Sick Care. Not Healthcare. American Crossroads.

[00:00:00] Speaker A: Today, customer service teams have to do. [00:00:02] Speaker B: More with less More work, less team, more expectation, less budget. But AI is changing everything. Intercom's new AI first platform upgrades support for everyone. [00:00:16] Speaker A: Customers get more answers, less waiting, agents. [00:00:20] Speaker C: Get more interesting work, less busy work. [00:00:23] Speaker A: And managers get more efficient teams on less additional headcount. So if you want less of this. [00:00:29] Speaker B: It'S time to get more out of your support platform. [00:00:32] Speaker C: Intercom AI first customer service this is. [00:00:36] Speaker D: Open youn Eyes radio with Dr. Kerry Gelb. [00:00:39] Speaker C: Good morning, I'm Dr. Kerry Gelb and welcome to Wellness 1280 on Open youn Eyes Radio. Please listen as I discuss the newest information in the world of health, nutrition and sports every Saturday morning, 6am Central Time on AM 1280 the Patriot. Also, please share your thoughts by emailing [email protected] that's D R K E R Y G e l b gmail.com and visit my new website, wellness1280.com where we have all guest links, wellness 1280 info and previous shows. Wellness is taking over the Patriot Airways for the next hour. Sit back and enjoy my interview with Dr. Mark Marciano. The US healthcare system is in crisis. According to Dr. Marty Bachary, author of Blind Spots, healthcare has increasingly become a business first industry where big pharmaceutical companies yield growing influence over health policy and medical education. Despite spending twice as much on health care as any other nation, the US Constantly ranks last among high income countries in key measures like access to care, efficiency and health outcomes, as reported by organizations like the Commonwealth Fund. Today's guest, Florida optometric physician Dr. Mark Marciano, has deep insights into these pressing issues. Dr. Marciano is an adjunct professor at Nova Southeastern University and has served as President of the Florida Optometric Association. He also contributes to legislative efforts through his work with the American Optometric Association State Government Relations Committee. Beyond his medical career, Dr. Marciano has served as an elected City Council member and as Mayor of Palm Beach Gardens, Florida from 2019 to 2020. Dr. Marciano, thank you for joining me today. [00:02:47] Speaker B: Thanks Dr. Gelt for the invitation. It's exciting to be here with you and help share some insights into the health care system that we live in. [00:02:55] Speaker C: You know Mark, I've admired you for many, many years as President of the Florida Optometric association and all the good work that you've done helping the American Optometric association with its legislative efforts and its government relations being on the committee. But you were Mayor of Palm Beach Gardens, Florida. I gotta ask you, what's it like to be the mayor of a small town in The United States. [00:03:24] Speaker B: You know, it's so funny as growing up, you never think about who politicians are, they're always somebody else, you know, and then as you get engaged in the community, you know, you raise your family in a community, you start to see certain things in the community that interest you. Look, we're all individuals. We all have our passions and we all have our professions. And politics for some reason has been a little bit of a draw for me personally, especially at the local level, when you realize that all politics is local. Being a part of the city council here in my hometown, being serving as its mayor for a year was truly an honor. And, you know, it just ended a couple of years ago. So my time on the city council came to an end about a year and a half ago. And I'm starting to sit back and kind of look at that time and being able to help people, being able to engage with the community in a different manner than as a practicing physician was pretty interesting and exciting. You learn a lot. And I would invite anybody and everybody to try to get involved with their local communities as best they can. [00:04:26] Speaker C: You know, when I lived in Scotch Plains, New Jersey, I was somewhat friendly with the mayor there. And he, when it would snow, people would call his house so they would get their street plowed first. What's some of the craziest things people would ask you or request that neighbors would ask you as mayor of a small town? [00:04:47] Speaker B: Well, it was always about traffic and it was always about growth. And towards the end of my tenure on the council was about how come there's no more pickleball courts in town. So the needs and the desires of people at the local level is far different than what you see what goes on in Washington, in our state capitals. It truly is day to day things. It truly is how people live their lives every day. But getting, you know, why are the bus stops for the kids on such and such a street? You know, some infrastructure projects that are going on in and around the community and a lot of questions about what is going on, what's growing, you know, what's happening with our local community. Truly, truly inspiring work. A lot of fun being able to talk to people about their local issues and make a difference that way. [00:05:31] Speaker C: Now we're going to talk about healthcare and the problem with healthcare. You've been a practicing optometric physician for over 20 years, myself over 30 years. And medicine has changed a lot over the last 30 years. You know, where medicine seems to have been captured by industry, private equity, taking over doctor's practices. Hospitals taking over practices, pharmaceutical companies controlling policy and influencing medical education. And there seems to be a lack of transparency in healthcare and accountability. Can you comment a little bit on that? [00:06:14] Speaker B: You know, it's funny you say that because graduating optometry school in 1998, so it's been 26, almost 27 years for me out in practice. One of my favorite faculty members at Nova Southeastern University when I graduated, he always said, you wait 20 years. Every doctor is going to, every primary care doctor is going to be doing X and they're going to make X. Every specialist is going to make Y and they're going to be doing Y. Every subspecialist is going to be doing Z and they're going to be making Z. And his comment and concern was that the federal government was going to be creating a health care system, a single health care system for all. Although certainly Medicare and the policies of the federal government has created a lot of policies that impact the private practice. I don't think anyone really saw the impact of private equity coming in and purchasing doctor's offices and practices and creating systems that may not be best suited for the patient, but certainly more efficiencies and ultimately changing that patient doctor relationship that I think is lacking and really has been lost. And I think as a practicing physician is still in a private practice setting. We have two locations with my wife and two other doctors with us. You see this, the patient starving for that patient doctor relationship that is just being lost so quickly over the past dozen years or so. Where it goes from here, I don't know. I hope that we can find a good balance between what private equity brings and the efficiencies they bring and how physicians are able to practice, you know, independently without the pressures of corporate America. But time will tell and it's changing very quickly. [00:07:53] Speaker C: Doctors are in a tough position now, especially ones that are working private equity, equity or hospitalists. And when it becomes about the money rather than the patient and the. And the doctors are put in a very precarious position where they're looking at the amount of patients that they're seeing, the number of tests that they're doing, and the amount of money that they're producing rather than patient first, what kind of advice would you have for doctors that are put in that type of position? [00:08:26] Speaker B: Well, the first thing that doctors have to remember, and I think just, I mean, not all, but I would say the vast majority of doctors and physicians, no matter what their subspecialty, got into healthcare because they wanted to help people got into healthcare because they wanted to do the right thing for their patients. There is a joy in patient care that I think most physicians still, you know, still hope to engage with in their careers. And that's why you did it. So I hope that physicians remember that, and I think most do. But sadly, when you're getting into a system now and you talked about the money, the dollars and cents behind every patient encounter, you know, I go back to my faculty member who also said to us in school, like, we're teaching you how to be doctors. We're teaching you how to talk to your patients, understand their problems, come up with a diagnosis and treatment for them. We're not here to tell you to run every single test known to man for every possible case because that's being inefficient and it's not being very cost effective. And yet here we are 25 years later and what you're seeing is just that, physicians, because of the financial incentive to run tests to rule out every possible diagnosis known under the sun for every patient encounter, it becomes a dollars and cents thing. It's no longer what's right for the patient. And I think physicians get into that trap. Let me run every test to confirm that this is or is not a diagnosis. And patients are just as guilty of it too. They come in insisting that they may have a certain medical condition because they read something online and they come in and they ask their doctors for a test to rule something out. And in reality, that's a, that's a tough situation to be in. [00:10:06] Speaker C: Well, we're speaking with Dr. Mark Marciano. He's the former mayor of Palm Beach Gardens, Florida. He's in private practice. He's an optometrist in private practice. He has a practice in West Palm beach and in Palm Beach Gardens. And he practices with his wife. We'll be back right after this break. This is Dr. Kerry go for Open youn Eyes radio. [00:10:29] Speaker A: I went to the eye doctor the other day with my daughter Maggie. I was shocked when the doctor told me that my daughter was already becoming nearsighted. It turns out that this problem affects more than 40% of Americans. My eye doctor thinks this disease is getting worse. Perhaps it's getting worse because of kids prolonged time spent playing with smartphones or maybe because kids now spend less time outside. My genetics probably aren't helping her a whole lot being nearsighted myself. But the good news is that the doctor told me about a new FDA approved product called My Sight. This specific one day contact lens is already worn by thousands of children. In the US it is proven to slow down the progression of nearsightedness. And best of all, Maggie loves these contact lenses. The doctor taught her how to use them. Now it is so exciting to see her have even more success in the classroom and when she plays sports. I Recommend you visit openyoureyesradio.com to find an eye doctor that specializes in this treatment program. Learn more@openyourized radio.com if your approach to. [00:11:30] Speaker D: Everyday aches and pains is to mask them, you know, feel better for a few hours only to have the pain return and then repeat the cycle all over again. It's time to try Relief Factor. And the good news is Relief Factor makes that easy. Their three week quick start is just 1995. Less than a dollar a day. Instead of masking pain, Relief Factor helps eliminate it. How? Well, its unique formula of ingredients helps support your body's response to inflammation. Relief Factor was developed by doctors. It's 100% drug free and for so many people the results are game changing, even life changing. So give it a try. Right now their three week quick start is just $19.95. Go to relieffactor.com or call 1-800-for relief. That's 1-800-the number for relief. See how in a few weeks or even days Relief Factor can reduce your pa. When you feel better, life is just better. So don't mask pain. Fight it naturally with Relief Factor. [00:12:28] Speaker A: I went to the eye doctor the other day with my daughter Maggie. I was shocked when the doctor told me that my daughter was already becoming nearsighted. It turns out that this problem affects more than 40% of Americans. My eye doctor thinks this disease is getting worse. Perhaps it's getting worse because of kids prolonged time spent playing with smartphones. Or maybe because because kids now spend less time outside. My genetics probably aren't helping her a whole lot being nearsighted myself. But the good news is that the doctor told me about a new FDA approved product called My Sight. This specific one day contact lens is already worn by thousands of children in the us. It has proven to slow down the progression of nearsightedness. And best of all, Maggie loves these contact lenses. The doctor taught her how to use them. Now it is so exciting to see her have even more success in the classroom and when she plays sports. I Recommend you visit openyoureyesradio.com to find an eye doctor that specializes in this treatment program. Learn [email protected] we're back with Dr. Mark Marciano. [00:13:33] Speaker C: This is Dr. Kerry Geld for Open youn Eyes radio. And look for our documentary, the Open your eyes documentary, which is on Google movies and shows, Amazon Prime, Apple TV, YouTube movies and shows. So we're back with Dr. Marciano, optometric physician. And I want to ask you, the United States, we spend twice as much money as any other nation on health care, but we're getting half the results. Why are our results so poor in the United States compared to other places? [00:14:06] Speaker B: Well, that's a far reaching question and there's a number of reasons for that. I originally am from Canada, so I understand the Canadian healthcare system. And there's certainly good and bad of all of the systems out there. Here in the United States, we have access to so much capital to look for so many different methods of diagnosing and ultimately treating patients. But it's becoming more and more difficult for the average person to get that kind of care, to find physicians that are going to be able to give them the care that they need. Partly because of the amalgamation and the consolidation of care through the corporate takeovers of most private practices, also because of the difficulty in running a small practice and a small business here in America, a lot of regulation, a lot of changes in the way doctors can get reimbursed for the services that they provide. So in order to make payroll and pay rent, it's getting harder for individual doctors to do those things. And I think there's a number of other things too. Like in a society that we live in, there's a general push for people to get things quickly, meals quickly, maybe not very healthy, finding simple meals that are full of preservatives and colorations. And you've done wonderful podcasts in the past kind of highlighting some of these issues. So the foods that we eat are not very healthy. The healthcare that we receive is fragmented. I always like to talk about how healthcare in America has continued to become more reactive instead of proactive. Even though we all know getting in front of problems is always going to be more efficient, more cost effective, and ultimately provide better outcomes. But our healthcare system is not designed for that. It is still a reactive system. And so you put all these pieces together, you put the costs of care, you put the cost of running businesses, you put the, the foods that we eat and the products that we purchase, all of those things combined is making for a sicker population and an inability to really get in front of these problems and be proactive instead of reactive. [00:16:06] Speaker C: You know, 43, over 40, over 40% or about 43% of U.S. adults, delay or Avoid going to the doctor or getting health care, or avoid care or follow up with their care. That's recommended because they're worried about the finance of it. Healthcare has become so expensive in our country. You know, people are paying 20, 25, $30,000 a year for a family for their healthcare, and the average American just can't afford that if their employer isn't paying for it. So what do you think that some solutions can be because of the high cost of healthcare? [00:16:48] Speaker B: Well, first of all, anybody that has any type of health insurance coverage will get a complimentary annual physical, and women will be able to get women's examination as well. So take advantage of those things. The cost of preventative anything is so much less expensive than trying to fix something later. Just look at your car. If you don't take your car in for routine maintenance, then something breaks. The next thing, you're spending thousands of dollars fixing your car. And how do you live without it? I think we take our health for granted. I don't think people really believe that they're sick or that they may need help. And I also think people are afraid of what they don't know. They would rather not know that they have an illness than have to face it and fix it. You know, health insurance has become just a whole entity on its own, just like homeowners insurance and car insurance. I understand the cost of providing care is getting very expensive, but at the same time, it shouldn't be that expensive, especially in trying to really encourage routine care. The cost for an annual eye exam, an annual physical, should be, well, affordable for the average family, especially if they have insurance. How we fix that, I mean, how we get to the people to help them understand why it's important to get routine care and to encourage them to go and get a routine examination is a hard question. But ultimately, the cost of chronic care is eating up all the insurance dollars, and ultimately it passes the expenses down the line. [00:18:22] Speaker C: We have a sick care system, we don't have a healthcare system, and we wait for people to get sick and then we throw a lot of medication at them or we do surgery on them. But things are starting to turn a little bit. And I think it's because of education, like podcasts, like mine, other podcasts, where people are learning about preventative care, they're learning about health and nutrition. And you spoke about that a little bit before. You know, people are learning that, you know, now where we were always told to stay out of the sun, always. Now we're finding that there's new research and research that going in the sun a little bit is healthy for our circadian rhythm. You know, sleep, you know, 20. We're getting 20% less sleep than we did in 1900 and less lack of sleep. Lack of sleep increases the risk of insulin resistance, which causes diabetes. Just five nights of not sleeping properly. So now we're talking about sleep, we're talking about exercise. You know, the average American does about 3,500 steps a day, where you need about 7,000 steps to prevent many of the, or help decrease the risk of many chronic disease. So we're starting, people are starting to understand about food and about lifestyle changes. Let's talk about food. One of the biggest problems that we have is that 70% of our kids are the food that they eat is ultra processed. And about 63% of adults are eating ultra processed foods. That's what, that's oils, what we would call vegetable oils or seed oils, such as sunflower, safflower, canola oil that we, that we're seeing in our foods, peanut oil. So when you look at something and you see these oils, that's. That means the food is processed, processed grains, processed sugar. And that's causing a lot of the obesity and a lot of the chronic disease such as insulin resistance, which actually insulin resistance is the, is the foundation of inflammation, inflammation being the core component of most chronic disease. So if you could comment on that, I know you're very interested when it comes to the eye and protecting against macular degeneration and such as one of the chronic diseases that we see in the eye, which is the number one cause of blindness over the age of 55. [00:20:53] Speaker B: You know, it's interesting how you said you're sensing a change. And I do sense a change. Not so much in behaviors yet some people maybe, but it is pretty well understood. Like as I see patients every day, and I see patients four and a half days a week still, and I do enjoy it most of the time. But when I talk to my patients and I ask them, are you taking medications? What are you taking them for? Are you taking vitamins? What are you taking them for? Everybody's taking vitamins. Everybody's taking a supplement. And you ask them, which ones are you taking? A, C, K, D, multivitamin on top of that. And you ask them, why are you taking those things? Are you deficient or are you just taking them? No, I just think I should take them. And then you ask them, have you, you know, do you, do you, are you, are you understanding that the majority of over the counter Vitamins really are not good for you, or if they're not bad for you, they're going right through your system. The joke of some of the over the counter vitamins is they're the most expensive toilet water in town because it runs right through your system. And people say, yes, I've heard that before. And then you ask them, why are you taking them? Do you still feel you need them? And yet it hasn't quite crossed the barrier of, okay, I'm not going to take these anymore, where I'm going to make sure I take the proper ones. So just in the general population, general people in general, when I talk to patients about general health, when I talk to them about how general health impacts their eyes and their vision, there is a sense by most of my patients that say, I get it, I don't know why I'm taking the vitamins. My friend told me I should, maybe I should be doing something different that allows me to have a little bit of a different conversation with them about why they're taking vitamins, what ones they should be taking for general health purposes, which ones they should be taking to benefit their ocular health and vision. And so I have sensed this understanding that foods aren't necessarily as healthy as they should be, and vitamins are important, but why am I taking this any other thing? So has it really gone into the system as a whole? I don't think so. I think we got a long way to go. But I do sense that the average person is starting to see and understand that what we're doing to ourselves and the foods we eat and the vitamins that we take is not really the best thing for us. [00:23:00] Speaker C: I've had a lot of physicians tell me that, you know, I'm not going to go through nutrition and lifestyle with patients because they really are not interested in that. But what I find with patients is that they are interested, but they just don't know how to go about it. And the proof of that is what you just said. Most people are taking a supplement. You know, over, over 65, 68% of the population takes a supplement. About 40 to 50% of the adults take some kind of supplement. And the supplement business is a 300 is a 30 billion dollar business. So people are interested, they just don't really understand the best way to go about doing it. So when you're recommending supplements for the eye for preventing macular degeneration and us as optometrists, we deal with patients that have diseases that are nutrient related, such as macular degeneration the leading cause of blindness over 55, such as diabetes. The leading cause of blindness under 55, dry eyes is nutrition related. So let's talk about macular degeneration for a second. What supplements do you recommend for macular degeneration and what kind of diet do you recommend for for it? [00:24:20] Speaker B: Well, the joke is, well, it's not really a joke, but it's the reality that if you can eat more leafy greens, that's great. Leafy greens colored the vegetables of the rainbow is always the conversation that we have with our patients. But you're not going to tell a patient that may have risk of macular degeneration to go eat more vegetables. They may want to. They may already be eating enough, but they're just not getting enough in their system. Ultimately, what we talk to our patients about is taking the carotenoids. You know, we always used to say, eat your carrots. Beta carotene is good for your eyes. Eat your carrots. Well, beta carotene is a great carotenoid, but it's not in the eyes. So we really hit them with the need for lutein and zeaxanthin and meso zeaxanthin as well, which are heavily concentrated in certain leafy greens. Most multivitamins, as you know, don't have these in them. Most people are taking multivitamins for general health. They're not really understanding why the eye. [00:25:10] Speaker C: Let me interrupt you for a second. We're up against the break. This is Dr. Kerry gel for Open youn Eyes Radio was speaking with Dr. Mark Marciano, former mayor of Palm Beach Gardens, Florida and has private practices in West Palm beach and Palm Beach Gardens. He practices with his wife. We'll be right back. [00:25:28] Speaker A: I went to the eye doctor the other day with my daughter Maggie. I was shocked when the doctor told me that my daughter was already becoming nearsighted. It turns out that this problem affects more than 40% of Americans. My eye doctor thinks this disease is getting worse. Perhaps it's getting worse because of kids prolonged time spent playing with smartphones or maybe because kids now spend less time outside. My genetics probably aren't helping her a whole lot being nearsighted myself. But the good news is that the doctor told me about a new FDA approved product called My Sight. This specific one day contact lens is already worn by thousands of children in the US it is proven to slow down the progression of nearsightedness. And best of all, Maggie loves these contact lenses. The doctor taught her how to use them. Now it is so exciting to see her have even more success in the classroom and when she plays sports. I Recommend you visit openyoureyesradio.com to find an eye doctor that specializes in this treatment program. Learn [email protected] hi, this is Ralph Drehlinger. [00:26:29] Speaker D: The founder and president of Capital Ministries. I have the privilege of leading the Senate and House Member Bible studies in Washington, D.C. every week and I'm also the host of the new weekly radio program heard here on this station called Capital Ministries Weekend. I invite you to listen along every week as we discuss the crossroads between what the Bible says and political thought. For today, listen to Capital Ministries Weekend Sunday mornings at 7 on AM 1280. [00:26:56] Speaker A: The Patriot every 36 seconds a vehicle is stolen in the United States. Cars are an important investment and you have the power to protect it. Remove valuables from your car or place out of view. Roll up your windows completely. Don't leave your car running while unattended, especially during the winter. And always lock your doors and take your keys or fob with you. If you know something about a vehicle theft, call us at 1-800-tell this is. [00:27:24] Speaker D: A public service message from the National Insurance Crime Bureau. [00:27:27] Speaker A: I went to the eye doctor the other day with my daughter Maggie. I was shocked when the doctor told me that my daughter was already becoming nearsighted. It turns out that this problem affects more than 40% of Americans. My eye doctor thinks this disease is getting worse. Perhaps it's getting worse because of kids prolonged time spent playing with smartphones or maybe because kids now spend less time outside. My genetics probably aren't helping her a whole lot being nearsighted myself. But the good news is that the doctor told me about a new FDA approved product called My Sight. This specific one day contact lens is already worn by thousands of children in the US it is proven to slow down the progression of nearsightedness. And best of all, Maggie loves these contact lenses. The doctor taught her how to use them. Now it is so exciting to see her have even more success in the classroom and when she plays sports. I Recommend you visit openyoureyesradio.com to find an eye doctor that specializes in this treatment program. Learn [email protected]. [00:28:30] Speaker C: This is Dr. Kerry Gel for Open youn Eyes Radio. We're back. Today's guest, Florida optometric physician Dr. Mark Marciano, has deep insights into these pressing issues. Dr. Morciano is an adjunct professor at Nova Southeastern University and has served as president of the Florida Optometric Association. He also contributes to legislative efforts through his work with the American Optometric association state government Relations Committee. Beyond his medical career, Dr. Marciano has served as an elected city council member and as mayor of Palm beach gardens, Florida. With Dr. Mark Marciano of Palm Beach Gardens, Florida. He has a practice. He practices with his wife, Brandy, in Palm Beach Gardens, Florida and West Palm Beach. He's an optometric physician. He knows everything you need to know about the eye and more. So Dr. Marciano, before the break, we were talking about different types of supplements, but specifically for the eye, talking about macular degeneration. And we were talking about lutein zeaxanthin, meso zeaxanthin. And we know through research that lutein zeaxanthin could decrease the progression of macular degeneration. Depending on how well you absorb it. Studies show up to 93%. And that doesn't include Omega 3s and the B vitamins if you have high homocysteine. And new research about curcumin, decreasing the risk of macular degeneration and melatonin. So please, can you continue a little bit about the lutein, the zeaxanthin, the meso zeaxanthin, decreasing the risk of macular degeneration? [00:30:17] Speaker B: Well, yeah, sure. I mean, we as eye doctors know that those three specific carotenoids are heavily concentrated in the macula and around it. So when we talk to our patients about their risk factors, when we talk to the patients about their family history, when we ask patients if they want to live until they're 95 and see until the end of their time here on this earth as optometrists and primary eye care providers is that the medical community as a whole isn't really in tuned with what we're talking about. The medical community as a whole is more interested in medical treatments. When we talk to some of our ophthalmology friends and some of our retina specialists in particular, they'll tell us when patients have macular degeneration, eat more leafy greens, when you start losing your vision, we'll intervene with injections and medication. And I think it's just important for us as primary care eye doctors to really get behind the research and educate them. One of the challenges that healthcare as a whole has faced is that primary there's very few primary care doctors anymore. Most primary care doctors have a hard time surviving. They become part of a larger group. When you talk to when I talk to my primary care doctor and ask him, how many patients can you convince to live a healthier lifestyle, he says 3 or 4%. The hard part for a lot of physicians is that they understand that patients aren't really that keen on changing their lifestyles to live a healthier lifestyle and be proactive in their care. I think as physicians, many of us would get very frustrated with having to have that conversation over and over again with your patients, watching them, watching their health decline, and yet have very little influence on helping people change their lifestyle. And that's, that's just a symptom of the healthcare system as a whole. But that has to change. [00:32:07] Speaker C: Yeah, I mean, I think people are definitely interested. They just don't know how to do it. And if they were explained the proper way to do it, I think many more would do it than what primary medical doctors think, internists or that don't have the chance or the time to really speak with their patients. Now, you brought up something before about we need to look at the research and follow the research because there is great research on lutein zeaxanthin, meso zeaxanthin, these carotenoids for decreasing the risk of macular degeneration. There's also cognition where lutein has been shown to be in the brain. And with a, we could, we could measure the amount of macular pigment which shows the amount of lutein in the eye. And if the lutein in the eye is low, it's also low in the brain and that, that affects cognition. So. And that all comes from processed foods. But one of the problems is there's been a study that showed it takes about 17 years for research to make it into clinical doctors practices. So this great research is being done, these researchers are working really hard. And then us as doctors are supposed to use that research and disseminate it to our patients to make their lives better. But unfortunately it takes 17 years. So that's something that we have to try to figure out how to shorten that 17 years. And you would think with all the, with all the technology that we have with, with the Internet and constantly being bombarded with research, that we could shorten that. And I think that should be a goal of all physicians, whether it's optometric physicians or general physicians, to shorten that time. So to shorten that. The other thing I wanted to bring up is that on that note, and the 17 years, there was a research study done at Mayo Clinic and Dr. Macri talks about this, it was 14,000 kids that got antibiotics the first couple of years of life versus kids that didn't get antibiotics the first couple of years of life. And I gotta say, you Know, before I knew better, my two older kids were both on the gum medicine, which everybody knows are antibiotics, back in the day with liquid antibiotics for kids that were getting air infections. And I really feel, looking back because of how it negatively affected their microbiome that, you know, that they, it took them a little longer to catch up, catch up physically as they grew. But the studies show that kids that took antibiotics the first couple of years of life versus the ones that didn't, there was a 20% higher risk of obesity, a 21% higher risk of learning disabilities, a 32% higher risk of attention deficit disorder, a 90% higher rate of asthma, and 300% increased risk of celiac disease. Now, as optometrists, we do use a lot of antibiotics, but we typically don't see infants. But if you want to comment about antibiotics being used overused. Are optometrists, are we overusing them? Are all doctors overusing them? Can you talk about that a little bit? [00:35:34] Speaker B: Well, sure. I mean, it's a fascinating set of stats that you just shared. And they're real. We talk about from an optometry perspective and a vision perspective, how general health is impacting children's ability to learn. We were at a roundtable just the other day speaking about third grade reading. In most school districts around the country, third grade reading is really under 50%, meaning under 50% of the children. In most school districts across the country, children are not reading up to school level. Why is that? What's happening? And the other remarkable study and stat is that they project the number of prison cells that they're going to be building in any given community based on third grade reading and all of these years that have gone by, those no matter how much money is being spent in the school districts trying to either add tutoring or special testing or what have you, giving children more time to perform their testing in the classroom. During test time, those numbers are just inching up, barely. They're not changing drastically. So what is the underlying cause of third grade learning deficiencies? Is it truly there's more ADD in this community? I don't think so. Is there truly some increased number of children with dyslexia? I don't think so. Certainly the foods that children eat, the nutrition that they get is going to allow them to sleep properly and energy, have proper energy for concentration purposes. The ability for children to go outside and run and play, burn off some energy, which is great for the parent, but it's also good for the child's general health to be able to divert Some of that energy. And then when we talk about the other toxins that may be a part of their diet. Antibiotics are not toxins, but they're certainly not normal in a human body. They serve a purpose for short term optometry really doesn't get too engaged with using antibiotics of those concentrations. But certainly my kids when they were younger, ear infections, tonsil infections, antibiotics all the time. So are these things having an impact in children's learning abilities or is it something more than that? I think there's a number of things that go on and sadly again, it's just like everything else that we do. Instead of being proactive, looking for a solution that might be right under your nose or in our case, inside their eyes, helping them see better, helping them perform better with school activities as opposed to running to the child psychologist, getting diagnosed with ADD and taking medication for those things. There's a number of factors involved and ultimately I think again, being proactive instead of reactive is a great way to solve a lot of our problems. If only we can get the message out. [00:38:05] Speaker C: I mean, we have to look at the ultra processed food that the kids are eating. 70% of what they're eating is ultra processed food. So they're eating all these chemicals and they're eating all these oils and they're eating all this sugar. And our body, their little bodies are being made out of the food that they're eating. So if they're not eating proper food, their brains aren't going to develop properly and they're going to have trouble reading and they're going to have trouble doing math and they're going to have trouble getting along with other people and have trouble concentrating. So I think that's, that's one of the real problems is the ultra processed food, the chemicals that the kids are exposed to, the glyphosate, the atrazine. Atrazine is used in our country but is not allowed in in other countries. So these are all things that we need, we need to look at. So do you have any comments about that? [00:39:03] Speaker B: Well, you just have to look at the line at McDonald's at 5:00 after school and see the parents just getting something for their kids to eat before they rush them to here. They're in the other place. It's easy, it's fast, the kids are no longer hungry, but they're not getting the nutrition that they should. And it takes a real commitment from parents and from the community to do that. You know, we talk about government involvement in all of these things and people certainly don't want government to infringe on their privacy. But at the same time, some regulations and some real push for education and reducing some of the, some of the, you know, the garbage that's put in our foods is probably going to have to come from a higher source than just relying on patients and people to know what to do on their own. [00:39:48] Speaker C: I mean, our kids are medicated. 18% of our kids up to age 0 to 11, from birth to 11 have been on a prescription medicine over the last 30 days. And the average, the average American is on three or four prescription medications. And 40% of older Americans take five medications or more and 20% take 10 or more. This is Dr. Kerry Gelb. We're speaking with Dr. Mark Marciano. You're listening to AM 1280, the Patriot on Open youn Eyes Radio. We'll be back after the break. [00:40:27] Speaker A: I went to the eye doctor the other day with my daughter Maggie. I was shocked when the doctor told me that my daughter was already becoming nearsighted. It turns out that this problem affects more than 40% of Americans. My eye doctor thinks this disease is getting worse. Perhaps it's getting worse because of kids prolonged time spent playing with smartphones or maybe because kids now spend less time outside. My genetics probably aren't helping her a whole lot being nearsighted myself. But the good news is that the doctor told me about a new FDA approved product called My Sight. This specific one day contact lens is already worn by thousands of children in the US it has proven to slow down the progression of nearsightedness. And best of all, Maggie loves these contact lenses. The doctor taught her how to use them. Now it is so exciting to see her have even more success in the classroom and when she plays sports. I Recommend you visit openyoureyesradio.com to find an eye doctor that specializes in this treatment program. Learn [email protected] Join Gene Sullivan each week. [00:41:29] Speaker D: On where YOU live. [00:41:30] Speaker A: Where he takes on Gene who do you take on anyway? Maniacal landlords, slippery renters, overbearing HOA boards, demanding homeowners. [00:41:41] Speaker D: Oh, and the legislative lunacy brought on by local politicians wanting to fix everything for us. [00:41:47] Speaker A: It's a common sense perspective on the news and stories that affect you the most right where you live. Join Gene Sullivan every Saturday morning at 10am on AM 1280 the Patriot. [00:41:57] Speaker D: What would you buy today if it was half price? Go to mndeals.com click on the red tell us what you want button and we'll try to find it for you at half price. MnDeals.com works with local businesses to offer great deals for Patriot listeners like you. We've sold pellet grills, water systems, furnaces, hot tubs, balloon rides and more. What would you buy today if it was half price? Go to mndeals.com and let us know. While you're there, read the reviews and check out the current deals. MnDeals.com is a service of AM 1280. [00:42:26] Speaker A: The Patriot I went to the Eye Doctor the other day with my daughter Maggie. I was shocked when the doctor told me that my daughter was already becoming nearsighted. It turns out that this problem affects more than 40% of Americans. My eye doctor thinks this disease is getting worse. Perhaps it's getting worse because of kids prolonged time spent playing with smartphones or maybe because kids now spend less time outside. My genetics probably aren't helping her a whole lot being nearsighted myself. But the good news is that the doctor told me about a new FDA approved product called MySite. This specific one day contact lens is already worn by thousands of children in the US it is proven to slow down the progression of nearsightedness. And best of all, Maggie loves these contact lenses. The doctor taught her how to use them. Now it is so exciting to see her have even more success in the classroom and when she plays sports. I Recommend you visit openyoureyesradio.com to find an eye doctor that specializes in this treatment program. Learn more@openyourized radio.com we're back with Dr. [00:43:31] Speaker C: Mark Marciano, optometric physician, West Palm Beach Palm Beach Gardens and we were talking about kids and being on medication and adults being on medication. Let's turn it to eye exams for kids. Dr. Marciano, at what age should a kid get their first eye exam? [00:43:49] Speaker B: Well, we recommend children before the age of one come in for their first eye exam, really just to see if their eyes are working together, make sure they don't have any eye diseases even though they're very rare. Really. At age 3, a child's vision is starting to develop and by 5, especially before going to kindergarten, we would really love to be able to get children's vision a full eye exam checked. One of the concerns that we have as optometry and not really so much in the medical community is the realization that children and parents are relying on school screenings and screenings at the pediatrician's office to assess the child's vision. And we all know that in the optometric community especially that 2020 vision or 2030 vision may be Adequate to pass a driver's license. The child can see the board, but they're not able to concentrate and read. When we talk about all of the different possible causes of why children aren't reading at third grade level, certainly behaviors, foods, activities, too much screen time, not sleeping properly, kids not going to bed at a reasonable time, not staring at their, their iPad the second they go to bed. These are things that need to change. But at the same time, we know that 30% of children will actually pass a vision screening at a school or at the pediatrician's office and yet have a vision learning related problem. And if we can just get those kids in that second and third grade, those kids that are failing school reading levels at second and third grade, get them to a proper eye doctor that is happy to see children and can diagnose sometimes, you know, a hidden prescription or one eye seeing different than the other, we talk about medicating our children. It's easy to take, even for adults, it's easy to take hypertensive medication than trying to get a little bit of an exercise regimen and eating properly. For parents, it's easy to give their parent, their child, you know, any type of medication for ADD or ADHD instead of maybe taking them to the eye doctor to get a proper eye exam. When you solve a problem at the base, when you become proactive in treating a patient from their actual problem, instead of reactive and just giving a medication to try to solve a problem, you're actually solving the problem. You'll see the child's development take off. You'll see their ability to perform in school take off. You see their confidence take off. You'll see their ability to communicate with other people in their schools, their teachers, and their ability just to flourish as a child. They're able to read properly, they're able to perform better in school, and they're happier to do that. So, you know, as a system, we need to bring it back a little bit, look for solutions, some real holistic solutions to problems instead of looking for a band aid. And our system really, as you said earlier, is really just designed. It's not health care, it's sick care. Let's see if we can change that conversation and see if we can get to the right physicians, the right providers to give that proper advice so that maybe we can start changing the trajectory of general healthcare in this country. [00:46:40] Speaker C: I think the refraction for people that are listening is when we decide what prescription glasses or contact lenses to give somebody. And the refraction is really an art, a Very important art people get glasses. They might wear them a year, they might wear them two years, they might wear them three years. And this is how 80% of learning for kids is through the eyes. Talk about the art of the refraction, which I think is a really underappreciated. You know, we love to talk about the sexy things, treating glaucoma and giving injections and removing lumps and bumps and doing lasers. But we don't, we, we underappreciate. I think eye doctors and the public because of eye doctors under appreciate the refraction. Talk about the refraction for a minute. [00:47:33] Speaker B: Well, sure. I mean 20 some odd percent of the population is myopic, meaning they can see near, they can't see far. Those are the easy ones. Kid can't see the board at school. Okay, well you need to get some glasses. A third of the population really doesn't have a prescription until they get in their mid-40s. And then the rest of the population is actually farsighted. We call it hyperopia, meaning they can see far and close. And those are the ones that are the challenges. Those are the kids that can see the board at school. They can see up close, but they can't maintain that concentration. And why? Because their focusing system is overtaxed. It's working far too hard in the add on screens, which generally makes it harder to concentrate on a screen than it does to look at a piece of paper. And our world has become screen dominated instead of looking at paper. That adds another level of stress to the focusing system. But in being able to refract a farsighted child, being able to, able to understand a child's behaviors, watch them in the chair, look and see if they look at you in the eye. Being able to use different techniques to determine if a child truly is farsighted or not, is one eye different than the other. These are key factors in the art of a refraction. Not every doctor likes to do refractions on children because it is tricky. Not everybody likes to see children because kids are a different breed. You know, they're not always as easy as seeing an adult that can answer questions properly or succinctly. But when you find that doctor that likes to do it, when you can see that child and be able to refract them and find a solution to their problem for that mom. When they look at you and you give them the questionnaire of common children's vision problems and then you refract them and you show the child what they are missing and the parent sits on the other side of the room and their jaw drops when they realize, oh my gosh, my child's beautiful. I thought they could see everything they're not seeing like I thought they should. Let's make their lives better. I mean, that's a real, real positive moment as an optometrist to make a positive difference in children's lives. And unfortunately, we don't do enough of it. We don't get to see enough of the kids because the system doesn't draw them to our practices. And that's something that I'd love to be able to change. [00:49:40] Speaker C: I have to ask you this question as a optometrist that I really respect who you're. You're a tremendous speaker, public speaker. I listen to your lectures. You're an amazing speaker. But I want to ask your opinion and somebody who deals with policy. What do you think about online exams? Eye exams? Online exams. People pull out their phone, they think they're getting an eye exam. [00:50:04] Speaker B: Well, it's a danger. I mean, we're all supportive of telehealth. I mean, I did a telehealth visit with a patient today. He's elderly, he's got a initially with his eyes. And I was able to facetime him and talk to him and provide a medication for him, a topical antibiotic to solve one of his problems. That's what telehealth is for. Because optometry is so retail driven, there's a big retail component of what we do. People don't think about their glasses and their contact lenses as a medical device. So they're looking for simplicity. There's a number of legislators across the country who think that this is more of a convenience for the consumer as opposed to a medical device. Look, we're all very busy. My son was joking the other day about who goes to the grocery store, who goes to the store anymore to buy things. You just buy it on Amazon. We're in a vastly changing, fast changing society where people are purchasing things online and they want simplicity. But the problem with the eye portion of all of this is that you can't diagnose, you can't do the art of a refraction online. It doesn't work properly. Yes, I understand. Patients are only wasting their dollars by purchasing a product that doesn't serve them well. But if you think of the bigger picture, the difficulties, the time out of work, the number of headaches being had by people because their vision is impacted, that along with all the screen time that people are stuck on a screen. If you're not wearing the proper prescription, if you're not wearing the proper glasses, if you're just trying to get something cheap and fast and easy, you're actually doing yourself a disservice. I don't know what the stat was, but the number of MRIs being ordered for headaches in this country is through the roof. Are there more brain tumors in the world? Are there more aneurysms going on in our country? No, but, you know, defensive medicine, doctors looking for the possibility of brain tumors, patients having unexplained headaches, that drives these types of tests to being done. But ultimately, if you were just to find the, the right solution to that problem, being proactive instead of reactive, maybe spending a few extra minutes on something that's important, you would, you would realize that you suffered for a long period of time with just a simple refraction that was done improperly. And most of the time it's done online. So how do we fight that? Well, legislation is going to have to require certain things, and our colleagues and all the whole medical field is going to have to be a little bit more in tune with the risks. [00:52:26] Speaker C: Coming up to the end of the show. But you mentioned before myopia. Talk to me about myopia control, something that we've recently been able to do as optometrists decrease the progression of someone getting, needing very, very thick glasses. [00:52:41] Speaker B: Yeah, this is a big thing. Again, screen time is a big problem for our society and our kids. Adults get headaches, kids get headaches, and they act up. But we're also seeing nearsighted myopia becoming more of. Some people call it a pandemic. When you start to see nearsightedness increase, it's not just the inconvenience of needing stronger glasses or higher prescription contact lenses. It's a true health issue. It's a true ability to see things properly. Yes, you can see 20, 20 letters, but are you seeing them as like you want to? And then ultimately, as we get older, the risk of glaucoma, macular degeneration, cataracts, and retina detachments at an earlier age certainly become a factor. The beautiful thing about technology is we're seeing real advances in this, and most of our colleagues are cognizant of it. Not every one of them wants to treat it, but certainly the options are out there. And this is where the final call comes to encourage our doctors. No matter what your discipline is, find the love of what you do. Find the love of the profession that you chose. Do the little things to make your patients lives better for our patients out there. Listen to your doctors, ask the proper questions and try to make your life a little bit better by being proactive instead of react. [00:53:50] Speaker C: Dr. Marciano, if people want to find out more about you, how could they do it? [00:53:54] Speaker B: They can go on our website, drmarciano.com d r m a r c I n o.com that's our office website. You can see our two locations, obviously, Facebook and everywhere else as well. [00:54:05] Speaker C: I want to thank my good friend Dr. Mark Marciano for joining me today on Open youn eyes radio with Dr. Terry go. And until next week, have a very, very good weekend. Thank you. [00:54:17] Speaker D: When our furnace quit on us last winter, we needed help fast. So we called Sedgwick. They're proud to have the highest referral rating of any H vac company in the Twin Cities. And now we know why. Their technicians are not only the best at what they do, but they're also really respectful and clean. They don't play games like some of the other companies. No bait and switch tactics. Right now they're offering $1,000 off installation of a new high efficiency Lennox Furnace that is hands down the best offer in town. For a free consultation, visit mnheat. 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