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Thanks for joining us for sustaining us here on KLCS PBS.

I'm David Nazar.

Have you walked on the beach recently and noticed all these interesting looking kind of minuscule marbles, these tiny marbles of all different colors.

They're scattered all over the sand all throughout the U.S..

Probably at a beach near you.

Well, if you're wondering what they are, so are we.

They're what's known as nurdles.

The most simple definition of a nurdles is a very small pellet of plastic, which basically serves as raw material used in the plastics industry for the manufacturing of plastic products.

So we decided to find out more about Nurdles.

What are they?

Why are they all over the beach?

Where do they originate from?

Are they good or are they bad?

And here is what we found.

Scrolling on.

Tick tock.

One day I saw a girl.

She was either in Texas or Louisiana.

She was talking about what Nurdles are and how to find Nurdles.

And I was like, Well, I live right by the ocean.

California has a lot of ocean.

I could probably find these if I went outside right now.

And so I did.

And I found some.

I'm Rachel.

I'm a reporter with Patch dot com today.

I'm at Sunset Beach.

Hunting for turtles.

A turtle is.

Kind of like the way that atoms make up every living organism.

And turtle is a small piece that makes up everything that's plastic.

They melt them down to make bigger things like plastic chairs, sunglasses, anything that's plastic that was made out of a turtle.

They're a type of pollution that nobody really notices, nobody really thinks about.

And so hunting for them is kind of exciting and kind of like a fun adventure to look for these things that nobody really sees.

That's what.

there's a bunch even.

Well.

Once you find the turtles, what you do is you go to turtle patrol dot org.

There's a section on the website for data entry.

If you put your name, your email and there's a space on the map for you to put where you are, where you're from, and how many you found.

Once you find your first turtle, start the timer for 10 minutes, and in 10 minutes you see how many you can find.

Finding turtles really helps.

The researchers at the University of Texas keep track of how far these nurdles disseminates and the impact that it has around the world.

This is a turtle, a tiny plastic pellet used to make millions of nurdles are spilled at the factory or in transport, and they're washing up on our beaches.

They are dangerous to marine life.

So we need your help tracking where they wash up on our beaches and based.

Join the turtle Patrol.

As a citizen scientist, you can help put a stop to this harmful plastic pollution.

Go to turtle patrol dot org and learn how you can conduct your own scientific survey.

It's easy and anyone can do it.

Your data combined with thousands of other surveys, is more than a research project.

It's a potential solution.

You can make a difference.

Join the turtle Patrol.

Dothan.

Turtle Patrol.

Dawn.

This is a turtle, a small plastic pellet that is the raw material for most of our plastic products.

They look like fish eggs, and they've been mysteriously ending up in the ocean, killing wildlife.

And now a small advocacy group in Oakland is helping to find out where these.

Tiny plastic beads about the size of a lentil found on a Bay Area beach.

And thousands of these pellets.

First washed.

Up in Texas.

When we think of ocean contamination, we think of water bottles, plastic bags and other plastic items.

But now scientists want you to keep an eye out for the tiny materials that are used to make those plastic products.

Only a few nurdles have been found so far here locally, but scientists say it's likely we'll start to see more of them.

So after I learned about Nurdles, I got a little bit more curious and I wanted to know.

I wanted to know more from the people who study these things.

I'm Rachel.

I am a reporter with Patch dot com and it's really good to talk to you about Nurdles today.

Thank you.

I'm James Tuttle and I'm with the University of Texas Marine Science Institute, and I'm the reserve director here.

Tell me a little bit about what nurdles are for people who have never heard of them before.

So they're also the raw material to almost everything plastics that we use on a daily basis.

So, you know, maybe you're drinking from a water bottle or you're on a computer or your glasses.

You know, before these things were actual products, they were tiny plastic beads that were the size of about a lentil that then are shipped to a factory that milk them down at color and make them into a product.

How do these nurdles go get spread?

Like, where do they come from?

So we have a number of different ways that we've figured out that these are getting into the environment.

So these nurdles are made at a manufacturing site during the processes of making these nurdles, there's a couple of different places that they can get out during the manufacturing.

Then whenever they are going to ship these to a factory, that's going to make them into a product when they're on loading to a railcar or on a truck, or maybe they're just bagging them up to put them on a ship, they can get out at that point.

Then during transportation, they can leak out.

So they can leak out from the truck.

They can leak out from the railcar.

They can actually every year or every other year they fall out from like a container will fall overboard from a ship.

The container will break open and the nurdles will get out.

And then once the transportation company gets it to a factory that's going to melt it down and make it into a product, they can actually get out onto the ground from the offloading process.

And so each one of those stages we call the value chain.

And so Nurdles can get out anywhere during the value chain process.

So where would people, if they're looking for nurdles, where would people be able to find them?

So we found Nurdles at a number of different sites, definitely at the beach.

And so, you know, all rivers right into the ocean.

And so it's easy to find them along the beach line.

So whenever you go to the beach, there's something called Strand Line, and that's where the sticks and leaves are.

That's where everything that's been floating in the ocean gets pushed up onto the beach.

And as you move that stuff around sticks and leaves, usually you find Nurdles in there.

And then if you're along rivers, there's a strand line there as well.

So you can imagine a lot of stuff flows down rivers.

There's sticks and leaves along the edge.

Looking there, you can find Nurdles in there as well, and then also in lakes.

So we've been finding that if there's a manufacturing site that's inland and there's a creek that runs nearby, that goes into a lake will be finding in lakes.

So where are these manufacturing sites?

Like where where do you find the most concentration?

So if you go to turtle patrol boat or you can see a map and you can see wherever the data has been collected and on there there's color coded dots that the colors go with the concentration of minerals that's been collected in the 10 minutes.

And so where we've seen the highest concentrations are along the Texas coast and Louisiana coast.

And there's a color on there that's purple, and that is when over a thousand turtles in a ten minute period is collected.

That sounds like a lot, as.

We know.

Ten.

Minutes.

Manufacturing sites, you know, it's not uncommon in areas like Houston, which is like a mecca for plastic production, like Galveston Bay.

They have around 55 plastic manufacturing sites.

It's not uncommon to go to the bay shoreline there.

Look in the high tide line and you'll find, you know, over 500 in a ten minute period.

So basically, they're scooping handfuls of these nurdles up at one time.

With with these nurdles spreading like all over the globe.

What is the biggest impact you've seen on the environment?

Definitely the biggest impact of Nurdles being in the environment is to birds, fish and sea turtles that are eating them.

So the wildlife.

You know, back in 1992, the Environmental Protection Agency actually put a document together about the problems that there were with these nurdles in the environment.

And in that document, they had over 80 species of birds that they knew about at the time that were eating these.

They had four species of sea turtles, a number of different fish.

Well, fast forward 30 years and now, you know, there's actually hundreds of species of birds that are eating this many more species of sea turtles that are eating and fish.

And so the problems associated with these are that if they eat enough of them, they can get stuck in their intestines.

It can twist the intestines around to where they can't eating anything natural, and they can starve to death.

The other impact we see is that these like like sponges in the water and they absorb harmful chemicals.

So you can think of like patches that come from our cars, PCBs, from light fixtures.

You know, these are chemicals that are in the waterways.

And if the plastic pellets are out there, these absorb onto the outside of some of the animals eating these.

You know, you don't want these chemicals inside their body because then you get to where you have impacts on, you know, reproduction, reproductive cycles and things like that.

Is there any way that the animals, like the birds and the fish eating the nurdles could affect humans?

Who birds and.

Fish?

So there is a possibility that when, say, a fish that we eat eats these nurdles, you know, do those chemicals, leave the plastic pellet and then go through the stomach lining of a fish and into the muscle tissue that then we're eating?

That is a very difficult answer to come up with because, you know, we're all exposed to so many different things throughout our lives as well as the fish that's in the water.

So to be able to tease that out is difficult, but there are research researchers that are looking into that now.

So maybe in the next three or four years we'll have that answer.

When people are out and collecting nurdles and they have collected a handful or so, what should they do with the nurdles?

Well, we always tell people that go out and do a national survey and they collect nurdles to put them in a cool looking jar because then you can show other people what they are, tell them what to look out for, and hopefully spread the word that they could be doing a nurdles survey at their local beach as well.

With the spread of Nurdles, is there anything that like people like me or people just walking on the beach?

Is there anything that they could do to stop the spread of Nurdles?

Well, yeah.

So there's a couple of different things.

One is just by going out and doing a national survey, they are collecting valuable information that is being put into National Patrol Board that other organizations can use to try to help change policy at the state level.

With the companies that are like the main source of like where the nurdles come from.

Is there any like penalty that they get from these nurdles being out.

There is a penalty and it depends on what state they are in and it depends on what their permits require them to do.

That's why we're targeting permits.

So what we're pushing for is for states to put in language in their stormwater and wastewater permits that say zero plastic pellet loss.

That way, whenever a state agency inspector goes out and they find nurdles, they can say this needs to be cleaned up, it needs to be solved on how this got out here.

And if we come back again, there's going to be a fine associated with it.

Thank you so, so much again for Talk to Me.

It was really, really fun to talk to you again.

Yeah, absolutely.

And if y'all need anything else, feel free to reach out and talk.

And now joining me to further the discussion is the young woman who was featured in our report, Rachel Barnes.

Rachel Tell me about you.

Who are you?

Are you a journalist?

What did you study?

I want to know about you.

I have been a journalist for a few years now.

I went to college in Long Beach.

I graduated from Cal State, Long Beach with my journalism degree.

And since there I've been in Long Beach ever since.

And I really like to cover local news outside of work.

I don't really do much.

I just hang out with my two cats.

Talk a little about some of the environmental journalism that you have been reporting on for Patch.

Well, Nurdles is obviously a really big one.

That one was my own interest.

I found out about Nurdles online and just couldn't help but look it up.

But I have done a couple of other things.

One thing that I always get really excited to cover is America's very first trash compactor that's in the bay on a creek over in Marina del Rey.

I watched them launch that.

I was at the ribbon cutting for that, and it's been doing a lot of really good work about getting trash out of the ocean in Los Angeles County.

And if I'm not mistaken, that's that's the Bionic Creek Interceptor.

Right.

Take take about 60 seconds to tell us about that.

it's the nation's first trash compactor.

They've got them all around the world.

And it has, like, nets in by on a creek.

And so as trash flows down the creek and usually it would go into the ocean, this interceptor picks it up and puts it into trash bins that get emptied every so often by city staff, by public works staff, and it I think last season it took it took a lot of tons.

I can't remember the exact number, but 5 to 7 tons of trash just out of the out of the creek from going into the ocean.

So going into this.

It's so vital to because all of the environmentalists I always speak with on various news stories I report on, they're always telling me you've got to get the trash or it begins, right?

So it doesn't run into Santa monica Bay, so it doesn't run into the creeks and through the lakes, into the ocean, where ultimately that's where we're dealing with all the pollution.

Yeah, absolutely.

Yeah.

You mentioned.

Something.

Pick up something as big as a couch.

That interceptor.

Yeah, that is very true.

You mentioned something interesting at the beginning of this interview.

I want to talk a little bit about that.

You talked about the fact that patches hyper local.

In your opinion, why is local news so vital these days?

I remember as a kid I was your age just 30 years ago, probably they were talking back then about local, local, local stuff.

In other words, you were a reporter in Los Angeles or in Long Beach or in San Bernardino or in Bakersfield or wherever in California.

Don't focus on the national news.

Focus on what's going on in your backyard.

Why is that so important, in your opinion, Rachel?

I think it's so important because on a local level, that is where people can be directly impacted and directly a part of things happening in their community and in their cities.

You see big, huge national news all the time.

And a lot of people, when they read them, they feel kind of disconnected because America is such a huge country.

What do I have?

What can I do?

Just living in Long Beach, living in Los Angeles County, What can I do to, like make an impact in that?

Or whereas in local journalism and in your local communities, it's important to stay connected via like local news channels.

And we have a few in Los Angeles, quite a few, but because it helps inform voters, it helps to inform, inform the community, and it brings it brings people together and helps them make a difference.

what are some of the concerns that a lot of people have?

What are they telling you when you tell them your news?

Reporter When you're a journalist, what are some of their concerns?

a lot of local journalism is covering crime.

So I get a lot of concerns about safety.

Crime statistics discuss the homelessness population, what the county is doing about that.

And then just a lot of like activism and I hear a lot from activists and just how people want to make a difference in their city.

in our remaining minute, I am going to ask you the billion dollar question, and I hope this does not make you uncomfortable.

But here's a question What is right with journalism today?

What is wrong with journalism today?

I think that this is a really interesting question.

I just had a I just had a discussion in the South bay with a few residents that live in Hermosa Beach about this.

And I think that it is it's up to journalists like me, it's up to younger journalists to see the pitfalls of journalism now and how it's kind of dividing the country and how it's making it harder for people to find common ground.

And it's I think it's really important that young journalists and people who are seeing journalism today and just coming into it today to know that you can, like anybody, can make a difference.

Anybody can come in and speak for what's right and and even more like take a personal voice out of the news, just present people with the facts so that it's easier and more useful to understand for the American people.

Rachel Barnes You are the future.

You young journalists of the world keep doing what you're doing.

And thank you so much for this interview.

It was really good talking to you, Thank you, you too.

As part of our continuing content sharing partnership with Public media and PBS stations all throughout the U.S., we traveled to Central Washington, where farmers there are dealing with labor shortages, and they're testing out how robots.

Yeah, robots could possibly be a new and efficient way to get things like apples to your tables.

Our public media partner, OPB, Oregon Public Broadcasting, has this report.

You ready?

I get fired on, and then you can go.

What is this thing?

And what is it doing in the middle of an apple orchard?

Agriculture today isn't the quaint, low tech pastime.

You remember from storybooks.

In the orchards of central Washington.

The future is here.

Each robot has stereo cameras on it, and it's live looking at every apple, and it's ranking the candidates based off a number of components.

It's looking at, okay, what's the ripeness of this apple?

It's also looking at how difficult do I think it will be to pick this apple?

It's the future.

So if you didn't adopt and you didn't make changes, we'd still have horses and carts and those other things.

And so you have to change with the times and the times, our technology as.

Opposed to the state of Washington, produces a lot of crops, but none more than apples.

In fact, nearly 12 billion apples are harvested each year, making Washington the number one producer of apples.

In the U.S.. We do produce more apples than anywhere else in the nation, and each and every one of those pieces of fruit is picked by hand.

Concerns over the availability of skilled harvest laborers remain at the top of most growers minds, and industry has looked for solutions.

Guest worker visa programs.

Improvements in production efficiency and of course, the interest in potential robotic solutions.

One of those solutions is taking the form of a 14 foot apple harvesting robot.

On the front of the harvester.

You'll notice a main computer and it's coordinating the motion of the six robots and also keeping the harvester itself tracking in the middle of the row.

When it's ready to pick, it will come out and you'll notice that it can go in and out, side to side.

It can twist up and down.

And then when it sees an apple it wants, it'll go into the canopy and pick the apple with the suction cup and then return.

Once all the robots say, all right, I don't have any more apples, I need to find more apples, then it'll start to move forward and the robots will continue to scan and identify more targets.

And you can see as each robot picks an apple, it will take that apple to the back and drop it into the command system.

And that's the motion that you see after.

Each successful pick.

And so right now, all six robots are feeding into these conveyors.

That's all the apple coming up.

And then I take this clipper, I come in here and clip the step.

This is something that we're hoping to automate in the future, but it's one of the many examples of how impressive the human is at identifying an apple, reorienting it, placing a trimmer in the proper spot and clipping the step.

It seems really simple, but it's incredibly complicated task, and it's something that we're going to need to solve going forward.

But there's a whole lot more work to do around it.

Again, students at Washington State University are working behind the scenes to bring these robots to life under this programing, a robotic arm to trim flowers using a mock up orchard.

Let's see if it moves at all this time.

Needless to say, programing requires a bit of trial and error.

There are 30.

Flower thinning is an essential component of apple cultivation.

Not only does it improve apple quality, but it significantly increases the probability of an annual crop.

So this is giving us like what is the position and orientation of the flower clusters.

I think ten years from now, a good vision would be the machines could harvest maybe some majority of the fruit, and then there'd be a smaller labor crew that could feasibly just finish up the rest.

So I think a combination of both humans and machines would be a great future.

So will these robots.

It could work 24 seven eventually replace human labor.

How do the actual laborers feel about giant robotic harvesters rolling through the orchard?

I know that machine.

Come and make me surprised because we've never seen that before.

You know, Bruce, the opinion that people say that, well, we in the future, we're not going to have a job because they kind of put another they started picking, you know.

Currently humans are still faster and more efficient than most robot pickers.

But that gap narrows with each passing year.

Some manufacturers are testing the limits of robotics technology by developing robots that are ungrounded.

Literally, the system consists of eight autonomous drones, all picking simultaneously.

This robot can work 24 hours a day, and it just is something that can help us get the job done because the younger generation doesn't aspire to be an apple pepper.

Right now I kind of say maybe we're treading water trying to figure out how we can keep enough employees to get our crops picked until this technology evolves.

One thing is clear.

Robots are here to stay.

And with increasing labor shortages, they're becoming more common in orchards and farms across the country.

We mentor and help them.

It's not like it before.

Everybody wants to work right now.

There's more.

The young kids.

They're looking for easy jobs.

So I think that robots, they're going to help more to doing the labor in on the knowledge of.

Thank you.

Oregon Public Broadcasting for that report.

Now, for more information about our program, just click on to KLCS.org and then click Contact Us to send us your questions, your comments, your story ideas.

We want to hear from you or obviously you can contact me @DavidNazarNews on X or just go to my YouTube channel, David is our news.

Send me a message there.

I'll be sure to get back with you and be sure to catch our program here on PBS or catch us on the PBS app.

Thank you so much for joining us.

I'm David Nazar.

Hello.

Thanks for joining us for sustaining us here on Klcs PBS.

I'm David Huizar.

We're about to bring you part two of a special two part series, Our Health Care Crisis.

As we ask the question, is there a solution on this second part of our brutally honest investigation of why our U.S. health care system is failing us?

We dissect this issue from all angles.

Doctor care, hospital care and patient care.

As we re introduce you to my guests so we can continue our uncensored discussion with part two of health care crisis.

Is there a solution?

And joining me now to discuss all of this is an esteemed panel of experts.

Dr. Corey Waldman specializes in internal medicine and is a board certified cardiologist.

Dr. Waldman is the medical director of a Los Angeles hospice company, and he is currently in private practice, which includes a hyper specialized practice for concierge patient care.

We'll learn about that.

Also joining the panel is Dr. Alon SHAPIRO.

Dr. SHAPIRO was a representative from Mexico as part of the World Health Organization and the W.H.O.. Dr. SHAPIRO is a board certified pediatrician, and he's currently a community physician working as a chief health correspondent and medical affairs officer with Ultimate Health Services, Outpatient Care.

And also joining the panel is my great friend and former news colleague Elizabeth Espinosa, who was a reporter in Los Angeles for years with KTLA, Fox, CNN, and PBS.

She walked away from an amazing and accomplished news career to devote her entire life to take care of her special needs brother, her mother and her father almost single handedly.

Thank you all so much for being here as we continue our discussion from last week on the health care crisis.

Dr. SHAPIRO, let's begin with you.

Thank you, Dr. Waldman.

And Elizabeth, I'm Dr. SHAPIRO.

You represent communities that are underserved.

Now, truth be told, whether you're underserved, you're middle class, you have a lot of money.

Health care costs a fortune and and it's tough for everyone.

But let's talk about poor people because that's what they are, poor.

Forget the politically correct low income term.

Poor people need help.

They need your health care.

Dr. SHAPIRO, when you deal with an underserved, impoverished community, what are the challenges that you are met with these days?

Because obviously the system is failing and then talk about low income folks, but then obviously everyone else on the financial spectrum, because getting adequate health care, it's not there anymore.

David They may be.

When I see my patients, they come to my clinic.

I see them as on owner for me.

And let me tell you why we need to see where they're coming from on the community.

They probably have 2 to 3 jobs.

You know, they are probably actually at that moment because they are outwardly.

There is not getting paid and they're coming to our clinics to be served.

And that means that they needed to earn a lot money or time for a care, making sure that there was gas on their car, if they have a car or at least make sure that they are on time for the appointment.

Because of public transportation, then there's a lot of barriers around them.

In order for them to get to the clinic, let alone be healthy for the other side.

I tell them the truth and they know the truth that we need to be healthy and need certain things vegetables, certain mean things.

Go out there and do exercise.

And at the end of the day, when they go out on the community, there's a couple of things.

When they go to the supermarket, they have a choice to actually get the green stuff or fight against hunger.

They have the option to go exercise and they go, Well, maybe there's not not a green space or the green space out there.

It's not safe for them or their families to actually do some exercise or actually be out there.

Then there's a lot of buyers and social determinants of health opportunities there that we can start managing.

Then at the moment, and that's just the structure that we have around this, you need to have culture.

You need to have language barriers.

You need to have also the other part us as physicians in our health care system, that when we're not used to actually taking care of diverse populations, well, that culture that touch it's way different.

Why?

Because one thing is, you know, you can tell the same thing about diabetes.

It's the same thing for diabetes for everybody else.

But taking away, for example, a tortilla from from on this panel, Mexican family, well, that's probably not the best way to talk about it.

Maybe we need to tweet, tweet, go around.

Although they are dietary things that we can actually improve.

Then putting everything together to cater underrepresented communities is extremely important, especially right now that we have all the things that are happening with the nation, with Medicaid.

And here in California, our medical what's happening also with kids.

Then if we are not taking care of all of this populations well, it will become a public health problem.

Elizabeth, you know, one of the observations I've made being in the emergency department very often with my family in clinics, in hospital settings, is that our underrepresented communities, they show up and they show up very sick.

They show up and they would need a heart transplant.

They show up or they need a kidney transplant.

They don't get it.

They're done.

It's and I think it's also one of the other challenges, like we have this.

I would argue that law enforcement also has to do a better job at is it goes back to communication.

You have to be a good storyteller.

I know you sign up to be a journalist, but you have to tell people, Let me tell you why kidney function is important.

Do you know why your blood pressure goes up?

Because if not, you know, like you have to, like, see them through the line because people don't understand.

They say, well, I got diabetes, but you know that that'll be fine because I don't feel anything right now.

Well, you don't feel it today, but every day that you don't control your blood sugar, you're killing little veins.

That then means when you see that guy without a leg amputated, that's because he didn't control his sugars.

It's the baby.

It's everything.

But really, explain to people the full rainbow.

You know, it's incredible.

That's why I'm really proud of this.

Doctor Rastogi here is a neurologist at UCLA, and he has this core kidney program where they have folks from all ages who've suffered, you know, kidney disease about I got transplants or living donors, which we really want to make a push for as well.

Right.

Organ donation.

But it is an incredible group because they're out there trying to explain to people why it's so important that peer mentorship really explains it.

So it's interesting, my mom with her kidney failure now, we happened to just go.

We were in the city of Lenox just a couple of days ago before this surgery, and we went to a Salvadoran restaurant, my mom's Sharm El Salvador, and we walked in there and my mom starts talking to the owner.

And while I'm paying, I look over at my mom, who's petrified, petrified of going on dialysis.

Right.

And about to have the surgery.

She's like to months ago, this woman, you know, she's like 57.

She's so young.

She looks so much older because she's in kidney failure, her GFR.

So you learn these things.

GFR Right.

Doctors, that means their your kidney function is at 6%.

And instead of what is your follow point of your day project, she said, Jan, this is in November we're talking about she I said, You're going to be dead in a month.

At that rate, you're going to your heart is going to stop because your kidney is going to funct It's going to affect and you guys speak to that and I'm trying to the doctor here, but.

Right.

It's going to affect your heart and do all these things.

You got to understand why it's important to take action now, right.

So I think we have to explain it to you because I will sit there because I am a reporter, Right, David?

Like you and I can hear when doctors are explaining sometimes to my parents, you know, things and I'm like, okay, take it another step.

You got to, you know, to have to explain to them why that's important.

What does that mean if you don't do that?

Like, we're all it's like back to the first grade when you get diagnosed with something that you've never been diagnosed with.

you know, talk smiling in my heart because the things that you're saying is so true.

And I have a phrase that actually I understood during COVID 19 is that we need to translate medically to an actionable language for our community.

That's extremely important, especially for anybody.

It doesn't matter your language, your color, your your obstacles, your religion, having that conversation is so important and also connecting the dots.

And you're mentioning something that actually came eventually triggering me and that's the word that I'm using, because at the moment that we do not have information, one thing is having information and not acting upon it.

But if you do not have the choice, even to understand what's happening, there's no way that you can do anything.

Then at the end of the day, if you vaccinate or not, that's not you.

But at least you have that balancing act based on evidence based information to act upon it.

Then giving that chance is so important.

so.

Yeah, I think you need to go on dialysis.

That's a hard thing to hear.

I mean, I was crying for weeks, you know, and my mom, too.

But I said, Mom, let's not die before we die.

Let's don't be paralyzed by fear.

We got to do this.

And you know, to your point, Dr. Wallman, drive to medicine is a problem.

And I've been through that and I've had to cut doctors.

I mean, I have no problem being, you know, a little bit more assertive like David, when we've had to be advocates for our family members to say, Hey, don't rush.

They're asking you a question they don't understand.

You got to break it down like you're talking to a two year old, because even I don't understand some things, right?

This isn't why I spent 20 years studying like you did.

There's another there's another thing I noticed.

Doctors Waldman and SHAPIRO, correct me if I'm wrong, maybe, maybe perception is reality.

It seems there is so much burnout in your field.

You guys, as doctors are burned out.

And I say that because it's complicated.

How do you as doctors navigate a system and I'm not going to walk back from about to say that's infested with bad doctors, insurance companies that are disgustingly greedy and lawyers who are even more disgustingly greedy ambulance chasers.

You've got to deal with all of this and you're dealing with it then affects every patient.

Can both of you talk about that?

Because health care system is failing, The system is broken, know that.

And I think that's fair.

And I think that there has to be, you know, as families, like I always say, you know, so many times like we will be in a hallway or something and they'll say, well, we can't, you know, do the I.V.

started in the hallway because of hip hop violations and like releasing our hip on his behalf or, you know, my parents, like, we we need to get the health care.

We need to get that if that's the outcome, is what matters, not some law that somebody passed.

Right.

But to your point, I agree.

I as a family, I think there may maybe let's come up with a legal document says, look, you're taking a risk by doing this in your driveway, but you're willing to take that.

You've got to give the doctor a chance.

You can't just sue him, say, well, this just turned out wrong.

Well, there it was.

It was in good faith.

Everybody was working in good faith.

I think that's what matters.

So we got to we need to get some lawyers on this show and say, let's create that.

Let's get some legislate and say how are we creating loopholes for people that, you know, like I say, disability access within health care isn't just a wheelchair ramp.

It's not just a wheelchair ramp.

Right.

It's giving you guys access to so that you can see a patient not in the normal setting, because accommodations for people with sensory issues with autism doesn't mean a wheelchair ramp.

It means in the parking lot, it means in their car, it means in their house.

In that one space in the hallway.

What?

They will let you touch them like that's how unique it is and that's how patient centered we should all be.

When it comes to health care.

there's an even simpler problem.

And Elizabeth, I know in all of your years of reporting, I'm sure all the health stories you did, patients say the same thing to you.

And what I'm hearing when I do my health stories is we have to wait forever just to get an appointment.

Sometimes months.

We have to wait forever to get in May.

We have to wait forever to even find a specialist.

This is a joke.

Dr. Waldman and Dr. SHAPIRO.

Whoever wants to talk about that.

Go ahead.

The reality is that we love to have a decent way to answer what's happening right now on our health care system.

I can tell you for sure that it breaks my heart when I hear that it breaks my heart.

When grandmother comes with the kiddos with me, and I need to give them vaccines.

And I'm asking regarding, you know, everything.

And I see that she's limping and she tells me that story that she doesn't have access and she goes to the E.R.

and she doesn't know how to, you know, that she can get access to a healthcare insurance, but it's too much for her.

And she do not know doesn't know how to get, you know, the Affordable Health Care Act plans for her or she doesn't know where to go to community clinics.

And there's a lot of things are around what we have in our community that it's already there.

But somehow we're missing the point of communicating that we have certain tools out there.

On the other side.

We need to see all the barriers that we have created.

You know that of course, you know, every doctor statistically will have some type of lawsuit at least drafted against them at some point in their lives.

That's something that, you know, if we did something wrong, we need to be punished and we need to take care of that and be honest on that one.

But also that we do a lot of over shooting with a lot of this things.

The third one is that the system, we have a lot of intermediaries.

The idea of actually having a primary care doctor in the old days and I love what I listen to what saying about, you know, my patients, I have no neurological conditions.

I love doing telehealth with them.

I love actually approaching in a different way because they get that they don't see the white coat.

They actually enjoy the interaction.

I get to see a little bit more about their house, and that's stuff that I used to do in Mexico.

I'm going to right now for the first time at least, I get like a little window of what's happening with them.

The kids actually maybe smiling, but not like terrified of running around in a different setting.

Not necessarily because he's medical, but it's not his hat or home.

Then there's a lot of opportunities there that the system can actually improve and go out from that box of the clinics of the healthcare system.

We need to move to social determinants of health.

We need to bring community healthcare workers to the conversation.

We need to make make sure that we have a nutritionist medicine that's as good as medicine.

That's a new thing that we need to be talking about.

And, Dr. Waldman, as we segway these stories, all of you have told her somewhat unbelievable.

Somewhat amazing.

With that said, let's let's take our remaining minutes.

We're now into our second part of this health care special.

In our remaining minutes for the remainder of this program.

What are the solutions?

How do we fix a broken health care system?

Let me give each of you about 2 minutes.

We'll go to Dr. and Dr. SHAPIRO and then Elizabeth, who's been dealing with it firsthand.

Dr. SHAPIRO, thank you.

Dr. Waldman.

It sounds good.

If we can implement it.

Maybe that's another story for a future broadcast.

Dr. SHAPIRO, your ideas about solutions.

Maybe we need to start creating more doctors.

We need to make sure that we are going and outreaching the underrepresented community and bringing doctors for many communities.

And by underrepresented is every color and favor that we have that will stay on the community and serve because that that creates an amazing pathway.

That means that from high school, a college, med school, and actually even residencies to make sure that that pipeline exists and we bring up the amount of doctors that we have out there.

If not, we will just be chasing something that we'll never achieve.

The other thing is something called value based care.

Right now, Dr. Waldman and also Elizabeth have mentioned the importance of quality interactions with our healthcare system.

And maybe it's not specifically physician and maybe some nutritionists, maybe some community health care worker.

We're making sure that we're creating a healthcare system that is humane, that it's actually for our patients, and it's the quality.

And actually that resolution of the problem and most importantly, the prevention of them, that is their key and crucial for the future of our community.

And finalizing with this, making sure that we continue translating medical insight to actionable opportunities for our communities, if not all the information.

Although this trust will continue to go along.

Elizabeth as great as the doctors are, no one better to ask than you.

You are in the trenches.

You are a caregiver and a reporter.

I guess you could say a journalist.

Give us your perspective on solutions for a broken health care system.

Well, you know what?

I want to thank Dr. Waldman, Dr. SHAPIRO, and all the doctors that are out there and nurses and Libyans and seniors and caregivers who care.

First, we got to care because I believe it is about caring.

It is about having a will.

You have to want.

You got to be have this desire to say, you know what?

We can change this.

Why do people act like just because this is the way it's been?

It's going to be this way forever and it's going to stay broken.

No, let's have that, Will.

I think, Dr. Wallman, you talked about you know, you do home visits, right?

Concierge Right.

So I think it's about accessibility.

So it has to be.

Let's, let's how do we fix this?

There is a solution.

There are solutions.

Maybe not overnight, but they're baby steps and there's little solutions every day.

So, for example, UCLA has a program now that I think is great.

It's called extensive its program.

So people that are chronically ill.

So the way you try to keep them out of the hospital setting is you give them longer appointments with a doctor, a primary doctor that instead of spending 15.

Right.

You think it isn't doctors?

15 minutes usually is what you get with a patient.

You get 40 minutes.

Woo!

Who?

Right.

Still not a time, but 40 minutes with a patient that's got a lot of complex medical needs.

So that help a lot.

Let me tell you.

But then it's also about fixing.

So your point about home health, making it accessible.

Why do we send everybody to the emergency department?

Because they hurt themselves.

It's like they need IV fluids.

Let's get it easy and set up through home help.

It should be an app.

Like, why are we thinking about that?

We got to think outside the box.

Patient centered care means let's make it.

Let's make it accessible.

Because I think part of the problem is people go to try to get medical attention and it's everything is an act of Congress.

Even when I leave the hospital and I get a home, help, you know, order the doctors.

God bless them, they like Elizabeth.

I wrote all the orders.

I put A, B, D physical therapy in O.T.

And by the time the home health agency calls me and I see you're nodding your heads because you know what I'm talking about, Right?

And so let's make it simple.

Let's make that faster, quicker.

You know, even at the county level, there's a program called In-Home Supportive services.

Right?

That program is supposed to help get caregivers.

We need it.

We need also fund for caregivers, because that's going to help people not get sick and end up in the hospital.

Right.

And need all these specialists and and, you know, more doctors is a solution.

But it's got to be also quality over quantity, right?

Like you that you care.

And I think going back to the agencies comment, I was in that office the other day and I met a woman who has stage four pancreatic cancer.

She had to go in there with her eight because they can't even make a phone call to get through to the social worker.

So the woman gets paid because of the woman is a get paid.

She's like, I got to leave.

I got to go find other job and she'll find another job.

But guess who won't find another staff that quickly?

The woman with stage four pancreatic cancer and that those are underrepresented communities are impacted the most.

So I think private practice needs to make things more accessible and generally are better at it anyway, but also programs that are funded by government, Medi-Cal, you know, Medicaid, they've got to make it more accessible and easier.

And yes, I think that making doctors do all this paperwork is taking away from spending time with patients and really saying, this is what you need and this is how we make it work faster.

So I think if we just all sit down and say, let's take top five, top five, let's fix this, this, this and this and start with that, we can do this.

I am going to end the show by saying this.

Elizabeth, you said probably the key word caring.

It may sound cliche, it may sound simplistic.

However, what I do know on this special two part series we just produced together, Dr. Waldman is a caring doctor.

Dr. SHAPIRO is a caring doctor.

And Elizabeth, you are a caring sister.

You are caring daughter who has really helped kept your family alive.

So I hope we can do this again in a few months later this year.

If I invite the three of you back, will you be on this broadcast so we can further delve into this very critical situation of the health care crisis in the United States today.

Thank you.

Thank you all so much.

Caring is the take away.

Thank you so much, Dr. Corey Waldman, Dr. Alon SHAPIRO and Elizabeth Espinosa for a great interview.

I don't know how to thank the three of you.

It meant a lot to me.

Now for more information about our program, just click on Kelsey US dot org and then click Contact us to send us your questions, your comments, even your story ideas so we can hear from you or you can contact me at David is our news on X or just go to my YouTube channel.

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Contact me there.

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