You wouldn't be able to continue practicing? Would your license get suspended? You'd have to spend time in jail. Accept anything where you don't spend time in jail.

They consider you a criminal. You didn't build your clinic to feel like an employee in your own business. I'm Matthew Kulowgli, and on Out of the System, hosted by Doctor Talks, we challenge the broken rules holding healthcare entrepreneurs back.

Hear from clinic owners, rebels and builders who are creating bold, profitable patient center practices and doing it their way. Dr. Muhammad Ali Rafai, right?

Do I have that correct? You got it right. So the greatest. The greatest of all time. Yes. Tell everybody who you are and what you do. I am Muhammad Aly Rafi, Dr Rafie.

I'm a psychiatrist and internist, and I help people who are under pressure optimize their brain performance and function. Okay. And by the way, thank you for being on the podcast, because what intrigued me, we have lots of people that listen to us on a regular basis.

So we always highlight people that are leaving systems, abusive systems. Yes. What intrigued me about your story is a couple of things. Is one, like a lot of our clients, you dealt with a Medicare fraud case.

The Department of Justice came after you. We'll talk about that. Absolutely. They came at you hard. And you beat them. Okay, so we're going to talk that, but then also the fact that in our work with doctors, And we work with a lot of orthopedic surgeons, pain management, um, urologists, you know, and general surgery and surgery, all of that coming into the, now we're a moment of broader than that, but those are kind of where our BTEDs were.

We noticed that there's a lot of, one of my doctors called it once called a grooming. That there is a pressure of going through residency and all of that and what that does to the body and the nervous system and how in the PTSD that people deal with.

So I'd love to dive into that as well. Absolutely. Let's start with you and your story. You went to school in Syria, right? Yes, yes. How did you wind up here in the States?

Tell us a little bit about why psychiatry, why, what intrigued you about the human mind? So my family is originally from Syria but I have a lot of family members who are here, in The United States.

So I actually spent part of my childhood here In The Unites States, that's why I speak English. It's either a lotta training or I spent a lotta time here.

I spent a lot of time here in the United States as a child and went back to medical school in Syria because my parents wanted me to be with them at that time.

But I was lucky to do my residency here, in United State, at the University of Virginia. And because I am a Middle Eastern, I listened to my parents. My parents, when I told them I wanted to become a psychiatrist, they said, well, that's fine.

Could you do something else with psychiatry? Where like you're a real doctor. Yeah, not a really doctor, you know, dealing with the mind. So I actually went for a combined residency in internal medicine and psychiatr and board certified in Internal Medicine.

Why Internal medicine? What was the attachment for you? and the body altogether. And this was rural Virginia, and they needed to train doctors to manage both psychiatric issues and medical problems.

Okay. University of Virginia had that program for rural, Virginia to trained doctors, to be there. I'm lucky that I am in rural Pennsylvania now, for the last 20 years, treating people who have nobody else to treat.

How much does, now are you, do you study a lot in like the functional medicine space, like gut health and things of that nature as well? Absolutely, I'm very, very active in that field too.

What's the connection between gut and brain health, and mental health? There's a very, very strong connection. I mean, we used to think that people got depressed because of serotonin and norepinephrine and dopamine, but now we know it's all the inflammation, all of the inflammatory processes that happen in the gut, the microbiome, and how is that also affecting the brain?

So we never, for example, When I trained, nobody knew anything about C-reactive protein, something that we check on a regular basis now, high sensitivity C reactive protein because inflammation translates into inflammation of the brain, translates in to depression, anxiety, sometimes even psychosis.

Okay, so what's causing the inflammation in the gut? What's, what causing that? Is it just our food supply? Walk me through that. A variety of things, stress, food, supply, environment.

Just living. Yeah, just the day-to-day living? Yes. Is it more prevalent? Do you feel like it's more prevelant here in the United States say in like France or Germany or?

It's traveling all over the world. So it is all-over. It is. The world… Is that we're more aware of it? That we are better to diagnose it do you think?

Or is it on the uptick? I think it's on the uptick. The world is just a stressful place for everybody. If you live in the rural areas of Africa, if you're living in Bangladesh, or you are living the United States on Main Street.

It's a stressfull place. You know, I had a client, Kent Holthorff, Dr. Holter. He's in El Segundo, California. Kent's one of these guys. he's like you, he has taken on The Department of Justice like three times.

And he's just kind of nonchalant about it. He goes, eh, take him out. It's like, he just so, and Ken, if you're listening, you know how much I love you, but he travels at his own rhythm, his beat of his drum.

Time is just an imaginary construct to him. Brilliant man, though. So he was in our mastermind one day and we're talking about this topic. Functional health, gut health.

This was like three years ago. And, He's sitting there and he goes I already solved this. Like, what do you mean? And he goes, I've written, like, three papers on it.

Here you go. Sends the link out to everybody. He goes we took guys off the streets that were Navy SEALs, right, special forces. Went from 250 pounds, perfect health, to 120 pounds mumbling to themselves, just living on the street.

Fixed their gut health. Bam, they're back. And everybody in the room was just the way Kent talks about things. It's just like I already learned how to time my shoes.

Like it's literally like that. In your experience, You feel, what's your thought on it? Do you feel like we can help this mental illness of the people in the streets just by simply taking care of inflammation and the gut health?

Is that a big part? I know it's not 100%. It's a bit part, yeah. How big would you say? Very big. 50%. I healed myself. I used to weigh 400 pounds. Get out of here.

Yeah, and I'm 275 and want to lose another 50 pounds Fantastic, good for you. And that was because of all of this stress that I was going through. And nobody appreciated it.

Yeah. Was it the stress to the Department of Justice? Absolutely, absolutely. So let's talk about that. Let's. Talk about 2024. Yes. May 9th. Do I remember that correctly?

Yes, yeah. That was that was the jury jury verdict. Oh, that's the Jury verdict? Yeah, so let.s back up. Tell everybody what happened. You got in the they came after you for Medicaid fraud.

For how much? Medicare. Medicare, Medicare fraud? So I. I'm always an innovator. So in 2006, I started the first telemedicine, telepsychiatry program in Pennsylvania.

The equipment was the size of this room. And nobody did telehealth, nobody to tell us psychiatry, but I did that. I connected to rural folks in pennsylvania who had no psychiatrists to see.

We started this pilot program with a local hospital. Then I decided I wanted to do private practice and I continued with that It's a great benefit, by the way, because a lot of people, they're in rural areas.

I mean, this is a big issue. Absolutely. A lot people don't understand, one of the big challenges facing our country right now is the limited access to health care and the rural markets.

Rural hospitals are closing down. And then we're dealing with a lotta mental health issues. They're dealin' with job losses. There's lotta crystal meth.

So, I expanded that program. But, you know, the government, Department of Justice, that the right arm doesn't talk to the left arm, and they don't. So in 2017, they started an investigation.

They said, Dr. Raffaei, your billing patterns are different than your colleagues. Well, sure. I'm the only one who's doing telehealth. And so they start an investigate.

The investigation rolled for about three years. Then we gave them information. They didn't respond to us. And then COVID happened. I was on television talking about telehealth.

i was in television kind of educating my colleagues about Telehealth and the government needed a scapegoat. Tele health started with nobody doing it. It was 0.002%, and I was that 0,0.2%. And then now it's 100%, everybody's doing it.

And so the government needed, well, let's find somebody who was doing telehealth and we'll just prosecute them and will just teach everybody a lesson about tele-health to like bill correctly.

And their argument was that I was seeing patients for two, three minutes and not taking care of them. I saying that, I talking to them, and doing psychotherapy.

But why, here's what I don't get. In COVID, that was the way that we saw doctors was telehealth. All of a sudden, they increased the reimbursement rate for tele-health, it actually helped quite a few of our clients because all of the sudden now, you're getting more than they were for an office visit.

Why during COVID would they come after you? This is the wisdom of government. There's an oxymoron. So their whole entire case was that Dr. Rafai sees these patients only for 2-3 minutes and bills for 20 minutes.

That was the entire cases just summed up. And they said you billed for each visit $43.42. Four visits that they thought were criminal, $180. And then they extrapolated that to $1.3 million.

They said, Dr. Refai, we want $3.1 million, but it's not going to be civil. It's criminal. There was an indictment in November 2022. Did they come and arrest you?

They they because I was in negotiation with them. I. Was fortunate that they did not come and arrest me because we were in a negotiation. They knew my attorney.

We were asking why is this why? Is this being pursued? What is it that we did wrong? The government never told me what is that I did. Wrong until I went to trial and then we found out that didn't understand what they were talking about.

OK, so. What goes on inside of you? when the government comes after you and you feel wrongly accused. What's that like inside of you? It is a very unique feeling that you feel that your being persecuted.

I mean, there's a difference between somebody who knows that they did something wrong and between someone who know that everything that did is ethical.

That they tried their best to comply with the rules and regulations of Medicare, which are incredibly cloudy. And that the documented that. One of the exhibits that my lawyer showed in trial is emails from me to my staff.

I want to ensure compliance with Medicare rules and regulations. In writing. Multiple emails. This is one of the reasons why the jury says, well, you know, the government is saying this guy is stealing from Medicare and this is his emails, he's telling his staff, we want to ensure compliance and the rules are very murky and changing because telehealth was a moving target at that time.

Well, rules change all the time? Absolutely. And they change retroactively. Yes. That's what people want. So we asked, on what version of rules? That rule book?

had 30 versions. Which version of the rule book are you talking about? The government couldn't tell us. Did you feel like they were singling you out? Did feel they…

I felt some singeling out. I mean, I'm Middle Eastern, Muslim, my name, and that they target Middle-Eastern people. The other thing is I am a psychiatrist and I very vocal.

And one of the topics that I talked about was the mental health of people or politicians, famous people. And that escalated, I was in an interview where I talk about the metal health and the cognitive issues that the current president at that time was experiencing.

And that was not very, very positive topic. No, no. And what happened is… God forbid you should, like, he doesn't know how to get off the stage. Maybe this should be a concern.

Yes, and what happen is that a new US attorney got appointed and he said, we want to go after this guy. You know, I have talked with… I've had quite a few conversations with people that have taken on the federal government.

There is a common… We talked I've probably I haven't had them all I have and had him on the podcast I'm got one I got another one who took on who was not the government for the health insurance company for 2.5 billion or million I mean 2 point 5 million There is a common theme with regards to the Department of Justice is that people feel like they were being made an example of Did you feel that?

Absolutely. They wanted to teach people who were doing telehealth a lesson about what is it that you do, what you're not supposed to do and what it is that basically you are supposed practice in terms of tele-health.

documentation and all of our documentation was good. But the rules are very fluid and changing. And what they wanted us to document it changed over time.

They didn't tell us which version of the rule they want our documentations to comply with. Though I hired an expert and he was on the stand and said, whatever version you choose, his documentation complies with it.

So you decide to take on the government. Why not just do a plea deal? I mean, it's my understanding. There's no plea that involves you not admitting to guilt.

Right, because, you know, as a lawyer, if you were looking at this from a pure economic standpoint. Yes. It might cost you a quarter of a million dollars, let's say, in legal fees.

Cost me one million. One million to defend myself. To defend a one point three million dollar. Okay. So. You know if I look at Economic standpoint, maybe the settlement that they're offering is what 750,000 500,00 But yet you have to admit guilt.

What would you admit? Guilt and what would that look like? How would I change your life? You've become you become a convicted felon, right? So you can't elect you.

Can't vote in him You can't vote anymore. So your voice is gone. Your voice has gone, your practice is done. You wouldn't be able to continue practicing?

No. Would your license get suspended? Your license would get suspended. They were not going to accept anything where you don't spend time in jail. How much were they saying?

How much did they want to send you? So the press release says that I could spend 40 years in jail if I had gone to trial. Better off dealing heroin. You'll only get 20. And so I said, no, I did nothing wrong.

I want I went to go to try and my chances at trial were one in a thousand. What was your lawyer? What did your lawyers say? I mean, I'm sure he or she wanted the fees, but like what did they, what was their advice?

My lawyer, my lawyer is a very noble person. I like him, Mr. Paul Hetznecker. He chose him because his father is psychiatrist and his brother is the psychiatrist.

So he knew the psychiatric world very, very well through his family. And he's a Very, Very active criminal defense attorney, federal as well as state.

And I believe in it. This is every federal criminal defense attorney. They always believe that their client is guilty. They start with that and start the premise that they're guilty.

I mean, there's a reason why they believe that there is a reasons why the government prosecuted this person. They don't believe, that the Government prosecute this because of a political issue or because religious.

they always start that their client is guilty and there as they develop a rapport and a relationship with the client and as the go through the evidence They develop whether there's a defense to the case that the client is experiencing or not.

And I believe that he started believing in my innocence when the expert that, he hired, not me, He hired an expert and he says, can you look at Dr. Refai's notes and books and everything?

And that expert went through everything. And then he came to the lawyer and said, it's all made up. Dr. Rafai is innocent. That was the expert, not me.

Wow. So when you have an expert. How did that make you feel? I felt vindicated. I was going to say, yeah. And I asked my lawyer, well, why can't we just go to government and tell them?

He says, they'll change the strategy. We go at a trial. But we don't tell him that we know that everything is cooked. They cook the books. That's that's the the case.

Does that give you any pause to say that verbally that they cook the books? You afraid that that come after you again on something else? I mean, they kept they keep coming after people once they get somebody in their targets.

They could come. After me. I'm in. This is the world. Yeah. Right. Is the word. But but the cooking of the book is on on in in a transcript in court transcript.

. I have a I. Have a friend of them. who works in one of the law divisions of a federal government. And he goes, we know everything about everybody. Absolutely.

Yeah, he goes most people don't realize the laws they violate on a regular basis He goes, I'll be very frank Matt if we decide to go for somebody three felonies a day every American Yes, two in three fell and he's a daddy.

That's the book. Well, which once what see I've been up since five Three felons a daily felony's today in New York. It might be higher. Yes. Um, so In my trial, we discovered that the start of this trial was actually an audit that a contractor for the federal government did.

on my notes. Did that contractor get a piece of everything that's recollected, I wonder? They were going to get, yes. Most people don't realize how that works, right?

There's a contractor and they get paid a bounty for how much they recover from you. And so one of the employee for the contractor did the review and then that employee left.

This case continued for five years after that. Five years. After that employee left. So this whole audit happened in 2018, 2017, 2018. You got the indictment when?

2022. Okay, and then you went to trial? 2024. See, this is what people don't understand. This is six years later. Six years of your life. Absolutely. Peeting away at you.

And always on your mind. Yes, with federal agents after you all the time. Are you looking over your shoulder? Absolutely! Especially as you're Middle Eastern or Muslim?

They came to my mosque. Really they came to my mosque for what they just said that they wanted to hand me a Civil notification because they want to put you on notice and everybody else in that mosque.

Yes. Yeah, it's really disgusting It was it was on video surveillance and they admitted to it It's really. They said, oh, we called your attorney. We couldn't get him on the phone.

Oh, I had two attorneys. I was like, two attorney's? You can't them on a phone? How about their staff? Well, they had notice that they sent to the Department of Justice.

How bout emails? Yeah, you're supposed to only deal with the attorney, not you. And how did you know I in the mosque? Because they monitor you and surveil you constantly.

Yes. So did. You really feel like every phone conversation was to get notice of wiretaps? Everything. Really? Yeah. How about your wife? Did she notice the wiretapping?

They sent an undercover police officer to my office to say, OK, Dr. Rafai sees a patient for five minutes and bills for a visit that's 20 minutes. So they sent a person to office surveillance that this is part of the court record.

Police officer. To their chagrin. I met with that police officer for 90 minutes. All right, so folks, you gotta understand this. What are you getting paid for an office visit?

48 bucks or something like that? Yes. Okay. So you get $48 and the hospitals are like seven minutes and if you go over seven, your RVs go down, right?

Here you are. You're going, screw it. I'm only getting $ 48. That's effectively that you're getting like $29 an hour. I pay my executive assistant more than that.

And so their argument is like, okay, forget the time. We think he just fabricated the entire medical record. They just come up with something. Because the burden of proof is not upon the government, that burden is upon you because you are guilty.

until proven innocent. It's not the other way. And so, and they lost the video surveillance, the recording was lost. Of course it was. Then the police officer got on the stand and said, oh, I think this is what happened, but the, uh, video, surveillance was last.

How was it lost? It was in the cloud and got lost, Yeah. Yeah, if you did that, by the way, yes, If you made it that they would be all over your ass. Yes.

it really is. Its mind boggling. So what? What's going on? All right. So what was this like for you at the home? What was it? You're married. Yes. My wife is a physician also.

OK. She's an OBGYN. And she worked for a local hospital. What is this for her? Very stressful. It was very, very stressful for me, for my family, from my parents.

from my siblings, a whole family gathered together. I have three siblings. They're all physicians. they don't live in Pennsylvania. Your parents have to be so proud.

Two older brothers in Florida and a sister who's in Michigan. My parents live Michigan, they would come every few weeks, come visit me and make sure that we're okay.

Did the feds knock on their doors? Did they try to rattle their cages? did they come after them? No, my practice is a solo practice. So so nobody was nobody else was involved.

My wife wasn't involved She's an OBGYN so there's no relationship between OB GYN and psychiatry. It was just psychiatries So it was me. I was I the target of their of there anger and Just Their inability to just understand the rules and regulations So the verdict comes out May 9th, right?

2024, after a six-day trial. Yes. How did you feel during that trial? Were you optimistic? Or you didn't know, like what? I mean, I knew in your heart you knew you were innocent.

But there had to be a seesaw of emotions going on. Absolutely, absolutely. All the time, all the times. So how did feel when they were getting ready to go to deliberation?

Did you felt good about your situation? My lawyer didn't mince words. He says, they have enough to convict you. They have to find you not guilty. Jesus, my Lord.

How is that? And I would imagine. So he even, and it was a slam dunk. The first witness was was federal agent. And she butt about kind of exonerated me in her testimony.

The second witness was actually the coder, but she wasn't the one who did the coding. And she came out and just because my lawyer is good and he was supported by a very good expert witness, he cornered her and she ultimately said, I do not support the government's case or this prosecution.

I d- I don't want to put my name on this report. Really? This is their own expert that they hired. She came out to the jury, and I think that was the reason why the jury acquitted me, is, their OWN expert says, I DO NOT SUPPORT THIS PROSECUTION, i do NOT support this government case, nd I DON'T WANT MY NAME ON THIS REPORT, IM OUTTA HERE.

And did they- how long did the Jury deliberate? The jury received a case on Wednesday, May the 8th. In the afternoon, they received it at around 2.30. They went and deliberated for an hour and they came back and asked the judge to reread the jury instructions for them, specifically the mens rea, which is the intent.

And the judge re-read it to them in about 45 minutes. It was now 415, 430, and they said they wanted to go home. So they deliberated for one hour, heard the jury instruction again, then they came back the next day, May 9th, Thursday, in the morning, 930. They come in, they deliberate for about forty-five minutes, And then the bailiff comes out and says, the jury has a verdict.

How scared are you at this time? I would have been crapping my pants. Yes. You just stand there and you just look at the jury. Your parents in the room with you?

My parents are in my room, my wife is in a room. My lawyer is next to me, and my staff from the office is with me. They ask you to stand, right? Yes, they ask me to stay.

The jury is there. Walk me through that. And they come in. The jury, four person is a lady, so a jury four women. She brings in the verdict sheet and she hands it in to the judge.

And how big is the jury? 12? How big? It's 12 jurors. There's two alternates with them. So she hand in that jury verdict to judge Are you trying to make eye contact or read them?

What are you doing? I felt that the four jury person made contact with me and they smiled. This is, and maybe this is my feeling afterwards. Maybe it's revisionist history.

I don't know. But she handed the, the and then the judge and he says, do you have a verdict? And they said, not guilty on all charges, guilty charge one, charge two.

What happened inside you? Do you remember? I think I dissociated. I would imagine. Did you cry? My parents were crying. My dad cried twice in his life and this is the second time that he cried.

The government says we want to tally the jury. So every juror has to say, not guilty for each charge. There were four charges. Mm-hmm. I got 12 not-guilties, and then I again, 48 not guiltys.

Each jurors said, Not guilty on charge one. Not Guilty on Charge two. No Guilty on Charge three. not Guility on charged four. You whitewashed them. Yes.

48 Not-Guiltis. Forty-eight nothing. Congratulations. What was? OK, so you disassociate, right? That day is a blur. Right. But like, OK. So looking back at it.

Yes. I mean. Do you go back to that time and just think like what was I? What really went inside of me like? Was there is this release of just all this negative energy on you?

Like from what? And over the next couple of days, what were the Next couple remember? Remember, I, why did you go back to work the day and see patients?

I was resigned to the idea that I Was going to be found guilty. In fact, I contracted with a service that it's called mitigation service, white collar support service.

And basically, if you're found guilty, they'll help you mitigate your situation. They'll helped you get a short sentence. I said, well, okay, If I get convicted, where would I go?

So they said, the best place for you to go is at the Federal Correctional Facility in Otisville, New York. You're Muslim, they have halal food, a lot of Jewish people, kosher food.

They have a mosque, synagogue. It's perfect, it's like being in the Middle East. Just like home. So I said how far is Otusville? Otasville was two hours, so I had to get permission from my pretrial officer.

I wanted to look at Otosville and see, am I comfortable if I get convicted that I'm going to go there. And so I drove on a Sunday. I looked at it from the outside and I said, I am at peace.

So I was at peace that I… Did you surrender the outcome to God? Absolutely, absolutely. We always… I mean, I surrender everything to god. Right. Every day of the week, 24-7-365.

It's all with God. But… God says, I need a witness. God, faith comes before the miracle. I was raised Catholic. That has a lot of weird connotations for people, but my faith is very central to what I do.

But I'm not as, so obviously I am very familiar with the writings and teachings of Jesus. Walk me through how that, through the lens of a Muslim. Help me understand the tenets of your faith in times of deep crisis, like you were saying, how you surrender each and every single day to God.

Very similar, by the way, to the teachings Jesus, right? Yes, absolutely, yeah. But walk me though that. I mean, Syria is where Jesus is Syrian. Right, yes.

Yeah, so we are the land of Jesus Christ. We love him and it's the same teachings. I mean, we have one God and we basically, like people in Syria, fast together.

The Christians fast, the Muslims fast. We do prayers. I actually went to a Catholic school. Did you really? As a Muslim. What was that like? Very interesting, very interesting.

And so I still have a lot of Catholic friends from Syria. Were you allowed to pray five times a day? Yes, you're allowed pray and you are allowed go to church and see how their prayers are.

It was very, very a deep faith community, whether you're Muslim, Christian, or Jewish. My hometown, Aleppo, Syria, one of the two oldest continuously inhabited cities in the world.

at one time had the largest Jewish population outside of Israel in the Middle East. So it had a lot of huge Jewish populations. My grandmother, their neighbors were Jewish.

And on Saturday, on their Shabbat, I would go in and turn on the stove and their menorah, because basically they can't do that on Shabat. I was married to a Jewish woman for a while.

So yeah, I got a full, classic Irish Catholic, like straight out of central casting. I grew up, as I say, Irish, Catholic Democrat in Chicago. Like it'd be anything I wanted as long as that was Irish catholic and Democrat.

Uncle was a cop, dad was lawyer, brother's a union plumber. Another brother is a musician. And another brother of mine is, you know, in politics, it's everything.

The only thing we don't have is the fireman, right? Like we're, and I'm supposed to be the bar, we want to have a priest. Maybe this is my form of a priest.

But anyway, yeah, I am. You know, the thing that I find fascinating, i have friends. I mean, one of those folks that i don't have a very small network of people.

I'm very much of a chameleon. Like if you were to invite me to come, I don't know if I can come to your mosque, but if- You're welcome to. I would be like, great, let's do it.

And I like to do the experience of it, like I'd like understand other people's, and I am fascinated by other peoples' stories, fascinated about the human condition, am fascinated by why things are the way they are, right?

And the stories that they aren't. What I find, more times than not, is the basis is the same. Right? I'm hearing you talk about your faith and every day is a gift and surrender each and Every single day.

Absolutely. It sounds exactly like being in Catholic grade school. You know, I have Muslim, Muslim friends. I Have Mormons, Mormonds at work for my organization, Latter Day Saints.

Yes, have clients all across. And I think that's I think so much time in the world what we do is we spend more time trying to find the slivers of the differences versus the overwhelming commonality.

And since you mentioned Mormons, after I finished my trial, I decided that I need to train to speak better, to tell my story to the world. And so I went to a Speak Like a Pro program that is done by a motivational speaker by the name of Dan Clark.

He's out of Salt Lake City, Utah. And so I trained with him for a full year. They've sold that religion door to door like vacuum cleaner salesmen for the last 150 years.

I give them grief all the time. Jews never go door-to-door. My Jewish friends are like, you're right, because we're not taking any more members. Absolutely.

And I love that. So I have very soft spots for The Mormons in my heart because of my friend Dan Clark. The thing that saddens me about America today is The ability to disagree politely and to put down our arms.

It's like there's a litmus test every single day. And it just drives me crazy. We're all humans. All under God. Yeah, we're under one nation under god.

It's a pretty hard concept for a lot of people to understand, you know, because they want to say, well, it's supposed to be because for the Christian, I'm like, yeah, but it still extends to all of us, which I think makes the human, the American experience so unique because it is the only country where it really is a melting pot, right?

You know we don't have 20 centuries of systems and homes and belief systems, right? We have this place where we all come together and the Muslims is up next door to the Jews and Catholics and Christians and Protestants and Lutherans and all of it.

Yes. And we're all together. So let's go back to this day. I want to know more. What was so The thing that I'm fascinated about, you said you were 400 pounds, right?

So did that weight increase during the investigation? During the stress of the investigations, during that trial. Okay, so you're a highly trained psychiatrist.

Yes. You understand the human brain. Were you, did you have your own psychiatrist that you were talking to? I ended up having my own counselor and psychiatrist.

I bet you did. So walk me through, because, you know, I think one of the hardest things, like my docs that do PRP, they're like, oh yeah, injected my on Achilles with PRT, right?

And I'm like why didn't you add like your PA to it? Yeah, just figured I would do it myself. Were you trying to do it yourself? Trying to it myself and then figured out that I can't do myself.

And I ended up seeing a counselor, a psychiatrist, fellow friend psychiatrist and he's still my friend and I saw him for counseling because of the trauma that went through.

So let's talk about that trauma. If you were to go back, let say you had a doctor, psychiatrist friend in front of you and you are counseling through this.

What goes on inside of a person when this happens? Explain to me medically what is going on in side of someone that's dealing with this kind of high-level stress.

Feeling like you're being crushed, feeling like the weight of the world is on you. I mean, it's the government of The United States. The most powerful country in the face of earth.

Most powerful in face the earth, the Department of Justice of most powerful country in the world. Even if you're a president of a country, they snatch you from your home, from you bedroom, and you end up in jail.

The weaponization of the Department of Justice. So how about Muhammad Ali Rafai, little boy from Syria? If they can arrest the former president in United States and do a mugshot, what can they do to Muhammad Aliy Rafi?

Anything they want. Anything. Yeah. But God is great. God's great, I mean, so when you latch on to this idea that faith comes before the miracle, that God will intervene, God well parted the sea for me.

Didn't you have days where you didn't feel the Sea was going to get part of it? Absolutely. I've been there. Yeah. And it's in the Quran. It's then the Holy scripture is that even the prophets, they thought nothing was gonna happen.

And then God came and intervened. I feel that that was a miracle. One in a thousand chance kind of modern day miracle, that's what I call it. So you medicated the stress with food.

Is that safe to say? With food, prayer, anything I could do. And like, okay, so I've medicated over the years with alcohol. Yes, I didn't drink. I rarely drink anymore.

Yeah. Food was your comfort. Okay. How quickly, when you first started this, what was you weight? You said a balloon to 400. Where did you start? I started at 250. Really?

Yeah. You put on 150 pounds over the span of how long? Like two years. Really?! Holy cow. Yeah, you could see my pictures. It was like a different face.

This is not the same person. I've lost 30 pounds. People look at me and they go, I got a beard now and longer hair. They're like, they look in pictures of me from like four years ago, like who the hell is that?

That's me. Yes. That is the real me, this is real. What about with your wife? How was she dealing with the stress? Very stressed out. She's very faithful also, and she carried her faith, house going.

She had her patients. I mean, she's an OB-GYN delivering babies every night. That's a stressful life and lack of sleep. And my kids. They were just hearing all the news and everything about their father.

So my oldest is 23 and he's actually here in New York City. He's second year dental school at NYU. Smart. a dental school. Yes. No, I don't want to deal with medicine.

I'm not doing medicine if you're going to make money, go be a dentist or an orthodontist. Do those do one of those two things. Yeah, just, you know, do you have you thought about the collateral damage of the impact to the children?

Like what has been, what was that? I mean, I'm assuming they'd been through going through some therapy and if, you know, again, anything that you can't dive into.

Yeah, no, it impacts everybody. I means it's a wound that does not go away. Right, that's kind of where I want to go. So we do a lot of work, we're talking offline, and you do work in ketamine, right?

Yes, absolutely. Okay, so let's talk about your psychiatry practice today. And because of Medicare you've had to be Medicaid. I'm sorry Medicare Medicare.

Yes, they need them. They should have had better names. Um You can't take like 50% of your patient base now is cash. So it's a kind of blessing but let me tell you what happened so this is how the right side of the government, right arm of government doesn't know what the left arm is doing.

So I was being prosecuted by the Department of Justice and the Office of Inspector General for the department of Health and Human Services. But I am in rural Pennsylvania.

I had a group of about 250, 300 Medicare patients that are severely mentally ill. Nobody wants to take, nobody wants a deal with them. Mm hmm. We love you, Dr.

Raffaei, but the Department of Justice says that you did fraud. We don't know. we don' think that we did anything wrong. But we're going to suspend your Medicare privileges.

Were not going eject you from Medicare, we are just going do payment suspension. You're still going be in Medicare. Which means that, you can still see patients but we aren't going pay you for a couple of years.

Put it in the bank, no interest but were not gonna pay. They actually put it, kept it an escrow. Did they give you an interest rate on that at all? No interest.

Two years. And then when I was found not guilty, I sent them a letter. Within one month, they turned it back on. They paid me. within one month after the trial.

That check must have been at least a little bit nice. Very nice, very nice check. Yes, a very check that came in, because I asked for support from my congressperson, I ask for the support of the senator, and my patients wrote letters to Medicare.

It's like, okay, this doctor, you've got to pay him because he took care of us. It was the government's case was so misguided. They could not find one patient to bad mouth me.

I mean, like they said I did one point three million dollars of fraud. cajole or get the government couldn't get one patient, one Medicare patient to come to the trial and say, this doctor, if I build me wrong.

Yeah, did me one. One patient. Was your US representative, your congressperson? Yes. He or she supportive? Very supportive. Who is it? Who's your Congressman?

I wrote to Congressman Fetterman. The Democrat. Oh, the Senator, yeah. I love him, by the way. I mean, I think he's fantastic anyway. And so and so he wrote a letter to Medicare and says, Can you can you release the payment for this doctor?

And just like within one week, they paid me. Wow. So they paid somebody that the government said that he's a fraudster, and then 12 Pennsylvanians who don't know me, they don' know from Adam, just collected them from Pennsylvania, brought them into this trial, listened to the evidence for six days, then twelve Pennsylvans who know nothing about Medicare says, this guy's not guilty.

There's no better testimony from the people of Pennsylvania to say that the government just got it all wrong. We don't have any psychiatrists as clients yet.

Maybe you'll be the first one. Absolutely. I would love to because I get questions all the time pretty consistently. Can we help you? Just tell her, like, what do you get paid for from an insurance for a mental health visit with a patient?

How much are you getting reimbursed? So how long is the visit for? The visit is probably is about 20 minutes. Okay. We get pay like a hundred dollars.

A hundred bucks for 20 minute. Can you really get very far on 20 Minutes in a 20-minute session? No, so you bring it back. You're bringing back it. And you can't stack those 20 minute sessions.

No. Well, you could make it longer. It can make a longer session and you build a higher code. But there's always the chance that the insurance is going to say we're going down code your visit.

Doesn't matter automatically. Right. Without even asking you. We don't think we don' think there was there were more than 20 minutes done. OK, this is all we are paying.

So you could do a 40 minutes, you can do 60 minutes and code it that and send it to the insurance. You could say, I want $200 for that 40-minutes. That's equal to 20 minutes plus 20- minutes.

And the insurer's gonna say we don't think 40 minute happened, we're only gonna pay you for 20 minute. It's funny, if you cant get anywhere in 20 minuets.

Like I do some talk therapy and doing through some stuff with some family constellation issues and it's a 15-minute session and like We speak weekly right now.

Sarah Bittar, if you're listening, you are wonderful. God bless you for coming into my life. You are a phenomenal therapist. And she… And this is to my therapist, Dr.

Fred Moss. So, you're wonderful. God bless him, right? Dear Lord, God, bless them. And you know, we're at like 50 minutes. She's like, We gotta go. I'm like oh my gosh.

We just started cracking open the container, Right? Like, You know we actually talked later today. Yes. Can you get anything done in 20 minutes? Okay.

My charge for cash, 20 Minutes, is $200. Okay, do you go longer than that? What's your charge an hour? the hour we charge $450. Okay. And do you get any pushback on that price at all?

No, no. Because the patients can't find a psychiatrist. They can find one that they like. So this is the fascinating thing. You're confirming my suspicion.

When we work with doctors, one of the things we talk about is price, right? Like, my brother, the union plumber, makes more than… An orthopedic surgeon with the latest 20% reduction in joint replacement surgery is now like $900 for a joint replacements.

That includes 60 days, sometimes 90 days of follow-up. When you factor in what they pay their PA, everything, they make about $28 to $32 an hour. Okay?

I mean, that's ridiculous. 12 years of training, you get paid the same whether fresh out of residency or they've been doing it. And I don't know how Secretary Kennedy thinks that the orthopedic surgeons are going to continue to do joint replacement.

He just had a shoulder replacement himself. They're not. Then call me. Medicare paid for his joint replacements. Yeah. Well, you know, politics makes some strange bedfellows, right?

There's always, there's going to be stuff you don't like that comes along with the stuff that you do like. So when we talk to them and we say, look, You can charge $5,000 for PRP.

And they don, they're think, immediately think well, my doc, My patients aren't going pay that. But what was your experience when you raised prices? When you started going cash and you said, Look, we don' take your insurance.

What did they say? What Did your patients say Our first encounter with that was actually during this trial issue, and what happened is that United Behavioral Health, United Healthcare, actually targeted everybody in mental health.

So they placed everybody, in Mental Health in the Northeast, Northeast of United States, on something called prepayment review. Meaning you have to send in your note before they pay you.

Not just, so it wasn't just Dr. Refai, So actually that was an avenue for me to say, okay, that's it. Goodbye, goodbye United. And a year and a half later, actually, our local hospital, Lehigh Valley Health Network and Jefferson Health, severed ties with United.

Wow. So like a huge hospital. 30 hospitals. Jefferson health severed sever ties with United. Well, yeah, so so a lot of my patients Heard about it and I said if you want to continue to see me, that's my my fee and Basically, they tried to find other psychiatrists and they couldn't find can they come back?

Yeah, So they just decide to stay with me. Yeah No, you do ketamine. And I do. Okay. Let's, I'm a big fan of plant medicine. I've done somewhere in the neighborhood of probably 50 journeys for the last two plus years.

Quite a few of our staff, a lot of doctors, 45 plus of my doctors have gone dealing with trauma. and I did psychedelic training because at that time we were preparing for psilocybin to be approved.

So are you a fan? I'm a fan. Yeah, so we were preparing for a psilocybin to be approved for PTSD What and it wasn't approved by the yeah, yeah and don't learn go ahead and map I was part of man.

Oh, you're part map. Yes protocol that I trained with them. I have a certificate that i'm psychedelic therapist that III could I could take people through journeys and the FDA didn't So why are you a fan of plant medicine, psychedelics?

And in the MAP protocol, are using the map protocol that's like using MDMA in addition to psilocybin? Or what's kind of your walk me through kind, this is a big topic.

So we did, basically I'm a believer in different medications that work on different neurotransmitters. Okay. So, Ketamine, I was part of the group at the National Institute of Mental Health where we actually worked on ketamine.

This was 2004. After I finished my residency at University of Virginia in internal medicine and psychiatry, i went to the national institute of mental health in Bethesda.

I went at NIH. People hear about Dr. Fauci. Dr. Fauci's office was across the street from our office. I was there in that community. And I did research for about three years.

One of the research protocols that I involved in was ketamine. Basically, we gave intravenous ketamines to people with treatment-resistant depression.

Okay, so treatment resistant depression. Yes. Okay. Or and treatment is treatment with the use of SSRIs and talk therapy or is it just everything? It's everything.

So it's a big umbrella. It all of it. Oh, yes. All right. People who have tried the whole system and they didn't respond to anything. You give them ketamine.

And what did you witness with the use of ketamine? Robust response. Is it long-standing? Yes, within a few days, people who've been depressed for 20 years, their depression lifted.

Their scores improved. And did it stick? So I've read some, I won't say studies, just some of the papers I should say, or articles. Ketamine doesn't have as long a shelf life that you have to keep doing.

So maintenance? As with all medications, yes. All right. OK. So. Is there a model? So then one of the pharmaceutical companies developed a nasal spray.

Ketamine as a compound, it has two isomers, entomars. Esketamine and another. They developed esketamines. And they made it as a nasal spray so left side and a right side.

Okay, and they developed a Nasal spray. So you pervert which do you prefer to you? What modality do? You prefer? My office in my office we use intramuscular intermuscular.

Yes. It's the easiest way It' s it's kind of move robust way and we found that it was really not a lot of difference between Intramascular ketamine and intravenous okay in How long is that session?

So the session is about two hours. So they come into my office. I have a monitor. They sit in a dark room, something like this, and then they basically relax and they're connected to a And they sit on a couch or recliner and they get monitored and then they receive an intramuscular shot of ketamine.

They dissociate for about 45 minutes, they monitor for another 45 and their loved one drives them home. And then in that 45 minutes where they're coming out of it, is there talk therapy going on with that, or what do you do?

There's talk-therapy, they listen to music, sometimes they are seeing some imagery. I have them do homework prior to the session, and I had them homework afterwards.

And I find that kind of being involved inside the sessions is not very productive, so I've had to them to homework before, I'd have to have homework after, the dissociation is on their own.

Okay, great. Then I know that it's not legal in the state of Pennsylvania. It's legal and other states, right? The psychedelics, the use of psilocybin.

Yeah, they're not legally, yes. Right. What would be your model? What will be a protocol that you would, how do you, where would you use that? Where would decide, okay, this person needs ketamine?

So MAPS psiliocyban protocol was actually for post-traumatic stress disorder was a whole day protocol. And how much are you taking? How much is the patient taking of the psilocybin, if it's a whole day protocol?

Are they taking like five grams? Yeah. No, no, just one dose. Just one gram? One dose, yeah. Okay. All right. So this was just, one, dose that they developed through the FDA.

And basically, and then they basically they have a session for the whole and they're monitored, then they have to have two therapists, not just one. So part of my preparation was that I was preparing space.

We needed couches, we needed a room like this. we need two therapist. It needs to be a safe space for the person. You have hook them to a monitor. And where can you find two therapies who are willing to devote a whole day for one patient?

Right. What would you charge for something like that? And that was, that we didn't know. Yeah. I mean, that was one of the obstacles. And one the reasons why the FDA refused to approve that protocol is because they couldn't kind of dissect what was the medication, what the therapy.

So they had a whole psychedelic-associated psychotherapy, so they could not dissect which one was effective. Was it the therapist or was it medication?

It's interesting because, like I said, I've done my first session, and I speak about it all the time in the podcast. I'm a big fan. November 22nd, 2024 was about a four and a half to five hour session.

Did about 200 milligrams of Molly MDMA and then I think a gram to a graham and half of psilocybin, right? In the form of a chocolate. It was by far one of the most transformative moments of my life.

more transformative than watching my daughter be born, right? Like it was like, every, everything was made abundantly clear to me. It's changed the way that I've run my company and I'd done numerous, you know, I have done more sessions, I've done some self-guided stuff like this probably is like making your skin crawl but you know because I'm doing it self guided but I am very much of an experimentalist like once I go into something like well let's try this right and it has been it is completely changed me Um, if you were to have met me two years ago, I'm a vastly different person.

Like I showed people pictures of me from two ago. That's you. I mean, just like the way my energy portrays all of it. And the thing that, the think that it's, and I've done talk therapy for a long time.

It's helped me understand the depth of the trauma of what I grew up in and it helped understand that depth up to the generations of trauma. Um. It's been life-saving.

I mean, to say that I'm a fan is probably an understatement. And like you said, you have to create a very safe container. Because when you're on that dose of MDMA and then you get the psilocybin, You have to be very careful.

Absolutely. Is that a big concern for you? Absolutely, yeah. So is this person going to become unhinged and run out the street and get run over by a car?

Or fall in love with me? Yes. Or am I going take advantage of it? One of the concerns about one of these sites during the trial was that a therapist and his wife became romantically involved with one of the patients.

And so it's always a concern. I mean, they're humans. The therapists are humans and the patient is human and that there was that. It wasn't real. There was an insinuation that they got involved.

Didn't even happen. But somebody just insiniated and so they had to basically get rid of data from that site completely. Do you have hope? Like what's your, what would be, is this something that you are championing that want it to be?

Absolutely, so a lot of the pharmaceutical companies are believing that it's real, that is true, it is happening, but they're not focusing on the psychotherapy part.

They want to it be a pill, you take a pills and you get better. Basically, that's that American pharmaceutical. Yeah, they're trying to figure out a way Here you go.

You take a pill and your trauma just gets yeah, well Yeah this so I'm not a fan of that. Let's you know I've always been wonder like if they are against it because they can't necessarily monetize it They're monetizing it.

They are. All of the big pharmaceutical companies are on board with psychedelics, with different forms of psychedelic. The different psychedelcs, the different categories.

There's somebody that has active protocols that are very close to FDA approval in the next year or two. Interesting. Yeah. You're going to have compounds coming in in next years or 2 that they're on fast track because the current administration is very supportive.

Health and Human Services is very supportive of it. And so it's on fast track with the FDA and they want something like in the next like pronto like, in a next year or two.

You know, part of me is like I really don't want the pharmaceutical companies involved because I don' know. The monetization and the weaponization of those things always kind of scare.

There's some there's somethings like like you know obviously a big fan of peptides, right? I'm on hormone replacement therapy, use peptide. You know, I kind of like having the compounding pharmacies that are not that, are able to do these things and have a little bit, you know it's not so big money oriented, right?

Yes. So that gives me a bit of pause, but you, know I mean look if the mental health of our country can dramatically improve. I think so. Yeah. So will you be first in line if it's all approved of doing it?

Absolutely. I'll support it. What's your feeling on Ibogaine and say, Ayahuasca? I know that former Governor Rick Perry out of Texas is pushing the initiative on ibogain.

Yes. They got about $150 million. So there's like several categories of psychedelics that are available and they work in different mechanisms. And I think there is going to be some compound in each of the categories.

that compound or two, psilocybin, LSD, MDMA, Ibogaine. So there's gonna be a lot and they may come up with a ketamine, a pill form ketamin. Interesting.

And they come with an injectable approved ketamine for depression. There's going to be multiple compounds that are going become available in the next year or 2, I believe.

I'm not an overly big fan of the SSRIs. It really feels like it masks the symptoms. What are your feelings? I think that they've just, we've done that phase.

The first SSRIs have been around for 35 years, maybe now, almost more than 35 year. And they have helped some people, and they haven't helped people. So they only help about 20, 25% of our patients.

It seems like they're, Christine, my girlfriend, she's significantly younger than I am. She's 30. Mm-hmm. It's fascinating. Yes. Like, oh, yeah, I know I've been on Lights of Pro.

I'm on Will Butcher. For what? Yes, they want to mask their emotions and their feelings. But yet they try to be so in touch with their friends. Isn't it interesting?

Stressful world out there, yes. So let's talk about your books here. This is book two of three. Yeah, this is the first one that came out. Dr. Not Guilty came up.

So this is the story of your entire journey with regards to the case and prosecution. So it starts with trauma. The opening scene is my dad who was seven and witnessed his dad, my grandfather, um die as he was on the podium reciting a poem for the independence of syria 1947 was he assassinated or did he just die no he Just had a heart attack.

He was so emotional about the the uh Really the how old was your father when I was seven He, was 7 and he watched his dad who was under the, podium Reciting, a, poem and became so, emotional had.

A heart, attack and died So yeah, I lost my father when I was 13, heart condition, sitting next to him watching a baseball game at home. Messes with you.

Yes. Yeah. Is that part of the reason why you went into psychiatry? Part of family trauma, yes. much does family trauma dictate today's life for the average American, for average human?

How much is that dictate? A lot. So we used to think, the research used think that trauma didn't affect us. It affects us even to the DNA level. Yeah.

People who have trauma they have something called telomeric shortening. Telomeres are basically the caps on the chromosomes that kind of protects the chromosome.

And what happened is when we have trauma, we found out that the telomere get shortened. You know, like you have your pen, there's a cap on a pen. That cap gets shorter and shorter.

So what happens with the chromosomes is, when the cap get shorter, some of the chromosomes, some of the genes starts getting expressed. They're not supposed to be expressed because they're supposed be capped and protected.

Now you're uncapping them. And some these genes, cancer, inflammation, all these jeans that are supposed are now being exposed with telomeric shortening.

That's what we're having. So what does that, have you read the book, It Didn't Start With You by Dr. Wolin? Yes. Okay. What's your feeling on, do you remember, I don't know how much you're remember of it, but what's you feeling of like that?

You know, he talks about the generational trauma and like things repeating themselves at like the same age and same stage of lives. Absolutely. Yeah. So I always, so my grandfather, He was on the stage, she was 60. so I'm 53. I ask, i'm wondering at age 60, am I going to have a heart attack and just pass?

My dad, God bless him, he's 86. He survived that. So I am saying, is this gonna skip one generation? Is it gonna hit me? Now I'm gonna be 53. Is there gonna to be 60? And my grandfather was overweight and he smoked and it was 1947. People didn't take care of themselves.

And I wonder, so I I try for that not to happen. So we do a lot of work in this. So, we have a program that's called the Stairway System. It's how you grow your practice.

That's I grew my cash practices. I owned a rectal dysfunction clinic starting in 2014. We grew that from startup to three locations in 18 months doing six and a half million dollars a year.

And so, the system is the stairway system, right? So it's five steps. You've got VTED, Educate and Excite, Convert, Monthly Recurring Revenue. Have a top-end point and more percent offer.

So I put as the foundation of that culture, values, vision, all of them. But then one day, I'm reading this book. And I'm realizing, holy shit, I've got a lot of stuff that repeats in the family over and over again.

Now, Mike, we didn't talk a lots about my family. There wasn't a whole lot data. My father dropped dead when he was 60 and I was 13. I find out that his mother died when was 12. Okay.

Uh, my mother lost her father at two months old. And before that she was under quarantine because she had tuberculosis so he couldn't go in her room. So we have this double trauma stream that flows down into the thing.

Right. And I'm looking at all of this and I realize most of the males in my family are alcoholics on both sides except with the exception of myself and my father.

Right? And so I start studying this, and i realize what sits underneath all this. I've been coaching people for 20 plus years. Why is it that I can take two people who start the program at the exact same time?

Okay. And they have very similar businesses. They go through the same coaching tracks. We take them through. The same modules. Why is it that one, this person over here all of a sudden has a million dollars to the practice in here and this.

Over here, nothing changed. I dive into it and I go, Oh, it's their origin code. It's they're epigenetics. Its their family history. it. All of these things that create these anchors, I call it like you're, that's like, you've got a bungee cord wrapped around your waist and you are tied to a rack in a room and your trying to run to And it's been, it has been a massive revelation for us and our clients because instead of saying, try harder on this thing or work a little bit harder, on your marketing or do a bit better on.

We now, or the reason why you're not getting employees is because we're the right employees as you know, you need to create a better culture. What we are realizing is people are operating out of all of their holes in their woundedness.

And that, when we start to do that with our doctors, we watch transformations like this. Like I have a doctor here in the Northeast area. She's got five locations.

Jean went and did her sessions and she's like a completely different person or business because she confronted that. It's been one of the most fascinating parts of my life's work is seeing that and I find it just mind blowing.

I think of all the years of time that I spent talking about the other things, it's not the tactics. Well, it's not the tactics, I'll say it this way. It's the telomeres, like the shortening of the Telomere.

What do you see with your clients when you start to really dive into some of these things in the past and they're able to confront it or understand it?

What do you see? Transformation. Talk about that. I know you can't talk about a particular patient, but- I mean, I can talk outcomes. Yeah, let's talk.

People just change. In what ways? What would you say? I have patients who just are able to excel in life. They were stuck in things, and then they excel on life, I'm just, one client comes to mind that when we talked about his trauma, about the way his parents raised him and about how he was dealing with his son, and he's in the mental health profession too, he excelled, excelles significantly.

He started a side business and has a better relationship with son. And he got promoted in his job. And he's doing much, much better. So when we address these things, outcomes, people's lives improve.

Their relationship with their children, their relationship their spouse, all improve I liken it to you're running a, you have a program running in the background on your computer that you don't even know is in there.

And it's dictating everything that goes on in a computer. Slowing down everything. Yeah, it is like a virus. It really is, I think, I think for me, I'm almost 59. I know for a fact that that type of work is going to become more and more important to our clients' growth than the frameworks I create.

All of those things are great. But when you realize that people are hiring out of their woundedness so that they that they had a situation where they were a kid growing up and they at the young age of like 15 because a parent died that had to take over the family and that made them have a sense of strength or whatever.

And they still do that in their business today because they hire people that can't really run the business the way they wanted to so they always have to be there.

It's fascinating for me to see how those patterns replay themselves and the more I dive into it, It's like I see more and more of it. Absolutely. Yeah.

So let me tell you about something also innovative that I've been involved in. I'd love to. While I was dealing with all of this investigations, one of my things is I'm a geek in science.

There was this new modality. that looks at brain activity in real time. Okay. And you know, our brains are fed, two things feed our brain, glucose and oxygen.

All right. That's the fuel of our braines, oxygen and glucose. Now there's other things, nutrients and proteins, but mainly it's glucose an oxygen, that's what our Braines needs to function.

There's a guy by the name of dr. Amen Daniel Amen who's the psychiatrist very famous psychiatrist and he developed this modality where he actually looks at the brain in real time he injects radioactive glucose into somebody and then does a spect scan of their brain and that looks At the Brain activity in Real-time.

Mm-hmm and looks that your cognition A company in South Korea developed an advanced system to look at the oxygenation of the brain. You know, pulse oximetry, the thing that fits on your finger, they developed something that looks at frontal lobe.

And I started getting involved with them in 2017, 2018, and they developed this machine. And so in 2020, with the beginning of COVID, I connected with a longevity guru by the name of Brian Johnson.

Yeah, no, Brian. I know Brian personally. Yes. He had just developed and sold Venmo. Yeah. So he was, he, was one of the people who, who developed some wild stuff.

And so, and so I talked to him about this and he says, I'm going to start a company. We're going develop this. we're gonna read the entire brain. so he developed through 2020 to 2022, He developed a machine and called it kernel.

and it's a helmet that fits on the head and reads the oxygenation of entire. Hmm. and developed a model where it actually looks at your brain age versus your chronological age.

Okay. And basically, you scan your bring and then you get a brainage. Mm-hmm. Then you compare that with your Chronological Age. Is your Brain older than how you are?

How old you or is it younger? If it's younger, it is wonderful. If its older, we need to figure out why is your And we work on longevity, inflammation, see if we can improve your brain score.

And are you using this tool in your practice? In my practice, yes. I'm one of 10 centers around the United States that has the kernel. I would love I might have to make a trip back.

You are you are welcome to come. I wouldn't love it. We can do a scan. And we can scan for you. Can film it? You can go to my website, Colonel Helmet dot com.

Colonel helmet. Yes. K. E. R. N. E. L. colonel helmet h e l m e t colonal helmet dotcom. and you can see testimonials I've scanned a psychiatrist, I scan a therapist.

So what do you do to improve the oxygen? What do in the glucose? what are some of the things that you could do? To help improve that? Oxidation, gut microbiome.

You look at their entire health, you do a whole panel of laboratory testing, and then you just work through that and see why is their brain age more than their chronological age.

Are you familiar with Dr. Frank Schellenberger out of Carson City slash Reno, Nevada? He's kind of the godfather of ozone therapy. He's a He just was on the podcast.

It just wasn't Reno. We just interviewed and we just dropped it like last week Yes, Frank's been in this space for like 50 years. He 80 years old now.

Yes looks great Sharpest attack still And he's the client like he we've worked with him for years to transform his practice He he holds a conference on ozone therapy for healing like for you know, he helps with healing joints and like, you don't Increase you're reducing cellular age all of those things.

So just to know if you had ever heard of him or Check him out. His brain's brilliant. He's fantastic. So my goal is to scan a million brains. Really? Yes, that's my goal.

And that will lead them into, will you lead that into kind of like functional or will You lead into talk therapy or combination thereof? So there's multiple things that I can do to improve your brain.

We can improve the chemistry of your body, oxidative stress, inflammation, microbiome. We can look at your DNA. we can Look at methylation now. So you got to check out Frank.

He's got great tools on methylations. Go look up Frank Schellenberger. And then I have a FDA approved machine that actually stimulates the brain. so transcranial magnetic stimulation.

Oh, you've got it. You'd have to talk to Frank. You guys are like two peas in a pod. Yes, so I do TMS. I've been active with Tms for the last 10 years.

It's FDA approved for depression, but now there are protocols that it's FD approved also for cognitive enhancement. My business brain's going off right now.

So it would be fascinating to take your model and build a customer journey centered around talk therapy, the use of functional medicine, and create an entire package of program and wearables.

We didn't talk about wearable. Oh, by the way, I can see the whole new business model in my head. So this is how I operate, right? And I just connected yesterday.

This is why I took time off from my day to come talk to you. I just connected yesterday with a company in England and they have a software, just an interface that connects the kernel helmet with wearables with their oxidative stress, with scales, With your iPhone, everything all in one platform.

So we'll give you everything. Connectacom is the name of the company. So is the kernel something that would be eventually an at-home tool or is it only in office?

It's only an office. It is only office because it's kind of expensive. Yes. Okay. The machine is about $200,000. Yeah, okay. I was going to say, I didn't think it was a…

And how often do you have people come in to do that? Every three months. Every 3 months? Yes, yes. So you get a baseline. You get baseline? And then you put them in a protocol with regards to functional health and all.

And you bring them back in three month and see what happens to the brain. Oh, baby. Interesting. My business brain is clicking off. And what you do is you see how their brain and then you would have already looked at their microbiome, you had looked their oxidative stress at the blood work, methylation, and you actually see if maybe you can do transcranial magnetic stimulation to enhance their brains.

And I deal with leaders under pressure, executives. So the other metric is, is my company doing well? Are we having more money? are we have more revenue?

So, the metric, it's not just, okay, my health better? Is my colonel saying? It's like, no. The other metrics is are you performing better at work? Right.

How's that relating back? Yes. And so a big part of it also, I'm going to throw that in the mix because I have a book that's coming. Is it book three of three?

Is that the third part? No, it's actually a Book Four. Okay. Three of Three is coming out. Wait a minute. It says three. Now you're going do four of threes?

So there's a fourth book. The third book actually talks about my work that I did when I was at NIH working on hepatitis C. And hepatitis C is a disease that, in my lifetime, we've killed it.

It's gone. But it's normally transmitted through needles and things like that. Needles and blood, yeah. Right, needles in blood. Now we have treatment.

You take a pill for eight weeks, and the hepatite C's is gone forever. Forever. Doesn't come back. In my lifetime, we discovered hepatitis C in 1991. In MY lifetime we killed a disease.

So the title of the book is called Killing the Disease. I love it. And it's coming out in the next couple of months. Okay. That's book 303. Then in January, my book, The Humanity Algorithm, is coming about how people are responding to artificial intelligence.

Really? So what's, dive into that a little bit more. What's the premise of that? When you're pumping out some serious books, do you sleep at all? Well, you know, I don't know if you'd know the movie Forrest Gump, what happened to Forres Gomp when he started running.

He just kept on running and so I started- You're one of these guys that has a never-ending well of energy. Started with Dr. Not Guilty and that was my first book after the trial and I said I'm gonna keep writing.

How long did it take you to write that one? This one took about a couple of months after the trial. I can do a book in about eight weeks. Once I get it, now it takes like, they have to percolate a little bit, so we've got another book.

The Origin Code is gonna be the next one, which is going to talk about the impact of epigenetics and family history and the body keeps a score and its impact on your ability to grow.

It's gonna targeted for entrepreneurs and founders as to why those are the anchors. So the humanity algorithm is basically, I'm talking about what is artificial intelligence doing to us humans?

And what does it do to you? We don't know yet. I'm worried about getting rid of critical thought. Yeah, I am going to be talking about that specifically.

So I wrote about 12 essays that are being published through Forbes Business Council, specifically talking to executives and entrepreneurs. What is AI doing to us as humans?

And I started at the first iteration. The first one was the mirror we built. is the title of the. Okay. So yeah, it's the ultimate mirror. Like, It's The Ultimate Echo Chamber.

Yes. We'll have doctors be like, Oh, I ran it through AI and it says I shouldn't do that for my marketing. I'm like I've got 25 years of marketing experience.

AI may not be. It's not pumping my brain in there. But on the flip side, I have like an entire, all 500 of my, like I got 500 hour long teaching classes that are recorded.

And I get this massive, the voice of the stuff that we can create now is pretty impressive. But it's taken a long, long time. So now that we're talking about AI, I'm going to bring you back to Dr.

Nagelte to my case. One of the evidence that the government presented in the trial, the early days of AI 2018, so they have an artificial intelligence, very primitive bot.

And there was somebody says that I sent a bill on a patient who was deceased, was dead. So they asked this AI to go through the list of all my patients and see did I send any bills on deceased patients.

And AI brought them back 30 names. They didn't investigate it. If this was right, they just believed it? They just just believe it and ran with it, and at trial, the name number one is for a Medicare beneficiary who died in 1968. I was born in 1973. AI hallucinated a name just because they told it.

Find people who died who were Medicare beneficiaries that we think Dr. Refai build on. Oh, so that patient wasn't, they weren't even never a patient of you.

Never a patients? Never, no record, nothing. Nothing. They died in 1968. I wouldn't have even, I was born in 1973. AI just hallucinated names. And we showed that at trial, and one of the, I mean, the agents just, their face turned red.

Why didn't they even check it then? All right, what's Hijacked Minds about? Hijack Mind is about addiction. Really? Yes, yes. Hijacking Mind's How Addiction Rewires the Soul.

It's the subtitle. Okay, that's fascinating. Oh, okay, how addiction rewires a soul. Fantastic. And addiction isn't just drugs and alcohol, it's food.

It can be anything, right? I talk about my food addiction in the book. I talked about in my story. Um, I was on the plane at one time in 2004 with Senator Kennedy, Ted Kennedy.

I was on the plane with him and I talk about my encounter with them. And I talked about the Kennedy story. I'd talk the story of the Trumps and how they have addiction and alcoholism in the family and one brother died from alcohol and there's another brother who's never drank and is not dealing with any issues with addiction.

So you could have that, truly. Fascinating. Can't wait to read it. If people want to get copies of these books, how do they get in touch with you? How do you get it?

The books are on Amazon, but they can go to my website, DrRefiBooks.com. And you spell Refi, spell that for me. That's D-R- R-I-F-A- I, Books, B-O- O-K-S,.com, drrefibooks.

com. The book are available on amazon and Barnes and Noble. Great. Dr. Refai, thank you for coming in. My pleasure. You are a true maverick. A true man who's looking at the system and going, maybe there's a better way.

Maybe this system that's in place isn't really serving us the best. And I appreciate you coming in all the way from Pennsylvania. I'm in New York City at this time.

Christine and I happen to be in Manhattan this week. My pleasure. It was worth it. Yeah, man, it was totally worth. And, I can't wait to talk to you more.

Absolutely. All right. Thank you so much for coming on.

Muhamad Aly Rifai, MD, DFAPA, FACP

The Psychiatrist Who Took the DOJ to Trial