Hi, this is Charles Hoskinson broadcasting live from warm, sunny Colorado. Today is November 15, 2024, and I'm back from California, where I recently visited the SpaceX team and had a chance to tour their entire facility. They build a rocket every two days; these guys are on fire! I have never seen a company that is so well run, with people who are so smart and motivated in their jobs. Kudos to Elon Musk and all the amazing people, including Gwynne Shotwell and others at SpaceX. It is one of the greatest achievements of the 21st century to build a company like that, and it’s just great to interact with people who really enjoy their jobs. Every single person I interacted with there was passionate and fired up, saying, "We're going to Mars!"
In fact, while I was flying there, I looked out the window of my jet and saw a Falcon 9 rocket in the air. I'm just like, these guys are everywhere! It's probably going to be the largest ISP in the world in five to ten years, and kudos to them for the remarkable technology they’re bringing to bear. Anyway, we were discussing some things still under NDA, so I can't talk about it, but when I can, I will.
Today's video is about healthcare in Wyoming, particularly my clinic in Gillette, Wyoming. I know many of you are aware that I have a clinic, and we've certainly talked about it from time to time, either in Twitter Spaces or occasionally in AMAs. However, I've never really made a dedicated video to discuss some of the things we're doing, the challenges we've overcome, the environment there, our effect on public health, and what we're trying to accomplish. So, I figured I’d take some time to roll things out and elaborate a bit about the goals of Hoskinson Health and Wellness and why I set it up.
As many of you know, I come from a long line of physicians. I almost became one myself; I thought about it, but I realized I liked the math and entrepreneurial aspects a little more than medicine. One of the reasons I chose not to become a doctor is because of the bureaucracy and the hyper-focus in the medical industry on processes and treatments instead of cures and innovation. It is not an industry that is dynamic, agile, and free-flowing. You walk into SpaceX, and every six weeks they ask, "How do we do better? How do we make the next one better?" There’s a culture of innovation and improvement. In contrast, in medicine, it’s often about managing the decline of people and systems, filled with cynicism, complaints, and a ton of middle management.
Unfortunately, the vast majority of people in prominent positions in medicine—whether they are nurse practitioners, physician assistants, or physicians—spend an enormous amount of time unpaid doing paperwork and dealing with the bureaucracy of the medical system. In many cases, you’re not compensated for the things required to take care of people. For example, you see a patient for maybe 15 or 20 minutes, but the work doesn't stop there. There’s also the consideration of the care plan and the people you need to contact. Traditionally, you’re paid just for the time you see them, even though you may be emailing people, thinking about things, or going through medical records. All of that additional work is uncompensated, and as patients get older and more complex, that can amount to hours of work.
Then you start having to make hard decisions: Do I go home and see my family, or do I stay at work and put in more time for free, basically volunteering to benefit the patients? Many physicians choose to stay late when they’re young, and their marriages deteriorate as they miss major events in their children’s lives. This phenomenon is well-known among those married to healthcare professionals, and they understand the sacrifices that people in healthcare have to make.
There is no reason for the healthcare system to operate this way. We’ve just structured it wrong, compensating the wrong things. A cartel has formed to push medicine in a direction where it’s about treatments, not cures. I wanted to solve two things at the same time with Hoskinson Health. I wanted to build an organization that was truly committed to public health, merging primary care, functional medicine, and lifestyle medicine with traditional allopathic medicine. The science-based medicine can benefit from the natural and lifestyle sides, which also have their own scientific roots but are often ignored by the conventional medical industry. In many cases, they can outperform conventional medicine, especially in treating chronic ailments or preventing them, which is currently overwhelming the entire healthcare system.
For example, if you are pre-diabetic, there are certainly some drugs and medical interventions that an MD can prescribe, but you’re probably better off focusing on mental health, getting proper sleep, eating right, and working out. After you lose weight, you can achieve better insulin regulation through that process. Would you rather become insulin-dependent or dependent on drugs for the rest of your life, managing a decline, or would you rather prevent it, increase your health span, and live a lot better? These two sides of medicine are not integrated right now.
One of the reasons I constructed the clinic was to bring both of those houses of medicine together and get them to communicate. The rigor of the allopathic world can improve the functional and naturopathic worlds, while the creativity, inspiration, and patient-centeredness of the lifestyle world can enhance the allopathic world. It makes it more caring and focuses on the right outcome: the overall health of the patient. Your job as a practitioner is to make the patient better and cure what ails them, not just manage them and push them through a flowchart hoping they go away and you get your RVUs, your billable events.
That was the hypothesis behind starting Hoskinson Health. We started three years ago. My family has been in medicine for 70 years; my grandfather was an OBGYN, my dad is a physician, my uncle is an infectious disease doctor, and my brother is a physician as well. There are many nurses in my extended family, and my brother started as a nurse before becoming an internist. We have that long legacy, and I brought family members and outside people together to co-found Hoskinson Health.
At the same time, we constructed a biotechnology company because I was very interested in creating therapeutics that allow people to heal themselves—regenerative medicine. Almost all of these are also anti-aging in a certain sense; they increase both your lifespan and your health span. The first thing we started investigating is the use of mesenchymal stem cells, specifically adipose-derived mesenchymal stem cells. There are two broad categories of stem cells: the primordial ones you have when you’re an embryo, which are pluripotent and have the highest potential, and the mesenchymal ones that you have in your body as adults. They’re in your fat, blood, and bone marrow, and there are many different ways to extract and use them.
One of the things I was always curious about is whether we can take stem cells from your fat, culture them in just the right way, expand them, and then conduct a series of clinical trials in partnership with the FDA to showcase the regenerative and anti-aging effects of these, especially when paired with other therapies that promote the activation of those cells. Currently, we are pairing hyperbarics, which have been shown to release stem cells and program your body to use them, with mesenchymal stem cells. You can take stem cells from one person, extract them, and re-inject them, or you can take stem cells from a donor, culture and expand them, and then re-inject those, which are allogeneic stem cells.
We are currently working with the FDA, and next year we’re going to start a phase one-two clinical trial where we will look at a combined trial of hyperbarics and allogeneic stem cells to see what happens in the body. Part of the clinic was building up capabilities to conduct that type of clinical research. We have state-of-the-art imaging, including a three Tesla MRI with AI upscaling, a state-of-the-art CAT scan, and a state-of-the-art lab. We have more than two dozen physicians and many mid-level practitioners working with us at the facility. Some of our practitioners are MD-PhDs, so they can translate basic science into clinical applications. We also have a dedicated science division led by our chief scientist, San J. Dar, who moved from the University of California to Gillette to set all these things up.
The clinic is growing by leaps and bounds. It’s currently 10,000 square feet, and we’re building an additional 80,000 square feet next year. It’s an enormous construction project in Gillette, Wyoming. I got so tired of dealing with external construction companies that I founded my own construction company, Hoskinson Construction, which is actually building the clinic. We’re completely vertically integrated and want to get it done quickly, so we’ve been working 24 hours a day on that facility.
We already have about 10,000 patients in our population, which is about one out of every three people in Gillette, depending on how you count Campbell County. Those patient encounters are growing, and the depth of services we can provide is expanding as we bring on specialists like rheumatologists, ophthalmologists, and cardiologists. The goal is to create a holistic view of a patient’s health and find a way to combine these two sides together. We’re a little biased toward the allopathic side because of the family legacy, but we have a lifestyle group led by very good people, and functional medicine physicians are coming on board. We already have Dr. Gerard and others joining us, and we’re starting to integrate ourselves into the lifestyle side of the world.
In addition to the foundation with mesenchymal stem cells and hyperbarics, we’re also exploring other modalities, such as photobiomodulation, which uses red light to enhance cellular health, especially ATP production in mitochondria. We’re looking at PEMF and vibroacoustic medicine. In fact, we may begin a study next year to use directed vibroacoustic techniques to promote the release of endogenous DMT in the pineal gland. There’s a litany of things to consider, but it’s exciting to see these capabilities.
We’ve also gotten into transcranial magnetic stimulation (TMS), working with MagStim, a major provider of this technology. We’ve been using it successfully to treat depression in many patients. About 85% of the people who go through the program show some signs of improvement, and some have even gotten off SSRIs they’ve been on for years. TMS is remarkable because you can do over 30 to 40 sessions that lead to lasting changes, removing drug dependency from the patient. If it is a treatment, it’s a highly effective one that doesn’t require persistent dosing, just occasional refreshers for many people.
We’re also looking at other alternative treatments that have been done in traditional medicine. For example, we’re keen to explore darkness retreats and set up a ketamine clinic. We have two psychiatrists working with us, and we’re exploring how we can combine a program together. As you know, I recently went to one myself, and I believe it had a positive impact that could be shared with many others.
On the vibroacoustic side, there seems to be a lot that could be done for treating pre-diabetes and diabetes and improving insulin sensitivity, as well as potential treatments for cancer. As the clinic grows, its primary concern is the public health of Campbell County, ensuring we provide holistic care for everyone in the area.
We’ve faced some challenges, particularly conflicts with external providers. The biggest example is Campbell County Hospital, which seems to perceive our clinic as a threat to their existence. Some people they recently terminated even comically came to us and told us that their marketing department has a dossier on me, my brother, my dad, and my mother, which is pretty funny. They even have a board up on the wall with strings connecting pictures of us and others, and they’ve sent fake patients into our clinic to get interviewed and see what we’re doing. There’s a culture of fear and paranoia there.
How often do people invest over a hundred million dollars to build a clinic that doesn’t seek to make money? Our sole purpose is to improve public health and learn more about combining lifestyle medicine with allopathic medicine. There’s an expectation that if someone operates outside a profit-and-loss framework, there must be an ulterior motive. The reality is that the anti-aging and regenerative medicine world is a multi-trillion dollar marketplace. The therapeutics developed at Hoskinson Health are intended for sale as we go through FDA approval across the United States and later the world.
This multi-trillion dollar market means we will use mesenchymal stem cells long-term in products that could restore lost smell from COVID, enhance mental performance, cure TBIs, improve orthopedic outcomes, and address dozens of other downstream issues. The hope is to manufacture the stem cells in Gillette, creating hundreds of jobs, and sell those products across the United States, generating billions in revenue.
I’m not entirely sure why there’s a perception in that organization that we’re there to put them out of business, but that’s a challenge in healthcare in general. They don’t like change and often view it with skepticism, thinking that the goal of change is to harm people. I can’t tell you how rewarding it has been watching this clinic grow and how it has improved the lives of so many people.
Before we created our clinic, people had to wait six to twelve months for health appointments for issues that really ought to be seen urgently, whether they be heart conditions, neurological issues, or autoimmune disorders. These are people just like you and me; they just happen to live in Gillette, Wyoming. When there was a massive need for public health, we were able to build a 10,000 patient panel in three years. If someone steps in to fill that need, I’d like to believe that’s a net good.
If the system resists that or fights it, or if there’s a culture of fear and paranoia behind it, it indicates that healthcare as a whole is sick. I don’t think the other providers are the problem; they live in a mindset that creates many issues for people. Unfortunately, they often view everything as a zero-sum game, which is sad. Regardless of their beliefs, we’re not going away. We’re going to keep doing what we do and continue building what we build, and the reality is we’re building it for everyone.
Millions of Americans are suffering right now; over 60% of the population has some chronic ailment or mental health concern. It’s the highest it’s ever been in American history, and much of that is due to what’s in our food, how we live, our dopamine addiction to phones and social media, and the loss of meaning and hope.
Despite spending $4.5 trillion on healthcare—the most expensive of any nation in the world—we still have large pockets of the United States that can’t access basic healthcare or quality care. In many cases, they receive the worst possible outcomes, and we pay for the wrong things. This is the challenge of our time.
With our new HHS Secretary, Robert Kennedy, I believe there will be a renewed focus on returning to a healthy state in America. We can’t solve all the problems, but I’d like to believe we’re at least trying to do our part. One of the reasons allopathic medicine has difficulty integrating with functional and naturopathic medicine is that while there are amazing ideas on that side, there’s also a lot of pseudoscience and charlatanism, with bold claims lacking evidence.
One of the things I believe we bring to the table is rigor. We brought this to the cryptocurrency industry, having the largest research group in the world for cryptocurrencies, with 168 scientists and 230 papers from Stanford to Tokyo. We conduct our work in partnership with high-quality research organizations and university partners, adhering to good old-fashioned science.
Unlike traditional science, which has closed itself off and no longer has an open mind due to its financing, we have the luxury to pursue unorthodox ideas and research things that may not result in profit. Many people avoid naturopathic approaches because there’s no patent or drug protection, and even though there may be substantial circumstantial or anecdotal evidence, no one takes the time to do the necessary science because there’s no profit at the end.
We have the freedom to pursue these types of things due to the nature and structure of our organization. We don’t have unlimited resources, so we’re starting small, but we’ll continue to grow. The fact that we can share this with our over 10,000 patients and continue to expand is an honor of a lifetime. It allows us to work with affiliates and satellite clinics across the United States, integrating various categories from lifestyle and biohacking to traditional clinics.
As we broaden our scope and the spiral continues to scale out, we can go from trials of dozens to hundreds to thousands, helping an increasingly larger pool of people and generating evidence. There will continue to be challenges along the way, and despite someone like Kennedy taking over HHS, I have no illusions that the bureaucracy of medicine will remain a barrier.
However, we’re learning as we go, and at the end of the day, we never forget why we do what we do. It’s about the family legacy and tradition: you cure people, you help people. Being a physician and a health practitioner means a lot. People trust you; they come in not feeling well and just want help and compassion. They want someone to tell them it’s going to be okay and that we’ll figure it out together.
It doesn’t matter if it was thousands of years ago with Galen or Hippocrates or all the physicians of antiquity; it’s one of the noblest and hardest professions in humanity. Often, you can’t help them completely, and in many cases, you can’t help them at all. But the fact that there’s someone devoted to trying, with the compassion and dignity to put every effort into getting that person back where they need to be, is what really matters in the end.
Every day, we’ll grow a little better, and we’ll continue to invest in research. The clinic will reach its next evolution probably around July to August if our construction schedule stays on pace. We’ve hired a great deal of providers, and our science division is growing at a rapid pace. One of the cool parts is that we have such a large ecosystem with Cardano.
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