We’re quick to blame genetics for our health and wellness issues, but the reality is that genetics only makes up 18% of our health destiny. That means the rest is up to us.

Our guest today, Dr. Grant Zarzour, has seen that first hand in his own family. When his son was diagnosed with moderate autism, he and his wife refused to accept the predictions for his future. They dove head first into the data and in so doing, revolutionized not just their son’s life, but their own. Now a relentless proponent of diet, sleep, and exercise for physical and mental health, Dr. Zarzour feels like we all have a hand in our own destiny. We just have to commit.

Dr. Zarzour is a practicing hip and knee surgeon in Mobile, AL. He is the president of the largest orthopaedic practice in Alabama. While treating thousands of patients a year, Grant has developed a passion for preventive medicine. In 2024, he founded Sperity Health, which offers personalized longevity coaching to help its members improve their diet, exercise, and sleep with expert MD guidance. Sperity Health’s mission is to lower its member’s risk of cancer, cardiovascular disease, and dementia by up to 50% based on data and science.

Forty percent of the time, oncology care is not being delivered in concordance with guidelines. FORTY PERCENT!

As our guest today explains, that’s not because of bad doctors. It’s because oncology care changes rapidly and because almost eighty percent of patients are being seen by a community oncologist, a physician who is responsible for treating ALL types of cancer, instead of a specialist. How can we address that? Well, as Dr. Yousuf Zafar explains, there are really three options.

1. The patient travels to an NCI Cancer Center to seek a second opinion. This is obviously expensive and inconvenient and out of scope for many patients.
2. The patient’s provider calls another oncologist in their network consult on the case. These relationships are critical but not universal.
3. We can formalize this provider-to-provider framework and have it paid for by a patient’s employer. This is the basis for AccessHope.

Today’s guest is a practicing oncologist and adjunct professor at Duke University, and chief medical officer at AccessHope, where he focuses on expanding access to expert cancer care for patients treated outside of academic centers. While National Cancer Institute Designated Comprehensive Cancer Centers deliver superior outcomes, they treat only 20 percent of cancer patients. Dr. Zafar is working to extend that expertise to the remaining 80 percent.

It’s rare that an article title alone makes me want to stop what I’m doing and read it, but that’s what happened when I saw the title of Jess Craig’s recent article, “Why More Doctors are Billing Their Patients Like it’s the 1920’s.”

In this article, and subsequently, our conversation here on the podcast, Jess explains what she means, citing the growing number of physician practices organized around the concept of direct pay. That is, the practice or physician determines a set cash price for their services and the patient pays that price out of pocket. This model may seem like we’re going backwards, to a time when health insurance didn’t exist, but in fact, it’s starting to be seen as one of the most progressive ways of managing rapidly inflating costs and concern about quality. While there are still questions around accessibility, as Jess points out, it may be one of the first advances we’ve seen in over a decade that could actually move the needle.

Jess Craig is a health reporter for Straight Arrow News (SAN). Prior to joining SAN, Jess worked as an infectious disease epidemiologist and health security technical advisor for international research institutes and US government agencies, including the CDC, USDA, and USAID. Jess worked as a freelance journalist for eight years, covering science, health, and world news for various outlets. She also served as a reporting fellow for NPR in 2020 and for Vox in 2024.