Let's Talk ID x Febrile at IDWeek 2024

Buddy Creech: [00:00:45] Welcome to Let's Talk ID. This is Buddy Creech. We're glad you've joined us. This is a special episode today because this is in the category of our crossover episodes. We've got our Let's Talk ID cast here, Paul Sax, Monty Davis and me. But we also have Sarah Dong, the podcast queen of Febrile. We're at IDWeek right now. She's been signing lanyards. She's been giving autographs to trainees. It's been pandemonium in the LA Conference Center.

Paul Sax: [00:01:13] She has been designated a VIP.

Buddy Creech: [00:01:18] Yes, very important podcaster and person and just an all around great person. So she's getting a little bit of cramping. It's like a carpal tunnel light. But we're getting there. It's going to be a new fundraiser. It's going to be a fundraising opportunity between the PIDs Foundation and IDSA. I think it's a great, great model.

Paul Sax: [00:01:36] You know ID doctors are always looking for new revenue streams.

Buddy Creech: [00:01:39] This is awesome. This is what workforce development has come to, is that we're generating revenue streams off of Sara's John Hancock. This is fantastic.

Mati Hlatshwayo Davis: [00:01:47] As someone who is not there in person and has had all the FOMO because when I say med Twitter, or should I keep saying X, is hot, hot, hot right now, I can't even tell you. So what are the hot sessions hot points so far and what am I missing out on, guys?

Paul Sax: [00:02:06] I was glad that they gave a special session. For those of you ID docs out there who also do HIV to the presentation of the data on lenacapavir for PrEP. So you know, the lenacapavir for PrEP is a twice yearly injection that in at least in the first study, was 100% effective in preventing HIV so far. And then in this now second study in a different population, the first study was in women. This study is in men who have sex with men and trans women. And it was almost 100% effective. Just two breakthrough cases. Both of these studies got a feature in the state of the art section of HIV management, and I was very happy to see that.

Sara Dong: [00:02:42] Well, I was explaining how I am a relatively freshly graduated new faculty, and I've realized that the more you come to ID week, actually maybe less sessions, I end up going to and like meeting with people, which is invigorating and wonderful, but it's like a totally different experience. So each IDWeek I feel like I've gone to has totally evolved. So I actually don't even have a specific session to talk about, but I thought that might be something that we can dig into as like, you know, the experience of being here in person and meeting with people and how that's quite special.

Mati Hlatshwayo Davis: [00:03:17] But Sarah, I actually really love that evolution for us, because what I'm seeing a lot of is the young people loving all these opportunities for mentorship. I'll tell you that the advocacy sessions were a big, big hit. One of my little babies, Dr. Bisono from Mayo, was getting a lot of play. But I just love that we're creating more intimate opportunities for people to meet the mentorship session. Darcy Wooten was putting out a lot of information. So, Sarah, I agree with you. I think that's a really great thing that we've done to make this not just about the discrete sessions, but the opportunity for us to network and connect.

Buddy Creech: [00:03:52] Yeah. So we had our PIDS Foundation dinner, and I think I made the comment that this meeting is sort of like a science fair/CME/family reunion, all in this weird infectious disease turducken. We were chatting a little bit and Paul, you made this point about, this meeting is in full. I mean, it's back and it's back with a vengeance and continuing to set record numbers. And the energy is super fun. It's great to see people. That is in contrast to other things that have taken on a more virtual.

Paul Sax: [00:04:27] It's really a striking difference. I mean, with the pandemic and obviously almost every conference being moved to virtual, it created opportunities for people to attend to otherwise couldn't, which is the good part. I mean, you avoided unnecessary travel, which is a good thing for the preserving the carbon footprint. And you also it was just basically good for access. But the problem with it is that it does not replace actual human interaction. And so it is remarkable how all of these professional meetings have come back in full force. You know, I have friends who are cardiologists. They go to meetings with 20,000 people at cardiologists. This is really in contrast to, for example, you know, many hospitals ID case conference. Now a lot of the people attend virtually rather than in person. And I wonder whether it's ever going to go back to the way it was or whether we'll always have this sort of hybrid model.

Buddy Creech: [00:05:16] So can I ask it? This is a random question, but I feel like I have more conference calls, more Zoom meetings, team meetings, whatever the platform is, than I ever saw. Even busy colleagues or busy mentors having. It feels like every hour of the day is is apportioned in these like 45 minute segments of conference call one, conference call two. I it's it's fine. We get things done. But where does brain time come in? And it's strange because now that we're virtual, I don't have that luxury of walking across campus, walking with someone, catching up with them as easily. Because I'm just going from one Zoom link to another. Is that, I think that's y'all's experience too?

Mati Hlatshwayo Davis: [00:06:01] Couldn't agree with you more, Buddy. I actually had to. For those of you who don't know my background or know me as much, I'm the Director of Health for the city, so I have a big you know, I'm involved in public health more than on a traditional campus, but we had to sit down and do calendar management because we didn't even build in times I could eat or go to the bathroom. But from my position and purview, it was important for us to even be more strategic. About at least 25% to 30% of my time has to be in person, really encouraging those in-person interactions, really going to community based events. Because while I think it's so important for us to be able to increase the number of touch points we have with these virtual models, man, you cannot substitute that in-person touch.

Sara Dong: [00:06:43] Yeah, I agree, I feel like it's that combination of you having some time to decompress that used to be built in, like you were saying, walking between places, running into someone when you grab a coffee and even if you schedule those in, my experience is that we tend to eat into those spaces in a way that we didn't have to allow when it was more in person. I'm trying to be better about converting things that are virtual to in-person when I can. But yeah, it's a hard balance to strike.

Buddy Creech: [00:07:12] Well, I'm curious what it's going to look like for our workforce development, because it is those face-to-face touchpoints that are probably a lot more compelling than the digital. And now, I also want people to be able to do things digitally while they walk. Like, I don't know, I'm just spit balling here, like listening to a podcast like Febrile or Let's Talk ID. I mean, I'm just I'm just making things up here as we go. Yeah. But I do think there's I mean, I think, Paul, you said this, there's something lost, but there is something gained, right? We've given access. We've given probably equitable access, more equitable access to content and to meetings.

Paul Sax: [00:07:45] But I mean, just the fact that Maddie could attend a session while she's in Saint Louis.

Buddy Creech: [00:07:49] That's right.

Mati Hlatshwayo Davis: [00:07:49] I mean, I got to register my assistant was able to build in time for me to do these sessions virtually, and that means so much. So I do think this is an important part of the future, but one that we need to keep a good eye on to make sure that it is. It continues to serve us well. So a question I have for you guys is, you know, I'm now a board member and I have to shout out the IDSA staff now sort of being behind the curtain and seeing how much work goes into IDWeek. This is such a formidable outcome and so much work goes into this. So I just want to really give them their flowers. But I did want to say that one of the things that was important that I saw evolving as well, is how much our interest groups have grown. And sessions that five years ago were in small rooms. I mean, I'm looking at a gorgeous picture right now on social media of the women and ID session, and it now looks almost as big as the open plenary, if I'm being honest. Right. Is that what you guys are seeing and experiencing too? I got beautiful text messages about record turnout for the George Counts interest group, you know, for African Americans in ID and Black folks in ID, these are the folks that opened the doors for us. I wouldn't be on the board or even on this podcast if it weren't for George Counts, Dee Banks and Dial Hewlett and others. So just you know, I just thought the interest groups and the evolution there and how they've become more prominent has been really wonderful to see.

Paul Sax: [00:09:10] Can I weigh in as an editor of one of the IDSA journals? You know, I find that attending the IDWeek is really great because potential contributors can come right up to me and say, you know, we're thinking like, for example, someone just came up to me and said, look, you know, there hasn't been a good recent review of the infectious risks of hurricanes, and that is a good topical subject. And I said, well, that sounds like a, you know, I'd encourage submission of something like that, you know, and off you go. I mean, it's that, that kind of happenstance that is very exciting about being here. And then also I was able to sit down with about I think there are about half a dozen of other ID journal editors at the what's called the BugHub, which is this little stage that we're sitting at. And, you know, people showed up, People asked questions. I thought one of the very best questions was, you know, what sort of papers are you interested in seeing more of? And we each got to respond to that question. Another really good question was what would you advise a junior investigator before they submit their paper to your journal? That was another good question. So anyway, I greatly enjoyed it.

Mati Hlatshwayo Davis: [00:10:20] I love that you make yourself so accessible in that way, Paul. I think it's so great for young mentees to be able to see how accessible our journals have come. And I just wanted to say kudos for the type of content that I'm seeing that I would have never imagined I could contribute and others could. I thought Darcy's article earlier this year was just so important to ID, so kudos to you Paul.

Paul Sax: [00:10:40] To give Darcy another shout out, why don't why don't you tell tell us what that article was? Because I think I know what it is, but just please, Mati.

Mati Hlatshwayo Davis: [00:10:48] I mean, for me, it kind of read like her love letter to ID, right? What it meant to her kind of love letter to ID and what ID means. And I think the timing of it was impeccable, right. In a sort of, I hate using the term post Covid environment because Covid will always be with us, obviously, but I just thought it was such a beautiful reset. It was her love letter to ID at a time where we're talking about workforce development. I thought it was a beautiful homage to what ID means to so many of us.

Paul Sax: [00:11:16] Agree. And for those of you listening, we do encourage these personal reflections as submissions to CID. It's called Voices of ID and so if you like to write and you want to give us something that really reflects your experience as, as a clinician, as a researcher, as a public health person, we want to hear it. And that's true for everybody. Whether you're a physician, a pharmacist, a nurse, someone in the ID world, that's what we want to get.

Sara Dong: [00:11:44] And I'll add that these interactions and that spontaneity of meeting people, I am going to plug the IDBugCrawl, which is new this year. It's a, you know, program for trainees to come and get this like special experience at IDWeek, and I got a chance to go to the Next Gen Lounge, which is this awesome. It's got like a ping pong table in there and snacks and like, places for -

Buddy Creech: [00:12:09] Wait, a ping pong table?

Sara Dong: [00:12:10] Yeah, I don't know if you can -

Buddy Creech: [00:12:11] Am I invited? No, no.

Sara Dong: [00:12:13] [laughs]

Buddy Creech: [00:12:13] Okay. I don't get access. Okay. I'll sneak in.

Sara Dong: [00:12:16] Yeah. You gotta see if you can sneak in. But there are a ton of trainees yesterday, and I got to meet with a lot of them that I don't know if they would have felt comfortable, you know, messaging through email, I hope that they would. But I think there's something different about being there in person and hopefully seeming approachable. And so a lot of, you know, med students and residents who came up and said, like, I want to do ID, or even if they're pre ID, they're like, I really want to do for me, med peds. I heard you talk about med peds ID that's that sounds really awesome. Like how did you do that and how did you get there. And that was a lot of my experiences from IDWeeks as a trainee and was like, I love how you think, or I love this project you did or this experience you made. Like, how do I do that? How do I get to where you are? And that is something quite special that even though I interact with trainees a lot for Febrile. This is always different when I get to come to IDWeek and see people in person.

Buddy Creech: [00:13:12] Well, and this is where some of the travel awards and some of the intentional programming that we have for workforce development come into play. Right? So whether that's travel awards through IDSA, whether that's work that Shay and his team are doing, I can speak to PIDs. You know, we started with support several years ago, the meet ID program, where for our three meetings that we really have each year, we have IDWeek, which is when we're ID doctors first and pediatricians second. We have PAS, which is our we're pediatricians first, ID doctors second, and then we have a meeting at St. Jude where we get to just be our little, you know, cohort of peds ID folks. We now sponsor students to each one of those. And I don't know about you all, but I mean, I still remember that first meeting. I still remember being just uber intimidated. But also, I mean, like it was the biggest dopamine hit that I think I'd had professionally because I'm like, wait, all these people do this and they just talk about clinical care and science and have a good time, like what's happening right now.

Buddy Creech: [00:14:11] And it was everything that was right about a science fair and everything that was right about just being with people that you grow to love. And now, I mean, I'm on the north side of 50, and I've known these people for 25 years. And these are these are family. And we talk about life changes and we talk about all kinds of great things, as if we, you know, see each other all the time. It's just really a I don't know, I think as a trainee, I'm wondering what you guys think are the, the touch points that were most important and where we can lean in. I don't know, to galvanize those because for me it was meeting attendance, it was mentorship, and it was somebody taking a chance on the work that I was doing, whether that was my mentor Kathy, whether that was grant funding, that was, you know, from PIDS or whoever. Like those were the probably the three things that meant the most to me was, was meetings, mentorship and someone taking a risk. Does that resonate?

Mati Hlatshwayo Davis: [00:15:07] Yeah, for me, it was even having the opportunity to go, because not all of us come from backgrounds where we even have enough money and budget to go. So the CAS award, my very first IDWeek meeting was because I was able to get a CAS award that fully funded me, and it was in Boston, and I got to give my first ever oral presentation of my medical career as a medical student, and it really plugged me in. I'll never forget my first IDWeek. So shout out to IDSA for prioritizing funding for young trainees to be able to attend, first of all. But I couldn't agree with you more that those mentorship sessions were big. And then I had a mentor who thought, who was really thoughtful about making sure I was invited to my first George Count's interest group meeting, and that continued to keep me plugged in after IDWeek. So those three and obviously the meetings themselves, you know, I've always been passionate about HIV, so I had a whole schedule lined up. But I would say the ability to apply for funding through the CAS award, the mentorship sessions, and then being plugged into interest groups that sort of saw me through residency and fellowship.

Paul Sax: [00:16:09] We have a mentorship program through the each of the IDSA journals, so CID, JID and OFID all have mentorship programs. And so not fellows, but early career investigators can apply. And they it's really we get a lot of applicants and one of the things they get, in addition to learning what it's like to be an editor at the Journal, is, is that they also get to come to IDWeek. So we pay for their coming to IDWeek. And I had I had lunch with our winner yesterday and it's terrific. You know, you get a chance to meet him and he's a very promising young investigator from Toronto. And there's one for OFID and I think two for JID.

Buddy Creech: [00:16:52] Sierra, I'm going to pick on you. We talk a lot about workforce development right now. Where do you think the most important things to lean in on that are? We've talked about mentoring and mentorship and meeting attendance, maybe, but do those resonate? And where else do we need to be really focused?

Sara Dong: [00:17:06] A lot of the programs that have been built, you mentioned PIDS, and I met with my meet ID mentee yesterday, and I realized that sometimes it's this those small connections, we always talk about them, and it's hard to make an easy way to replicate it for everyone. But I think oftentimes they're not things that we even intentionally planned. And for me, it was sometimes having conversations or just hearing about people's career paths that you're like, oh, you can do that. And that's why I was telling my mentee, especially for medical education. She was like, oh, I was really a little bit worried about, could I have a career like that in ID? And I was like, absolutely, let's talk about it. And I said, I had that same fear for a little while. Like, do I have to only be a certain type of ID physician? And I realized, no, there's like so many pathways. And I think any way that we can demonstrate that to trainees and show them, like ID is not one type of job or career. It has so many different aspects and so many avenues that you can go down creating these programs, that we can bring people to meetings and not force, but like allow those connections to happen organically is awesome.

Buddy Creech: [00:18:16] Okay so I have a friend named Dave who I don't know if he originated this, this saying or if it's just one that particularly resonates with him. I find it remarkably compelling. It's that, "when we get together and we and we only share successes, it breeds competition. But when we're also willing to share our challenges, our vulnerabilities, it actually breeds community." And so we have a choice in our society to breed competition, by only talking about the wins. Or we could do what I think we're all committed to. What IDSA and PIDS is committed to is to say there's a lot of different ways to do this. Rarely do successes come without preceding failure of some sort. And so let's actually talk about those with our trainees. Let's talk about the fact that you are going to mess this up. You're going to take some pivots. You're going to you're going to find some things that you like, and you're going to find some things that you don't. You're going to find some things that go unfunded. You're going to find patients that you can't fully fix. There are going to be hard things about this, and yet there's still a path forward for you, right? That seems to be something we can teach our young folks, right?

Sara Dong: [00:19:30] Being vulnerable and sharing doubts that you had or questions that you had.

Paul Sax: [00:19:33] One of the most difficult talks I was ever assigned to give was assigned by a brilliant clinical neurologist who unfortunately died recently. And he gave a talk called, "My Mistakes and What I Learned From Them." And it was a great talk. He was such a great teacher. And what he did was he reached out to specialists that he knew, and you had to sort of create that talk in your area. And I did one on my ID mistakes, which included two clinical mistakes I made and one research mistake I made. And it was hard to do. It was like the hardest talk I ever put together, but it was actually very fun and very therapeutic.

Buddy Creech: [00:20:11] That's Amazing. It's really easy, I think, for us to get young folks excited about this career. We're all passionate about it. We all like what we're doing. There are challenges to it, but whatever, that exists in every single profession. I mean, my son in law is an investment banker. Please, we have it better than those guys in terms of, like, everything that guy has. No.

Sara Dong: [00:20:32] Not everything! [laughs]

Buddy Creech: [00:20:33] Not everything. Okay, okay. Fair enough. Compensation. A wee bit better. Fair, fair. That's a good note. We'll fix that in post. But realistically, we have one of the best jobs on the planet. We have such in typical form. We have so much autonomy of what we get to care about and love. I'm really proud of that. But that also it's one of those where coming up there are some, there are some I don't know. There are some sideways things that happen that we just have to almost, almost embrace. We have to embrace that mess.

Mati Hlatshwayo Davis: [00:21:04] And the elephant in the room, right, is compensation. And I know that the board is so committed, and we've done so much offering consultants to work with folks. But what ID makes so special about the compensation discussion is it puts on display a wider array of options within ID than people think are possible. It allows us to have these conversations in real time. What I've loved about the evolution of sessions is that I, as a public health expert, am sitting at the table with basic scientists at some sessions, and you can see the collaborative spirit and the cross sections there. But we are working diligently on compensation, and we are able to make that clear. The rollout of our new strategic plan that you all will be seeing in the coming weeks is also making that clear, formative steps we're taking. You know, the other elephant in the room around workforce is what happened with the match, right. And how devastating that was as a blow. But again, we come to IDWeek and I mean the strength of our education corps. Our program directors, the mentorship sessions and the pipeline that we're continuing to build, and the innovation around how we're bringing people to the table excites me for the future of workforce.

Paul Sax: [00:22:13] There is another issue that comes up with compensation that that we struggle with. And I'm sure that all of you and all of you listening have been in this situation. A lot of what we do is not reimbursed clinician advice, you know, serving committees, etc. we've been told that unless you create a scarcity, you're really not going to succeed in ever getting supported for that. And creating a scarcity puts us in a position sometimes that makes us feel uncomfortable, because potentially you could be harming a patient. You potentially could be harming a relationship with one of your colleagues. So I have actually had explicit discussions with faculty that, you know, this is a service that we're providing, but we have to tell them that unless we can get supported to do it, it takes time and energy and expertise. Unless we can get support to do it, we have to set a date to stop it. And that's been one of the hardest discussions I've had in my entire career.

Buddy Creech: [00:23:10] I'm over here getting like urticaria, just thinking about this conversation. Like that's a challenge because it flies in the face of why we do this, right? We just, we will absolutely try to do more with less. And there's a there's a burden that we feel for that. I'm curious, how do you have that conversation?

Paul Sax: [00:23:31] So the example that everyone is, you know, so bored of hearing me talk about is we do a really robust e-consult service for our hospital system. And, you know, it started a little over a decade ago, and they pay us a nominal amount for it. And there's never been a pay increase, even though the cost of living has gone up quite a bit since then. And on a busy day, it can take several hours to complete these tasks, you know. And this only exposes us to medical legal risk and puts our name in the chart. And it provides an incredible service to the providers and the patients in our, in our system. And seems to me that at some point we're going to have to walk away unless we do get some better support.

Buddy Creech: [00:24:15] It feels like one of the things that would be really helpful, and we're trying to think about what this looks like is how do you just come to the table and say, let's forget everything that currently exists? What would we do to create a model that is most effective for learners, most effective for patient care, most effective for our own balance and well-being as physicians and scientists? Like, how would we create de novo that system? Now that's a pipe dream. But like, yeah, how do we do that? And should we have that type of conversation. I know that several are working on this. But yeah.

Mati Hlatshwayo Davis: [00:24:51] So I'll give you a little preview of some of the sessions that we had earlier this year at the board meeting to really discuss the future of workforce compensation. The first thing is to just really, again, shout out the IDSA staff advocacy session. They have been diligent in making sure that we're on Capitol Hill, we are in offices of Congress and Senators offices and really pushing for bills around this that really fortify and provide budget to move this work forward. But we were really pushed in, in multiple day in person sessions to put metrics to this, Buddy, like, what does this look like in real time? How do we measure this? And how does that translate into policy that will protect the future of workforce as well? So we're not known for being aggressive in ID. We care about impact work and less about the dollar amounts. But I think we're becoming appreciative more of how assertive we have to be here and how we have to build these metrics and more importantly, make sure they translate into policy that protects our workforce and our young folks.

Paul Sax: [00:25:52] Can I make a suggestion?

Mati Hlatshwayo Davis: [00:25:53] Please!

Buddy Creech: [00:25:54] I think you have to. Otherwise, we're just running in place.

Paul Sax: [00:25:58] I would blow up the RVU system for reimbursing physicians, which, of course, we're never going to succeed in that. There's just no way. I mean, it rewards volume and procedures. And if there's anything that ID doctors are bad at, it's volume and procedures.

Buddy Creech: [00:26:14] Well and it's the great irony that, and it's one of the easiest things to take care of now, would be sepsis in an ICU setting. There's you just give them a bunch of drugs. You don't give them all the drugs. But I mean, you know what to culture. You know what to asset. I mean, like, we kind of have an idea. Even though that's the most complicated from an RVU generation standpoint, the actual time it takes as you've been doing it for a while, it goes down right. Osteo is pretty complicated from a pathophysiology standpoint, but treating it, we got it.

Paul Sax: [00:26:46] Especially in pediatrics.

Buddy Creech: [00:26:47] Especially in pediatrics, right! Exactly. Now the adult hardware stuff. Yeah. You all are messed up on that. But even going to time-based billing has made it challenging. So I know we don't want to get into the weeds of all of that, but I think it does impact workforce development. It does impact what our learners see, how we prioritize different things, how we see them. Sara, you're a lot closer to this in terms of seeing trainees and transitioning into faculty and all of that. How has that impacted your early faculty years? And I don't know what that looks like for you.

Sara Dong: [00:27:19] What I like to remind people is thinking about being careful about how we put out that narrative of like, where we are in ID, not to defer these questions, but also for people who are interested in ID of it's not all doom and gloom. We are still, even with lower match numbers, bringing in more people into ID than we were previously. Making sure that we're emphasizing that while we're also addressing all these other questions, is important and like making it both for us as junior faculty, but for trainees that are coming in and interested in ID, that let's make a balanced view of what being an ID is like, which is that it's awesome. That's what I've tried to model is, is being making that spin on that to be positive and focusing on that component of we still have a lot of people who want to come into ID, and we need to find ways to support them while also answering all those questions and making improvements.

Buddy Creech: [00:28:19] I totally agree. So we were talking earlier about some of the sessions that have gotten us most excited, or things about IDWeek that have gotten us most ramped up. I started laughing the other day, so I started in fellowship, working on staph aureus, and have continued to do that for 20 years now.

Paul Sax: [00:28:36] Well that's a very obscure pathogen.

Buddy Creech: [00:28:37] It's not very common. Not very important. It's, you know, it's a niche kind of thing. Right. But over the years, transition to clinical trials and all this kind of stuff, the two sessions I've probably been most excited about are some work in adolescent mpox immunization, with the JYNNEOS vaccine that then led to the EMA licensing, or giving a licensure down to 12, and now starting vaccination campaigns in the DRC, where the disease is endemic and where we've lost 1000 kids and adults and realizing that we got to play a role in that, or seeing the data from Clesrovimab, the monoclonal antibody for RSV, that will likely be a new player in the market along with Nirsevimab, which has a greater than 90% efficacy in preventing hospitalization in infants. So here I am, somebody who has worked on staff but could contribute to mpox and RSV. Like what? What is going on? And I bring that up because I don't know that we always do a great job of saying to our trainees, I mean, we need to go Field of Dreams on them and say if you build it, they will come. Like if just the pure smorgasbord of academic activity that that you can be engaged in with ID, I think is unmatched by other specialties, like they can't do it.

Mati Hlatshwayo Davis: [00:30:00] I could have never imagined that a young woman from Harare, Zimbabwe, could be on a podcast with all of you and also being considered a leader in the field of ID as a person who loves infectious diseases, public health, community engagement and health equity. Right? What field do you know? Where our leaders just literally encompass all and are global and national leaders in being able to contribute to health across so many spectrums? It's beautiful. And, you know, I think about some of the collaborations I have with literally basic scientists and translational researchers and implementation scientists around public health right here in the health department. It is just such a joy to know, and I could have never guessed that we could do this. So I couldn't agree with you more.

Buddy Creech: [00:30:45] All right. I think this is exciting. We're at a really great inflection point within our society. We have a ton of interest. We want to see that translate into new faculty, new fellows, residents who stay engaged in IDD. It's really fun to be here in person. Mati, we miss you. We will see you next year, hopefully in Atlanta, Georgia.

Mati Hlatshwayo Davis: [00:31:07] For sure.

Buddy Creech: [00:31:08] There are so many opportunities. And maybe, maybe one thing we would say is be thinking now about those junior learners, those fellows and residents who have not just an interest in ID, but maybe a developing interest in ID, like those residents and students be thinking now about how to get them to this meeting so that they can get a taste of what we get to experience each year.

Paul Sax: [00:31:30] Well said, Buddy.

Buddy Creech: [00:31:31] Well, until next time. This is both Febrile and Let's Talk ID. You can find a lot more at all the websites on the internet. Thanks, everybody.

Mati Hlatshwayo Davis: [00:31:40] Bye everyone.