Dana Serrano: Good afternoon. I’m Dana Serrano. Nice to see you, Dr. Erik. I am the founder and CEO of Gate Mechanics Therapy Services. And our company delivers long-term therapy services in the home for anyone experiencing movement or memory disorders, all covered by Medicare. And to kick off our new spotlight series, which is reinventing dementia care in the home, we have Dr. Erik here. Very honored to have him. Dr. Erik, you share our mission in delivering homebased care for patients who do not have access to health care outside of the home or have lack of caregiver support. Uh we really need to to focus on that in this day and age for sure. Dr. Erik, you are the founder and CEO of Med Health, which is a practice that is dedicated to serving at homebased care through the CMS dementia guide model. Um you are no stranger to healthcare innovation. I am extremely fascinated and impressed with your merging of entrepreneurial talent with your healthcare expertise. It’s remarkable. I am I’m just in awe of what you’ve been doing. I’ve done quite a bit of research and and seen what you’ve done up until this point and would love to just hear a little bit more about your journey and how you started the process of homebased care.

Dr. Erik Ilyayev: Uh thank you so much uh Dana for the introduction and thank you for having me on your show. It’s really exciting to talk about guide and the great work that you and your team do as well. So, just incredible. A little bit about my uh my journey. So, I graduated residency in 2012 and um you know I was looking you know a space what am I going to do as a doctor and an opportunity came about to do house calls and now house calls are becoming more prevalent, right? But in 2012 it wasn’t as big as it is now nor as it was in the 50s or 30s, right? With a house call doctor. So, I remember start I remember being recruited to go to an organization and later I said, “Well, I want to do this in my community in in a community in Queens, but I didn’t have any patients.” So, my mom’s like, “Well, why don’t you see grandma? Grandma fell. She’s declining to go to the hospital. We want to make sure nothing is fractured.” And I said, “Okay, let let me let me try it out.” And so, I I came, I saw grandma, I did a full exam in the home. And then I didn’t know that you can get X-rays done at home at that time. I said, “Let me Google it,” right? Where do we go? We go to Google. So, I Googled a company and I found an X-ray company. They came the same day within 3 hours. They did an X-ray. I’m like, “Wow.” Like I’m I was working as a resident in a hospital and it took longer to get an X-ray there than I got it at home. And that began really about a 10-year career in the state of New York of doing house calls. First it was me, then I hired a nurse practitioner. Then I said, “Well, how do you scale, right? How do you scale education?” And I was reading a book from Ray A. Croc, Grinding It Out. It’s McDonald’s book and he had something called McDonald’s University. This way your French fries and your burgers are always delivered the same way. There was a system to it. So, I said, “How do I systemize the delivery of a house call visit and the training?” So, I founded something called My House Visit University where all of my nurse practitioners were trained through video by me and, hey, my name is Dr. Erik. How do you knock on the door? How do you do a physical exam? How do you take care of congestive heart failure? And that went on for for 10 years. We were one of the largest h home care house call organizations in Queens, New York. Um and it was incredible. Uh then we moved to the state of Florida and also we started doing house calls as well. But an opportunity came along called the guide model. Guiding an Improved Dementia Experience. So, I’m excited to talk to you today about that. I’m sure you have some questions about it and then the audience will have some questions about that and we can uh we can uh discuss that.

Dana Serrano: Fantastic. That’s amazing. I I really I really appreciate and reflect on what you’re saying about how this approach to homebased care has changed. We’ve kind of reverted back to it to some degree, which I think is fantastic. There is a need. I I personally have a mother that has Alzheimer’s, a father that had ALS, ciaer, and so I have really seen not just as a physical therapist and healthcare provider, but the need and the lack of support that’s been in the home for people who have movement and memory disorders and the things that are being missed clinically in in an office setting that really, you know, you can’t see unless you’re in the home. You’re checking their laundry. You’re checking to see if there’s old food in the fridge. Is is the stove been left on for 3 days? The these are things that are really so important.

Dr. Erik Ilyayev: You bring up a good point in that, you know, if you think about it in an office setting, how much time can a provider, a physician, a nurse practitioner, a physical, how much time can someone give you in an office setting? If you typically imagine an office setting, you have a full waiting room of 30, 40 people. You have a doctor or a provider, nurse practitioner, anyone kind of in the grind and how much time can someone spend with you in the office usually, right? You usually get a 15 minute, 20 minute visit, you’re not going to get a 40minut or an hour visit. I mean, it’s it’s very unlikely to do that. In a 15 minute visit for a 75 year old female with 12 medical conditions and 15 medications, do you think 15 minutes is really enough? No. So, the house call visit gives the opportunity to sit in someone’s home to look at their refrigerator, to look why the sugar is that high. Maybe like I had a patient who was 92 years old um and she was a diabetic and all she did she loved every morning she got her teaspoon of honey. She had to have that. It was a tradition and you couldn’t break it. So, we we identified why her hemoglobin A1C was on the high side. Okay. Couldn’t do that in the office. Same thing with physical therapy. Some of the things that you do, I mean, looking in the home, looking what’s safe, looking if there’s tripping hazard, looking what the bathroom situation looks like, what the shower situation looks like, training someone in their own home how to navigate and walk around in their own environment. That’s that’s priceless.

Dana Serrano: Absolutely. And and I think you hit the nail on the head earlier when you mentioned the word educator. you know, when you are educating your nurse practitioners, your PAs, your physicians to go into the home, if that’s something that that has not been their their uh mode before, really, you have to educate them on what to look for. And I can speak for my field, physical therapy, occupational speech therapy, we have forgotten to be educators. So, we’re very quick about going in and do maybe some exercises or to, you know, let’s see how you’re getting out of bed, but but to really take the time and educate people on how to do things better, to take a step back and really look at the broader broader scope of what’s going on in the home, how we can support the caregivers to get Mr. Smith who maybe has some cognitive impairment and some challenging behaviors to get him into the shower. You know, three sets of 10 of a of a quad set is really not going to improve that. And I think we need to own that space a little bit more.

Dr. Erik Ilyayev: You’re you’re very on point with the education piece. Very often in medicine, we feel like it’s our role to tell you what to do. If you’re a patient or a caregiver, you have to take this. You must do this test. You really, you know, an example of the guide model, we’ll take a deeper dive into it, but some some side notes is we asked the question, what matters most to you? Right? That’s the first question. As a caregiver, as a patient, what matters most to you? How aggressive do you want to have any therapy or treatment or medications? We look at medications as part of the guide model. There’s something called the Beers Criteria, right? It’s a beer. The Beers Criteria are medications that an elderly individual is not really recommended to be on. So, as part of that conversation, it’s not you shouldn’t take this medication. So, I know that you’re taking Ambien and you’re 82 years old and you have a little bit of a gait issue and you’ve had some falls. Now, look, let’s discuss and let me try to educate you on the medication. What are some of the side effects? What are the percentages and the rates of people falling down on that medication? And let’s weigh it out the pros versus the cons, right? How do you feel about that? Let me give you a little bit about what happens after the fall. How many percentage of patients have a hip fracture? How many actually never recover from the fall? And once I do that as an educator and I educate you on that as a physician, as a as a patient, you’re listening, let’s say, then you should ultimately make that decision, you and your family, right? with the guidance and the education that I’ve provided. And hopefully I was balanced in giving you the pros and the cons. But a lot of the times it’s like don’t take it, take it. There’s no real education. It comes down to time because in an office setting very often and in primary care there is not a lot of time. You’ve got 15 diagnosis, 15 minutes, shoot, go.

Dana Serrano: Right. Right. That’s why that’s why we have programs like the guide model where Medicare says look we have to focus not only on the 17 medical conditions but on dementia as itself and everything that’s associated with dementia. Let’s have a single program for patients who have Medicare and dementia. Not only that, let’s not forget, here are some stats. In the state of Florida in 2022, there were 580,000 patients who have the diagnosis of Alzheimer’s disease. So, Alzheimer’s disease is not all dementia, right Dana? As you and I know, Alzheimer’s is just a category. Dementia is the broad and then you got the specific dementias: Parkinson’s dementia, right, um Lewy body dementia, vascular dementia. So, in the state of Florida 580,000 in 2022. In 2025 that number went up to 720,000 patients just Alzheimer’s, not the other dementias. That’s a 24.1% increase. On top of that, on top of that, we know that 40% of doctors, nurse practitioners, physician assistants, and this is from the Alzheimer’s Association article that came out from Carolyn Clevenger. She’s from Emory. 40% say they don’t feel comfortable or don’t have the tools to make a diagnosis of dementia. So, if you put the numbers in the state of Florida, you say there’s 720, but you’re saying you don’t even 40% say I don’t feel comfortable making the diagnosis. How many people are really there?

Dana Serrano: Correct. Correct. That’s amazing. And and scary to be very honest with you. Um terrifying. So, in through the lens of this dementia guide model, what can you explain so that people have a better understanding of how this might be different than your tradition traditional homebased care approach for people who have dementia diagnosis?

Dr. Erik Ilyayev: That’s a great question. Great question. So, first things first, we know that there are a lot of I don’t want to say scams, but there are a lot of programs there that call senior citizens and they switch them their to their insurances and there’s a lot of that switching going on. We’re going to give you a voucher for this, voucher for that, and then they realize they lose their doctor. They can’t go to the same doctor, can’t go to the same specialist, their pharmacy. So, the first thing to say about GUIDE is nothing changes. Your insurance doesn’t change, your physical therapist doesn’t change, your home care agency doesn’t change, nothing changes from a taking away from you perspective, right? That that’s important. Number two is who is the guide model for? Well, the first uh uh stakeholder is the person living with dementia. So, you need to have a documented diagnosis of dementia. That’s number one. Number two, you have to have traditional Medicare. What does that mean? You know, you have the Medicare advantages like Humana, like the Aetna, all the other ones that doesn’t qualify. It’s only traditional Medicare. A person can’t be in hospice. A person can’t be in a PACE program. There are these different programs called PACE. And they cannot be in a nursing home. They can be in an assisted living. That’s okay. But not in a nursing home. So, okay, we said who is it for, Dana? We said it’s for the person living with dementia. Okay, but who else? Well, it’s also for the caregiver. Let’s say, Dana, you are the caregiver for your 92-year-old grandmother who has dementia. What does it mean that Dana is the caregiver? Well, according to the guide model, Dana is an unpaid relative or non-relative. So, unpaid, right? She’s a daughter, she’s a granddaughter, she’s a spouse, she’s a friend who is unpaid, but she’s a caregiver and caregiving for what? In things like Activities of Daily Living. It’s called ADLs and Instrumental Activity of Daily Living called IADLs. What is that? So, bathing, grooming, going to the bathroom, uh IADL’s like paying rent, balancing their checkbooks, things that are not connected with physical activity, but more executive functioning activities as well for the IADLs. So, Dana is a caregiver. Okay, great. Dana is a caregiver. How can you, Dr. Erik, and Med Better Health through this new guide model help Dana and her grandma? Right. That’s an interesting question that people want to know. Well, the first the first thing is we would have a conversation with Dana with you and we say Dana we’re going to do something called the ZBI, the Zarit Burden Interview index. What is that? The ZBI. Well, in that index we ask you 22 questions and we see how exhausted you are, right? How burdened are you? And there’s different percentages, right? Let’s say you’re 50% or you say, “I’m okay.” Or you say, “Like most caregivers, I’m exhausted.” Dr. Erik, fun fact, in the state of Florida, close to a million unpaid caregivers, 66% have chronic diseases themselves. 30, close to 30% have depression. Just to show you, right, my mom and my dad are caregivers to my 93 year old grandma and they’re 70 years old. Wow. And so you can imagine how difficult it is, right? So I would ask you questions. If you answer and you say, “Dr. Erik, man, we are I am really tired. I don’t have time for myself. Um, you know, I’m I’m trying to be with my kids, but I have to go see my grandma because things are always happening and I just need a break.” Okay, let’s see how we can help you. But before that, let’s see what type of dementia, what level of dementia grandma has, what stage, you know, there’s mild, there’s moderate, and then there’s severe dementia, right? And very often your doctor will tell you, “You have dementia.” You’ll have a diagnosis. You’re like, “Oh, he told me I have dementia.” But did anybody actually sit with grandma and stage the dementia? Is it stage one, stage two, stage three? Because different stages require different resources. And obviously, the higher the stage, the more burnout the caregiver has. Sure. So Medicare says, “Look, if you have a stage two or stage three dementia, moderate or severe, or your grandma, and you, Dana, are exhausted on the ZBI index, Dr. Erik and his team will submit that information to Medicare, and Medicare will say, “Yes, you’re approved.” Okay, what are you approved for? Well, you’re approved for four or five key things. The first one is respite. And some people may say, “Well, that what is respite?” Respite is you, the caregiver, now get some time off. How are you going to get time off? Well, Medicare is going to pay for through Medicare, never done before, for three types of respite. Number one is home care, right? So, someone from a home care agency will come to your home and say, “Dana, you go get your nails done, go to dinner with your husband, relax. We’ll help grammar for these hours and we’ll we’ll be in the home. We’ll watch after her. We’ll help her with her ADLs just so you can get some rest and respite.” That’s one. Number two, it is adult daycare respite. Same situation except now grandma goes to a adult daycare and she’s there for 48 hour 4 to eight hours a day and you Dana now have some respite too. Grandma’s having a great time. She’s there. There’s music, there’s food, there’s entertainment and you also now have that time for yourself. And the last form of respite that Medicare pays for is called the respite for assisted living communities. You, Dana, have a son who’s in New York. He’s getting married. The whole family is there and the wedding is in New York, but you’re living in Florida and you don’t know because Graham’s needs your attention. You give grandma her medication. You check up on her. What do I do? I got to be in New York for 4 to 7 days. Medicare now pays for that respite where grandma can be in a short-term assisted living short-term while you are in the wedding for your son and then you come back and you take grandma back. So that’s a little bit about the respite component.

Dr. Erik Ilyayev: There is Dana another com four components um such as caregiver education. I like to ask you like when it comes to caregiver education, I know you do a lot of that in the in the physical therapy, in the occupational therapy space, in the speech space, you know, what are some issues that you have that the caregivers come to you with that they’re like, I I we don’t know what to do. Like I’d love for the audience to your audience to hear that as well.

Dana Serrano: A great example, I think, speaking first as a physical therapist, one of the misnomers out there, is the fact that they will often say, “Well, you know, my loved one is just they’re they’re just being lazy. They’re being obstinate. They were never lazy or obstinate before.” And we have to take pause and say sometimes there is an expressive issue that’s going on with the patient where they are starting to recognize that movement mobility is very difficult but they don’t have that executive functioning and reasoning to actually express, “you know Martha I’m sorry but I’m having a really bad day and when I get up it takes all of my energy and I just can’t really figure out where to put my feet today and when I go to stand up I I I actually don’t realize that I’m not bending over enough and I can’t quite get up.” Instead, they just sort of freeze and they shut down. So, a lot of times I I I hate to sell myself out of a job for physical therapy, but we do have to explain to the families just to take a look at maybe positioning in the chair. Perhaps the feet are not in the right position. Perhaps they’re not leaning forward enough. Perhaps they’re having a a a difficult time walking because it’s too taxing for them and they need an assistive device. but to really recognize that the the behaviors that are coming through are not going to be communicated by the loved one like they were before and to to kind of dissect that and diagnose it a little bit differently. And that has been life-altering. How many patients I’ve seen go to physical therapy clinics, not that I have anything against that, but they, you know, they’re lined up, they’re on the bike, they do all of these things, you know, three sets of 10, and they don’t get any better because they’re just being taken through the the motions without any real purpose and really any understanding as to what’s happening. Um, same thing when it comes to just difficult behaviors. How many times I’ve had loved ones, myself included, 15 years ago before I started this journey with my mother, where you try to reason with them and you try to say, “That’s not true, Mom. Today is not Tuesday. It’s Monday.” And all of this wasted energy and agitation that’s created in this dynamic without having the education of someone just saying, “It’s okay. It’s Tuesday. You want it to be Tuesday. it’s okay.” And really learning how to navigate some of these behaviors without recognizing that there you’re not losing them to this disorder if you don’t confirm or disconfirm what the day of the week is. This disorder is coming and there’s ways to make the journey better. I I wish I had had that education 15 years ago and the guidance, the journey would have been very different. It really would have.

Dr. Erik Ilyayev: You you’ve really hit it on the spot uh when you’re talking about those examples of the education. You know, to share a few u um incidents from from my personal experience, like my mom and my dad, as I mentioned, they’re caregivers for my grandma and my dad is the son and my mom is the is the daughter-in-law. So, the dynamic also, right, like a daughter-in-law, right? That’s it’s already like there’s always a daughter-in-law and a mother-in-law dynamic, especially especially when there’s a dementia, right? So my mom I I I I go into my grandma’s room and my mom my grandma tells my mom, “Where is my mother?” So my grandma who’s 92, 93 is asking my mom where my grandma’s mother is. So my mom who wasn’t trained in the caregiver education component of how do you how do you tackle that situation? Right? Someone with dementia is asking you where her mom is and she herself is 93. So my mom tells my grandmother, “You know what? Uh, you listen, grandma, she she died. She died a long time ago, right?” So my grandma, she gets, “You are always lying to me. You’re the worst daughter-in-law in the world. She’s not dead. She’s alive,” right? So now my mom, she kind of, you know, she kind of heard she’s alive, but what hurt her most was, you know, you’re the worst daughter-in-law in the world. Because my mom doesn’t understand that it’s a different what what people don’t understand is that people with dementia they have very different glasses on. They see the world very differently than you and I do. And if you’re trying to expl— So I educated mom. I said, “Mom, let’s do this.” I came up to grandma. I said, “Grahams, no. No. Yeah. Your mom, she went shopping to get a piece of bread for the family. She’ll be back soon.” “Oh, really?” Yeah. And I redirected. “Hey, Grandma, look at this. Look at this album over here. Remember when I was young and this was my Bar Mitzvah and this was we were celebrating.” “Oh yeah, I remember.” And that completely deescalated the situation, right? That is one component of caregiver education. There’s there’s many many many others like how many of your listeners have a person living with dementia who they’re a caregiver with and they either decline to take medications or they declined to take a shower. So someone’s like, “I’m not going to take a shower, but mom, you can’t anymore. We can’t walk by like and you’re trying.” “No, I don’t. I’m fine. There’s nothing wrong with me.” How do you message that? That’s where the education component comes in. So what we what we teach is we say, “Look, don’t tell mom what to do. It’s a control issue. No one wants to lose control. Even if they’re losing their memory, you always want to be in control of your own life, and you’re going to fight for it. So when someone tells you what to do, you’re going to say no. So reposition the value proposition and say, “Hey, mom, I know you told me you wanted to take a shower. I want to know what’s the best time for you. Do you want to do it at 1:00 or 1:10? And I know instead of the shower, you’d always wanted to go to the spa with me, and I miss hanging out with you. Why don’t we go and have a spa experience together?” Mom’s like, “That’s interesting. I’m in control. You know, I I didn’t say 1:00. I’ll say 1:10.” You take mom, you put some candles on, some music on, right? And then and then you don’t tell mom, “Okay, mom, let me undress you.” I I don’t want my kids to see me undressed, right? That’s it’s a control thing, and I don’t want anybody seeing me undressed. So saying, “Mom, let me tell me what do you want to take off first? Do you want to take off this jacket first? Then, you know, I’ll only help you if you need my help, Mom, ‘cuz I know you can do it,” right? Do that approach. That deescalates. “No, honey, help me, please help me. It’s okay,” right? That’s a very different approach. That’s the caregiver education component.

Dana Serrano: Fantastic. I I think that’s so important and you know as you mentioned that control is a big piece when someone is going through a a cognitive impairment experience. They are already losing control and and for the most part, especially in the earlier stages, they’re they’re very aware of it and that is so nice to be able to give them a little bit of dignity, sense of autonomy, independence. Um, there are so many different guide programs out there. One of the things that I I wanted to kind of end with here or lead into towards the end of our conversation is you as as a healthcare innovator have really done a terrific job in your space at really improving what the homebased model of care is, which I think especially in the therapy world, I have to say we have a lot of work to be done there. I think we have to improve our reputation by really stepping up to the plate as as you have as a physician and really showing people what can be done in the home to improve quality of care. Absolutely. There’s a a place for clinic-based care. No question at all. We need it. But we also have to own the space of what homebased care looks like. So in a world as you mentioned earlier where there’s lots of nonsense and you know seniors are offered different things to disenroll from Medicare and there’s just a lot of misinformation. What can you provide people to let them know that Med Health is going to be a different approach through this guide model since there’s so many popping up here and there?

Dr. Erik Ilyayev: Yeah. Yeah. That’s a very very good question. You know, I’ve learned very early in life that the only way that you can become successful as an individual is if you bring value to someone else. Right? We have the old saying, the more you give, the more you get. So very often the approach in in healthcare is just to is just to get get. Uh we are very mission-driven, right? We want to bring if if my team or I don’t bring you value even like in this conversation today, right? Giving value about some education, how can you educate if mom doesn’t want to take her meds or mom doesn’t want to take a shower, right? If I don’t give you value, then there’s no reason for me to exist if you as a caregiver or as a patient don’t walk away saying, “Wow, we’ve spent this time with Med Better and we were so thankful that you exist.” I’ll give you an example. Medicare as part of the guide model has a very big emphasis on something called uh goals of care advanced care planning. Right? So a lot of people they say we don’t want to be resuscitated or intubated or they don’t know what a DNR DNI is. And very often when I remember when I was a resident, I remember being in an ICU and seeing a gentleman who had a code. Their heart stopped and they were they had resuscitation and intubation and the daughter and I always say this daughter, the daughter and the mom were there. I was a young resident and he had been in the ICU for a week. He was swollen. He had tubes everywhere. And the daughter told the mom, she said, “Mom, did dad ever want to be like this like like to be through go through this process?” And the mom said, “No, we we talked about it.” Dad never wanted that, but we never discussed it with anybody. So when it happened, we didn’t have no paperwork. We had nothing to show. Like in the state of Florida, there’s a yellow DNR, DNI form. And I never say, “Oh, DNR is good, not DNR is bad.” No, it’s a personal choice. But when you didn’t know that it existed. So we as Med Better Health, we spent a lot of time. And I remember I wasn’t talking about hypertension. I wasn’t talking about diabetes. That was talking about advanced care planning and goals of care and DNR DNI. And the caregiver was so thankful. She had a paper. She was taking notes. She’s like, “Thank you for letting me know. I’m going to speak to my primary care doctor ‘cuz this is something we never spoke about, but I I know it’s important.” That conversation is value, right? Because if they didn’t want to be intubated and I spent that 15, 20 minutes and I spoke about that and when something bad happened, they said, “We want them to be comfortable.” That family didn’t go through something for two, four weeks that they didn’t want to go through, right? That’s value. So, you know, to just like what you do, I see you’re very mission-driven. Uh I only hire people who are mission-driven. I tell them right away like these are our values. It’s on my website. This is our mission, right? We are fanatically efficient. We are obsessed with a customer. If you’re not obsessed with your customer or your patient, you’re in the wrong place. The reason you and I are so attached to Amazon and we buy from there because Jeff Bezos put the customer first in essence. How do I make it easier for the customer? How can you get your package the next day? That was his mission. Yes, they made a lot of money doing it, but they only did they did well because they did well for the world. Today, we all use it and it’s not super expensive, right? It’s convenient. You order it. It comes to your home. It’s great. That’s my vision for for Med Better Health to deliver value and satisfaction in every interaction.

Dana Serrano: I love it. I and and I absolutely appreciate and I am just absolutely fascinated with your intentional approach to healthcare and and really that’s what it boils down to is the ability to be super intentional and driven by what the patient and the caregivers need. Um and just to wrap things up, I would love to make sure that people can get to you. So if they have a loved one that is suffering some from some form of cognitive impairment uh you know maybe in the earlier stages of dementia, they have Alzheimer’s, how can they find you? How can they reach out to you?

Dr. Erik Ilyayev: Yes. Yes. So the one of the best ways is to visit our website. It has all of all of my team members, their bios about the guide model, and that’s medbetterhealth.org. That’s the best way. Uh you could always call us 305-339-1756 and you could always send us an email even at info@medbetterhealth.org.

Dana Serrano: Fantastic. And I I for one—

Dr. Erik Ilyayev: Sorry. You are one of our partners in the guide model and the reason that that is, we’re very selective and we’re very very happy because you have the same mission. You have the same vision to help people at home. You you know health care, the there’s a care there, right? It’s not health, it’s health care. You and your team at Gate Mechanics have the same care that we do and that’s why we’re partners and I’m excited to work with you and your team.

Dana Serrano: Same. And and I will say anybody that is currently a a a patient of ours or within our scope, obviously we will whether you stay with us as a patient or not, we will make sure that we get you to Dr. Erik and his team at Med Better Health so that they can participate in the guide program. Dr. Erik, thank you so much for your time. It was a pleasure. It’s an honor being a community partner with you. I I can’t wait to see what comes next. Honestly, thank you so much.

Dr. Erik Ilyayev: An honor to be on your show. Have a great day.