Dr. Rachel Bedard

Yeah.

I mean, some people are really nauseous and vomit at the beginning because they just haven't figured out how to eat on the drugs.

Like they're still eating too much.

But some people have like constipation that they just can't tolerate.

Some people are persistently nauseous in a way that doesn't get better.

For most people, it gets better.

But that's a real like rate limiting step.

Sure.

So I work in New York City.

New York State has generous Medicaid.

New York City's public hospital system has its own pharmacies, and they did some amazing job I don't totally understand in which they were able to provide access to the GLP-1s even during the period when it was very, very hard to get them at sort of regular community pharmacies.

And so...

Between both that sort of generous insurance and that access in our hospital pharmacy, I have had this incredible good fortune of being able to prescribe Ozempic for diabetic patients since like 2023 or 2024 who are poor and otherwise would not have access to it, right?

And this is like a huge issue is that like for most patients like my patient population, they aren't on it yet because their insurance doesn't cover it.

Or if their insurance covers it, it covers it only for a very narrow set of indications and they have trouble getting it or whatever it is.

My patients have been able to get it the whole time.

And I do think it's sort of like a miracle breakthrough in primary care for underserved populations that have...

the morbidity burden that my patients have.

So most of my patients have diabetes and high blood pressure and high cholesterol and some degree of kidney disease and maybe some degree of other complications of diabetes, like retinal disease in their eyes and fatty liver disease.

Most of my patients also have some addiction history in my homeless clinic.