I think is the name. You
have to continue using them, don'tyou, because once you're off, the
weight comes back on. And thesethings were one thousand and fifteen hundred dollars
a month. How do people affordthat? Yeah? I mean, well,
it's never ceased to amaze me.You know, people get a bill
(20:45):
for you know, their fifty dollarscopay for coming to the emergency department,
and many they are upset. Theysay, my insurance is supposed to cover
all of this. Why am Ipaying this? And they're screaming and then
yet there's these this other pool ofpeople who will pay fifteen hundred dollars a
way for an injection to lose weightor to you know, to get hair
back, or you know, tohave an erection or whatever. Those things
(21:07):
don't cost that much anymore, butwhen they did. You know, people
are willing for lifestyle drugs to paya ton, and that's why the entire
pharmaceutical industry has now kind of shifted. And you know, forget curing Alzheimer's,
although that is going to be ablockbuster drug if it happens, they
would rather, you know, makethis money on discretionary spending. They're not
going after the insurance companies anymore.They're just going after people who can discretionarily
(21:33):
spend whatever it takes to look goodor feel better. Yeah. Look to
me, I'm still looking for adrug at helps directions and hair loss and
obesity all in one drug, andthat will definitely be the magic pill,
and I would pay big bucks forthat one. Yeah. Are they going
(21:55):
to a very good company? Alot of people would, Yeah, I
know kidding quickly. Do you seeespecially obesity drugs being part of formula ere's
where it is just offered as amatter of any other medication like bariatric surgery.
They finally figured out it makes senseto pay twenty thousand dollars for bariatric
(22:15):
surgery because even in the medium term, it saves money. Yeah, I
mean, this is one of thefew areas where healthcare and people's desires kind
of align. You know, whenI tell somebody that have high blood pressure
and they need to take this pillfor the rest of their life, they
feel fine, they look fine,they have super high blood pressure. That's
going to put that out very highrisk for heart attack, stroke, those
(22:37):
type of problems. They don't wantto take the medicine because they don't feel
bad, and sometimes the medicine hasbad side effects. But when somebody looks
in the mirror and they see thatthey don't have the ideal body shape that
they would like to have, andwe also know that with significant obcity you
do have medical problems, Well,now our incentives are aligned and people do
want to take care of that.Absolutely. I think that insurance companies will
(23:02):
pay for it because they recognize thata certain level of obesity and it's not
going to be though, you know, I think people we're trending more towards
a more normal body shape as theideal body shape, or we're not so
much into the anorexic look anymore.But when it trends towards that innirexic look,
people of a normal body weight willwant to take this drug that won't
be covered. But when you havesignificant obesity that's going to impact your health,
(23:27):
absolutely, insurance companies will will Ithink in the future they should because
they you know, you can reducethe risk of everything from diabetes to irregular
heartbeat just by reducing your weight.Yeah, to your point about where the
perception of normal body weight has sochanged, I mean we look at TV
(23:48):
commercials now and there are genuine,genuinely fat people in the lead role in
those TV commercials. I mean that'sjust a matter of facts, almost obligatory.
You go to a musical, youhave to have at least one fat
person in the chorus. I mean, you have to do it. Yea,
they're just trying to do that.But I mean, at the same
time, even just normal you know, like Serena Williams and being an athlete,
(24:17):
but being larger than the normal shapethat people expect out of magazine,
and you know, there's nothing unhealthyabout her, for sure, and so
people are starting to understand that notall bodies are shaped the same, not
everybody fits into a mold. Allright, Jim, thank you. We'll
talk again next Wednesday. Always enjoyyour time and experience. All right,
(24:38):
coming up, we're done, bythe way, the musicals, just quickly.
You know I go to musicals alot, especially at Lamarada. There
are two things that are now obligatory. One fat person in the chorus and
at least one straight person somewhere,straight guy somewhere in the musical. It's
just automatic. Now, Okay,we're done. Come on, Neil,
(25:03):
come on, see coming a mileaway. I know. Well that's because
you know me and I had togo there. You know, I had
to go there, and we weregonna do a story about STI STDs too,
So we'll do that probably next week. All right, we're done,
guys, come back again tomorrow.You really could tell I was going there.
Yeah. Oh I can you wantme to tell you the jokes you're
(25:26):
gonna do about the the STDs tomorrow? Yeah, you can do them now.
All right, Well we start allover again tomorrow morning. Amy in
wake Up Call or at wake upcall and then the rest of us until
nine o'clock and oh, Memorial Day. I won't be here, but Wayne,
Will and Neil you're filling in forGary and Shannon. Indeed I will.
(25:47):
Yeah, we'll talk more about thatthrough the rest of the week.
All right, tomorrow, everybody,kf I Am six forty live everywhere on
the iHeartRadio app. You've been listeningto the Bill Handle Show. Catch My
Show Monday through Friday six am tonine am, and any time on demand
on the iHeartRadio app.
You're listening to bill handle on demandfrom KFI AM six forty. You are
listening to the bill handle. Showto us all that buy AM six forty
bill handle. Here it is aWednesday morning, May twenty two. Last
(00:21):
week, the President announced new tariffsagainst China. One hundred percent tariff,
Chinese evs coming into the country,semiconductors, various electronic goods. Boy,
that means a lot, doesn't it. It means nothing. We don't buy
Chinese evs and the chips that arethe tariffs have increased because China really is
(00:47):
the world market at this point forchips. All right, Well, we
don't buy chips directly from China.You know what we buy. We buy
cars, we buy appliances that aremanufactured all over the world. And guess
what they have chips from China.So all of that means very very little.
And so what is going on?What do these tariffs mean? Well,
(01:08):
they don't mean anything in terms ofeconomics. But man, they are
part of a strategy and a statementby the President and the US looking at
China as a real enemy economically.So the tariffs are part of an economic
strategy. This is what we're toldby US economists. It is one of
(01:30):
actually four pieces, three but four. They're trying for number one subsidies to
build technology manufacturing here in the UnitedStates. That's really what this is about.
The second is to make sure thatif Chinese import imports do come in,
we want to tax the hell outof them because what that means is
(01:53):
that we're simply going to do moremore manufacturing here. That's all part of
it, because the US spend billionsand billions of dollars in research and subsidies
grants to build, particularly chip manufacturingfacilities, and then restrictions on access to
money technology know how to help theChinese and finally trying to figure all this
(02:17):
out and out this and having ourallies be part of this. And at
this point, no, and hereis the problem with the US and China.
China has a unified system of strategy. The US never has, doesn't
even have a name. You havea unified strategy to create industry businesses.
(02:42):
Japan did that and does that.Certainly China does. And China can turn
on a dime. For example,what China has done it became a world
market leader in manufacturing by incredibly cheaplabor, good quality and government subsidies across
the board not exploded. They becamethe world manufacturing facility. And then as
(03:04):
the economy grew in China and amiddle class grew, you know, not
so much anymore. Labor became moreexpensive, it became more sophisticated, it
was harder, and so that decrease. Well, guess what China's decided to
now increase that once again the manufacturingcenter of the world, particularly in the
world of high tech chips, etcetera. Why, Well, because labor
(03:27):
is still cheap, cheaper, butthey're at the top of the heat when
it comes to robotics, they're rightup. They're a world power, and
they subsidize. They want to breakinto a market, they subsidize. The
US doesn't do that for the mostpart. I mean it does a little
bit. It's starting to do moreand realizing that unfortunately, protective tariffs is
(03:50):
the way it goes. And theseare countries that believe, and we believe
in market systems of free, openmarket that's how we operate. That's the
basis of a capital system. Lotsof competition, consumer wins, certainly businesses
(04:11):
win. Well, what do youdo when you're competing against the country like
China, that the government is willingto plow tons of money in and subsidize
a given sector, be it cars, be it solar panels, steal.
And that was the original issue.They subsidized, steal and virtually destroyed the
(04:31):
American steel manufacturing sector. So we'regoing to see more and more of that.
And here is the irony. WhenTrump in fact passed tariffs and pulled
US out of treaties with China,Biden went berserk, How dare you do
that? And now that Biden hasbecome president, he's doubled down on what
(04:55):
Trump did, sort of leaving outthe fact that Trump really called it early
on China is no friend. Butthen again, Biden doesn't think Vladimir Putin
is a friend, and Trump thinksPutin is the greatest things in slice bread.
We know your time is valuable.Thank you for holding someone will be
with you as soon as possible.Yeah, you've heard that a few times.
(05:20):
Bill Handle here Wednesday, May twentytwo. A survey was recently done
as to what is the worst Okay, you know, stepping on dog poop,
you know, not good? Allright, going to the dentist,
you know, what's worse than that, according to the survey, waiting on
(05:45):
hold for customer support. Hi,you get the recording. Hello, thank
you for calling. All of ouroperators are busy right now. Your call
is very important to us. No, it's not. You don't care.
This is customer support. This costsyou money, all right. So now
(06:09):
you're on hold and you get tohold music. And I don't know what
is more obnoxious than hold music,especially if you're on a loop. Oh
yeah, and especially you're waiting.Yesterday, I had to call Kaiser.
I had an appointment. I wasgonna have a telemedicine appointment, and I
had to call back and it waseighteen minutes on hold, listening to the
(06:31):
same crap. Why is the musicso bad? Because if you look at
music, for example, in supermarketsand on elevators in lobbies, you know
that's science, I mean that's realscience. In the morning it's more energetic,
and supermarkets people buy more. Inthe afternoon it's more mellow, where
(06:54):
people spend more time. All ofthis to macimize, maximize purchasing in elevators
and office building, same thing.You're more productive based on the music,
and this is true. How abouthold music don't care. You want to
know why because the people who puthold music on the phone aren't music people.
(07:16):
They're not be able to study this. It's a guy who's head of
it that's set up a phone systemand he throws phone music on there,
puts hold music. And why isit all crap? Because it's all public
domain. You're never gonna hear Beyonce. You're never gonna hear anybody. You're
not Bandanna. You're just not gonnahear it. Why because it costs money
(07:36):
and they're not willing to spend money, which is so bizarre because this is
the connection between a customer. Youstrive. These companies strive for customer service
and then already they're gonna wait.The customer is gonna wait because the staff
for customer service is gonna be reallimited because there's no money in customer service.
(07:59):
That's an spence. Selling is aprofit sales, folks. And by
the way, how long do youwait when you're trying to call and buy
something? Press three for purchasing boop, You're not going to put a vehicle
put on hold for eighteen minutes?Hi, can I help you? Nope?
(08:22):
It is a whole different world atyou. Let me give me a
little bit of the history of holdmusic, and it's really fascinating. Goes
back to nineteen sixty two. Therewasn't hold music before nineteen sixty two.
And there was someone it called andthey were waiting right, and there was
an exposed telephone wire. This wasat a factory. And what it did
(08:46):
is people that were put on holdgot to hear this music from a neighboring
radio station. That the music leakedonto the signal the wire that went onto
the phone, and all of asudden, people who are on hold were
listening to music. And so thefactory's owner, a guy named Alfred Levy,
(09:11):
bright Guy, patented the telephone holdprogram system, And in his application
for the patent he wrote, andthis is brilliant that the originator of the
call, where he or she hearsnothing, can believe that the connection has
(09:33):
been broken. And the original purposeof the invention was meant to prevent dead
air, not to provide an alternative, a pleasant alternative, which of course
has not become pleasant anymore. It'sabsolutely debilitating. It is so bad.
And here's the case in point nineteenninety eight, Opus number one. Probably
(09:54):
the most used song in the entiregenre. Composed in nineteen eighty nine by
a teenager, recorded on four tracktape by a buddy who later went on
to design phone systems, and sohe put that on that and it was
an early early one. Cisco PhoneSystems, one of the largest phone systems
(10:18):
in the world, that five minutesof tape is the default hold music for
more than a hundred million phone systemsaround the world. They listened to that
crap, No beiance, no AndreoBacelli. What you hear is songs you've
(10:41):
either never heard of or really cheapinstrumental versions of popular songs that have gone
to the public domain. Opus numberone, by the way, is so
iconic. It has such a fanfollowing that it was even featured in a
Super Bowl commercial last year. Andit's out there in the public domain.
(11:03):
And the other reason why it's notso important it sounds like crap anyway,
you know, why would they engineer, why would they even go into a
studio supposed to doing it in agarage, because music sounds like crap on
the telephone highly compressed signal, andeven if it's selected and mixed to maintain
integrity, like it is in supermarketsbecause they have good speakers, you know
(11:30):
what, doesn't mean everybody's gonna likeit. And there's a whole scientific approach
to this in terms of how musicaffects our moods, how music effects our
cognitive abilities, how music helps thestore owner sell more product. I mean,
(11:50):
they're literally study after study done onthis, because I mean, can
you imagine retail sales in the UnitedStates, how big that is. If
you're a supermarket, if you're aVaughn's, for example, or an Albertson's,
how many people go through that supermarketin a given year you want people
to buy. If you're a departmentstore, how many people go through that
(12:13):
store you want people to buy.So a couple of rules. One,
don't loop it, especially if you'reon hold for a long time. Try
to make it a little bit different. Here's what works. You know,
Apple does this, and that isyou can choose your hold music. You
know, press one for jazz,press two for country. That's kind of
(12:37):
neat, And the other one,which is kind of neat too, which
I like, is you can holdor you can give us a phone number,
we'll call you back. And thatusually happens within ten or fifteen minutes.
The other one I really like iswait time is approximately ten minutes or
(12:58):
less or eight minutes or less.That's easy to do. That I'll buy.
Other than your call is very importantto us, hang on the line,
and the first available representative, we'lltalk to you. I got that
for eighteen minutes yesterday, which iswhy there is now a broken window at
my house because the phone went throughit. Now it's time for Jim Keeney,
(13:26):
and we do this every Wednesday withour medical news. Good morning Jim,
Good morning Bill. All right,we have a few things to cover,
just a fun one and this wasthe last on the heat. But
I thought of this, and alot of it has to do with reducing
the risk of diseases in certain nameof disease here and that is some vegetarian
(13:48):
diets. And here is I'm readingthe headline here, certain vegetarian diets reduce
a risk of cancer, heart disease, and death. You would think obesity
would be part of that too,because it's so boring. People just don't
eat very much of it. No, So it's an interesting study you sent
me because it's a it's what dothey call an umbrella study. So an
(14:11):
umbrella study takes all these studies fromthe past twenty years and then just dumps
them all together. So there's someadvantages to that, there's some disadvantages to
that. I mean, you getthis bird's eye view of what the overall
research seems to say. But ofcourse every study has a different methodology on
how they did it. There's certainbiases that they'll even warn you about at
(14:33):
the end of the study that say, hey, this was this was only
done in you know, people underthree feet tall from you know, northeast
Europe. Well does that really applyto us? You know, you lose
all that kind of data when youget an umbrella study. But I mean,
overall, the results aren't too surprising, right that that you eat healthy,
you avoid too much meat, protein, and you'll do better. But
(14:58):
you know, you can be avegetarian or even a vegan and eat highly
processed food. So that's the onewarning is you know you've got to still
eat healthy. Let me ask yousomething about these studies, and we mentioned
these before, studies of studies thatwere done, studies of many studies,
and I would think that AI usedin this category would be the end all
(15:20):
be all because AI could look atevery study ever done on a given disease
or syndrome and figure out correlations andcome up with these hypotheses where you don't
even need people to write these anymore. No true. And you know,
there have been studies to look atlike markers for AI writing, which is
(15:43):
hard to find. It's really hardto detect reliably. But they estimate that
something like ten percent of peer reviewedresearch has been written at least in some
sections by AI, So I meanit's being used. The problem again,
like I said, you have inherentbiases always in all data, and to
understand those and so that doesn't negatea study. It's just you need to
(16:07):
understand what those are, so youknow the limitations of what the answer you
got, and that gets lost whenyou add that when you aggregate them altogether.
The aggregation can be complex, andwhen you use different methods to look
at one thing versus another, thenmaybe also the different method comes with a
different you know, maybe a differentlevel of normal versus abnormal. So suddenly
(16:29):
you don't know, you know whatin one study what they call normal,
another study they might call abnormal becauseof how they aggregated the data. So
it's hard. It's very hard.But so who can figure out if you're
looking at typically how many studies,two hundred studies is that common in a
a in a given disease? Doesthat work maybe like ten sentinel studies that
(16:53):
really identify Okay, So with thatyou're putting together how do you read bias?
Well, who's experien that one biasis more legitimate than the other.
A good article will identify the bias, right, They'll identify where the weaknesses
are in the study because either theynotice that too many people in the study
(17:15):
arm or smokers versus non smokers.They'll notice that, you know, because
you can never get in the realworld, you can't get a perfect set
of data, and so you haveto, you know, scientifically, we
identify the data as weakness so wecan understand what we're learning in the context
of that weakness. Hey, justone quick question before we take a break,
(17:36):
and that just occurred to me.So you've got as you describe two
kinds of studies. You have theinitial study, the primary study, and
then a correlation of studies and thestudy is then made and then it is
published. Is there a difference interms of the reputation. I mean,
is an initial study just considered bigger, better, more important than the study
of the studies. I'm just curiousabout that one. Yes, yeah,
(17:59):
absolutely so if you're a professor andyou need to publish or perish, you've
heard that term. Sure, that'swhere they earn their reputation. If you're
only doing these kind of aggregate studies, you're not going to get a good
reputation. And in some places it'sa point system, and you're not going
to earn a lot of points forpublishing aggregate studies. You definitely earn a
lot more for prospective meaning you saywhat's going to happen beforehand, you give
(18:22):
a hypothesis, then you actively lookat a group double blinded, so neither
you nor the people in the studyknow who's actually getting the treatment. And
then and it's randomized. And sowhen you have all those elements, that's
like a holy grail of studies,and that's definitely gets the highest respect and
it really is a better understanding ofhow something's going to react in the real
(18:44):
world. All right, that helpsexplain it, Jim obesity, because obviously
that's we suffer so much for we'regetting fatter and fatter, and we now
have the miracle and that's in quotedrugs. We have no idea of side
effects long term that now there's agene test and we're going in that direction
anyway across the board. Would youtalk about that for a moment, sure?
(19:07):
So, I mean, what you'retalking about specifically, is there has
been a gene identified that or notan a gene, but a pattern of
genes that has been identified. Youcan get a sample taken and it would
tell you the likelihood of ozembic orthose type of drugs GLP one drugs working
for you. Because some people takeit and it works great. Other people
take it and barely have any weightloss. And this market identifies what they
(19:32):
call a hungry gut, and ifthe gut is hungry, then it works.
If the gut is a not hungrygut, then Ozempic's not going to
work for you. But overall,I mean this is an example of kind
of personalized medicine. There's a lotof features to personalized medicine. One of
them can be a genetic analysis wheregenes will tell you and identify which drugs
are likely to work for you,which is great because every drug has side
(19:55):
effects, and if you can avoidthose side effects because it's a waste of
time not going to help you,then that's a huge advantage alone. But
then you can look at Okay,maybe a specific dose, maybe you know,
half the normal dose would work forme, Maybe triple the normal dose
would work for me and have nobad effects. You know that those are
the kind of things that we're goingto get in the future as we personalize
medicine. A couple questions about simplecost simply cost, and that is the
(20:22):
gene test. I'm assuming that couldbe pretty pricey. And the other thing
about these drugs like ozimpic will goV I think is the name. You
have to continue using them, don'tyou, because once you're off, the
weight comes back on. And thesethings were one thousand and fifteen hundred dollars
a month. How do people affordthat? Yeah? I mean, well,
it's never ceased to amaze me.You know, people get a bill
(20:45):
for you know, their fifty dollarscopay for coming to the emergency department,
and many they are upset. Theysay, my insurance is supposed to cover
all of this. Why am Ipaying this? And they're screaming and then
yet there's these this other pool ofpeople who will pay fifteen hundred dollars a
way for an injection to lose weightor to you know, to get hair
back, or you know, tohave an erection or whatever. Those things
(21:07):
don't cost that much anymore, butwhen they did. You know, people
are willing for lifestyle drugs to paya ton, and that's why the entire
pharmaceutical industry has now kind of shifted. And you know, forget curing Alzheimer's,
although that is going to be ablockbuster drug if it happens, they
would rather, you know, makethis money on discretionary spending. They're not
going after the insurance companies anymore.They're just going after people who can discretionarily
(21:33):
spend whatever it takes to look goodor feel better. Yeah. Look to
me, I'm still looking for adrug at helps directions and hair loss and
obesity all in one drug, andthat will definitely be the magic pill,
and I would pay big bucks forthat one. Yeah. Are they going
(21:55):
to a very good company? Alot of people would, Yeah, I
know kidding quickly. Do you seeespecially obesity drugs being part of formula ere's
where it is just offered as amatter of any other medication like bariatric surgery.
They finally figured out it makes senseto pay twenty thousand dollars for bariatric
(22:15):
surgery because even in the medium term, it saves money. Yeah, I
mean, this is one of thefew areas where healthcare and people's desires kind
of align. You know, whenI tell somebody that have high blood pressure
and they need to take this pillfor the rest of their life, they
feel fine, they look fine,they have super high blood pressure. That's
going to put that out very highrisk for heart attack, stroke, those
(22:37):
type of problems. They don't wantto take the medicine because they don't feel
bad, and sometimes the medicine hasbad side effects. But when somebody looks
in the mirror and they see thatthey don't have the ideal body shape that
they would like to have, andwe also know that with significant obcity you
do have medical problems, Well,now our incentives are aligned and people do
want to take care of that.Absolutely. I think that insurance companies will
(23:02):
pay for it because they recognize thata certain level of obesity and it's not
going to be though, you know, I think people we're trending more towards
a more normal body shape as theideal body shape, or we're not so
much into the anorexic look anymore.But when it trends towards that innirexic look,
people of a normal body weight willwant to take this drug that won't
be covered. But when you havesignificant obesity that's going to impact your health,
(23:27):
absolutely, insurance companies will will Ithink in the future they should because
they you know, you can reducethe risk of everything from diabetes to irregular
heartbeat just by reducing your weight.Yeah, to your point about where the
perception of normal body weight has sochanged, I mean we look at TV
(23:48):
commercials now and there are genuine,genuinely fat people in the lead role in
those TV commercials. I mean that'sjust a matter of facts, almost obligatory.
You go to a musical, youhave to have at least one fat
person in the chorus. I mean, you have to do it. Yea,
they're just trying to do that.But I mean, at the same
time, even just normal you know, like Serena Williams and being an athlete,
(24:17):
but being larger than the normal shapethat people expect out of magazine,
and you know, there's nothing unhealthyabout her, for sure, and so
people are starting to understand that notall bodies are shaped the same, not
everybody fits into a mold. Allright, Jim, thank you. We'll
talk again next Wednesday. Always enjoyyour time and experience. All right,
(24:38):
coming up, we're done, bythe way, the musicals, just quickly.
You know I go to musicals alot, especially at Lamarada. There
are two things that are now obligatory. One fat person in the chorus and
at least one straight person somewhere,straight guy somewhere in the musical. It's
just automatic. Now, Okay,we're done. Come on, Neil,
(25:03):
come on, see coming a mileaway. I know. Well that's because
you know me and I had togo there. You know, I had
to go there, and we weregonna do a story about STI STDs too,
So we'll do that probably next week. All right, we're done,
guys, come back again tomorrow.You really could tell I was going there.
Yeah. Oh I can you wantme to tell you the jokes you're
(25:26):
gonna do about the the STDs tomorrow? Yeah, you can do them now.
All right, Well we start allover again tomorrow morning. Amy in
wake Up Call or at wake upcall and then the rest of us until
nine o'clock and oh, Memorial Day. I won't be here, but Wayne,
Will and Neil you're filling in forGary and Shannon. Indeed I will.
(25:47):
Yeah, we'll talk more about thatthrough the rest of the week.
All right, tomorrow, everybody,kf I Am six forty live everywhere on
the iHeartRadio app. You've been listeningto the Bill Handle Show. Catch My
Show Monday through Friday six am tonine am, and any time on demand
on the iHeartRadio app.
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