Maryline Bossar: Welcome back to the Current Yachts podcast. today we're going to talk about the one thing that most boat owners don't plan for seriously enough. And that is what happened when someone gets seriously hurt ⁓ or sick offshore or in a remote anchorage. So Dr. Rez, welcome to the show.

Dr. Rez: Hi there, thanks for having me.

Maryline Bossar: You are a board certified emergency physician. You're the founder of this company called Modo MD in Maui and someone who has built a practice around bringing serious medical care directly to patients wherever they are while offering to the most customized experience to your patients. So Dr. Rez, Tell us about you and how ⁓ a Cedars-Sinai doctor ⁓ ends up in Maui running a mobile medical practice.

Dr. Rez: Well, so much to talk about. First of all, thanks for having me. I love your show and I've been very intrigued with all the good guests you've had. And I've been learning a lot about yachting and boating with all your guests. So I'm honored to be here. So a little about me. I'm just a normal kid that grew up in LA surfing and just loving the ocean. And I got in a car accident is the reason I went into medicine on a surf trip in Cabo back in 1993. We got air rescued out and I realized how limited resources are when you're abroad.

Maryline Bossar: Thank you.

Dr. Rez: So I tasted that firsthand. We got medivac. One of my best friends almost died. They almost amputated another guy's leg. One guy had a punctured lung. So a few of us spent a couple days in the hospital and I thought about what life is about and I just wanted to surf but I also wanted to help people. It's always been a passion of mine but never believed in myself and going through the years of training that it to be a doctor. So I signed up for it. I became an EMT. I worked on an ambulance just to taste and feel medicine injury. just to see I want to be around it. ⁓ And undergrad while I was at UCLA, I continued to work as an EMT and it just kind of just strengthened my desire, but I gave.

Maryline Bossar: Mm-hmm.

Dr. Rez: being a marine biologist one chance and I decided to sign up for the marine biology quarter at UCLA, which happened to be in Hawaii. So I spent six months in Hawaii and the year that I signed up, they're like, sorry to tell you this, you have to buy your ticket to go to Morea. I'm like Morea, where is that? Like it's in Tahiti. I'm like, that sounds great. What's the problem? Like have to pay for your own ticket. So I'm like, sign me up. So UC Berkeley had a lab there and that's how, had the Aloha spirit and the Polynesian culture. Just ⁓ show me how good. ⁓ lifestyles can be on the islands and the aloha and the fish and the sailing and the boating and that's how I kind of got into that. I was one of the only students that was allowed to operate the boats during our marine bioresearch. So I did a lot of scientific diving, some real experience with snorkeling, free diving and scuba diving, which comes in handy as an ER doc on the islands because you see these injuries coming in, dive injuries, aero trauma and all those things. And after a while of working in the Emerge and having a really good job after training at UCLA, at Cedar Sinai, just kind of missed the islands and it had been 10 years. So started flying back and forth and helping and Maui became home overnight. It just was an island that needed good doctors and I liked working night shifts and surfing and playing in the ocean during the days. And after a while, I kind of realized there's a big need for house calls and nobody was doing it. So I worked on bringing the traditional house call doctor. back in present modern day ⁓ world with modern technology. So I have a portable ultrasound that I've trained on how to use. I have a portable EKG. And at first I did it for trade. got coconuts and avocados and I stitched up friends. I got to buy malpractice. This is risky stuff. I'm putting a finger back. Everybody's your friend until something happens. You don't know. So then I'm like, Hey, just buy malpractice. Would you pay? And people were willing to pay and they paid more. And then the Four Seasons asked me to help out because I took care of a couple

Maryline Bossar: Hahaha True.

Dr. Rez: they're like celebrity actors that called and they gave me a room and I told the ER I'm gonna take a sabbatical. I think I'm onto something. It's so fun because I learned so much when I go to patients homes. I get to see what they're eating, where they live, what their risks are. You just, you in the ER you got five, 10 minutes. You make a decision in or out surgery or not surgery, home or stay. You know, you got to make quick decisions. After 10, 15 years it...

Maryline Bossar: Yeah.

Dr. Rez: You know, you can only enjoy the feeling. There is no joy. It's just hiding the pain of like telling ⁓ a wife that her husband drowned or a mom that her kid died. You know, just hearing those screams of families afterwards, I still get teared up thinking about it. So I kind of do emergency medicine in a small pulse. I'm still, you know, very excited about adrenaline and helping and being there when someone's really critical. But I also like the wellness and longevity. And that's where I've moved my practice to. And after we got on that show, White Lotus, believe it or not overnight, my company kind of took off. We helped HBO while they filming.

Maryline Bossar: Wait a minute. So hold on. You were the star of a show on HBO and you're now just telling our listeners this. So, so much to unpack. So tell us about this experience and next, ⁓ tell us how you got started into yachting after that. It sounds like this is pretty recent development from your side. And we met you actually on the docks at the Palm Beach Boat Show, which was ⁓ just a very exciting encounter because I've never met a mobile doctor before. I don't think there's many others out there that are. offering what you offer. let's start with White Lotus. What was that?

Dr. Rez: I don't really brag about it. Some of my marketing teams like you should. just, I don't know. I grew up in LA and Hollywood. Acting was always there. My friends did it and never, you know, did much for me, but I got a chance.

Maryline Bossar: It was a no big deal thing for you.

Dr. Rez: Yeah, it just happened. And to this day, my friends will see the show. Like, how the heck did you get a line on that show? And you're never told us. I've been trying to act my whole life. I'm like, I'm just a lucky guy. But I took care of Mike White, who's a very talented, amazing director. after we left, ⁓ was like, what are you filming? And nobody knew. I didn't even know if the show was called White Lotus. And I was like, sounds like an interesting show. And then I was walking out with my nurse and I'm like, hey, man, we're in the middle of COVID. I'm so tired of doing COVID tests and the stress of people trying to get on their flight. seeing people sick from COVID. go.

Maryline Bossar: now.

Dr. Rez: Give me a George Clooney moment if you ever have one. If you ever need a doc, call me. And my nurse goes, you're so LA, you're so cheesy. I can't believe you asked them that. I'm like, I was kidding. And while I'm on the elevator, literally next day I get a call. What's your name? What's your chest size? What's your portfolio? Have you done any acting? I'm like, who is this? Do you need your COVID result lady? She goes, no, Mike White said you're on the show tomorrow. We fired the actor. What do you have? What are you going to say? I'm like, I don't know, but I'll show up. And I did. And I'm on the first season as the doctor like the White Lotus at the resort. So I helped deliver that baby when her water breaks and on another episode, like episode five, season one. So that's my little like 30 seconds to the Hall of Fame. But that made us kind of get known about doing resort medicine and concierge medicine. And then I ended up opening a practice very close to the four seasons in Wailaya. we...

Maryline Bossar: Mm-hmm.

Dr. Rez: high acuity urgent care. Everything from shoulder dislocations to heart attacks to strokes, we'll diagnose in that clinic and help manage by sending them to the hospital, but we'll do everything else in between. And then now, then since I went to West Palm Beach for a longevity anti-aging conference, we'll do everything from exosomes, stem cells, peptides, and just biohacking and making people feel like they're in their 20s and 30s again, and prolonging people's lives to stay active and stay more active in the yachting world and everything. else they're wanting to do but they're slowing down because of aging which is a natural process but learning of making you feel better and prolonging that youth feeling is a hot topic and it's everywhere so we're kind of one of the only concierge services that does traditional western medicine and I'm really big on finding the root cause and doing functional medicine too and I've gotten so good with telemedicine during COVID. That was one of the first they called? The first edition of the iPad came out. ⁓ I like, hey, your kid has pink eye. I don't need to see him in person. Just let's FaceTime. ⁓ And could see the goop coming out of it. And I'm already feeling like I'm itching my eye. You know, it's so contagious. Stay home. I'll call in the medicine. So I was doing telemedicine three years before COVID came. ⁓ And or fortunately, COVID put telemedicine as a thing. And now I use it all the time to talk to my clients. I have private jets that are on yachts, that are on boats. they call us and I give them really good medical advice and it's personalized and that's what sets us apart ⁓ a lot of pilots even told me they call the general line, they like ground the plane, do this or just give them very general safe advice. It's good advice but ⁓ much nicer when your doctor knows your captain, your crew, your flight attendant, knows your shipment, knows everyone, knows your chef, knows their medical problems, you know. So that's what I do and that's what I'm really excited to tell the world and it was just by luck that I met you guys, that I was there. I got to go on a yacht. A year before COVID, we went to Formula One and the Cannes Film Festival with a family that wanted me to be on the boat. And it was great. I took care of her whole family. She had a daughter that was also pregnant and they just wanted someone there to help out. And I did IVs for them and took care of a couple little like injuries. One of them got hurt on the foil board. And the nice thing is I'm a big waterman. So instead of just sitting there as a doctor watching them, I kind of did water safety. I helped out. I'm really good at stand up, I'm good at kite surfing, so it's kind of nice to have a water safety person with you and I learned a lot of those skills when I've been the island doctor at Taborua and Omoto in Fiji where they give you a little tree house, you stay there and take care of all their guests. But get to be in the water with them to make sure they're safe as well. the two have kind of come together and it's been super fun and I'm excited to share it with you guys.

Maryline Bossar: Yeah, and especially as you just pointed out, boaters are constantly managing a different type of risk, ⁓ usually involving something like weather and gear. ⁓ Crew navigation elements play a big part and you kind of speaking that language, super helpful. The other thing to point out about this population is sailors and boaters in general, they're a special breed, right? They're physically active for the most part. ⁓ often remote. Some of them, you know, are on the high net worth individual side of the population and there's fewer of them, but you can pretty much help everyone across the board with their unique needs remotely, which is first of all, absolutely awesome, which is why we invited you here. But the second component of that personality of boaters is sometimes they're a little bit cavalier about risk and they're frequently away from traditional care. So now that we have all of this perfect recipe for disaster potentially, it's even easier for you to come in and say, listen, I can be there of support. However, you will not get heliported to the boat. So how do you provide this care remotely? It's gonna be one of the questions we're gonna answer. But first, perhaps let's unpack from your experience, what are the most common injuries and issues that you see in boaters, cruisers so far?

Dr. Rez: Yeah, so these are very good points that you bring up. mean, one thing is to be on a small vessel versus a big yacht, right? So just if you're kind of like running your own boat and working on it, which a lot of people do, right? Like there's exhaustion, there's simple things. There's just like a back spasm, your back going out, right? That could be debilitating. When you can't get out of bed, you lose a crew member, especially if you're operating at your own it, right? The basic things are just dehydration. right? ⁓ Sunburns, seasickness. Look, you're not going to buy a boat if you get seasick, right? Like these people are experienced, but even the best of them gets sick. It can happen.

Maryline Bossar: It can happen. Listen, the conditions will make it happen for you.

Dr. Rez: I we were supposed to do this two weeks ago and I was deathly sick Like I haven't gotten sick in like two years, not gone what, but of course it happens. And I forget how debilitating it took me like five days for my brain to start, you know, working properly. I was so fatigued, you know, so ⁓ I actually called Moto. got IV drip from my own team. And it's the second time I've used my own services and I almost want to write myself a review and be like, this company is great. They came to me. ⁓ I had a toe infection from a reef cut that I didn't clean too well because it was my birthday and I was hosting an event. I ignored my own cut like any good patient would and I'm probably one of the worst patients. So that's what I'm very understanding when my patients like I forgot to take the medicine. And I make everything very convenient. Like giving someone a medicine four times a day is a pain in the butt. Twice a day if you're lucky if they take it. So I kind of really manage my care and I always put... myself in their shoes or my family members. Like I treat everybody the same way I would treat my mom or siblings or cousins and I go what's cost-effective? What's reality versus what a textbook says? Because medicine is an art and every person is different. Every art piece can be different if two painters paint it. It's not the same. So generalized medicine and studies are done for the mass public but if you're an individual and you're unique and you're sensitive to one thing or another that's why the personalized care and concierge come in handy. We're not rushed in 10 minutes with like an ⁓ office meeting. I get to really talk to you and tailor what you need. ⁓

Maryline Bossar: Absolutely, and I wanted to add to you were speaking about, you know owner operators small crews often times long-distance cruising boats ⁓ two people maybe three people to family Sometimes most times if the primary, you know driver slash captain slash boat handler is Incapacitated that's a huge risk. There's high vulnerability in those situations and access to care cannot wait

Dr. Rez: Yeah.

Maryline Bossar: I actually personally had this experience. We were returning our sailboat from a race, sailing back from Bermuda to Annapolis. My husband was extremely ill. It was not seasickness. He couldn't really explain what it was. And we had access to actually a doctor who had covered the race and we used the set phone to contact the doctor, get some reassurance, did the best we could. ⁓ He was feeling so bad that had we been in Coast Guard range, I think we may have made the call. We were in the middle of the ocean. We didn't have a choice. So.

Dr. Rez: Yeah. Wow. Yeah. Yeah.

Maryline Bossar: Your point. Thank you for bringing this awareness to your service.

Dr. Rez: I mean there's decisions like you guys have to make real time you know when you see a weather pattern come up or swells or the winds you make a decision to go and you have the experience for that but to make that call they're like okay what do I do someone's sick do I go in or do I not and that shouldn't be your responsibility now that there's Starlink and there's wi-fi like people coming from Africa on safari like I scratch my eye what do I do I'm like go to that medical bag I gave you use this medicine and they're like the ones that like I never get sick and they jinx themselves maybe but it comes in handy and being able to call someone. So whether it's dehydration or ⁓ your back goes out or just even jet lag or basic things like that like there's I have remedies for all of that and it could just be the incidental food poisoning gastroenteritis or some virus like look what's happening on real time right now as we speak this next maybe pandemic this hontovirus coming out like you don't know you know and hontovirus has been around for a while I've seen maybe two cases of it in years, we had a kid that cleaned out a cabin and we figured it out by playing doctor house because it's such a variable thing. It's not a common disease to pick up. But he had, you know, encephalitis. He was confused and based on his labs, we reviewed it. We're like, yep, he cleaned this attic in a barn at a bunch of rat poop. And that's how he got it. You know, and I've seen a case of it. So it's just being able to call and say, no, it sounds like the flu. Why don't you use the flu swab? We're not worried about hantavirus. At least you navigate.

Maryline Bossar: Mm-hmm. Mm-hmm.

Dr. Rez: You did a differential diagnosis like, hey, my belly hurts. You don't know what your appendix is. You haven't seen enough appendicitis. I've seen probably 500 cases of it. I could gauge you and tell you, I think it's your appendix. You need to get off the boat. Or meanwhile, I have some antibiotics to kind of help cool it off. I could, you know, I've done so much. I've even seen a guy dislocate his shoulder, a windsurfer, right? And they're out away. And for sure, standard of care is get an x-ray, do procedural sedation, reduce it.

Maryline Bossar: Mm-hmm.

Dr. Rez: to go to an ER unless you're like super experienced like in that movie where he dislocates his shoulder and gets angry and hits the wall it pops in but that's a movie what's his name the guy from Braveheart to me what's that Mel Gibson thank you yes there's a movie where he's in a straight jacket he pops his shoulder out puts it in the 80s probably 90s but

Maryline Bossar: terrible at movies. Mel Gibson? Who is it? Mel Gibson? ⁓ And another thing as well to add is the community of boaters we're speaking about tend to be older. In fact, in the US alone, half of boat owners today are over 60. So now that I've shared this with you, and we've had a conversation with an offshore safety specialist who is not a doctor. He's more concerned with offshore safety in general from equipment and crew preparedness in particular.

Dr. Rez: Really?

Maryline Bossar: And his recommendation was before an offshore passage, get anyone over the age of 40 to do a cardiac test. I think it's called cardiac stress test beforehand.

Dr. Rez: Yeah. Yeah, cardiac tests, of course. So that's not a bad recommendation. How useful are stress tests? It doesn't really tell you the amount of disease you have. It just tells you your exercise tolerance with your heart and if you have any narrowing and it's really there to capture if you're having angina, like a narrowing of a blood vessel where have chest pain. So that's a little bit, I won't say old school, it's still standard of care. We do it, but now there's modern technology. There's CT scans that have minimal radiation, almost a couple x-rays.

Maryline Bossar: Okay.

Dr. Rez: take a, it's called a calcium cardiac score. You could see how much calcium you have in your blood vessels, right? And your heart, how much narrowing. And then there's even a better one where you could do it with some IV contrast that looks at your heart. ⁓ So those are like the great things I'm doing more for longevity and screening. do like a blood test that screens for like 50 cancers. So as you retire in 2016, you want to sail and go away. One problem I realized is I realized that during the pandemic, when people became nomads,

Maryline Bossar: ⁓ wow, that's weird Vance, okay. Mm-hmm. Mm-hmm.

Dr. Rez: just working in different cities doing work on a computer, they couldn't get a primary care doctor. One, a lot of people weren't taking new patients. They wouldn't talk to you if you had a fever. was crazy. I'm like, how are you a pediatrician and not seeing a kid that has a fever? Oh, it could be COVID. What? I don't know. Maybe I'm an ER doc. I jumped in. I diagnosed the first case of COVID in think Hawaii, at least in Maui. And I did it in half the time I was just like, that's what I do. I'm an ER doc. I got to help. know, while a lot of people just stayed home and garden and

Maryline Bossar: Mm-hmm.

Dr. Rez: watching Netflix and chill for a year. I was running around seeing the worst of the worst and helping people. And I learned a lot during those years because nobody wanted to go to the hospital. You go to the hospital, you don't make it out or family can't visit. I started treating your urosepsis at home, bad cellulitis, bad pneumonia because people didn't want to go to the hospital and get COVID. Even though they didn't have COVID, that's something else. They don't want to risk getting COVID, which I totally understood. So it made me feel really comfortable, push my level of

Maryline Bossar: Yeah.

Dr. Rez: home care where I've made some of the rooms in the IC at the Four Seasons comparable almost to an ICU a nurse and me and a monitor and a guy's like I'm 80 I've had a bladder cancer. I'm Irish. I'm here. I rented a whole third floor I'm not leaving and he had his private chef and he's like goddamn it I'm gonna have my whiskey. I'm turning 80. I'm like, you know what sir you've had whatever it is, and I allowed him to have like one cocktail at night and you know when you get good food and I realized the love and the support is healing from family as opposed to being in a hospital getting woken up by a random nurse every four hours to check your blood pressure. I've had a paramedic, a friend of mine get admitted to the hospital for a reef infection, he almost went septic. He goes, the only difference from this hospital and prison is I'm allowed to walk out of this hospital. It's like I felt like I was in prison, problem, no schedule, the food was horrible.

Maryline Bossar: Not a great experience, no.

Dr. Rez: My roommate kept coughing. He's like he felt like he was in prison. So what I kind of bring is just access to a good team and people are gonna ask how do you take care of all these people? I take care of my clients for sure and I have a whole team of other doctors and PAs and NPs that I've trained that could answer a phone call for a UTI and pneumonia a strep throat and all those things are remote to kind of give you ideas and they always call me I'm always available and I help out before the comp.

Maryline Bossar: So there is, I was gonna ask, there's a little bit of triage to kind of take the low level emergencies first and then obviously bring a doctor on the phone or on the, and actually we're gonna get into that pre-departure medical planning and we have a show and tell section in the show, so this is it. Tell us actually, show us what every crew should have in their medical kit before they leave the dock.

Dr. Rez: Absolutely. ⁓ Yeah. Can I just show you a picture? Yes. So there's some medications that you people I know this a lot people come to Hawaiian like I need a refill of this it's a controlled substance even Ambien, even Adderall even and Viking and you take for your chronic pain after a surgery or whatnot You can't just hop to different states get it the DEA has gotten so strict ⁓ hard You walk into a random doctor's office or an urgent care and ask for control meds They'll give you one or two now if you're sailing you're going somewhere. How do you ask for a lot? like a normal doctor might feel uncomfortable. But if you're dealing with a concierge doctor, like I understand you needs three months supply, I could help out or call in advance. So right now what we're talking about, this sailing event that's coming up, I recommend anybody on that trip that is more complicated, higher risk for their medical needs has, you know, there's so many things, even if they're diabetic, like I could work with them and having like glucose monitors I could put on them and I could monitor their blood sugars while they're out at sea and just keep in touch with them. I have a dietitian. that helps out with that portion too. One I recommend is just doing a consult with us privately one-on-one and getting your personalized meds. If you're one person that always gets a yeast infection, a bladder infection, someone that always is prone to pink eye or a stye or just you you need your own personalized ear drops, call us for a consult and we'll take an hour and talk to Order the meds to any pharmacy that you're at and you could pick it up and your insurance should cover those meds. As far as the boat, I

Maryline Bossar: Mm-hmm.

Dr. Rez: I think every boat should have some medical safety stuff more than some band-aids and some Tums and some, you know, meclizine, right? Or Benadryl. You should have an EpiPen. You should have some antibiotics for a reef cut. You know, you should start topical antibiotics. I have stuff to like show you how to suture. You know, a good sailor man will pretty much do anything and I even FaceTime one of them to teach them how to suture a cut. But now I have Dermabond, which is the medical grade like glue to close your wound. So what I do is I basically have two different levels. I'll show you this one little medical bag is just like a carry-on and it comes with a note saying you're allowed to travel with this. It's never a problem. It's super light. It's maybe less than five pounds, but everything organized in here for topical creams, ⁓ stuff for wound care, ⁓ antibiotics, blood pressure cuff, pulse socks. And then even now, a lot of times I've had hard times, you know, treating ears over the phone because

Maryline Bossar: Mm-hmm.

Dr. Rez: don't want to look. What if it's ear wax? I don't want to give you ear drops. It's just going to make it worse. What if it's an ear infection in the canal? Oral antibiotics don't get into the cartilage of the ear walls. So you're just taking oral antibiotics for nothing. So now there's a camera.

Maryline Bossar: Okay.

Dr. Rez: Simple you just charge it. I didn't open it. It's in here You could take pictures of your ear and send it to me and I'll tell you yeah Go ahead and take the Moxie ceiling in here or the Z and then this I sell as just an annual prescription membership that stays on your boat and then This is inside it you open it you have my direct cell phone to call or you call the office and you're like Hey, I'm on this vessel. I'm on this yacht. I'm on this private jet. We look them up in our

Maryline Bossar: Wow. Amazing.

Dr. Rez: system prepaid doesn't matter who they are as long as they're on that boat and they have access to this and it's locked up they unlock it they find this they go right here point to what hurts okay your bladder hurts go over here we got some bladder medication and everything is just teed up and color-coded so you know so this is way more I've been on so many planes I've been on private jets I was on air Rome to Italy I to help this guy I looked at their medical kit I'm like this is horrible

Maryline Bossar: If it's not expired too.

Dr. Rez: So I switch. Yeah, exactly. I switched to my own bag and I was like, wow, my stuff is way more advanced. So these are all prescriptions. These are prescription antibiotics and people are like, ⁓ you're to give those out to people. like, what are they going to do? Abuse a Z-pack? you know, there's really for the private person, if they need a Valium to get on a plane, if they get a little anxiety on that boat, I'll even talk to them. Sailors and most people, some of them like to drink. Let's say something happens and they go into alcohol withdrawal, right? Those things can be Devastating going to DT's and seizures. So I'll have some meds to calm the nerves and get you in I also I don't advertise it much but I'm getting my board certification addiction medicine So anyone that's worried about boating and going away and and worried about like alcohol withdrawal or opiate withdrawal like I'm very Capable of helping I've managed at least two to three Rehab centers as our medical directors and then you know, everybody talks about AEDs They're usually these big things at the airport like who wants like carry one. So look, just found out this year. So I just bought this company and this is how big it is. It fits in this and the coolest thing is it just stays charged with a USB port. You don't have to worry for a plug and it's this big. This thing can save your life. It has a pediatric and an adult pad and then with the bag, this is an add-on, we give you full training and once a year I go, hey, it's time to change your pads. But now you don't have to change your battery so this saves money because all you do

Maryline Bossar: Nobody, show me. ⁓ wow. There we go.

Dr. Rez: just charge it with the USB. So it's really great and I feel safer and I know the battery is good. And then for the more advanced people like when I travel, I use my Pelican one and this is the one I give to some captains on planes and yachts. It's a Pelican case, super sturdy. And this is the one that has way more than the, this is mine. It's a little bit more disorganized, but it's mine. I have stuff for IV starts every now and then to always be a nurse or paramedic that could help you.

Maryline Bossar: Amazing. The run of the mill medication.

Dr. Rez: It's got all nauseam meds. It has injectable meds. It's not that hard to drop a medicine and give it to you a FaceTime and show you. It has a thermometer. It has pulse socks. It has all your meds. And the nice thing about this kit is I have medical grade COVID tests, flu tests, RSV tests, and strep throat. And again, this is pioneered. If you have kids, I do oral medicine for kids that are liquid. ⁓ You know, it's just powder. You just add water and mix it. Like you literally become my medical assistant and with this I kid you not I could operate my urgent care for a day or two. Enough supplies in here to see like multiple patients throughout the day and use the antibiotics in there for, you know, common things like a bee sting. Like one captain was telling me right now, he got stung by a bee and he called their Marine line and they said, go ahead and use the Epi. But he's like, the ambulance was 45 minutes away. I forgot where they were somewhere in the Caribbean. I go, why don't you do it again? He's like, well, the guy said you can only do it once and we're waiting. He goes, the symptoms came back. I go, Epi lasts about 15 or 30 minutes. It's very short lived. He goes, when I got into the ER, the ER doctor is like, why don't you do it again. exactly. ER doctors know that the guy was just a normal doc in the box that picks up the marine line and gives you the basic advice. So he's like, man, I wish I knew you then, you know? And then he also told me the Mrs. that runs their boat with him, their owners, just unfortunately got diagnosed with a type of cancer that needs blood tests done like every two days. She's doing some intense chemo. So she'll only be two hours away from Miami.

Maryline Bossar: Right. ⁓ wow.

Dr. Rez: and they're on a board going in and out like this. So I was like, dude, that machine to do the blood test is 600 bucks. You just need a nurse. I'll put a nurse on that yacht and extend. You know, she could go out for a 12 hour trip further away. So my goal is to like, let people know about this and just say, Hey, I'm 80. I can't go on a yacht anymore. I can't go on a sailboat. Not true. Just take the medical team with you. It's simple. And the technology is there at least have the medical bag and let us know where you're going. So it's on our radar. But for any boating guy, any boat that runs a rental, a tour guide, fishermen, I could tell her to remove fish hooks. Like the common stuff happens, right? It's the trip and fall, it's the ankle injury, it's you slipping on the deck, it's the head injury. Google says, ⁓ go to the ER. You call an ER, it's like, can't give you advice. So do you make that decision as a captain to keep sailing and someone has a head bleed, or do you call an ER doctor that sees head trauma daily at work and knows when to do a CT scan and when not to? So it gives you ⁓ reassurance, gives you less liability. So I think it's a no-brainer to have access to a good team.

Maryline Bossar: think if I recall correctly during ⁓ the safety at sea training that is dispensed by US sailing, it's very intense course with how to climb on a life raft. So you do an in-pool trial, they have lectures, and they had mentioned that two of the, I guess, sources of most common medical emergencies on yachts relate to pregnancy and number two, dental. What can you do about dental, if anything? What do we do?

Dr. Rez: Yeah. So antibiotics, antibiotics, antibiotics, that's the best thing to cool it off and pain control, pain control. look, again, I have dealt with surfers that been, you know, I've been traveling to Indonesia, going on boat trips that are literally 12 hours away from land and finding these remote islands and trying to find the most remote place to surf because it's un-crowded. Right. ⁓ And I've seen people get hurt there and I was just like, wow, I can't believe how remote we are. You know, I took care of a lot of surfers there and

Maryline Bossar: Got it. And get off the boat.

Dr. Rez: Guys, thank God you're here, Doc, because in the past I've stitched myself using a fishing line. What like these guys are cowboys and they just want to surf and they'll do what they need to to stay in the water ⁓ But with the stuff you're talking about with pregnancy, I do have a portable ultrasound So for anybody that wants one I could order one there are a couple grand but it's a nice tool to have it connects to any iPhone or iPad You can literally put it on and just show me so I use it all the time Maui is a huge place for baby baby moons, right? Six months pregnant. They take a little

Maryline Bossar: Really.

Dr. Rez: week vacation and they come out, I don't feel the baby or I'm spotting. So do we go to the ER? Do we do this? And it's their first time baby and they're concerned. I just go through with the ultrasound. I called the magic wand. I turn it on, give it to them. It's really, I use that ultrasound more than a stethoscope, right? It just depends when you trained. And at UCLA, we were on the frontiers using ultrasound and I did a mini fellowship in it. So I'll use it to look for gallstones, kidney stones. I use it to look for, you know, ovarian cysts. You could leave someone's like having pain and they didn't know they're pregnant. You got to make sure they don't have an ectopic pregnancy That's life-threatening But if you see a little fetus a little peanut you're like the chances of having twins and one being ectopic is like one in a million So I think you're fine keep sailing, you know, that's the nice thing about it know and and I did deliver a baby on that show white lotus, but in real life I've done it before at least 50 times. So it's

Maryline Bossar: Not just on television. Got it.

Dr. Rez: Exactly. someone's at least, know, a baby's viable after about, God, it depends what city you're in, 24, 26, you know, but usually if you're like seven months, eight months and you care to go out to sea, you want to be close enough that if you're starting to have contractions to come in, I don't advise someone to be out. But God, I know someone that said three other kids were born out on a boat. Like there's some people that are very cavalier and will do that, you know. Do I want that responsibility to be there? So I'll deliver your kid at sea. And that wouldn't be the best for that been in an emergency. Can I deliver a baby? Yes, and I've done it plenty of times at cars But people don't even make it to triage or popping their kid out in a car Especially if it's like the third or fourth kid, but the hard stuff that to go back for too I don't have one with me but a portable EKG so when you have in chest pain, it's really hard to tell if it's really cardiac Is it indigestion is an angina or is it really an MI? Look not all people show up with the classic textbook that an elephant's on their face And there's there's sweat on the guy's chest and he's like I can't breathe them I think I'm having a heart attack those are slam dunk right the ones that like ⁓ man I was like cleaning the deck I start feeling this pain I think it's my shoulder, but I started doing in the pink came back Mike. No sounds like it's exertional I think you're having angina so if you do an EKG and it's not rocket science everything's on YouTube and with FaceTime I could tell you put lead one here lead to lead three four five and six plug it in put one here put one here put one on your and hold still and have your friend hit start. And then you show me a picture of it. I could tell you, yeah, you're having EKG changes that are very concerning. You're having like ST depression here. Take that aspirin, take that nitro if your blood pressure is good. Let's get you into C. And that's the nice thing is, the Concierge white touch or high glove, whatever you want to call it is, I would coordinate wherever you're going to take that bone in to make sure there's an ambulance, make sure there's another Concierge doctor to take over you or at the minimum. call that ER and give them a heads up. Hey, I have a patient with this. Absolutely.

Maryline Bossar: ⁓ you will do that. I I was going to ask if you've actually had to intervene yourself like in an emergency for a high profile client, ⁓ you had to go

Dr. Rez: Yeah. Yeah, absolutely. We had a... It's super VIP that is out in Hawaii that needed their kid evacuated. And they literally called my office and my office was like, um, I think he's a little busy today. And then when I found out who it was and I looked at the schedule, everyone's like my friend, I'm like, tell my friends, I'm going with this person. They'll understand. Yeah. So I've flown out and usually from Hawaii or LA where I usually reside, I could be pretty much anywhere in the States and, you know, six to 12 to 24 hours if really needed.

Maryline Bossar: you

Dr. Rez: ⁓ And you know, I usually like to do things preventative. I always say an ounce of prevention is worth a pound of cure. So if you're having a tummy ache, you're having an earache, let's not sell for a week. Let's get it taken care of. ⁓ I already tried. I called the ENT doctor. They're booked for six weeks. Let me handle. So this concierge world now, like there's favors I'll do for other docs. One, they're like, hey, I'm sending this guy into the ER. I'm so sorry. My office is closed. I just operated on him. Can you check him out, Raz? Absolutely. And now I call it. I have a visitor that needs your special ear device. I don't carry one. Your office says your booked for four weeks. He goes lunchtime 1230. Done. Done. Everyone's happy. So it's really nice. I had a client right now that was on a plane that was flying to Europe. Was sick for some reason. He just didn't want to go to a doctor in Spain. I don't know what his reason was with Spain. He goes I'm gonna go to London. Find me someone. I called and there's this other doctor I've Collaborated with he's like mate. I'll meet him in his hotel or the runway Just tell me when his planes landing and they'll so reassure another guy that does concierge and their scans the kind of service and he met the guy in the runway took care of him and then he took off and went on and his trip so We've done all kinds of stuff and like I said earlier to just by video I had the Sun reduce the dad's shoulder that was dislocated it literally showed him a link a medical link to watch They had some medicine and gave him the Valium in medicine to help him relax and then within 30 minutes, know, he's on video, I told him what to do and pull and I had someone else pull and I even saw it pop in. I was like, that was impressive. that, I even

Maryline Bossar: sure. That was

Dr. Rez: Let's say I reduced the shoulder by telling a guy that knows nothing medically because time was an essence. You don't want to leave the arm dislocated, a nerve and artery injury. So you give it a E for effort, a college effort and it worked and they kept going. So I'm just like getting into all this like cool things with technology and then we have, and that portable EKG, portable ultrasound and this bag, like you are set for, you know, anything like a mash unit, you know, and I've done event medicine. before I've been the medical director at big events. did Coachella three years. I did Stagecoach. So I'm used to like overdoses, dehydration, and just really bad asthma and people having allergic reactions out in big crowds. You know, it's really dangerous. So I've ran into, I've operated out of a big medical tent that if, I don't know if you remember, you're too young, but MASH the show, like people would, you know, it's like a MASH unit, you know, like, wow, look at this. for people that are too hot and heat exhaustion and we have IV drips. But now what I love is just making that yachting and boating for those high-end like weeks when they're like in Monaco and they're watching Formula One. You know, they're going, they're partying, they're watching events, know, 18 hours out of the day, they're sleeping five, six hours, if that. So that's the fun stuff I really like and with a lot of my clients they sign up for their medical stuff but they're like how do I feel better in this and I educate them about peptides and just biohacking and just functional medicine stuff. So it's been a really fun journey and having the experience as a boating person I wish I had more time to get on a boat and operate and do things but just that experience I had as a marine biologist getting to diving and knowing about injuries and jellyfish stings and sea urchins injuries and all those things that could kind of ruin your trip and telling you what to do. It's just super nice especially if you have guests and other people you know to decrease your liability and make their their stay on your boat a more pleasant safer one you know.

Maryline Bossar: One question then that comes to mind, Dr. Rez, what is the service that's most appropriate, most relevant for the average boater? Let's say a family cruising 50 to 60 foot yacht or somebody that does a longer passage on maybe a larger boat, but nothing extravagant, nothing in the 100 foot super yacht category where perhaps budget is a little bit more of a concern. What is the right approach to getting personalized care? Can you give us some price points and what would be appropriate for them?

Dr. Rez: Absolutely. So we have concierge memberships that are individualized or family planned. Right. So our kids are very reasonable. Our kids are like twelve hundred for the whole year. Unlimited calls, unlimited questions about what happens to a kid under 18 or adult rates are somewhere around thirty six hundred and then older adults are think become like six grand. But I'm very reasonable. I'll see what medical problems you have and your proposal for the family. And we discount a little bit as other people come on because it's it simplifies it and I'm reasonable if one person's sick the other one has the same so we kind of do that. Right now we'll do like an Alicarte visit it's just just $299 for a week retainer if you want to just call and get some prescriptions for your travel and we'll answer your calls on your trip. We did that for a lady that was sailing to Fiji for two weeks so she paid us a little retainer to be available and give her some meds for medical problems she sometimes has. But I highly recommend just a medical bag

Maryline Bossar: Okay, very good.

Dr. Rez: because then this would just service anyone on that boat. I guess if you carried it with you and you're the owner, I would still help you. But this is just, it starts out at $1,500 for the whole year and includes the meds I discussed. The AED is obviously more and I think it comes out to maybe $4,500 or $5,000. I forget.

Maryline Bossar: ⁓ But the point is you can customize the package and what's in the bag for the client. Okay. For the patient. Okay.

Dr. Rez: Yes. the client and their family. So I highly recommend just a basic travel one and you can take it anywhere, but just leaving on your boat is key. And then I have the more advanced upgraded ones like this, this Pelican. This is the medium sized one. There's even a super size one, depending how big your crew is. You know, if you have a 30 crew, I give you the bigger one. You got a plane or a boat with six, eight people. do that one. So that's what I recommend. You guys could always call. It's free for a consult and just to talk to see if we're a good fit for each other. And then nice thing is

Maryline Bossar: Okay.

Dr. Rez: while you're sailing and stuff, what Concierge's Medicine is, is me doing my due diligence. I become the main orchestrator. I become your doctor for a lot of your stuff. I go, listen, it's time for you to get a mammogram. So let's come back to shore at some point this year and get a mammogram because you don't want to end up with breast cancer. And hey, sir, you're due for a colonoscopy. You said your brother had colon cancer at 50. You definitely should get one in your 40s. So let's schedule you one. And that's the nice thing. And you get a patient care coordinator, a PCC, to you. So you always call me, can't get a hold of me, you call the patient care coordinator, which is super nice. And you're like, hey, I twisted my ankle, I want an x-ray or my back went out, I want an MRI. And we do it all for you. And we'll fight, you know, and call your insurance and get it pre-authorized and pre-approved. Or a lot of times cash is king with radiology centers. You pay, you just get to go do your study the same day because they don't have to deal with the billing and things like that. And then should you want to talk about longevity labs and supplements? and other things, we add that on and that'll charge more for that. So ⁓ it's of a game changer in the ability to just set up a mobile person to draw your blood. I could have someone meet you at your dock or your home or your office ⁓ to your labs. You don't have to do much because going to the doctor is not fun and I've been on that side. Parking, sitting next to sick people, the doctor is always running late. I get it. You know, I've been on both ends. But ⁓ if able to have the luxury to have the medical team come to you, ⁓ it's no brainer for me, you know. And like I say, this point some people have taught me like what is your wealth if you don't have your health. at some point you realize it catches up to you and you don't want to treat a disease when it hits full force. You want to preventative and catch it.

Maryline Bossar: I'm going to put the link to your company profile and contact info in the marine directory for current yachts below. ⁓ Anyone who wants to learn more about your services and what you offer can find out more. Thanks again so much for sharing your insights with the Full Displacement Community. Thank you, Dr. Rez, and fair winds.

Dr. Rez: Thank you.

Maryline Bossar: If one of your clients signs up for your longevity program and they're 50 years old, how many more years are they likely to enjoy on their yacht?

Dr. Rez: ⁓ my gosh, with the way technology and biohacking is going, I hope another 50 years. I hope to keep them sailing until they're 100.

Maryline Bossar: what is the one thing you enjoy most ⁓ a concierge doctor?

Dr. Rez: would say just being able to connect to my patients on a personal level outside the traditional like medical room or emergency room and getting to know them, being able to travel with them and just kind of being part of their family to that level of just knowing what every single person needs medically.

Maryline Bossar: What is the most unique or difficult diagnosis that you can handle remotely?

Dr. Rez: I would probably say the challenging things would be where I need tools like an EKG or an ultrasound. So if you have a pregnant person having some concerns about their baby, having that mobile ultrasound there and being to telemedicine in with them, or if they're having cardiac chest pain and having that mobile EKG is a game changer. So these are like high risk medical cases that normally I would say get off the boat or call a helicopter. Now I could kind of manage with good insight and good accuracy having those tools available.

Maryline Bossar: if you buy any boat and have the time to enjoy it, what would you get?

Dr. Rez: Well, my dream is to kind of go and do the search, like what all surfers want to do. So I would like to be on a boat that is fast and safe and can get me to like remote islands in the South Pacific or anywhere where I could just find surf breaks that haven't been ridden before. That's my dream.

Maryline Bossar: We're gonna find you your boat.