A Dose of Canadian Healthcare

Transcript Generated by AI.

Announcer: 0:00

Welcome to MedEvidence, where we help you navigate the truth behind medical research with unbiased, evidence-proven facts. Hosted by cardiologist and top medical researcher, Dr. Michael Koren.

Dr. Michael Koren: 0:11

Hello, I'm Dr. Michael Koren, the executive editor of MedEvidence! and it's always fun to do a podcast with an old friend, and I have that opportunity to do that today with my friend, Allan Rosenfeld, who is a very prominent physician in Toronto, Canada, and Allan is an expert in occupational medicine and we're gonna have a little conversation today talking about his path to occupational medicine and also some insights in terms of the Canadian healthcare system, which I've learned a lot about over the years from Allan. So, Allan, welcome to MedEvidence!

Dr. Allan Rosenfeld: 0:45

Thank you. Thank you, Mike.

Dr. Michael Koren: 0:54

So let's just start off by kind of giving everybody a sense for your background. Tell them we grew up, we went to school and how you got into this whole occupational medicine business.

Dr. Allan Rosenfeld: 1:00

Sure, I was born in Toronto. I went to medical school at the University of Toronto. I graduated in 1984. I did a family medicine residency at McMaster University, which I completed in 1986.

Dr. Michael Koren: 1:15

All amazing programs. Yeah, very, very prominent programs.

Dr. Allan Rosenfeld: 1:21

It was unique. I then went on to do my diploma of occupational health and safety from McMaster University in 1993. And then I got my fellowship with the Canadian Board of Occupational Medicine in 2007. During that time I set up a. I started a family medicine practice in a suburb of Toronto in 1988 and continue to do that until 2023, two years ago when I closed the practice. So I was on staff at one of the local hospitals we were responsible for. We were MRPs for our patients. We assisted in surgical procedures on our patients

Dr. Michael Koren: 1:56

Say MRPs tell people what that means.

Dr. Allan Rosenfeld: 1:58

Most responsible physician. So those patients that were admitted were our responsibility. We would use consultants as needed, but ultimately they were our responsibility. So I was in a call group. We did rounds On weekends I'd see patients. At nights I'd get calls to see patients. So I did that for many years. About five years into family practice, the Ontario government decided that there was over-utilization by both the health professionals and the general population, that their budget was being busted and they decided, if overutilization continued they were going to go directly into your accounts to withdraw month to month, based on how much overutilization it was and this was Bob Rae was the premier at the time.

Dr. Allan Rosenfeld: 2:43

So I came home and I talked to my wife. I said look, I'm working really hard. I was doing 10-hour days plus going to the hospital to see patients and at the end of the month I was seeing withdrawal on the fee-for-service deposits that I was getting. So I got frustrated. I grew up with a family business, which I'll talk about. We ran a lumberyard and I thought I love medicine, I love patients, I love being with people, I love being a family physician, but I need another niche. So that's when I went back to McMaster in 1993 and did my diploma of occupational health and safety.

Dr. Michael Koren: 3:19

So interesting,

Dr. Allan Rosenfeld: 3:20

I grew.

Dr. Allan Rosenfeld: 3:21

Companies reached out, I developed a name for myself. Unfortunately, a prominent occupational physician not far from my practice passed away and I picked up a lot of his work and it just grew from that point on.

Dr. Michael Koren: 3:34

Well, good for you, good for you. So let's unpack that a little bit. So Canadian medicine is something that we talk a fair amount about in the United States, and it's usually as a criticism of US medicine, quite frankly. And I've learned from you over the years that there are pluses and minuses to the Canadian system, and you've mentioned one of the minuses, certainly from the physician standpoint. But maybe you can flesh that out a little bit for the listeners and people that are viewing this podcast.

Dr. Allan Rosenfeld: 4:06

Well, there are two models in Ontario, which is the province that I practice in. One model is a fee for service, so you see somebody, you get paid.

Dr. Allan Rosenfeld: 4:17

The average fee for the family physician was about $35 per visit. I think it's a little more now.

Dr. Michael Koren: 4:19

And the payer is the government.

Dr. Allan Rosenfeld: 4:20

Yeah, the government is the payer. As long as the patient has a provincial health care number, the doctor is guaranteed to get paid Sometimes not what you bill for, but you're guaranteed to get paid. Patient does not pay anything. The other model that we have is what's called family health organization or family health network, which means the doctor is paid a retainer based on the demographics and the numbers of patients that he or she has in their practice. So, for example, if the doctor has 2,000 family practice patients and they're mostly elderly, they'll get paid more, and if they have 2,000 patients and they're 25-year-old men, the fee is less. There's also bonuses for doing cancer screening and immunizations and things like that. So colonoscopies, pap smears, and so there's bonuses in that kind of model as well. So I practice in the fee-for-service model.

Dr. Allan Rosenfeld: 5:15

More and more doctors are doing the family health model, which the government likes because there's more understanding of what the billing is. So for me, a family for service. Some days I could go in and see 20 people. Other doctors would go in and see 100 per day, and so the government was pushing, I felt, most physicians to do the model where they were on this family health network. My family doctor right now, who I've only seen once, is in that kind of a practice. I found that the hours were limited.

Dr. Allan Rosenfeld: 5:45

A lot of these clinics bring in nurse practitioners to take up a lot of the work they have paid for by the government or the clinic. The model's been changing so I haven't even kept up on it, but you know it's fee-for-service. When you're seeing 40 to 50 patients per day, really I felt lent to. It was really hard to be a good family physician when you're seeing that number per day. On the other hand, with the Family Health Network my read is a lot of the doctors see very few patients. It may not be true for all clinics and I don't want to talk for all doctors, but I've seen clinics where the doctors are seeing 10 to 15 per day.

Dr. Allan Rosenfeld: 6:18

My daughter has several peers that have gone into medicine family practice in their early 30s. We talked about the other day about five family doctors in their early 30s who worked the Family Health Network group and after doing it for two to three years departed. Even when they had bought the practices. They couldn't continue it. A lot of the young family doctors are finding other niches as well. So if they do family practice, they're doing it two days per week and then they're finding other niches like palliative care, like Botox, cosmetic dermatology, things like that

Dr. Michael Koren: 6:51

I see.

Dr. Michael Koren: 6:51

Interesting. So from the patient perspective, I know that there's been some pluses and minuses. The plus may be lower costs and the minus may be waiting lines for certain procedures or imaging and not getting access to things that people might have access to in the US. I don't know if you want to comment on that.

Dr. Allan Rosenfeld: 7:16

You're correct. So nobody pays. You can come to Canada as a new refugee immigrant and you're here three months and you're now covered by the Ontario Health Insurance Plan here, so you're covered. If you're lucky enough to find a family doctor, you don't pay for anything. You pay for notes, return to work, notes, forms, things that aren't covered under the Ontario Health Insurance Plan, but you don't pay for anything. And even if you've been living here 60 years or you've been here three months, it's the same level of care that's provided and offered to anybody that comes here. The negative, and I'll talk about an example for me I was playing hockey in late December and I sustained a concussion in men's pickup ice hockey, if you want to believe that. I had warned the guy off a few times about being reckless. Anyways got hit. I, um. I went to the emergency room that I had been on staff on as a family doctor, not recently but till about 15 years ago, and I knew the doctor who was working, numerage the the uh, it was the one doctor.

Dr. Allan Rosenfeld: 8:15

There was 190 patients in queue waiting for one physician this is a 72 year old er physician ER physician who I knew because I had dealt with him in the past when I was doing family practice and it was about a nine-hour wait to see a physician and that's not unheard of. My spouse was recently in hospital for a medical emergency. She was admitted, the care was relatively quick to see the physicians but there were no beds so she lay in a gurney in the eMERGE hallway for 36 hours before getting a bed and that's common. When you walk through the eMERGE there's people sitting on floors, lying on floors. So the access to care can be quite limited. Access to investigations like MRIs, ct scans, can be limited, especially if it's a subacute or chronic medical problem. But if it's acute, you walk into a EMERGE with chest pain still pretty good. You have various cancers still pretty good. So if it's a really acute thing, you'll get seen. You go in with a migraine, headache or a subacute or chronic issue. You may wait hours and hours and hours. The other problem I found as a family physician and one of the reasons I left family practice two years ago is that the paperwork was becoming untenable. It was all the paperwork. The specialists refused to do paperwork so it was all falling on the family physician. You weren't really paid for it or you could bill whatever nominal fee you wanted that your patients would pay. But I was finding patients that had been admitted under the care of specialists um were coming back to see me in my office and the follow-up with the specialist was at times months later. And these were complex internal medicine cases, uh, complex cardiology, psychiatric cases, where I I mean in my practice I refer people first to see a psychiatrist. They'd wait nine months

Dr. Michael Koren: 10:09

Ooh my goodness

Dr. Allan Rosenfeld: 10:10

-and that's, that's not unheard of six months to a year. Then I'd get a consult back from the psychiatrist telling me try these three drugs, these three drugs. And, uh, you know, if you need to have me see them again, just call the office again. You have to go back in the in queue. Now there are better systems to get people in, but that's and I know they exist and they are available, but that's kind of what I was seeing.

Dr. Allan Rosenfeld: 10:30

Orthopedics, uh, geriatrics, psychiatry. The wait to see uh specialists is extremely prolonged, especially for geriatrics and psychiatry. My son has an impingement of his left hip. Um, the wait time to see an orthopod and get it dealt with is probably two years by the time you see the ortho and they get referred, you're like so in Canada, like we do provide healthcare to everybody, nobody's turned away. But you have to wait a long time at times, unless it's really acute like chest pain, cardiac stuff or stroke. But it's a long wait and I have patients who refuse to go to ER because they don't want to wait, especially elderly. They don't want to wait that 9, 10, 12 hours Every emerge here is just security everywhere, because I gather they've had patients that have just lost their minds in these emerges.

Dr. Allan Rosenfeld: 11:24

So the system is, in Ontario at least, is buckling, to say, to put it nicely. At least that was my perspective from two years ago. Um, even getting family doctors to complete forms in occupational medicine is at times problematic, so a lot of we're hiring nurse practitioners to do the work they don't want to do and um, so yeah it's, it's.

Dr. Allan Rosenfeld: 11:43

it's a bit of um chaos and I don't see how it's going to be fixed in the short term. The current government government I do not think values family physicians for sure they don't value them. I don't know how it's going to get fixed unless we privatize, and I don't think that privatization will occur in the near future.

Dr. Michael Koren: 12:02

Got it? Yeah, interesting perspective. Not what we hear in the US media very much about the Canadian system. Canadians are well known for their patience, but even Canadians have some limits in terms of patience when it takes two years to see an orthopod. So interesting perspective. One of the other things that comes up is using a Canadian pharmacy. So drug costs are quite high in the US, as you know, and often they're less in Canada. Do you have any insights into that? Should US citizens and US health care patients be concerned about using Canadian pharmacy?

Dr. Allan Rosenfeld: 12:39

I haven't ever had any issues with that, Mike. I mean the pharmacies. There's two big pharmacies here. It's almost like a monopoly. There are small independents but there's two huge ones in Ontario and I haven't had any issues with distribution of any medication.

Dr. Allan Rosenfeld: 12:56

Some of the drugs that, for example, I take ranitidine. It's no longer, it's not sorry. Health Canada supports the use of it. In the US they do not. So there's drug differences in terms of what we carry. I've never seen an issue with any pharmacy.

Dr. Allan Rosenfeld: 13:13

There is, I think, a conflict of interest.

Dr. Allan Rosenfeld: 13:16

Maybe that's not the right word, but the pharmacists here are also paid to do what's called med checks and that means if somebody walks in and they're on three medications or more, from what I understand, the pharmacist can pull them aside and review the medications and talk about any potential drug interactions or complications or side effects. And they're paid by the Ontario Health Insurance Plan and I think it's $65, something like that, which is more than I would get for assessing somebody for congestive heart failure or post-surgical, and it would take probably less time. So I feel like the two pharmacies here. They're good. The pharmacists that I've dealt with are very professional. They're very hardworking and they work pretty hard by the companies they work for, but I have not had any issues with and I can't see if an American comes here to get their medications. I think they can be comforted that they're probably going to get good care from the pharmacists and the medications are what they are. But keep in mind, we won't get every medication that you have there

Dr. Michael Koren: 14:14

Just for the listeners,

Dr. Michael Koren: 14:15

ranitidine is a drug for stomach acid and it's called an H2 blocker and it's been replaced by proton pump inhibitors by and large, but it's a good old generic drug that probably works pretty darn well.

Dr. Allan Rosenfeld: 14:31

It works amazing and yet I question Health Canada as to why the US pulled it. Every other country in the world, except for two or three countries, has pulled it and as long as they do ongoing checks of that drug, and when it's at a pharmacist, they test the drug for NMDA, which was a potential carcinogen when the drug was overheated or left in shelves and got hot. So not all the drugs that you have and I would say a large portion that you have are not supported by our healthcare system or supported by Health Canada, and some that are are not

Dr. Michael Koren: 15:05

Supported, meaning they don't pay for it, yeah?

Dr. Allan Rosenfeld: 15:09

in Canada over 65, ontario Drug Benefit pays for drugs that are on the benefits Not all drugs, but drug that's manufactured drugs that are on benefits. So after 65 you don't have to pay for medications, except the first month you have to pay a $100 retainment stipend. So drugs are covered over 65.

Dr. Michael Koren: 15:15

Yeah,

Dr. Michael Koren: 15:15

in places where they found very very low levels of carcinogens

Dr. Allan Rosenfeld: 15:37

Correct.

Dr. Michael Koren: 15:38

-and for that reason there was some concern about continuing to use them.

Dr. Allan Rosenfeld: 15:42

Correct.

Dr. Michael Koren: 15:43

But if you happen to be on ranitidine, there's probably no great acute risk. Talk to your healthcare provider about it. But that's the reason why it's been quote pulled from certain parts of the world.

Dr. Allan Rosenfeld: 15:55

Right, and there's famotidine hydrochloride, which we call Pepsid which in the US on the shelves is called Zantac, which is the trade name for ranitidine, is now available and it's another H2 antagonist which is supposed to be as effective but did not work for me.

Dr. Michael Koren: 16:10

Gotcha, okay Well in any events. So moving on to your career, which I find super fascinating, tell us a little bit about what you do as an occupational medicine expert. Who your customers? What's your day-to-day like? And you mentioned that you've moved out completely from family medicine and is it good living You're supporting yourself? Tell us a little bit more about how things are going.

Dr. Allan Rosenfeld: 16:34

So occupational medicine is not covered by the government. They're trying to get it, they're trying to get a code for billing through Ontario health insurance, but it's not covered. So I went back, did my postgraduate training. I then developed relationships with various corporate clients, industrial clients, so it's a mixture of lots of stuff and my son, who's trained in Australia, is now working with me as well, and my daughter, so it's a family business. It's got her MBA and she runs the business side of it and so I deal with.

Dr. Allan Rosenfeld: 17:03

I guess there's two major, three major aspects to it. We do pre-employment exams, so companies that are hiring employees that are concerned about baseline hearing, baseline pulmonary function testing, whether there's a baseline medical illness or physical illness that will make them incapable of doing the job they're being hired for. I do aviation medicals for Transport Canada, so I examine pilots for Category 1, which is commercial, and Category 3, which is um, private pilots. I I do work with health canada, so that's canadian server board as agency and transport safety board um which be compatible with your TSA um. I do disability management for short term for lots of the clients. I've been with some clients 30 years plus, which which in my area, anybody that lasts more than six to eight years because it's very political, especially disability management. I've been with two clients one 30, one 20, and one 16 [years], which is unheard of, so I pride myself on the fact that I have longevity with these corporate clients. I stick to medical. I never get don't get pulled into the political stuff, but I understand that it exists.

Dr. Allan Rosenfeld: 18:13

We also do medical surveillance for a number of employers. So what that means is Ontario has a number of substances, which are called designated substances or chemicals, which are being used in the manufacturing process and they're known to be biologically harmful if levels in the body go up beyond a certain point. So we do blood testing, urine testing, pulmonary function testing. We do hearing screening if the employer has a lot of noise, and that's also a big part of our business and we've been growing. We have contracts with US companies that do a lot of work out of Toronto, where a lot of the work is, and so we do medicals for marine medicals for companies out of the US that have employees here, and so, yeah, so it's been growing and I developed expertise in it. Now I have my son working with me and my daughter working with me.

Dr. Michael Koren: 19:04

That's exciting.

Dr. Allan Rosenfeld: 19:05

It is very competitive. We have to go into RFPs, which is requests for proposals, we have to put in bids, and it's competitive, but I would say it's been relatively successful.

Dr. Michael Koren: 19:21

I've heard very positive things about your business success and your acumen, so congratulations on that.

Dr. Allan Rosenfeld: 19:25

And it's not covered by the government. So I can go in and set the tone, the price Keeping in mind there's competition. I can set the price. The price keeping in mind, there's competition, I can set the price, the fee schedule.

Dr. Michael Koren: 19:35

Well, good for you, and it sounds like something that gives you great satisfaction from a number of perspectives.

Dr. Allan Rosenfeld: 19:42

The medical surveillance it absolutely does when I can pull somebody out of the workplace where there's been exposure. And we're looking at chemicals like isocyanates, asbestos, lead recently. So examples of things we benzene is another one we have a client with. So it's great if I can actually mitigate any potential risks to employees.

Dr. Michael Koren: 20:04

Well, in our show notes we'll definitely put a contact number and information to get in touch with you and your company about any kind of occupational medicine issue. Or if you want to just state what the best method is to get in touch with you and your company about any kind of occupational medicine issue, or if you want to just state what the best method is to get in touch with you, please use this opportunity.

Dr. Allan Rosenfeld: 20:20

You can reach me through our email address at OCCDOC. Occdoc, it's easy. Occdoc at Rogers R-O-G-E-R-S dot com, and my office number in Canada is 905-828-6061. As I said, we do have contracts with US companies as well.

Dr. Michael Koren: 20:39

That's great, so let's segue a little bit. The other thing that's incredibly impressive about you is you've actually written a book about your path and it's fascinating, and maybe you can share a little bit of that journey and what led to writing the book with the audience.

Dr. Allan Rosenfeld: 20:56

So early on in my career I was a medical consultant on a television medical drama show called Side Effects with the Canadian Broadcasting Company. It lasted two seasons. I actually contributed a storyline to season two. It was canceled about halfway into season two. It was at the same time that Michael Crichton was doing ER and I think it was Chicago Hope was the other big medical show that was going on.

Dr. Allan Rosenfeld: 21:22

So I got into writing. I wrote for a number of medical magazines and journals. I won an award for best short story in one magazine. One story was picked up by three magazines. It was called Cardiologist for a Day where I was on an airplane and somebody had some cardiac event and I brushed up to the front and I pushed the two guys aside and, unbeknownst to me, I had just graduated and one was a cardiologist and one was a thoracic surgeon. I was like get out of my way. So some of the stories are really sad, some are funny, and then I kept writing. I, my parents, were new immigrants to Canada after the Holocaust. They came to Canada in 1951. They were sole survivors of their familias, after the Holocaust.

Dr. Michael Koren: 22:03

What area of Europe did they come from?

Dr. Allan Rosenfeld: 22:03

They came from from Poland. Ukraine and my dad was Ukrainian, my mother was Polish.

Dr. Allan Rosenfeld: 22:14

My mother would have been 100 yesterday. She died at 98. So I wrote a book of short stories 30 short stories. That's called Holocaust Lumber. I can show you that cover there, if you can see it and I self-published. I probably sold 5,000 books. It's available on lulu. com as an ebook. I've had people from all over the world that have read it and been touched by it. I have about a dozen super fans who write me emails every few months to say why aren't you writing more and how much the book touched them.

Dr. Allan Rosenfeld: 22:51

It's really a first-generation Canadian book in a lot of ways, about being a child of first-generation Canadians and all the expectations that were put on me to be successful and to be a physician, because nothing they wanted more than for me to be a doctor, and one of the stories talks about that that my mother was in a concentration camp called Majdanek, which I visited in 2012 with my wife, and she said and maybe she was her perceptions were inaccurate, but she said that she thought the doctors were treated better by the nazis during world war ii in the concentration camp. So I got pushed and pushed and pushed to be a physician. That's one of the stories, and so I wrote the book into a play for the Jewish Canadian Playwright Contest in 2019, and I finished third out of 25. It's my first time ever writing a play, so I take a lot of pride in the fact that the book is sad. It's funny. It does touch a lot of people. At times, some people are really taken with it. Recently, I've had two high school acquaintances that I haven't literally seen in 50 years reach out to me via Gmail and tell me how much I like the book.

Dr. Allan Rosenfeld: 24:08

I was at a wedding a year ago and a woman comes up to me. She's probably in her mid-80s and she says is it you? I had no idea who she was. I go what do you mean? She goes. Are you Allan Rosenfeld, the guy that wrote that book? I go, yeah, she goes. Oh my God, can I sit down with you? I read it four times. My book club has read it, so I've gone to book clubs as well. Two library systems in Canada bought 20 copies the Mississauga Library and Cape Breton in the East Coast.

Dr. Allan Rosenfeld: 24:34

I actually went to Nova Scotia and spoke at Pier 21, which is in Halifax, about the book. There were 400 people there, including politicians. You could have heard a pin drop. And then we flew up to Sydney, Nova Scotia, which is about five hours north and north of Nova Scotia, and the RCMP, about 300 people. So I take a lot of pride in writing a book. I've almost finished the second book. It's more of a wonder year. It's the coming of age, sex and drugs and bullying and all the things that kids in the area that I grew up in had to deal with. So yeah, and it's a lot of reason as to why I became a physician and why I actually left family practice to run a business like occupational medicine was because of that lumber yard.

Dr. Michael Koren: 25:27

That's a tremendous story. Thank you so much for sharing that. That's wonderful and I'll definitely have to get a copy of the book and read it myself. Fascinating stuff. So again, terrific comments, and I love that you share that with the audience. Some of it's very personal.

Dr. Michael Koren: 25:47

I know it's probably a little bit hard to share, but that's wonderful that you have

Dr. Allan Rosenfeld: 25:51

I just want to point out, we talked aboutthe healthcare system in Ontario. We have extremely intelligent, dedicated doctors and nurses and staff at our hospitals who work so hard in such long hours, and they certainly are not the reason that the healthcare system, from my perspective, struggles. They are amazing and my recently a family member's care, when she did eventually get on the floor and even in the eMERGE, was spectacular from the perspective of the medical care and the nursing care.

Dr. Michael Koren: 26:19

I'm going to conclude with one last thing is again to thank you for your participation, Thank you for sharing these great insights and also point out to the audience that you're doing this under tremendous emotional distress at the moment. And I say this because I know that Allan is a passionate Toronto Maple Leafs fan. And for those of you that don't follow hockey, the Toronto Maple Leafs have been one of the hard luck stories of the National Hockey League in that they have not won the Stanley Cup since 1967. They are in the playoffs playing the Florida Panthers. I happen to be in Florida as we speak. I'm not a Florida Panther fan, but I am a Floridian, so I have that allegiance and unfortunately Toronto is facing an elimination game today in Florida, so you must be on edge right now. This must be very, very difficult to even talk to me, given the circumstance.

Dr. Allan Rosenfeld: 27:15

You know I can't even, I don't even want to talk about it, like my, one of the things in the book that I wrote is hockey. Maple Leaf hockey was so important to new immigrants coming to Canada. They identified with our culture and our country through the Maple Leafs so I grew up with it from the time I was five or six years old, so watching an organization and watching a team that continues to stick with the same group nine years out and always eliminating great, great hockey players. I play hockey, great hockey players, great young men, very talented, but they're not built for the playoffs, so I don't want to talk about it. Florida is an amazing team and that's what we should be trying to reach.

Dr. Michael Koren: 27:56

Well, one thing I will say is I remember growing up in New York and I was a hockey fan still a New York Rangers fan and I used to watch the Rangers play in Toronto on TV and I noticed that everybody in the arena was wearing sport coat and tie and I thought it was interesting how formal people were in Toronto even going to a hockey game. Now that, unfortunately, has changed. When I was watching the game on Wednesday two days ago, I noticed that finally, people in Toronto are now wearing jerseys like the rest of the world when they go to the game. But it took a little while.

Dr. Allan Rosenfeld: 28:30

Yeah, well, I think a lot of those season tickets are corporate through corporations, and so, yeah, that's why. But I was at a game I was at the Ottawa game where they lost 4-0. We were sitting row two Again. The power, the speed, the finesse of that game. Those kids take a beating, but I don't know, I think it's over tonight, Mike. I think it's over for the Leafs tonight.

Dr. Michael Koren: 28:51

Okay, well, I'll be rooting for you, my friend. Thank you Well, Allan. This has been delightful. Thank you for being part of the MedEvidence family, and we'll definitely bring you back to talk about something else relevant to your many areas of expertise.

Dr. Allan Rosenfeld: 29:05

Thank you so much. Thank you for having me.

Announcer: 29:07

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