Tackling Obesity Stigma and Access: The International Weight Loss Collaboration
Welcome back to The Weight Loss Collab, where we unite passionate voices from around the world to tackle the global obesity crisis and reimagine what effective, compassionate care looks like. In today’s episode, we’re thrilled to welcome Jarryd Walkley, a bariatric coordinator from Austin Health—one of the largest public hospitals in Australia—who joins us all the way from Melbourne. Together with co-hosts Hannah Schuyler and Dr. Dovec, Jarryd shares an inside look at how Australia’s public healthcare system is meeting the challenges of obesity treatment, what it means to build meaningful patient relationships in the face of stigma, and the innovative ways her team has managed to drastically cut down wait times for bariatric surgery.
You’ll hear stories of resilience—patients who waited years for life-changing procedures, and the joy of witnessing their victories, both on and off the scale. We'll also unpack the value of global collaboration, as Jarryd discusses lessons learned from her travels to leading bariatric centers across the world, and how different systems approach access, innovation, and patient-centered care.
If you’re ready to be inspired by a truly international perspective, discover what’s possible when creative minds bridge continents, and learn why the future of weight loss treatment is all about teamwork, curiosity, and “just doing it,” then you won’t want to miss this episode. Let’s jump in!
Transcript
She's a doctor. Hi, I'm Dr. Dovec and she's a dietitian.
Speaker:Hey, I'm Hannah Schuyler and together we are the weight loss
Speaker:collaboration and welcome. From all around the
Speaker:world in Australia. Melbourne, Australia. We have Jared
Speaker:Walkley with us today and we are going to
Speaker:dive into this global crisis which is obesity. And
Speaker:we're going to talk about all the creative
Speaker:conflict that we can get into to really innovate and advance
Speaker:our specialty. Very excited to be here. Thank you both so much
Speaker:for having me the way. It was a very long flight to get here, but
Speaker:I'm so excited. Well, we're very excited to have you. Thank you so much for
Speaker:joining us today. So I know we just kind of wanted to dive in. Yeah,
Speaker:we do. So I want to talk a little bit about for our listeners and
Speaker:hopefully the listeners welcome from Australia that will undoubtedly be
Speaker:tuning in as well. But tell a little bit about your health system
Speaker:and what your role is as a bariatric coordinator at one of the
Speaker:largest public hospitals in all of Australia. Yeah,
Speaker:so in Australia it's very different to what I understand of the American
Speaker:system and also what I've come to understand of,
Speaker:say, even European health systems. I've been on a three week
Speaker:tour around the world looking at different innovative
Speaker:spaces. So in Australia we have,
Speaker:everyone has what's called Medicare. So if you're an Australian citizen,
Speaker:you have a very base level of health care. So
Speaker:everyone can access health care. It's just whether you can choose your doctor, whether
Speaker:you can choose your time, time frame. So there are certain time frames
Speaker:set to have a surgical procedure like bariatric surgery by the
Speaker:government. However, not every health service offers this.
Speaker:So Austin Health, where I'm from, is one of only
Speaker:23 government funded hospitals in the country. So we have around
Speaker:700 and we're one of only 23 that offer
Speaker:any sort of obesity services. So bariatric
Speaker:surgery. And having said that, where one of only
Speaker:six out of those 23, only six offer what we consider high
Speaker:volume bariatric surgery, and I use that term very
Speaker:loosely. So high volume would be anything over
Speaker:50 cases per year, which is really low compared
Speaker:to a lot of other centres. So we do around about 200
Speaker:procedures a year and so we're considered one of the highest volume public
Speaker:services in the country, which is really exciting. And my
Speaker:role, I get to do it all, which is what nurses are known for,
Speaker:but I manage all of that. Incoming
Speaker:referrals, I do a lot of the advertising as such,
Speaker:of Our service, talking people through what to expect, what
Speaker:obesity services we offer, whether that be medication, whether that
Speaker:be surgery, lifestyle management, all of that kind of thing.
Speaker:And then I manage the entire journey through to surgery. So I
Speaker:do an education seminar I, which is a live event that we
Speaker:run and then patients go through a self directed series of modules to, to build
Speaker:all of that comprehensive knowledge to ensure success down
Speaker:the track. And then I book all of the surgery
Speaker:once they've seen the surgeon and decided on a procedure type and I continue
Speaker:that education and that relationship. I think the most important part
Speaker:of what I do is building that relationship from the outset.
Speaker:So my face is the, you know, whether they like it or not at the
Speaker:moment, we will have that, you know,
Speaker:consistency through the journey and be that safe space because
Speaker:a lot of our patients, and I'm sure it's the same here in the US
Speaker:that there is a lot of stigma associated with obesity
Speaker:or living in a larger body or even seeking treatment for
Speaker:obesity. And so creating that safe space and for people to
Speaker:feel that coming and seeking help is, you know,
Speaker:they're in a secure place, they're not going to be judged, they're going to be
Speaker:supported through this journey because we, we get it for one of the better term,
Speaker:we're in the bubble and, and we're there to support them. So, yeah, so
Speaker:the whole spectrum of care and I love so much that
Speaker:I will have patients call me, you know, five, 10
Speaker:years down the track after their surgery to tell me their
Speaker:successes. And one of my favorite ones is, you know,
Speaker:a patient had called me and she said, I'm not sure if you remember me.
Speaker:And little does she know everyone's stored up there, but,
Speaker:and she said, I just wanted to tell you I went down the slide with
Speaker:my son today at the park and that was her,
Speaker:you know, that was her goal, that was her, her aim. And it always makes
Speaker:me a little bit, you know, teary because those kind of wins
Speaker:are so important to people and getting back into life and
Speaker:having that new lease on life, it's, it's what it's all about. And you know,
Speaker:people kind of get reborn at this point when they have their surgery, so.
Speaker:Oh yeah. Do you guys have a name for those wins?
Speaker:Non scale victories. Okay. Yes. The NSVs.
Speaker:And I mean, yeah, it's everything that makes life worth living and
Speaker:clearly you're experiencing it there. It's just, this is just a
Speaker:very human experience to go through. It is, yeah.
Speaker:And that human connection that we have with our patients and I Know, you. You
Speaker:have a very similar experience here. That human connection is really
Speaker:what bonds us at the core. And for our patients to
Speaker:know that they have us in their corner for that journey, it's. It's amazing.
Speaker:Yeah, well, it's like you said, I mean, there is a stigma of not only
Speaker:having obesity, but then also seeking out treatment for it. It's like,
Speaker:you can't win, you know, and people say it's the easy way out, or why
Speaker:can't you just do it the normal way or the natural way? It's like,
Speaker:so what? So, okay, thank you. Thank you for that. Yeah. It's like.
Speaker:And you don't have that in, you know, if you have hay fever,
Speaker:and I don't know if you get that down here in Florida. But if people
Speaker:have hay fever, no one thinks twice about going to
Speaker:pharmacy to get some help or, you know, saying to people, I suffer
Speaker:from hay fever. But there is so much stigma that's associated with.
Speaker:With seeking treatment for obesity, and it just shouldn't be that way. Absolutely
Speaker:not. So true. So you said, you know, you follow up with patients. 5,
Speaker:10 years. How long have you been in this bariatric space?
Speaker:So I. So just shy of 10 years. Wow. Which
Speaker:is really exciting. In the bariatric space. I've been a nurse for 14 years.
Speaker:It is not. Not a field that I thought I was going to end up
Speaker:in. I trained as a. I don't know if you have something similar like a
Speaker:stomal therapist, like a stoma nurse. If someone has colorectal
Speaker:surgeries, they end up with a, you know, a stoma.
Speaker:So I trained in that field. I did a lot of nursing
Speaker:education, but then my. What we call our
Speaker:head of unit. So I had head surgeon Dr. Ahmed Ali.
Speaker:He asked me what I thought about bariatric surgery. And at
Speaker:the time, I'd only been exposed to a lot of the
Speaker:challenges. So we have a lot of people that travel overseas to get surgery just
Speaker:from accessibility point of view, and then we manage
Speaker:a lot of the complications following that. So what I had seen
Speaker:was, I guess, all of those challenges.
Speaker:And so I said, oh, you know, hadn't been a field I thought I would
Speaker:go into, but we'll give it a go. I always love a
Speaker:project and a new idea and innovating. So I did a small project
Speaker:of evaluating our service. And the more I got into
Speaker:it, the more I felt like, you
Speaker:know, I think I said this before. I found my people, I
Speaker:found I love my patients so much. They bring me so
Speaker:Much joy. And that is, you know, my sole motivation for most
Speaker:things in life is to be happy and have joy. And they bring a
Speaker:lot of that for me and also the people that I work
Speaker:with. It's so nice to feel valued and to
Speaker:feel heard. And we, my unit,
Speaker:we don't exist in a hierarchy. I'm elevated as a
Speaker:nurse, I'm elevated as a healthcare professional and a clinician in my own right
Speaker:amongst our surgeons and dietitians and psychologists and administrators
Speaker:as well. So a very, very, I call it a unicorn. It's a nice
Speaker:place to. Nice place to be. So. Oh, I love that you're so happy.
Speaker:I. In the culture and then the work environment
Speaker:with the people, both patients, but also your colleagues, like, there's
Speaker:a lot to say about that. And that is a reflection on the care that
Speaker:you give your patients. Without a doubt too. Yeah. And I
Speaker:mean, you run this, this huge thing. I had the opportunity, of
Speaker:course, to meet you a few years ago in Australia and my first stop
Speaker:off the plane, I don't know if you realize that, but I flew,
Speaker:I wasn't even on the ground for one day because I cross the
Speaker:continental divide and whatever and I landed and I
Speaker:was kind of like staggering off this 20 some hour flight and
Speaker:I immediately went to Austin Health and I met you. The very first person
Speaker:I met in Australia was you. And we had this amazing lunch and
Speaker:this incredible conversation and you showed me a presentation and just kind
Speaker:of explaining a little bit about what, what you guys did. And then I took
Speaker:a tour of the facility and it was interesting.
Speaker:It was interesting. Kind of the resources that you have and what you've done
Speaker:done with them is really unbelievable.
Speaker:And at that time you had said that you had a waiting list of over
Speaker:a thousand patients who were just waiting for care. And like you said, some of
Speaker:them go across overseas to get care
Speaker:elsewhere. Tell a little bit about that whole
Speaker:waiting process and how you've worked so diligently over these
Speaker:last few years to make that weight almost non existent now. Yeah,
Speaker:yeah. So we. One of the unique things around
Speaker:what we call public health in Australia is, and I mentioned that
Speaker:bariatric surgery is few and far between.
Speaker:So only about 5% of all bariatric surgery that occurs
Speaker:in Australia is done in public health. And so a lot of patients
Speaker:don't have equitable access to health care where we're from.
Speaker:And so people will wait a very long time for their surgery.
Speaker:Some people, at that point when you came out, Betsy, people were waiting, you
Speaker:know, five years for their surgery. And we.
Speaker:One of the real main points that we tend to make is
Speaker:that we've had more people die waiting for access to
Speaker:their treatment than what they have having had their treatment.
Speaker:So we have a very, very good program of very skilled surgeons,
Speaker:but people struggle to access it. And so
Speaker:there was a period of time because Melbourne was hit quite
Speaker:heavily by the COVID what we call lockdowns. And, and I'm sure you experience
Speaker:some, some lockdowns here as well. So we were on hold for a very long
Speaker:period of time where we couldn't do a lot of bariatric surgery among some other,
Speaker:what was considered non urgent procedures. And that's an argument for another
Speaker:day. Yes, and
Speaker:we just had a wait list that was blowing out and blowing
Speaker:out and people were waiting and we were just adding to the wait list without
Speaker:being able to treat people. So, so we took several
Speaker:steps at that point. I came back from maternity leave
Speaker:and I think I made that joke, Betsy, when you came, that you could see
Speaker:this lovely little graph of steady increase in procedures and this
Speaker:little drop when I went on maternity. I won't take all
Speaker:the credit for that. But we had this
Speaker:awful situation and I made a real concerted
Speaker:effort to. I presented to our divisional managers and directors
Speaker:what the plan would be. And so we paused our referrals, pause our
Speaker:intake for a period of time. And we have a pre
Speaker:surgery program. We ramped that up. We ran that very
Speaker:frequently once a month. And we got through so many patients. And
Speaker:there's a group of patients that will come through, have that education
Speaker:and understand the breadth and depth of the change involved
Speaker:in bariatric surgery and they will opt out at that
Speaker:point in time. It just might not be for them at that moment. And we
Speaker:keep that door open. It's a full circle so people come back. But
Speaker:we had that time and we've now
Speaker:gotten to the point. I'm very proud. I do sort of these month end reports
Speaker:and report back to our administrators and we have
Speaker:cleared all of those. So we cleared that outpatient
Speaker:backlog in 12 months and we are now at the point where we have
Speaker:a wait time for surgery of around two to three weeks. So for the moment,
Speaker:the people live by anesthesia have had their
Speaker:dietetic education and they are good to go.
Speaker:It's a really unique situation and I'm so proud.
Speaker:The moment that I booked our last long waiter,
Speaker:a beautiful, beautiful man. And
Speaker:I so look forward to seeing him throughout the journey of
Speaker:recovery and getting his life back. But he waited a Very long
Speaker:time and resilience in the face of
Speaker:adversity. He's the true definition of that. He went through so
Speaker:much. He was on hold during that Covid time and I got to have
Speaker:that moment in the operating theater where I, I went down
Speaker:and I wanted to be there with him on the day. And the last
Speaker:thing that happened before he went to sleep, our Anita just said, you know,
Speaker:you're going to go to sleep now. And he just popped his head up and
Speaker:he said, jarrod, Jarroding e there. Wow.
Speaker:And I just like tears welled up and I went over and I said,
Speaker:I'm here, I'm here. And he just looked at me and he said, you know,
Speaker:we did it, we did it. Just, it's such a,
Speaker:such an incredible moment for my career and I love that so much. And
Speaker:that's, you know, that's the benefit of so much effort going
Speaker:into to making sure that people have access to the care that
Speaker:they deserve. And it shouldn't be something that people feel.
Speaker:Everyone feels so grateful for. You know, they thank you so much.
Speaker:And I'll often remind people, you know, it's nice to be
Speaker:thanked, but at the same time, you should, you
Speaker:know, I tell people you should feel like this is just basic care. This is
Speaker:standard. You should have a right to this. You should have a right to stigma
Speaker:free health care and to access, you know, things that are going to help
Speaker:you, you know, achieve longevity. Absolutely.
Speaker:Oh yeah. So sweet story. I mean, and we
Speaker:talk so much about access to care. And I want to expl
Speaker:to everyone listening, like the scholarship or this grant
Speaker:opportunity that you're on. We're here right now. We
Speaker:built the surgery center, the Surgical Institute of Central Florida, and
Speaker:you came to witness it. And you know, kind of our backstory
Speaker:is very similar, that this should be basic. You have an
Speaker:issue. You should be able to have somewhat affordable,
Speaker:readily available care by people who are experienced. And not
Speaker:only that, your experience should be amazing as well. And you're
Speaker:here to kind of look at that. And I feel like we're already, we're just
Speaker:getting going. But that was always kind of our North Star that we're
Speaker:going to improve access. And we've talked about that endlessly on this
Speaker:podcast. So tell us a little bit about how you actually
Speaker:are here right now in Orlando, Florida in the US and
Speaker:how you decided that you wanted to come here. And also what are you
Speaker:learning? Like, is this worth it? Like, I don't know.
Speaker:Yeah, absolutely. And this has been several years in the Making so,
Speaker:so I think the first time Betsy also you present at one of our
Speaker:national conferences in Australia in Cairns. And that was my,
Speaker:that was my first ever conference that I went to and every. The world has
Speaker:opened up since, since then and then you came out to visit
Speaker:us and I was like this, you know, this is the woman that you
Speaker:are incredibly inspiring. And again that, that whole
Speaker:resilience in the face of adversity. There is so much to admire
Speaker:about that and the whole ambulatory
Speaker:surgery is such a novel concept and the.
Speaker:So I've the reason that I'm here. I've received the Beverly
Speaker:Bruce Austin Health Nursing Scholarship. So it's the
Speaker:highest value scholarship available to an Australian nurse. So
Speaker:it's the equivalent of around US$35,000 to
Speaker:travel the world and see different places and, and learn from different
Speaker:experiences and bring them back to the Australian healthcare system.
Speaker:Very unique for nurses. Nurses don't traditionally get a lot of
Speaker:funding. There's obviously medical device companies or
Speaker:multivitamin companies that fund other specialties. But nursing
Speaker:tends to be the unsung hero. So it's really nice to fly the
Speaker:nursing flag here as well. But yeah
Speaker:it's been this whole year and this trip has really been
Speaker:designed around this particular visit so. So I wanted to
Speaker:come to Orlando and see how everything worked because for
Speaker:us the longer that you're in hospital
Speaker:the more that it costs the government funded healthcare system. And
Speaker:there is always ways avenues being looked at to
Speaker:try and reduce cost while still providing really high quality care.
Speaker:And so part of the preparation that patients do through new
Speaker:Tri Health. I loved hearing about that a few years ago because
Speaker:that is a really big part of our preparation. We need to use
Speaker:limited resources to provide the highest quality
Speaker:preparation. So that was a really attractive thing for me and
Speaker:being able to see, you know we, we saw some people operating on first thing
Speaker:this morning and, and they've already, they're already off they, they're recovering
Speaker:so well and that's probably the main thing that we, we're really wanting
Speaker:to, to launch some what we call day case surgery
Speaker:in Australia. I've part of what we do,
Speaker:we're constantly advocating for our patients but we're also constantly advocating
Speaker:for our service to survive and thrive.
Speaker:And so things that the hospital administrators look at are
Speaker:is it resource intensive, is it going to cost us a lot of money in
Speaker:the long term, is that economic benefit there?
Speaker:And this is where that ambulatory surgery really comes in and
Speaker:it's not. There was one place in Australia that does it
Speaker:in lower volumes in a very finite group of
Speaker:patients. And so the fact that this is a fabulous
Speaker:standard of care here was such an attractive thing for me to
Speaker:want to come and see. And everyone had loved hearing about,
Speaker:as I was describing my trip. So when I applied, I had to
Speaker:describe what I was going to be doing here and all the benefits that I
Speaker:would be able to bring back. And everyone was so excited for me.
Speaker:It's a lot of my surgeons are sort of got fear of missing out or
Speaker:phone. It's the same thing because it's just.
Speaker:It's been an incredible, you know, it's been a few hours that I've been here,
Speaker:and it's just been incredible seeing. Seeing what you've created.
Speaker:It's awesome. That's such a cool opportunity. Like. Yeah, to.
Speaker:To obviously deserve to get that and to take that. And, you know,
Speaker:you've said you're. We were talking before, you've been to Elsa, to the Netherlands.
Speaker:You went to conference here this past couple weeks
Speaker:or last week, I guess, and then you're going to Chile.
Speaker:Chile, yeah. Have to. Have to learn how to use that
Speaker:accent to say it. So, yeah, the whole year has been. Been
Speaker:huge. It's. The scholarship has covered three international
Speaker:conferences and two site
Speaker:visits to hospitals or organizations. So it's been an incredible
Speaker:opportunity and I was really able to curate that with.
Speaker:With my own sort of goals in mind and what will fit our service.
Speaker:And I was actually asked. I received a message this morning from one of the
Speaker:conveners of our national conference in a few weeks, and they've asked
Speaker:me to present on my experience and what I've done
Speaker:because it's such a unique thing for nurses particularly.
Speaker:And from what I've come to understand, particularly in
Speaker:the Netherlands, the role of nurses and dietitians is so different.
Speaker:And it really goes to show sort of how advanced we are, which
Speaker:is amazing. So, I mean, we've certainly got a way to come for, you know,
Speaker:reaching where the US are, but that's the whole. The whole point
Speaker:of the trip, just seeing how we can advance and building
Speaker:those connections to be able to help that international collaboration just to
Speaker:bring the most to our patients. Yeah, that is so interesting to me.
Speaker:You had said before that Australia,
Speaker:you feel like is a few years behind. Why do you think that is?
Speaker:I mean, it could just be those that I am connected
Speaker:with and what I've seen internationally. I think that
Speaker:there is an element in Australia where
Speaker:people are so protective of bariatric surgery and that we have
Speaker:it available and we want it to be accessible for people.
Speaker:So we're a little bit protective. So we may not be as
Speaker:there's certainly innovation and drive,
Speaker:but we understand the climate that we're in and we understand the
Speaker:need to be able to present in a certain way, to not
Speaker:be seen as being radical and outrageous and expensive
Speaker:and dangerous and all of that sort of thing. So we try really hard
Speaker:to protect the message that bariatric surgery, it is
Speaker:what it is, that it's a safe, really effective treatment.
Speaker:And I think we're seeing more and more that we still know that it is
Speaker:the most effective treatment for obesity. So I think we're
Speaker:maybe a little bit conservative in that regard. But
Speaker:as we talked about that creative conflict our team is
Speaker:really good at.
Speaker:What's the term when you sort of,
Speaker:you go against the norm and you will share bold ideas because
Speaker:it's not a risk to be wrong where we are. So you can
Speaker:share an idea and it can be wrong and people can challenge you on your
Speaker:ideas. But that's how we all evolve. So in not
Speaker:every area, I've come to know that I use the term.
Speaker:A bit of a unicorn, our service, because of the people
Speaker:and the team that's been curated there and not everywhere is like
Speaker:that. I've come to know there's a lot of privilege in what I
Speaker:have and what I've been exposed to. So it's, it's
Speaker:interesting. But I think, you know, everything the Aussies or
Speaker:always sort of say, you know, America always does it so much bigger and I
Speaker:think you've got that, you know, you've got that
Speaker:ability to be able to drive change and things and I'm
Speaker:sure there's certainly areas in the US that are more conservative
Speaker:than others. But yeah, it'll be interesting, you
Speaker:know, new technologies and things. There's a lot that I saw at ASMBS
Speaker:that is not available in Australia. You've got a number
Speaker:of different multivitamin companies and we, we have mainly
Speaker:two, there's three available that are mainly two.
Speaker:So it's just that kind of thing. It takes a little bit, you know,
Speaker:Australia's 23 hour flight away takes a little bit to get. Shipping time
Speaker:is really long, shipping time. Is long and you know,
Speaker:cost of shipping, all of that sort of stuff. So that comes, comes into it
Speaker:as well. So. But that's the, you know, that's why I want
Speaker:to be so mobile and I want to be able to see what the world
Speaker:has to offer and, and be able to do that. With the ability to
Speaker:travel, it's easy to bring ideas back and evolve
Speaker:quickly. So hopefully, you know, we can lead the way with
Speaker:that. I mean, I think so. I think, yeah, you're. You're trying
Speaker:to just so carefully disrupt a space
Speaker:in the areas that need to be disrupted.
Speaker:And I think that outpatient, the same day discharge, both
Speaker:from either a hospital setting, like at Austin Health or even here, we're at a
Speaker:surgery center standalone. We're just doing bariatric surgery. They
Speaker:come in, they have the procedures, and then they safely either go home or to
Speaker:a hotel that's really nearby. And I think you do have
Speaker:to have the mindset of, okay, a
Speaker:always quality safety. You already went there. But I
Speaker:think the biggest thing is just. Just doing it. Like, I don't think there's
Speaker:anything that I realized I've been doing it since 2019.
Speaker:And what I realized over the last six years is that you just got
Speaker:to get everybody on the same page. We're all marching to the same goal that
Speaker:they're going to leave right after here. And the main things that they need to
Speaker:be, number one is educated, and you are that person that
Speaker:assures all of that. And number two, you need to be able to communicate with
Speaker:them. And it seems like they're waking up calling your name. They know
Speaker:how to get a hold of you or somebody in your clinic that
Speaker:24 hours a day. Like, if something's a little bit off, especially that first night,
Speaker:there's somebody that can help guide them. Let me troubleshoot this. Or even you need
Speaker:to go to a hospital, an emergency room, and be evaluated.
Speaker:And then I think it's about expectation management to not just the team,
Speaker:the nurses and. And the or personnel, and then the surgeons,
Speaker:but also to the patients and their supporting family members or
Speaker:friends who will be helping them out, that, hey, they're going home.
Speaker:You need to make sure that they walk, you make sure that they can drink,
Speaker:and you make sure that they're urinating, and basically they
Speaker:sleep, and then that's it. And they'll wake up the next day. They weren't bugged
Speaker:all night. They feel like they have their whole setup. You help them get organized.
Speaker:We have a multidisciplinary team. We have Hannah, who offers, you know, that kind
Speaker:of comprehensive look at this entire thing. And I think that's it. That's the secret
Speaker:sauce. Just do it. It's just, you know, your surgeons are great. You guys
Speaker:have the laparoscopic equipment. I mean, everything that you have. I
Speaker:don't think from an actual procedural or technical standpoint, you're behind
Speaker:at all. I think now it's just, all right, are we going to do
Speaker:it? Yes. Because I think the bottom line is this, whether we, you
Speaker:know, we know that this should be a basic right. But at the end of
Speaker:the day, it does come down to money. At the same time, it is a
Speaker:business. And you need to make sure you're not hating, hemorrhaging money out, because then
Speaker:you're not going to have any ability to subsidize all of these
Speaker:like you and, you know, your surgeons and all the things that
Speaker:go into making this such an incredible thing.
Speaker:So I think that if you can get them out, they'll
Speaker:ultimately, once they kind of get used to it, everyone will see like,
Speaker:they actually do better. Yeah, yeah, they do. And people want to be in their
Speaker:own environment. They want to be with their families, they want their own
Speaker:bed, their own shower. All of those things that help you feel comfortable.
Speaker:And I will always tell, even when I used to work back in a
Speaker:ward inpatient setting, I would tell my patients, you know, get in your
Speaker:own clothes. Do not sit in that hospital gown. You will mentally, you
Speaker:need to feel like you're progressing. And when you're doing that, and
Speaker:it's all those elements of. Everything you described is all those elements of that high
Speaker:performing team, and you brought your patients into that high
Speaker:performing team and their families and their communities.
Speaker:And that's why it works. Yeah. And just
Speaker:knowing, like, I don't know, you have the experts on hand that can look
Speaker:and say, yeah, this is going to work. Yeah, yeah. And I do think it
Speaker:is sometimes it's just that it's the first person to do it. And
Speaker:then there's this, like, theory that somebody taught me of, like, being the first follower,
Speaker:too. So, like, somebody's going to go out and do something crazy and then
Speaker:the first person to follow them, like, that's really who you want to watch. And
Speaker:so it's like, all right, we're doing it here, so you guys be. Our first
Speaker:follower, you know, Very happy to be the first one. Yeah.
Speaker:You know, it was such an innovative thing and we spoke earlier in
Speaker:that there was some real controversy the first time it was
Speaker:presented to, to some of the surgeons,
Speaker:because it was such a different concept to what they had been used to,
Speaker:and it really disrupted that norm. But that's where some
Speaker:brilliance happens because. And that's how you can be innovative. You
Speaker:disrupt the norm in a safe and calculated way
Speaker:and look where it's come and, you know, here I am, you know,
Speaker:two, three years later, after. After that talk, it's a. Yeah,
Speaker:it's exciting. Yeah. So the talk she's talking about,
Speaker:I had the opportunity. I was virtual. So it was like
Speaker:4am Eastern time, and it was like
Speaker:7pm dinner meeting there or something like that. And this was the first
Speaker:time that all these. Because you have Australia and
Speaker:New Zealand. So it was this huge conference and they were in
Speaker:person for the first time since COVID because they were very strict on their lockdown,
Speaker:and they were having fun. And I'm like, 4am just dying.
Speaker:And they're like, you know, drinking and talking,
Speaker:having a great time. And I
Speaker:presented on, you know, the work of. That I had been doing. And
Speaker:this, at this time, it was in 2020. It was like, I think either
Speaker:summer or fall of 2020. 20. 22. 2022. And
Speaker:anyway, so this was many years ago, and I still. I was hospital
Speaker:employed. I wasn't really even thinking about building a
Speaker:surgery center. And I presented it, and one guy got up there on the bike
Speaker:and he was a surgeon, and he said, oh, I know about your American
Speaker:sleeves. They're huge. And basically that was
Speaker:his way of me saying, like, oh, yeah, there.
Speaker:There's no way they could leave because they would just be so nauseated and have
Speaker:such a hard time. So I played a video of a sleeve and I was
Speaker:like, no, that's as pretty much as tight as you can get without, like,
Speaker:literally having a horrible time. And it was a real mic drop moment. It wasn't
Speaker:mic drop moments. And then that, like, I got the attention, like, oh, look at
Speaker:this chick. And that's how I got the invitation to come in person to go
Speaker:there. But it was like, people, when you're, like,
Speaker:challenging their comfort, they do kind of like lash out and
Speaker:they like, I love what you said, like, creative conflict. It's
Speaker:like, no, that won't work. Let me tear it down. And you do need those
Speaker:people, though, to make sure that you're not doing something
Speaker:that's dangerous or crazy or like, you said, yes,
Speaker:because you don't want to put at risk the reputation
Speaker:of all that we've come because there's still, like you said, about
Speaker:stigma and about sometimes these preconceived notions of,
Speaker:this is dangerous, this is nuts. Diet and
Speaker:exercise, like Hannah mentioned, because surgery seems so
Speaker:insane. I'm not saying that these aren't big procedures that it's not,
Speaker:you know, there's not risks. We're not poo. Pooing, what we're doing. But
Speaker:also, but it's, you know, it's less risky than some of your
Speaker:other traditional, like laparoscopic gallbladder removals and things like that.
Speaker:Yeah, well, and I think too, people are so scared of
Speaker:treating a patient with obesity as well surgically. Like, there's still. And
Speaker:like, for you, it's routine that we do that. And so I think that other
Speaker:people are like, well, not only are we doing a surgery outpatient, but it's on
Speaker:people who are typically seen as like, higher risk surgically. And it's like,
Speaker:yeah, but we're, we're. Showing that that's okay because we know how to take care
Speaker:of them. Such a great point. And I think that the hardest
Speaker:thing is going to be convincing not just your pre op and your post
Speaker:op and your or teams, but anesthesia. Because
Speaker:anesthesia. It's kind of interesting. These
Speaker:patients are having other procedures. It's just because,
Speaker:yes, they're going to be obese by,
Speaker:you know, it's just. Yeah, that's what we're treating. That's what we're doing. But we
Speaker:have them like, optimized and screened and we do all
Speaker:those things so that it's. And often our
Speaker:patients, I find, are the most. There is very little we don't know
Speaker:about them. They're. The workup is so intense and we
Speaker:understand every aspect of our patients,
Speaker:medical, surgical history, psychological history, all of those
Speaker:aspects. So it's a much easier thing to do when
Speaker:you know that information than waiting for them to turn up
Speaker:at the. In an. Or for something else. Yeah, for something else in an emergency
Speaker:situation. So we, we often will play that
Speaker:card. And again, we're very lucky with. Got a great group of anaesthetists that are.
Speaker:That are very happy to kind of agitate, which is great. Yeah.
Speaker:I mean, I think, like, for Hannah, for example, I mean, I feel
Speaker:what she does is a lot of, like, social stuff because you have to
Speaker:understand, like, when do you work? Who do you take care of? Who
Speaker:cooks? I mean, you can speak on that. Yeah, there is, it's so much more
Speaker:of a socioeconomic. It's.
Speaker:There's so many other factors in people's lives. And it is, I feel like.
Speaker:And this just not only goes to, like, doing this the way that we do
Speaker:it, but just the way that bariatrics is approached as a whole of kind of
Speaker:like there's more like the old school and then maybe this is the new school
Speaker:or this is the up and coming Whatever you want to call it. But the
Speaker:way that you have to approach education is so much different because it's
Speaker:not always the traditional household. It's not. You know,
Speaker:I see a lot of people that work night shift and they've been told,
Speaker:well, you know, I have a questionnaire and maybe I, you know. I'm part of
Speaker:the problem. It's like, it's like, what do you eat for breakfast? What do you
Speaker:eat for lunch? What do you eat for dinner? And it's like, well, I don't
Speaker:really eat any of those meals. I'm like, okay, scrap that. What do you eat?
Speaker:When, what time do you wake up? Like, you wake up at 4pm sure. Because
Speaker:you're going to work at 7. Like, what are you eating then? And I'm
Speaker:getting rid of some of those words and just the verbiage. It's like, who cares?
Speaker:It's breakfast, lunch or dinner, it doesn't matter. We're just talking about what you eat.
Speaker:And, you know, social norms have changed and obviously women are in
Speaker:the workforce force at much higher levels than ever before.
Speaker:And so there's not necessarily somebody that's cooking or we have grandma that's
Speaker:cooking or we've got. So there is just so much more. To, to all
Speaker:of it that, yeah, you really do have to be involved in that
Speaker:patient's like, life on a different level as well. Exactly.
Speaker:And meeting the patient where they're at. Exactly. And that's not, you know,
Speaker:certainly a term I've stolen from some of our fabulous nurses back home. But
Speaker:meeting the patient where they're at and understanding who they are as
Speaker:a person at the core, that's what's going to help determine how
Speaker:you can help that person along the journey. And every journey is unique and, and
Speaker:people need us to, to meet them where they're at. Yeah. I always also tell
Speaker:people, I'm like, these are the guidelines that we give you. You know, we
Speaker:tell you, okay, eat this way, or kind of think of these. I was like,
Speaker:but we have to live within reality. And so none of this is ever going
Speaker:to be perfect. And so, yeah, what's your reality? Let's
Speaker:live there. Because I can't. I can change some circumstances of what you do,
Speaker:but I can't change everything. Exactly.
Speaker:I imagine you do a lot of myth busting too. Oh, my gosh. Yeah. I
Speaker:love telling people they can still have a piece of birthday cake when it's their
Speaker:birthday, so be able to celebrate and still live life normal. It's
Speaker:not like they're entering into a, you know, incredibly
Speaker:restrictive lifestyle because the. Rest of their life. Yeah,
Speaker:yeah, that's. And that's another thing I always tell patients. I'm like, there will be
Speaker:a very restrictive period of time. And you know, we will. And it's
Speaker:to help you to be as successful as possible. It's not punitive. It's not to
Speaker:be. You're in trouble. It's just we know that this works. So if you do
Speaker:it, you're going to have good results and that's what. We want for you. And
Speaker:I'm like, but ultimately the goal is to be on a general healthful diet.
Speaker:That's my goal for you. And that includes birthday cake because, like. Of course it
Speaker:does. Like, that was, you know, that's reality. There's so much joy that
Speaker:comes from food and cultural celebrations, all of those things. And those are
Speaker:so important to a person's well being. So we always try and include,
Speaker:you know that with, with moderation, obviously. But if you
Speaker:like seven birthdays in one month, maybe you're scattered by a couple pieces. Like,
Speaker:I know some families that like your family, you have three in a
Speaker:week. Like, that's increasingly. Hasn't it
Speaker:recently. 12Th, 13th, 18th. Yeah, here
Speaker:we go again. Yeah. So, you know, if you know that that's your situation, like,
Speaker:but that's what you can learn and figure out what's most important to you and
Speaker:live. Yeah. Live there. So. Oh, your patients are so lucky to
Speaker:have you. Yeah, right. I know. I'm
Speaker:like, all the things you do is incredible. I will disagree that we're all amazing.
Speaker:We're all amazing. We're all the best. And
Speaker:Alex Craven, if you're listening, we're stealing Jared. Yes, it's
Speaker:ours. Spoiler. We're just gonna bring her family over here and
Speaker:yeah. Had several,
Speaker:what we'll call them just for legal purposes, fake contracts that have been
Speaker:offered to me in my trip. So it's not. It's nice to.
Speaker:It's nice to have good people that, that I connect with and they share that
Speaker:same ethos. Yeah. So, yeah. I mean, I love too, that the global
Speaker:idea of, of this because I
Speaker:think sometimes too, if you're in a local scenario where you're talking, you
Speaker:can be almost competitive with things. And maybe not intentionally, but it can feel
Speaker:like, oh, well, I can't give them my idea because they're right down the road
Speaker:for me. And I'm like, we're obviously not in competition with you. And mostly I
Speaker:don't think that competition is a Huge thing in general because there is such
Speaker:a population that this applies to, like, there is plenty of
Speaker:patience to go around, but it is kind of like, yeah, let's help out Australia.
Speaker:You know, it's amazing. Yeah, for sure. Well,
Speaker:tell us, just what would you say is kind of like the biggest things
Speaker:you've learned? Not just maybe even here at our site, but also
Speaker:at the American Society for Metabolic and Bariatric Surgery or even
Speaker:your trip when you went to the Netherlands, like, what would be some, what was
Speaker:some soundbite that you heard that you thought, man, I cannot wait
Speaker:to get home to Austin Health and tell. Them, oh, a sound bite
Speaker:puts a lot of pressure on it. The biggest thing
Speaker:I think that I have come to understand is that
Speaker:nurses in Australia have a really unique position. There is so much flexibility
Speaker:in what we do to be able to really solidify ourselves
Speaker:in the bariatric surgery process. So that's one of the main things and
Speaker:that integration is key. And that's be that integration with your
Speaker:team, being the integrated health team members, along with the surgeons,
Speaker:but also some of our more physician type content colleagues.
Speaker:Because everyone has sort of heard around the GLP1s and they're, you know, they're
Speaker:around and it's made a lot of people nervous to
Speaker:some degree. But having that comprehensive care is really
Speaker:what patients need. And we do this so well in
Speaker:things like when we're treating cancer. People don't just have their, you know, some people
Speaker:might have their surgery, but they have, you know, comprehensive
Speaker:consultations with a number of clinicians, they have medication,
Speaker:they might have chemotherapy, radiotherapy and surgery as a suite of
Speaker:treatments for obesity. And that's what obesity is. It's a complex chronic and
Speaker:remitting disease that needs that type of care. And
Speaker:so having that ability to be flexible and
Speaker:adapt practice to meet the patient's needs, that's the main kind
Speaker:of approach. And there was a number of talks
Speaker:that I went to around that integration and that teamwork. And that was really
Speaker:exciting to see that that, you know, flows over across
Speaker:different continents. But I've really
Speaker:liked the ability to elevate
Speaker:in the integrated health space, particularly the ASMBS meeting, the ability
Speaker:to elevate those around us and work together as a team and
Speaker:elevate the role of the team as opposed to the individual. And I know that's
Speaker:very different in surgery or it can be very different in
Speaker:surgery, but those are sort of the real key takeaways. And
Speaker:that whole, as you said, and I know, Betsy, you said this to Us
Speaker:several years ago. You know, you've got all these elements here.
Speaker:Just do it. Yeah. You know, and that's not my sound bite.
Speaker:Sorry, did you say Nike?
Speaker:Yeah. How's that one? Yeah. So certainly not. I'll take a
Speaker:lot, acknowledge that. But yeah, just. Just get out
Speaker:there and do it. And it may feel slightly uncomfortable. And for
Speaker:me, this trip felt slightly uncomfortable. You know, I'd had.
Speaker:I've shared a few times that I'd had, you know, a few tears in the
Speaker:lead up to coming because this is the first time I've traveled on my own.
Speaker:But you're using the phrase, you know, I had to put my big girl
Speaker:pants on, and I was. I was uncomfortable and I felt
Speaker:nervous and. But now it's nearly over
Speaker:and I've done it and that kind of thing, you know, and our patients
Speaker:do that all the time. They step into something that feels slightly
Speaker:uncomfortable in a safe space and
Speaker:they get success. And that's exactly what I've achieved here. So it's been
Speaker:really nice and supported by a team. Exactly. You know,
Speaker:you know, as you're back and all. Yeah. And even. Even though I've been.
Speaker:I say, you know, I'm doing this trip on my own, but it really
Speaker:hasn't been. I've been able to have those stepping stones of those safe
Speaker:places along the way, and it was just those
Speaker:in between travel times. And then I was able to get back in the
Speaker:bubble with. With people like you guys that just get it and. Yeah, so it's.
Speaker:It's my international safe space. Wow. Well, what.
Speaker:So besides obviously all the things you've learned and all the things you. What fun
Speaker:stuff have you done on. On your multiple trips?
Speaker:So the the Netherlands was wonderful. I was in a place called
Speaker:Ames Fort the first trip, and that was
Speaker:a beautiful. Very much that European, you know,
Speaker:there's cobblestone streets and little canals. I did a little boat ride
Speaker:along and had a beautiful seafood dinner with
Speaker:Edo Arts, the surgeon that I was visiting over there, and he showed me some
Speaker:of the local kind of flavor and things like that. So that was. That was
Speaker:great. And when I was in Rotterdam, that was very
Speaker:similar to Melbourne, just this real city vibe. And Ingrid, who is
Speaker:part of Fit for me over there, their medical affairs,
Speaker:she took me around. We had to drink on this really cool street and we
Speaker:went out for dinner again with some real
Speaker:history and flavor to it. I won't share too much,
Speaker:but just some of the historical context of Rotterdam. And they had this beautiful market
Speaker:hall, lots of different foods that I could try. And it was
Speaker:really, that was kind of really fun. ASMBS was great because I was able
Speaker:to meet a whole, whole group of new people and
Speaker:I, I feel lucky. I've, I've got that personality where I'll just go up and
Speaker:introduce myself to someone. And so I was able to meet a number of past
Speaker:presidents and things like that and have that connection through some of the
Speaker:surgeons that I work with. So that was able to kind of break down some
Speaker:of those, you know, doors and to meet a whole pile of, you
Speaker:know, people. But I did find my, my Australian, New Zealand
Speaker:colleagues over there, so we did get to have a bit of play there. But
Speaker:here has probably been my most exciting time because I, I've
Speaker:been went to Universal Studios yesterday. I'm a big Harry Potter fan
Speaker:and I just wandered around for hours. I think it was 10 hours all
Speaker:together. I was there and I had so much
Speaker:butterbeer and I just, I tried all of the
Speaker:things. I, I went on a ride which I probably never will
Speaker:again. This particular ride was, it didn't go upside down, this
Speaker:roller coaster, but it certainly got close to it. And I,
Speaker:I got off and I was shaking and I was just like, ah. But I
Speaker:did it. It was, you know, I, I, I wanted to try it and I
Speaker:gave it a go. So that was, that was great. And I think I
Speaker:will certainly need to make my way to Magic Kingdom at some point.
Speaker:Absolutely. Mickey ears and. Yeah. Mickey
Speaker:ice cream and the Mickey everything. Yeah, but we just call Mickey everything.
Speaker:T shirts, shorts, socks, any whatever.
Speaker:You'll just be dressed as Vicki. Absolutely.
Speaker:So, but, you know, you need. I love a mint julep. I.
Speaker:At Magic Kingdom. It's the only place I've ever had a mint julep. They do
Speaker:a frozen mint julep at Casey's Hot Dogs.
Speaker:Yes. I know it. Yep. On the corner of Main street there. Yep. Yeah.
Speaker:So I've been lucky. I've been to, to Disney World a few times.
Speaker:The first time as an eight year old, I lived in upstate New York and
Speaker:my family brought me down and that really just inspired a lifetime of Disney.
Speaker:And even when I visited Palmar, a surgeon from
Speaker:Fresno a couple of years ago, and she, she knew my
Speaker:Disney, you know, it just, it traveled with me my love of Disney. And I
Speaker:have a little set of ears that she gave me as well, so. Oh my
Speaker:gosh. So cool. Such a great trip.
Speaker:I love it. I got to mail you something. I have one little idea.
Speaker:Yes. I was, I know. I was like Wait, do we need to have body
Speaker:by bariatric's ears made so that we have them on hand? I know, but we
Speaker:need them on hand. We need them on hand. I know, I should have.
Speaker:I gotta get up. Well, now you have to come back.
Speaker:We have. Yes. 20, you know, days, years later,
Speaker:once I put them through the mail, at. Some point, they'll get to you. They'll
Speaker:get to you. There's that interest. There is interest in people coming over to do
Speaker:these kinds of clinical immersions and. And learn. So
Speaker:it's like you said that. That first follower and the rest. So.
Speaker:Yeah. Well, we are welcoming anyone if you're listening and
Speaker:you're interested in seeing kind of what we're doing, because our space
Speaker:is cool. We have our surgery center, the pre op, the recovery room, standard
Speaker:stuff. But on the other side, we're right now in our little podcast, little studio,
Speaker:my office. We have a med spa, we have a conference room,
Speaker:we have a pretty cool break room with lots of different
Speaker:celebrity art and all kinds of fun stuff, so. And we'll make
Speaker:you be on the podcast. Yeah, you're. You're going to be here. You're right here
Speaker:with us. The weight loss collab never fails. Yes.
Speaker:That was such a cool ending. You're just. I just. I so
Speaker:admire you for, like, just. Yeah. Trotting around the
Speaker:globe and just trying to bring better things back and improve. Improve care, and
Speaker:Australia is going to be the better for it. So.
Speaker:Amazing. Amazing. Yes. Well, thank you for coming on the
Speaker:podcast as well. And you. We are so
Speaker:happy to have done this with you. And as always, you can find us on
Speaker:Instagram at the weight loss collab at Hannah
Speaker:Schuyler rd. Are you publicly on? I am not publicly on. Okay. I
Speaker:feel like I should. It fits. There you go. Get started. So
Speaker:make an Austin Health one. Because it's funny, when I was in
Speaker:Australia, some of the bariatric patients there who had randomly followed me,
Speaker:they're like, oh, that's my surgeon. Like, people had, like, we were
Speaker:already connected through it. So you need to have. There's
Speaker:Instagram, YouTube, tick tock, Facebook. I mean,
Speaker:you got to be on the whole gamut. Yeah. You wanted a second job, right?
Speaker:Yeah. Yeah. So about five already. So job.
Speaker:Yeah, I've got 23 hours on the flight on the way home. Start it
Speaker:all, Start it up. Perfect. Well, again, thank you so much for coming
Speaker:and thanks for listening and we'll see you all next time. Thanks,
Speaker:guys. Bye.
