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11. Explaining the Inequity of Women’s Healthcare with Dr. Jocelyn J. Fitzgerald
123 Plays21 days ago
Did you know doctors are paid systematically less for procedures on female anatomy? (For example, 45% more to biopsy a penis than a vagina). This shocking reality, highlighted by creator René Jay @bornwithadarktan and Dr. Kemi Doll’s book A Terrible Strength, is a baked-in structural issue.
In this episode of Our Womanity, host Dr. Rachel Pope sits down with urogynecologist Dr. Jocelyn Fitzgerald—the lead researcher behind the landmark study "Price and Prejudice"—to dismantle the financial architecture failing female patients and their specialists.
Dr. Jocelyn Fitzgerald, MD is a board-certified urogynecologist and reconstructive pelvic surgeon at UPMC Magee-Womens Hospital in Pittsburgh, and an assistant professor at the University of Pittsburgh. Her clinical work and research span chronic pelvic pain, female sexual dysfunction, pelvic floor disorders, and genitourinary syndrome of menopause. She is a prominent advocate for equity in women’s healthcare, famously publishing research detailing the surgical reimbursement inequities embedded within female anatomy billing.
Key Conversation Highlights:- The RVU Trap: How the Relative Value Unit (RVU) billing system systematically devalues the female body, gynecologic surgery, and non-surgical menopause visits.
- "Moms of Medicine" Dilemma: Why society expects OBGYNs to constantly absorb uncompensated emotional labor and primary care duties, diluting their specialized surgical value.
- The Workforce Crisis: Why post-op "ghost towns" and devalued billing are driving a massive OBGYN shortage, with only six states projected to have adequate care by 2040.
- Beyond "Lady Stuff": Why menopause is a systemic transition overlapping with cardiology, rheumatology, and neurology, demanding interdisciplinary research.
- The Allderdice Connection: A fun look back at Rachel and Jocelyn's shared feminist upbringing at Taylor Allderdice High School in Squirrel Hill, Pittsburgh.
"In medicine, if we don't study it and we don't name it, it's not there. It's just treated as 'lady stuff.'" — Dr. Jocelyn Fitzgerald
Connect & Listen:Subscribe to Our Womanity on Apple Podcasts or Spotify, and follow Dr. Rachel Pope on Instagram: @DrRachelPope for daily midlife wellness tips!
The Study: Price and Prejudice: Reimbursement of Surgical Care on Male Versus Female Anatomies by Madeline Penn, Donessa Colley, Pratistha Koirala, Dr. Louise King, and Dr. Jocelyn Fitzgerald.
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Transcript
Gender Pay Gap in Medical Procedures
00:00:00
Speaker
Doctors get paid less when they do procedures on women. Ain't that crazy? That sounds like I just made that up. Okay. But I actually was reading a book called a Terrible Strength.
00:00:12
Speaker
In that book, as a footnote, like this, the way it was described, it it's like, it's just a known thing. Okay. So it says procedures specific to ah female reproductive anatomy are systematically reimbursed lower than male specific procedures.
00:00:30
Speaker
A doctor gets paid for 45% more money to biopsy a penis than to biopsy vagina. They get nearly 150% more to remove a legion on a penis than to remove a legion on a vagina.
00:00:48
Speaker
And Dr. Jocelyn Fitzgerald, a urogynecologist, is the leading voice and researcher in this area. So I go and check her study out. Now the study is called Price and Prejudice, Reimbursement of Surgical Care on Male Versus Female Anatomies, right?
Understanding Reimbursement Systems
00:01:01
Speaker
This is sad but true. RVUs are relative value unit. And this is kind of like the currency that hospital systems and the healthcare system across the U.S. uses to value what physicians bring into the hospital system or to their clinic system and how those procedures should be reimbursed, how far physicians of different specialties should be paid is really the basis of everything.
00:01:27
Speaker
And yeah, it's sexist at its core. If you look at very similar procedures that are done for men versus women, they are valued less when they're done for women. Even when you look at anatomy, you can hardly differentiate between the vulva, the vagina, whatever part of the vulva, the labia minora, the labia majora, the clitoris, it all just gets built the same.
00:01:48
Speaker
And so if multiple biopsies are done from multiple different parts, it doesn't matter. It's all the same. Now, if you do a biopsy on the penis or the scrotum, it all could be
Introducing Dr. Fitzgerald
00:01:58
Speaker
different. Sexist?
00:01:59
Speaker
Yeah. And I have a little bit of an advantage because I know Dr. Jocelyn Fitzgerald, the author of that paper. She and I went to high school together and she's brilliant. So I've invited her on today to really pick her brain, help her to explain what the problem is so that we can try to figure out, can it be fixed?
00:02:15
Speaker
Dr. Jocelyn Fitzgerald is a urogynecologist and reconstructive pelvic surgeon UPMC McGee Women's Hospital in Pittsburgh and an associate professor at the University of Pittsburgh. Just to mention, her views and opinions that are expressed today do not reflect those of her employer. She trained at Johns Hopkins in Georgetown, and her work spans chronic pelvic pain, female sexual dysfunction, pelvic floor disorders, and genitourinary syndrome of menopause. She's published research specifically on how surgical reimbursement is inequitable when it comes to female anatomy, which tells you everything you need to know about where her head is.
00:02:48
Speaker
She's been passionate about women's health since her undergraduate thesis, and she brings the same rigor and advocacy to her clinical work. I just want to like break it down for people. Like, why does this happen? And
Challenges in Female Healthcare
00:03:00
Speaker
what's the problem? Like, I feel like this is the example of a multi-layered problem.
00:03:05
Speaker
Dr. Jocelyn Fitzgerald, im so excited to have you here to talk about it. Oh my God. Well, it's such a complicated thing. Thank you for having me. I'm delighted to be here. And this is the thing where I want to help to explain it to women, because I do think the way things are set up is ultimately a disservice to women. And that's what I want to have this conversation with you is that it's all expected to be done for free. For free. No compensation for any of it.
00:03:31
Speaker
And here's what I mean. Like, i love that I can see women on a regular basis and they already have their hormone therapy requirements. regimen I'm just refilling things. I'm just checking in on them on a yearly basis and then I'm doing their PAP, maybe ordering their mammogram and it's considered an annual exam. And then they want to talk about, and I understand why they would, and I encourage them to talk about all the other aspects that I specialize in, whether that's their sexual function, their bladder health, et cetera, their vulvar care. I ah believe in the insurance model because if you're already paying for your insurance,
00:04:08
Speaker
policy. I don't want you to have to pay exorbitant fees. I'm not in private practice. I'm not in a cash-based program. I'm in an insurance-based model, but also really like I'm trying to give people more than the basics. And this is like where just it's all just set up wrong. It is. I agree completely. i think it really is like this Yeah.
00:04:47
Speaker
code. And I think it requires education on how many other specialists you'd have to see if you were like, frankly, a man with like so yeah similar issues, like asking a urologist to manage well man's care is an insane thing, right? That would never happen.
00:05:04
Speaker
That would never happen. That's analogy. And I don't know we that. I'm in a urology department. and So ask a urologist to do a man's like annual visit yeah and see how that goes. I know. I know. And like, let's explain it to people because I think they also don't know, like I'm not making money off of each patient, right? Like I have a salary. So my job is my job, but my bosses and the top of the hospital are going to look at my productivity. And that's like our RVUs are the values that we bring in for each visit. And that is something that I have to answer to at the end of every month or review period is to make sure that like I'm actually doing the job that they are paying me to do And when it comes to annual exams, that value is extremely low.
00:05:53
Speaker
Compared to a new problem visit, an established problem visit, a surgery, etc. And like that, ultimately, i can get over whatever that means for me, i have to go to meetings, have to talk to people about it, I can get over that. But I also feel like ultimately, it's a disservice for women, because it incentivizes or disincentivizes other specialists, and even just generalists.
00:06:14
Speaker
from taking on those patients or taking on those appointments. Yeah, that's a great point. I think it would be foolish for any of us to think, you know, that we don't need to understand how billing and reimbursement works in a healthcare care system. i mean, it is what keeps the lights on. It's what pays for our support, pays the salaries of the ABPs we need and pays for new equipment in our offices, pays for things like anesthesia. If a patient like can't you know, do something in the office, you know, without going to so outside the scope of kind of what we're talking about, like one of my areas of expertise is in the RVU system and how it discounted and devalued OBGYN from its very inception in the early 90s. And then there's this thing called the budget neutrality clause, which basically has more or less with little variation, like locked the total number of RVUs in all of medicine into place. So what that means in short is that if we want to make well woman or some other like OBGYN related procedure worth more, worth more what it should be worth, some other specialty in medicine has to take a decrease in another procedure. And so when you have this committee where you have a representative for each specialty, OBGYN really is two specialties, if not multiple specialties represented by one person. And you're trying to decide what gets cut and what gets more, what gets less. And it also come out even it's really like a losing battle. So we do end up doing so much stuff for free, like literally surgeries that have no codes. We're doing them because we know the evidence says it's the right thing to do, but yeah then we go to code for it and there's like no billing. And then the people who keep the lights on in the hospital look at the various departments and they say, how much money is the OBGYN department bringing in versus the urology department versus orthopedics? And it almost makes it look like OBGYNs are like not efficient or like good at business or good at billing. They're slackers. We're not working that hard when like all the data shows that we actually are in the top three most productive specialties in pretty much any given academic hospital. Our surgeries are just worth fractions of what comparable surgeries and other specialties are worth.
00:08:15
Speaker
And honestly, like this other layer of also needing to do like offering to do or whatever your situation is, your hospital doing well woman care, like dilutes that revenue generation. Again, like being at the top of your license means that you're operating most of the time or you're seeing complex problems because these sort of well woman things probably should financially being taken care of by somebody who doesn't have the ability to generate the RVUs that you can yeah as a licensed OBGYN.
00:08:42
Speaker
That's a great point because but i don't know if you know this, there is zero RVUs for post-op visits because and it's not that the productivity for a post-op visit is part of the surgical billing. Yes. But,
00:08:54
Speaker
Hospitals then move the post-op visits to be taken care of by an advanced practice provider, like a nurse practitioner or a PA who doesn't have to produce things like surgeries, right? And then people don't see their surgeons afterwards. I had a patient last month who said to me,
00:09:11
Speaker
in the recovery area after doing a very complex vaginal surgery for her. She said, Dr. Pope, will I see you post-op? I was like, well, of course you will. Like i see all of my people post-op because it's very important to me. If I operated on you, i want to see how you're doing in a couple of weeks, in three weeks, et cetera. I want to make sure that everything is going well and that you're recovering well. And she's like, oh, my last surgeon, I never saw her after the surgery. She was in institution where the APPs do all the post-op visits and she never saw her surgeon again. And guess what? She came to me for a second surgery to fix what had been done before, which might've just been caught during that post-op period if she saw her surgeon. Yeah. Yeah, I mean, me crazy. I'm so sorry. But I want patients. I want women to know about this. Yeah, I think it's important to set expectations. I do work in a practice that is like that. The APPs do see all the post-ops, but we we tell patients about that. We also work with like an amazing group of APPs. who we know very well and we trust them and patients actually see them for a lot of their care. They know that they are really part of our team and like do have the training to pick up on like weird things and talk to us. to home stop visit Don't you think that the docs would be doing those post-op visits? It's very hard to say because then those numbers are hard to crunch because like they want us to see new patients. New people to bring in more service, right? Yes.
00:10:34
Speaker
But on the flip side, it's like, again, they want us working at the top of our license. If we're pelvic surgeons, they don't want to like increase the wait time for someone because it's already like a big wait time to see us. I can see both sides of it, but I agree like on the days that I do get like a post-op on my schedule, I'm delighted. And the patient is usually incredibly happy.
Comprehensive Care and System Limitations
00:10:53
Speaker
And I do think there's also an element of like preventing us from burnout. Like when we do see people back who are doing really well, you're like, oh yeah, this is why I do this. So and I think your surgical practice, honestly, I mean, that's the other thing, but I mean, not to go into the weeds with that, but I want to bring it back to Melinda Gates. I'm so excited about what she's doing and the money that she's dropping and the funding she's infusing for women's health in general. But the reason I want to bring it up is because she's putting a ton of money in for education of physicians for menopause care. And I like immediately started thinking about you and what you continue to advocate for with the reimbursement changes and felt like, listen, we are lifelong learners as physicians. We didn't learn GLPs in medical school. And yet we've got lots of physicians who are capable of prescribing GLPs, right? You know, GLP-1s. And so I feel like we can learn things and a lot of people will take the time to learn new medical information if they're incentivized. And if this RVU model stays the way it is for OBGYNs, where people will not get really reimbursed from a non-surgical visit, like menopause is not surgical for the most part, the needle's not going to change that much. And so, I don't know. I wanted to ask you, like, am I just so cynical? is this is this a No, no. I mean, i have to like look at the individual things because yes, I know like well visits and problem visits are built differently. Like if somebody I think comes for like a specifically like menopause discussed visit, I'm E&M and m billing, I do think is generally like pretty consistent across the board for like an office visit. But, but that is a visit, again, to your point that doesn't generate a surgery, like menopause care for an OBGYN doesn't sometimes it generates Yeah, like an
00:12:38
Speaker
EMB or a DNC, or maybe you realize that like really what's bothering them is fibroids, et cetera, et cetera. like menopause isn't a pipeline for like more well reimbursable services. And yes, like you can bill it as like a complex return, which frankly it is because you're looking over so many systems. You're probably looking imaging. You're probably reviewing like labs, but there's just not enough people and it doesn't like do any system exactly like it probably would lose money for a system if an ob-gyn is the one doing it because that means that you aren't able to do the higher billing things which are procedural so and i mean it has driven a lot of menopause care onto like online platforms some of which that take insurance so that's good but it does then create like a probably a bit of a disparity between people who have like access to those platforms or can pay for those platforms or even have insurance at all. It is. It's very yeah problematic and it makes for a not sustainable system. And going back to like also the ways we are trained, people also really kind of need to know more of like the pipeline of how we are trained. Even the big OBGYN program trains 10 OBGYNs a year. Like I'll use my residency program, for example, which to be fair is like a very academic place. So a lot of people did fellowships, but out of 10 people, we generated one general OBGYN who maybe does some menopause care. There are three GYN oncologists in my class.
00:14:01
Speaker
Many of them do like learn some menopause care because they take ovaries out of young people. yeah So they have like, you know, the basics and things like that. They do practice. But like long-term, is a GYN oncologist going to manage your menopause symptoms? Probably not. And then we have, you know, there were two reproductive endocrinologists, me, a urogynecologist, and then one MFM. So it's like you get 10 OB-GYNs per year and really one of them practices general OB-GYN. I know there's lots of programs that are not like that, but people need to know like how finally we are splitting up our workforce where we already are projected to have a, I want to say it's like 7% to 10% shortage in the next to years in Like by 2040, I believe, which is not that far off either, 2035 or 2040, only six states in the United States will have enough OBGYNs for their population.
00:14:50
Speaker
We do have to, I hate to harp on this, but like preserve the most rare skills that we have, the ones that can't be passed off to someone else. You have to find a way to like keep those- I just keep thinking like, what's the best for the woman who's out there, like looking for someone to help manage her care? What's the best thing for the people providing the care to do it in a high quality sort of safe way and not burn out? It's a really hard mess to untingle. It's hard, insanely hard. And I do think it speaks to like both women and they're mostly female physicians in OBGYN to like our capacity to absorb beyond like what we probably capacity truly is and like keep going and going is a testament to how incredible women are. But I do think. We have to ask for help. And we also, think, need to advocate to our other medical colleagues the ways in which midlife touches their organ systems. I think that's another thing. And I do think as more women flood into medicine in all fields, people are recognizing like the neurologic parts of menopause, the musculoskeletal parts of menopause, the cardiac parts of menopause. That should be part and parcel of those specialties and not like, oh, your OBGYN will manage dementia. It's because of menopause, you know? Exactly. No, that's so true. I've been trying to find a rheumatologist to have on podcast. And I reached out to somebody said, well, after speaking to my colleagues, we all decided that there's really nothing about perimenopause, menopause and rheumatology. It's like, what? Well, I guess like you could come on podcast and tell people. Or what you need to say is that nobody has like done the research. Like, what do you mean? Like, I think we all clinically can see the overlap between... Menopause and perimenopause and autoimmune disease. I'm pretty sure like you'd have to really be an ignorer of patterns to think that there's nothing there. if nobody does research and defines it, then I guess it just doesn't exist, which is like such a classic thing in medicine in general. It's like we don't study it and don't name it.
00:16:53
Speaker
It's not there. it's just lady stuff. um I think a lot of what I talk about online at its crux is people not understanding the way that OBGYNs are trained, what our workforce Yeah, primary care.
00:17:08
Speaker
what i think is a real identity crisis in many ways for ob bg i n because we are surgeons but then every however often it cycles through some a cog president that is like we're a primary yeah like we're designation.
00:17:26
Speaker
and then like we do menopause. Nobody knows the difference, you know, between like all of our subspecialties and what their surgical training is. And I think how can we expect women to know the difference between those things? And then you show up and want to talk about something incredibly complex because Even women who I think have like bias training know it's like, well, of course they'll just know how to do everything. Like we expect OBGYNs to do everything, even though women's health and reproductive health touches like every organ system. And so i don't know, my take is that if we did a ah better job of identifying like what is the top of our licensure, like what is our scope? What do we need APPs and mid-levels to be more trained in? Like where is the healthcare care workforce going? Where are the shortages? Patients might have more realistic expectations of what we can do on a visit. Yeah, exactly. i want to bring this back. You said, you know, if people knew how we were trained. So can you share with people like, how is it OBGYN trained? And I'll tell you, i was talking to somebody.
00:18:25
Speaker
I feel like it was a customer care person online and she was asking what I did. And I said, I was a gynecologist. And she was like, what's that? I'm like, you know, we do pap smears, we deliver babies, we do hysterectomies. And she's like, you need to be a doctor to do a pap smear. I heard something like that. She said, you have to go to medical school.
00:18:44
Speaker
like, I mean, actually... your point, you don't. You don't. Like, there actually are a lot of things that I think we do that, again, are not at, like, the top of our license. And I think it's good that we do them. But to that point, I mean, I know these are some, like, hot sort of takes that I have. Not of the fans are going to agree with me. Like, my hot take also...
00:19:03
Speaker
So let's back up. Like how are we trained? We do four years of OB, GYN residency, so obstetrics and gynecologic surgery. And then there seven or eight subspecialties, some board certified, some not, where a lot of us track into complex gynecologic surgery, either in cancer, pelvic reconstruction, fibroids, endometriosis.
00:19:23
Speaker
Some do complex family planning. And then there's all the complex OB stuff, maternal fetal medicine. There's infertility and reproductive endocrinology. Those are all OBGYNs, like people who started at their core spending four years doing, depending on the residency program, about 50% OB, like obstetric surgery, which I like to call it obstetric surgery because again, that's like really what it is. Like we manage the surgical complications of obstetrics and gynecologic surgery. So that's what we spend like four years doing. But we we touch on all those specialties I mentioned. And I feel like particularly in the space you talk about a lot, and as do i like midlife health and menopause, people are always like, OBGYNs are not getting any training in menopause. And you're like, okay, well, how much training are hepatobiliary surgeons getting in diabetes? I mean, seriously, like, is that the top of their license? I generally don't actually think it is. I think we need to know a lot about it. I think obviously as people who take out ovaries and like manage, you know, women's health through lifespan through all these lenses. It's important to know But I do think, again, hot take, there's something to like, do you have to go to medical school to do a pap smear? Do you have to go to medical school to do longitudinal like well woman care, which could include menopause care? i think there's some incredibly highly trained, talented APPs, midwives that can do those things while OBGYNs who spend four years like basically doing trauma surgery.
00:20:47
Speaker
And like yeah high, high level, like life-saving pregnancy-related healthcare can do those things without also being spoken about in the media as though we are failing women when we are expected to do everything for women. And I have to say, okay, I have so many thoughts. I'm going to go through. I have to say first that I think we're expected to do it all. also because we are Just like moms are. Those are mostly women. Moms of...
00:21:12
Speaker
but It's a very direct parallel. We're the moms of the medical world. We are just expected to absorb and absorb and absorb. If we don't do it, no one will. And I'm sorry, it pisses me off when people say that we don't know how to manage menopause because we've been busy delivering babies. That's like saying your mom doesn't know how to talk to you about menopause because she was busy giving birth to you. Right. Like we know all this stuff because we take care of women through all all of these life stages. We may not all be the experts in even and like every single life stage, but we're going to know something about it and help something right way. Like don't throw us under the freaking bus. That's kind of hard. It really, really grinds my gears that OBGYNs always seem to be taking the fall for all the things we don't know about women's health. And it just is really hard. People just truly don't understand like obstetric and gynecologic surgery is truly life-saving surgical reproductive care. And I do think it does us a disservice to be like, We're a primary care designation because I don't know if anyone has looked at the insanely scary data about like how few people there are to deliver babies, which like pregnancy tries to kill women every like minute of every shift. If you've ever worked on labor and delivery, I mean, yes, we want people in the clinics doing pap smears and and managing menopause. Those things are so important, but like we do deserve to take up more space in women's health. Women's health deserves to take up more space of other specialties because honestly, our services are like life-savingly needed the high stakes settings. And I have to say, one of the things I love about being an OBGYN doing menopause care in this day and age is that I can also manage the freaking complications. I have had so many women who've come to see me because they got started. Thank goodness for some of the online programs that are getting people access to care where they otherwise wouldn't get access, then they need a physical exam and they might need a biopsy or a DNC and they might have a hysterectomy. And I'm so glad that I can do that for them and offer that to them. Absolutely. I'm in no way saying that we don't need to know and what is involved, but our time being spent, which I think we're going to talk a little bit more about like billing, our time being spent on the discussion around symptomatic management and hormones and I do think we need extenders like APP, like mid-level teams, you know, just any other specialty.
00:23:35
Speaker
Okay. Well, before we wrap up, I have one last question for you because i didn't mention one of the most important like pieces of your background. You know, I have a bio for you or is kind of talking about your training, but you also went to Taylor Alderdice High School. I'm a little bit older, but not much. Yeah.
00:23:52
Speaker
that's one year, right? i think it two and Maybe two. i i've forgot. It's been too long. Yes. But we're both from Pittsburgh, which makes me so proud.
Advocacy and Personal Journey
00:24:00
Speaker
And i love that we have that shared background. And I love seeing what you're doing to advocate for women. i guess I wanted to ask you, like where does your advocacy come from? Is it from Squirrel Hill?
00:24:11
Speaker
I was just going to say that. It has to be. i mean, think about actually how many people in our high school who like kind of went into women's health. I could name several OBGYNs off the top of my head just who went to our high school around the years that we did Listen, we like grew up in a place that I think had a lot of female representation in the mothers of my friends.
00:24:34
Speaker
were in like the really biggest, I think, first wave of doctors, scientists, lawyers, politicians, advocates for reproductive rights. I grew up in a political family. I was surrounded by intelligent, educated women. And I think it would be completely foolish to think that that environment didn't give me the the foundation and the interest. I think growing up near McGee Women's Hospital, where I currently work, had a lot to do with it. I'm the oldest of eight children. i went to McGee seven times to collect new siblings and like bring them home. So I had like a lot of reverence for that hospital and like the culture in the Pittsburgh community for OBGYN. But it was shocking to me, especially like going to college. I remember and kind of assuming everybody had not grown up in a place quite as, you know, special and possibly progressive as Squirrel Hill, but like shocked that that was really, turns out it's a very unique, a unique place. oh Like we were raised by feminists. I mean, we were raised by feminists.
00:25:32
Speaker
And I think even the male teachers, like I think about some of our history teachers. I mean, there's a lot of men that were feminists at And you don't even realize that when it's happening, because it's almost like if you watch Schitt's Creek, if you ever watch that show and it's like they're presenting things that like in maybe other shows would be like a thing, like.
00:25:52
Speaker
It's like a gay plot line, but it's like not even mentioned. It's just totally normal in the show. I feel like that's what it was kind of like. I knew that there were inequalities for women, but like I didn't feel them because the men and the women both spoke about them openly and treated us the sort of the same way yeah or treated us like equitably. And if anything, seeing that that's not turns out the case yeah made me more passionate about trying to make other places like that. But I don't also think I'll say one more thing. Like, no i don't think it was rose colored glasses necessarily. I think there was this nice balance of standing up for the underdog, like having sort of a political gumption while also being lucky enough to live in a sort of. Because we it was public school and there is definitely a lot.
00:26:36
Speaker
going on in Pittsburgh, a lot of gang violence. I wouldn't surprise. Definitely racism and like redlining and yeah very different experiences for kids that went to this very same school, like very different demographics.
00:26:50
Speaker
I know. I always tell people Mac Miller and Wiz Glee Faw went to high school. I also tell people that it gives me a lot of street cred. Me too. But also I'm like, it's very interesting if you understand like how kids were, yeah you know, divided up in our school, in the neighborhoods they came from. And it's just a really interesting sociologic yeah input. what day I know. I love it. I love it. Well, thank you so much for your time today. i i hope I didn't make things too riled up.
00:27:17
Speaker
I feel like it's... No, not at all. This is par for the course. I'm just a passionate person. no I love it.