Transcript
Will: [00:00:00] Knock,
knock,
hi! Knock, knock, hi! Hello and welcome to Knock, Knock, Hi! with the Glockenfleckens. I am Will Flannery, also known as Dr. Glockenflecken. I am Kristen
Kristin: Flannery, also known as Lady Glockenflecken. Do you guys like
Will: money?
Kristin: Do you like money? I, I, sure. You need money. You need money? Yeah. It’s good to have money. It is good to have money.
It makes things easier. We’re talking
Will: about money. We’re talking about money today. We are going to be talking to Jimmy Turner. who is the chief medical officer and co founder of Attend, a financial platform for physicians. He is very much into, he runs a podcast. It’s called Money Meets Medicine. Um, and, uh, is the author of the Physician Philosopher’s Guide to Personal Finance.
So he’s Definitely in this world, you talk a lot about [00:01:00] why are like physicians so averse to like talking about money I mean, I think everybody’s kind of averse to talking about money, but Doctors in particular and he focuses on physician personal finance Um, and so which is not something
Kristin: you ever get to learn about.
Will: Yeah, exactly and so we talk about a variety of things disability insurance and we also start talking a little about the U. S. healthcare system with regard to private equity. Yeah, the bad word, private equity. Uh, if you’re interested in our thoughts on that, that’s, you can expect that you just
Kristin: gave away your thoughts on that.
Will: I mean… Do I like it or not? Who knows? We’ll have, you’ll have to listen to find out. Maybe it’s wonderful. Maybe it’s something sent from hell. I don’t know. Um, but anyway, you have to listen. But this does, um, bring up a video series that I, um, am doing this month.
Kristin: Yes, very timely coincidence
Will: here. 30 days of U.
S. healthcare. That’s right. [00:02:00] So, uh, I spent, uh, pretty much all of August, uh, writing out all of these healthcare, U. S. healthcare system related skits, uh, and now every day I’m releasing one. And so, uh, that covers just everything from like deductibles and copayments and, uh, but also things like, uh, private equity and, um, uh, insurance denials and vertical integration, just all kinds of stuff.
All
Kristin: the things that make U. S. healthcare so special.
Will: Yeah, that’s right. Exactly. And I, I, I, I’m doing it this way to just try to, to, to bring a lot of awareness. and education Also make people laugh, maybe cry a little bit.
Kristin: Well, you
Will: laugh so you don’t cry. Exactly. Uh, and so hopefully people are learning a thing or two from from seeing all these videos and um, i’m excited about it been working hard on it and uh, [00:03:00] And so, um, I think so far it’s going pretty quick.
Yeah, so nice job. Yeah. Thanks. Thanks
Kristin: You didn’t like that. You didn’t like accepting a compliment there. Yeah, that made you uncomfortable. I appreciate it. Thanks.
Will: Oh, a compliment! Gah! No, I appreciate that. Especially coming from you. Thank you. No, I appreciate that. But let’s talk. Should we? Let’s get into it.
Should we? Yeah. Let’s talk about, um, let’s talk about finance. Let’s do it. Oh, you ready? Okay, here we go. Are you? I’m ready. Okay. Here he is, Dr. Jimmy Turner.
Today’s episode is brought to you by the Nuance Dragon Ambient Experience, or DAX for short. This is AI powered ambient technology that helps physicians be more efficient and to reduce the clinical documentation that leads to so much burnout in medicine these days. To learn more about how DAX can help reduce burnout [00:04:00] and restore the joy of practicing medicine, stick around after the episode or visit nuance.
com slash discover. Dax, that’s N U A N C E dot com slash discover D A X. All right. We’re here with Jimmy Turner, Dr. Turner, thank you for joining us. It’s a pleasure to talk with you again. Yeah,
Dr. Jimmy Tuner: likewise, super excited to be here and, uh, and to officially be on a. Knock knock. Hi.
Will: Yeah, it’s uh, you know, I’ve I’ve I came on your podcast Not too long ago and we talked about Something that makes my me and probably lots of physicians uncomfortable, which is money.
Sure. Yeah, totally It’s, why is that? What, are we special as, as like, as people in medicine? Or is this just like kind of across the board? Everyone just like, just money just makes people uncomfortable. I don’t know if we’re special or not. You have to think we’re special usually, but we might [00:05:00] not be. Yeah,
Dr. Jimmy Tuner: yeah.
No, it’s, that is a doctor thing to think we’re special. But, uh, yeah. It’s interesting, you know, some of it certainly is just like general cultural stuff, right? Like you just don’t talk about money, you don’t talk about politics, you don’t talk about religion. Like those are some, you know, taboo topics, right?
Um, but I will say that there are some unique things about doctors, right? Uh, one of them being that there’s this idea in medicine that you can’t go into medicine for any other reason other than altruism. And to talk about money means that you’re making patient care or the business of medicine financially related.
Um, which, which is really unfortunate because, you know, I’ve, I’ve had opportunities to, to speak and teach about money for, for years now. And sometimes, I mean, it’s not infrequent, uh, it’s an uphill battle and people will say no. And when I ask them about it, they’re like, well, you know, what, what if we teach people the wrong thing?
Right, they’re scared to death of it, um, which as an anesthesiologist, I find hilarious because like if we teach people the wrong thing about what I do, people die, but we’re concerned about teaching them about [00:06:00] money because God forbid they, you know, they do a backdoor Roth IRA, um, you know, so it’s, uh, it’s always been interesting to me, but yeah, it’s taboo and doctors financial literacy is abysmal, uh, so I think people are also embarrassed to talk about something.
You got a really intelligent group of people who… You know, uh, have to admit that they probably don’t know much about something, which is pretty hard.
Will: Yes. I, I know that my financial literacy coming out of, um, college wasn’t great. Part of the reason why Close to zero. Part of the reason why I chose to go to Dartmouth for med school over, um, over Texas.
We’re as a public school for in state tuition and state tuition. I chose 50, 000 per year over 10, 000 per year, but that’s okay. It was cause I got to stay with my beautiful wife here. So
Dr. Jimmy Tuner: I knew nothing about it back then either. So, you know, I think a lot of us come in to, to medicine graduate school, you know.
Post college life knowing very little
Kristin: and I don’t think people should be so ashamed of not knowing You know, I know with doctors that you’re can I pride yourself on [00:07:00] being the smart one or you know, it’s very competitive So you can’t ever let people know when you don’t know something But I don’t think anyone really knows anything about money just generally speaking because we don’t get taught that In school, you know, very best you might get like a macro or a microeconomics class in high school, and that’s the extent of it.
Yeah, exactly. There’s no personal finance.
Will: There’s no… Yeah, what do you remember from your macroeconomics class? Right. As a high school senior? Nothing.
Kristin: So yeah, so I think most people are in the same boat. Yeah,
Dr. Jimmy Tuner: yeah, yeah. It’s interesting because when they look at this, the American Psychological Association does study every year or two, and they basically show that the number one stressor in all American households is money.
Uh, and yet, we don’t do much about it, and that’s probably why, right? We don’t learn about the stuff in high school or college or, you know, I mean, if your parents didn’t teach you, there’s a really good chance that you know absolutely nothing about this subject. Uh, so, yeah, I think it’s super common.
Will: Now, you have a, an, uh, An interesting path to get to [00:08:00] where you are now, where, you know, you’re the chief medical officer, co founder of ATTEND, this, you know, financial platform for physicians, and, um, uh, but a lot of your story also, probably a lot of people can relate to, and it’s, you, you label it, Uh, part of your story as this, uh, arrival fallacy, which is a term I never, I’d never heard before.
Um, but I absolutely relate to it and I think a lot of, a lot of people, especially people in medicine can relate to this idea. So could you just tell us a little bit about that? First of all, did you coin that term? Can
Dr. Jimmy Tuner: I give you that credit? No, I wish you could. It’s a Harvard psychologist, Tal Ben Shahar.
It’s a super interesting concept and, and, you know, most of the time I talk about it, doctors are like, Oh my gosh, you know, this is me. And actually I think a lot of, a lot of people, even outside of medicine, but, um, but yeah, it’s basically this idea that, um, once you attain a certain goal or you reach a certain milestone that, that’s when you’re going to be happy.
Right. And, [00:09:00] and so there’s this arrival that you’re anticipating. Everything that you’re going through in life, you’re like, this is going to be worth it when I get there. And so the medical journey, right, you’re like in college, you’re working, you know, looking forward to getting to medical school, and you get into medical school, and you know, that, that’s supposed to be the answer, and then it’s super hard, and you’re drinking, you know, information through a, you know, a fire hydrant or a fire hose, and all of a sudden you’re like, well, you know, but when I become a doctor and I get to residency, That’s when things are going to be better.
I get to get rid of the short white coat. If your school does that, mine did. Uh, you know, and get the doll in the long white coat. Still have mine. Still
have
Will: my short white coat. You didn’t burn it? Are you kidding me? What if TikTok had been around? I had no idea. Like, now I use it on a lot of my videos.
Kristin: Mostly he was just lazy and it worked out well. There
Dr. Jimmy Tuner: you go. Yeah, you know what? I mean, lots of people do interesting things with it. You made videos from it. That’s right. Um, but yeah. And then you get burned out in residency and you’re like, you know what? When I make an attending physician paycheck, That, that’s when it’s going to be worth it, and then it’s not, right?
And you’re like, when I buy the house, when I buy the car, and so it really is more like what Gertrude Stein said, right, when she [00:10:00] said there is no there there. Um, you know, once you get there, this, this idea of everlasting fulfillment is a bit of a fictional narrative that unfortunately we tell ourselves and then set ourselves up for this arrival fallacy, and it’s called a fallacy for a reason.
It’s not real. Um, and so, you, you basically, Look for the next thing, you’re constantly looking for the next thing, so instead of enjoying the journey, you’re focused on the destination, and unfortunately the destination is not what makes people happy. Right, because when you
Kristin: get there, there’s always, you know, good things and bad things about every situation, every phase of life, right?
Like, then when you get to the destination, you are in an attending position, you look back on the med school days, and you know, you have all this nostalgia, and you think, oh, those were the good old days, you know, so I, I think. Even during the harder phases, there are some really good things about those phases.
And if you focus on those and enjoy those, you know, then it’s, it’s more fun. And it’s, it’s maybe, I don’t know if it would attenuate the arrival fallacy at all, but it would at least make your life a little better in the [00:11:00] meantime.
Dr. Jimmy Tuner: Yeah. Yeah. I think, I think switching to that, that narrative of enjoying the process is really important.
Um, and until I did that, I really had a hard time being, being happy and so I was always looking for something else. Even when I finished medicine, became an attending, I was like, oh, when I was an associate professor, when I start this business, you know, this is going to give me the financial independence that I need and then I’ll be happy.
And it turns out that, you know, it really is that way, looking at your current situation instead of looking up the mountain and where you want to be, looking back down and saying, hey, those were some pretty fun memories and look how far I’ve come. But shifting that perspective is, is really challenging for, for a lot of people.
Will: That being said, if anybody listening does know how to achieve everlasting fulfillment, please reach out to, out to us. Knock, knock, hi, at human content. com That’s right, please. We would love to know. And you and I, Jimmy, have, we’ve talked about this before, uh, uh, offline, but, uh, we, we have something in common, uh, that is financially related that I think a lot of people have [00:12:00] to go through in medicine, which is thinking about getting disability insurance.
Um, and, you know, the thing we have in common is that neither of us were able to get that. Yeah, we both failed. We both failed, uh, for probably very similar, or not similar, I mean, for medical reasons, obviously. Um, you know, I had a cancer diagnosis early on, and, um, and you, I guess, tell us, you know, your, I think it would be helpful for people to hear this, especially, you know, people just starting their medical careers, um, about what you went through with disability insurance.
Why it’s important, first of all, that’s, that’s another
Dr. Jimmy Tuner: thing. Yeah, so, you know, I would argue that disability insurance, is the number one financial task for a physician, um, and the reason why is because, you know, I can literally teach you anything you want to know about investing or paying down debt, but if you don’t have an income, it turns out that doesn’t really matter, right?
That knowledge shows, you know, it’s just completely useless. And, uh, and so, yeah, for, for me, I didn’t know anything about money up until I was, you know, basically finishing [00:13:00] fellowship. And so this happened during my fourth year of medical school. My wife and I, we had our first kid, Grace, she’s now 12, which is insane, but when Grace was born, my wife and I were like, hey, let’s do adult things and get term life insurance, right?
And had no idea who to talk to, and so it turned out that one of the brothers from my medical school classmates was an insurance agent. I was like, oh, perfect, I can trust this guy. And so approached him, and he’s like, yeah, absolutely, we can get you term life insurance, but you should also get disability.
And remember, I know nothing about money at this point, so I’m like. I don’t have an income, I don’t exactly understand why I need this, um, but you know, you’re the professional here. I said no a few times, got talked into it, and long story short, I’ve got an essential tremor, take propranolol for it, got diagnosed hilariously while I was doing a lumbar puncture as a fourth year med student, and my hands were shaking a lot, and the neurology rest was like…
Hey, uh, your hands shake a lot, I was like, doesn’t, like, don’t everybody’s hands shake when they’re nervous? He’s like, yeah, but that’s a lot. And, uh, and so got the propranolol, treated it. But the problem was, is that, you know, I basically got [00:14:00] denied disability insurance because I had a medical problem. And with that at the time, seemed like not a big deal.
I know nothing about money, but I get to training and then there’s something called the guaranteed standard issue policy, which. Fancy words to mean that they don’t care about your medical history. You don’t have to go through underwriting. They don’t look at your medical history at all. The only stipulation is you can’t have been disabled and you can’t have been denied.
And so since I got denied as a fourth year medical student because an insurance agent was trying to make money off of me, uh, to this day, I can’t get disability insurance. And so, you know, and that’s one of the reasons why if you have a medical history and you’re in training, you have to check into the guaranteed policy, uh, because it’s super important and it’s one of the only ways you can get it if you have.
Medical issues like I did and so yeah, so to this day I can’t get it Um, I am so uninsurable at this point that it is, uh, not funny, but kind of funny Yeah, two
Kristin: cancer diagnoses and a cardiac arrest? You want to talk
Dr. Jimmy Tuner: about uninsurable? Join the club, man. We’re in the uninsurable club. Yeah. Co founders. Co
Kristin: founders, yes.
What is the earliest people can [00:15:00] get disability insurance because that’s one of those things that you need to buy it before you need it, not when you need it. So when is the first chance people
Dr. Jimmy Tuner: can buy it? Yeah, people ask me all the time, like when should I get disability insurance? Now I say the day before you get disabled, but since you don’t know when that’s gonna be, it’s when you have an income.
You can certainly buy it before then, but then you’re paying for disability, you know. Premiums with loans, right? So, as soon as you become, you know, someone in training and you have an income, disability insurance is something that should be on your radar because you’re always the most insurable as you’re ever going to be right now, right?
And, you know, well, you didn’t expect to get cancer, you know, I didn’t expect to get Graves disease and anxiety that was associated with that after my tremor, uh, turns out propranolol masks Graves disease. When I ran out of that, that was, uh, that was a story too, but, uh, but yeah, so when you get an income…
That’s a step one question, I think. Oh, man. Yeah, I was on a golf course, I had a panic attack with my buddy Mike, and so, uh, you know, when that happened, I like literally just no propranolol, like I’m, you know, super anxious, like, you know, just impending doom, so I had to shotgun a beer. And [00:16:00] uh, that was my, my immediate treatment, my medical diagnosis and treatment at the time
Kristin: on a golf course.
Yeah, Shotgun a beer. Yeah.
Dr. Jimmy Tuner: Shotgun a beer if you don’t have propranolol. That’s, that’s the solution. Um. We do
Kristin: not give medical advice on this podcast.
Dr. Jimmy Tuner: That’s right. That’s right. But, uh, but yeah, so as soon as you have an income, I mean, that’s when it needs to be on your radar, um, because that’s when you have, you know, an income producing asset to protect.
Quick
Will: follow up, follow up question to that. How did the lumbar puncture
Dr. Jimmy Tuner: go? You know, the, the rest is like, I mean, you, you got it. It was good. I mean, I don’t remember it was like a champagne tap. Uh, you know, no RBCs in the, uh, in the fluid, but it’s hilarious because now like I’m a regional anesthesiologist.
I do spinals and thoracic epidurals. Like all of the time and so, uh, but yeah, it was, uh, it was successful. Maybe a Merlot
Will: tap. That’s right. Something like that. Yeah, it was
Dr. Jimmy Tuner: pretty bloody. It’s true. Oh boy. I’m just kidding. I don’t
Will: remember at all. Yeah. It’s just one of the things you probably blocked out of your memory quite a while ago.
Um, well, you know, I want to take advantage of having someone that actually knows [00:17:00] something about like money and finance here. Um, and so there. It seems like even more so now, there are some financial things in medicine that are like happening and, uh, um, it’s, it’s, uh, one thing is, well, the first thing I wanted to bring up is this issue of student loan repayment, uh, which is, um, the now starting to, after the, the deferments were going on during the pandemic, right?
It’s going to be kicking in again. Is that right? Yeah. What’s the date on that? Isn’t that
Dr. Jimmy Tuner: like later this fall? It was September. Now it’s potentially October. Oh, they might push
Will: it back a little bit
Dr. Jimmy Tuner: more. Yeah. But September is the, was the official word originally.
Will: Uh, and so do you have any advice for, for trainees who are kind of, that’s about to kick back in and potentially be a big change in
Dr. Jimmy Tuner: life?
Yeah, I mean, one of the pieces of advice I’d tell you is to not [00:18:00] sit on it, um, and the reason being is that when forbearance ends, and this is true going forward, right? So if you’re an intern from, you know, July till January, you have a six month grace period. But once that grace period ends and forbearance ends, you know, coming this fall, You get put in what’s called the standard replacement, or excuse me, the standard repayment, uh, program and so what, what happens there is you basically get like a four figure check in the mail or, you know, bill in the mail and like, hey, you owe us 2, 500 because it basically is figured out by how, how much would you have to pay to pay your own debt off in 10 years.
Right? And so, you know, the people that don’t enroll in an income driven repayment program before these payments start back and who have been in forbearance and were never in a program, um, They will get a, you know, multiple four figure bill in the mail potentially that wipes out their entire residency income for the month.
If not more. Yes, exactly. And so, uh, that’s fair. So don’t, don’t sit on it, make a plan, right? And um, and so, you know, the Biden administration came out with, you know, this new save plan, uh, saving for a valuable education and, you know, in order [00:19:00] to simplify things and unfortunately student loans still after this plan are incredibly complicated, right?
So if you are. You know, a single resident who is more than 12 months away from graduating and you don’t have any outside income, save is going to be the right plan 95, 97, 99 percent time. I mean the vast majority, right? But if you’re in any of those complicated situations, you’re married, your spouse has loans, your spouse has income, you live in a community property state, you know, like any of these things can kind of make it more complicated.
And so, you either need to become like a miniature student loan expert and, you know, do it yourself and figure it out, which is fine, certainly a route, or you need to get help with it. Um, but either way, the, the ostrich, like, you know, putting your head in the sand approach is, which is what most doctors do with most, most financial topics, including yours truly.
I forbear on my debt for five years, watched it increase by 150 percent because no one taught me about money back then. And so now, I know better and tell people, hey, don’t be like me. Don’t screw up your disability insurance and don’t screw up your student loans because I did both. [00:20:00]
Will: That’s two things right there.
There you go. We’re giving a lot of good advice. Are there any other big ones? Like, like the big mistakes that, that I’m asking mainly for myself as well, honestly.
Dr. Jimmy Tuner: So one of the biggest mistakes people make, well, there’s a few, I mean, you could go over several, but one is not, not believing in public service loan forgiveness.
There’s a lot of people out there like, this is not gonna work. It’s not gonna happen. When I get there, the government’s not gonna forgive. And you know, I would say to that a few things. One is that there’s a master promissory note that you signed. It’s a contract basically between you and the government that says that PSLF is going to exist and they’re going to provide it for you.
Most people get grandfathered into changes. And then in addition to that, if you really don’t believe it, right, just save up money on the side and if you get forgiven, great. If you don’t, you’re closer to retirement. Fantastic. Um, so that’s one. The second one, and this is devastating. I have a friend who owes 400, 000 out of his pocket because he refinanced instead of pursuing public service loan forgiveness.
So a lot of people, well meaning, really good people, like, [00:21:00] hey. I had a really good experience with company X and so you should refinance with them because I really thought that experience was good and what they don’t realize what they’re doing is saying refinance your student loans which for a lot of people now particularly with save coming out is not the right thing to do and so they’ll refinance their debt privately not realize that Forgiveness is no longer an option.
They’ve burned that bridge. It’s a catastrophic, you know, multiple six figure mistake for many people.
Will: Yeah, because they’re chasing after the lower interest rates. Although, I don’t know if you
Dr. Jimmy Tuner: can get that
Kristin: right now. Which sounds like good advice, but it turns out it’s, it’s not if you don’t know all
of
Dr. Jimmy Tuner: the little…
Yeah, and there’s lots of little things, right? Because a lot of people say, Oh, are you getting forgiveness or are you going into private practice? And it’s like, well… That’s actually a false dichotomy, right? Because 80 percent of hospitals qualify for public service loan forgiveness. So you can be in private practice, but if you’re employed by the hospital.
Right. Then you can still qualify. Um, and so there’s all these little nuances and caveats, which is why you can either learn all this stuff or [00:22:00] get somebody to help you with it, but you have to make a plan. So
make
Will: sure, bottom line is, before you do any refinancing, any changes to your student loan situation, find out if you’re working for a…
Nonprofit or whatever a qualifying organization
Kristin: What advice do you have for physician tik tok youtubers? Oh,
Dr. Jimmy Tuner: yeah. Yeah Physician tik tok. Just
Kristin: curious, you know, theoretically.
Dr. Jimmy Tuner: Yeah. Yeah, don’t spend it all don’t spend it all in one place. That’s right That’s uh, yeah, I mean, it’s really interesting having it all on X
Will: Is that, you know, plenty of dollars a month I think I can afford that, but,
Dr. Jimmy Tuner: you know.
I can’t, I can’t bring myself to call it X. It just feels weird.
Will: I know, it feels, it felt weird saying it. I don’t know how I feel about that. At first I didn’t know what you were
Dr. Jimmy Tuner: talking about, and I was like, oh yeah, X.
Kristin: He’s talking about drugs, which also don’t
Dr. Jimmy Tuner: spend it on. That’s right, that’s right. But, you know, it’s, non clinical income is, is actually becoming a, you know, a bigger and bigger thing, right?
You know, there’s Facebook news with a hundred thousand doctors in it that focus exclusively on [00:23:00] that. Everyone’s
Will: talking about the side gigs.
Dr. Jimmy Tuner: Yeah, the side gigs, they’re a big deal. And so, it is interesting watching what people do with that money. Some people, you know, they go part time, right? So, and that’s certainly the route that I took.
Um, you know, increased, you know, non clinical income outside of medicine. And, you know, right now I practice two days a week doing anesthesia. And amazingly, I like my job again. You’re just doing cataracts, right? Exactly. I just do 40, 000 pre op notes a day for just the iDocs. That’s exactly right. It’s an anesthesiologist’s favorite job.
Will: Yeah, I bet.
Dr. Jimmy Tuner: Yeah. If you like doing paperwork in your hand, uh, you know, cramping… But I mean,
Will: what does it, I don’t know, what does it say about the, the status of just being in medicine when that’s such a big focus now for so many people is I got to find some other stream of income so that I can not work in medicine as often as I am now.
Like, it’s not great.
Dr. Jimmy Tuner: No, it’s not. I mean, you know, the burnout numbers are super, super high and, and, you know, it’s [00:24:00] actually really interesting because, you know, we’re talking about personal finance and burnout. They’re actually winked, right? So the higher student loan burdens you have, the more burned out you are.
And then there’s all these other, you know, aspects of medicine that are burning doctors out too. Um, you know, and, and I really think that a large part of it’s related to an attack on autonomy. We don’t have the ability to, you know. A lot of us don’t have the ability to kind of dictate our own schedule, you know, are missing t ball games or recitals or, you know, dinner with our partner or, you know, even like professional responsibilities at work.
Like, how do you do your job? You know, and you have to check this box and write that note and build this way, you know, it’s, it’s, you know, really. Yeah, it’s hard, and I mean, the evidence is there, you know, people are pursuing side gigs. I mean, it reminds me of that quote, right, that an entrepreneur is the only person who will work 80 hours for themselves in order not to work 60 hours for someone else.
Yes. Right? That’s a good point. Yeah. And I know you probably relate to that if I do. Yeah,
Will: I do. Oh, yeah. Absolutely. Uh, I, and if anybody wants to pursue internet comedian ophthalmology, um, I’d, I’d be happy to have, uh, you know, [00:25:00] somebody. Yeah. Thank you. else, you know, a partner doing that stuff with me. Um, another thing that I’ve seen, uh, recently a lot of commentary about is private equity.
And this is a touchy subject for a lot of people in medicine. But I think it’s, it’s, it’s, It’s an increasing increasingly important thing to for people to be aware of and
Kristin: related to this issue
Dr. Jimmy Tuner: of autonomy
Will: Exactly. Yeah, so actually, you know what? Let’s let’s take a quick break and then let’s come back and we’ll we’ll talk about private equity
Hey Christian, you know what this is? Stethoscope. Yeah, it’s not just any stethoscope. It’s the echo core 500 digital stethoscope With three lead ECG. That’s pretty fancy. I didn’t even know they could do that. They’ve combined the ECG, the little tracing thing. The danger squiggles. Yeah, the danger into a stethoscope.
That’s pretty handy. And it’s, it’s also got 40 times noise amplification. noise cancellation, [00:26:00] and also a fancy little, uh, uh, display right here. Oh, nice. Yeah, it’s so cool. And so, uh, honestly, if I had something like this in med school, like I would not have been yelled at by as many cardiologists as I was.
That would have been nice. Yeah, it would have been really nice. Uh, we have a special offer for our U S listeners visit echo health. com slash K K H and use code knock 50 to experience echoes core 500 digital stethoscope technology. That’s E K O health slash K K H and use knock 50 to get a 75 day risk free trial and free case and free shipping with this exclusive offer.
Hey Kristen, can I interest you in a Demodex mite? No, you may not. You know what these little guys do? What? They cause Demodex Blepharitis, which makes your eyelids like red, irritated, itchy. That’s gross. Well, you can get checked out, you know. Your eye doctor can look and see if you have them.
Kristin: My eye doctor is currently covered in them.
And
I
Will: can find out for you. Oh, good. . To find out [00:27:00] more about dedex, go to eyelid check.com. Again, that’s E Y E L I D. check.com to get more information about dedex blepharitis. Don’t get freaked out. Get checked out.
All right, we are back with, uh, Dr. Jimmy Turner and, uh, Jimmy, uh, the, the thing, the reason I want to talk about private equity is because it seems like every month there’s a new private equity firm going bankrupt. And we’re seeing this now in emergency medicine. Uh, and yeah, it’s, uh, there was Envision, I think, is one of them.
And, um, the name escapes me for the other one, but, uh, they’re these big groups that are just, they’re running out of money and, and they’re filing for bankruptcy. And so. Can I, can you just help, you know, help the listeners out because you’re the finance guy here. Uh, just what exactly [00:28:00] do I mean when I say like private equity acquisitions?
What is this?
Dr. Jimmy Tuner: Yeah, so, you know, it is, and I’ll readily admit because I’m almost happy to admit when I don’t know something. So branching outside the personal finance space a little bit, right? But this is when, you know, companies that are, you know, not publicly traded, you know, a PE firm, um, you know, basically says, hey, we want to come in, we want to buy your practice.
Um, and they end up, you know, trying to structure things in a way that allows them to reap the most profit, right, while reducing expenses and at the cost of, you know, often medical care. Um, and so. With that, you know, the doctor that is working at said practice, who’s likely a partner, ends up taking, you know, some money home because of that deal because they’re paying the owners of the, the practice, which are the partners.
And so, you know, for the people that are in the practice, naturally there’s a very large financial incentive to sell it, um, but at the expense that, you know, you’re, you’re dealing with the devil a little bit because [00:29:00] on the back end, your job’s probably going to look a lot different than it does right now.
And, um, and so. You know, the, the financial ramifications, and, and you kind of have to wonder, like, is this about what we’ve been talking about before where, you know, low financial literacy, doctors don’t save a lot of money, only 10 percent of doctors have more than 5 million, you know, talk about how much that would give you every year in retirement, uh, but, you know, suffice it to say, it’s, you know, maybe enough for some doctors and maybe not enough for others.
And so, when someone comes along and offers this very large sum of money to privately buy this company and to own the equity of it to become the majority owner or the entire owner. Um, they now get to make the decisions about the company once they own 51%. Um, you know, and so it’s, it is an interesting phenomenon, and actually in anesthesia, this is actually, uh, you know, a really interesting thing, not just from the private equity side, but there are also practices that are owned by those, you know, large organizations, um, and this has happened twice in North Carolina, so I practice in North Carolina, where a group who is employed by one of those large [00:30:00] groups, so let’s say, you know, Mednax and Vision, like a very large group, whatever, um, and they have a contract with these hospitals.
And the hospital says, hey, we want to renegotiate the contract and they’re like, yeah, you know, we’re not really interested. Like, no, like we really want to renegotiate these contracts. And a large group’s like, no, like we’re not going to do that. And they said, fine, your contract’s gone. Well, all those docs work for that large company, so they now live in a city in which they can’t practice in the hospitals because that contract is gone.
But their employer is this like, you know, cloud service that doesn’t really exist in that, in that place. And they can enforce the non compete, right? And so now you have doctors that, this happened in Charlotte, this happened in Raleigh, um, you know, that live in a city that are still anesthesiologists that theoretically could still provide care, uh, but their large organization lost their contract so they don’t have a job.
Um, you know, so there’s a lot of these strange things in medicine, private equity coming in, these large organizations that, you know, don’t really fight for the doctor and don’t let them go when things, you know, go south. Yeah, huge economic pressures. [00:31:00] It seems
Kristin: to me from an outside perspective, uh, and you can tell me if this is an oversimplification or not, but it seems to me like, you know, a private equity buyout, they come to you and they offer to, to, what would it be?
Acquire your company. Um, that that. That would make financial sense for, you know, maybe people who are at the later stages of their career nearing retirement because you can have that lump sum right before retirement and then you don’t, if you’re retired, you don’t have to worry about the aftereffects of what the company is going to come in and do, right?
But that for anyone who’s not there yet. It maybe makes less financial sense for those individuals, right? And the further away you are from that, maybe the less sense it might make for you. Is that
Dr. Jimmy Tuner: accurate? Yeah, I think so. I think Will can talk to it make you stay for a little bit, right, Will? I think
Will: they do, yeah, because they don’t, what they don’t want is to like, to, to spend like 20 million on this practice and then have everybody retire, right?
So the way it [00:32:00] typically works is… They will offer you the, the, the big sum of money and then they will let you buy back shares of the company. So that you still have a little skin in the game. You’re still invested. in the success of the practice. And that’s how they, that’s how they sell. That’s how they try to get kind of mid mid career or early career physicians on board.
Um, but still you’re not owning a majority of the practice. And so yes, you do have that, uh, that equity in the company still, but you’re still not. The one who gets to make all the decisions. So
Kristin: what you’re gaining financially, you’re kind of sacrificing in autonomy.
Will: Exactly. Yeah. And that’s, and that’s the, um, that’s the trade off and why, you know, a lot of, I’ve certainly heard anytime I, I put something out there about Prevodek, cause I’ve done some videos about, uh, um, [00:33:00] you know, Bartholomew Banks, Private Equity.
Um, and it seems like every time I put a video about it, I get a, a, an email or message from somebody who’s either a med student or a resident or early career. And they’re, they’re like, so they’re concerned. They’re like, uh, this is scary, especially in certain specialties. You know, ophthalmology is one of them.
Dermatology, you know, there are certain specialties that Are more attractive to private equity. A lot of ones that have a little bit more like cash pay options, they’re, um, you know, perceived as just, there’s just a little bit more lucrative specialties that are obviously going to attract more private equity.
And so you, and you see the, the specialties that have the most private equity in them. It’s like dermatology is like top of the list. The ophthalmology is up there as well. Anesthesia, anesthesiology is a big one. Um, and so. Yeah, young people coming in, they’re, they’re concerned, they’re worried about this because [00:34:00] the worst case scenario, right, is you get, the practice gets sold up underneath you and you’re…
Dr. Jimmy Tuner: So in academics, yeah, I mean, that’s exactly right. So in academics, like my residents, you know, whether it’s, you know, a large organization buying a practice or private equity, uh, but either way losing basically the partnership track. Like they’ve got a two or three year partnership track in anesthesia and then, you know, it gets bought, you know, two years and 11 months into your partnership.
And so… It’s actually something I talk to a lot of my trainees about who are in that situation. You know, they go look at this group and like, Oh, it’s a great job. Like, it’s got everything that I want. And I’ll ask them about it, you know, uh, what happens if they get bought out? I’m like, well, you know, they say that’s not going to happen.
I’m like, okay, well, negotiations 101, right? Someone says that, you know, there’s no way that’s going to happen. It’s like, well, hey, that’s great. Then you should have no problem adding this language to my contract since it’s not going to happen, right? And, you know, and I can’t tell you how often people have come back and, and after that, it’s hilarious.
I’ll be like, hey, you know, how’d that, uh, how’d that conversation go? And they’re like, I’m not allowed to talk about it. I’m like, I guess it went well. Like, [00:35:00] no, like it’s confidential. They, you know, they got what they wanted. They’re happy. Uh, now they can’t disclose it because they don’t want everybody else finding out.
Um, but yeah, it’s, it’s a huge concern, right? And like, even, like, just working there at least, like, hey, if you get bought out, I’ve been there for a year, I get a third, right? In two years, I get two thirds. I mean, try to get something. But like, signing a contract nowadays where you have, you know, years to partner and, and potentially a buy in.
And it gets bought out before that happens. I mean, that is a lot could happen
Will: in three, two or three years. Right before the decision is made to, to buy into a practice. So yeah, it’s, um, it can be a terrifying situation for young people, but you know, it’s. Also, just fundamentally, the idea of private equity coming in and, and, and buying up all these medical practices, um…
Yeah, what does it mean for patient care? Yeah, and that’s, that’s the ultimate question, I think, for a lot of people is, uh, because, you know, for like physician owned practices, or physicians [00:36:00] are running the show, you know, at least… There, there’s some, something in that person that got them into medicine that’s not financially related, right?
Like they, they really do care. The Hippocratic Oath is
Kristin: in there
Will: somewhere. It is. It’s still, sometimes it’s a big part. Sometimes it’s, it’s, it’s diminished and it’s just a tiny part, but it’s still there. It’s still there. That motivation should still be there somewhere. But now you have these corporations that are like purely profit driven, right?
They’re coming in and have totally different motivations. And I think that’s… You know on a philosophical level kind of the the a big part of this the frustration and the And the conflict. And it’s not that they’re
Kristin: like evil people or something. It’s just that fundamentally these are different institutions with different purposes Right a health care institution is for patient care a business by definition Needs to make a profit and, and, you know, has shareholders or whatnot that they are [00:37:00] obligated to provide a profit for.
Dr. Jimmy Tuner: So yeah, it, it’s really interesting because it, it actually reminds me of, um, I think it’s Milgram who did this, uh, shock experiment. Yes. And, uh, yeah. And so, you know, if you’re familiar with that, the idea that you have a.
Kristin: I have a psychology, I have a psychology background, so I’m not picking up a lot of it.
What is the shock experiment? Yeah, go ahead and
Dr. Jimmy Tuner: explain the shock experiment. Yeah, yeah, so, um, no, that’s great, yeah, so I was a philosophy major and I love thinking about how people think, so, um, but yeah, so the shock experiment basically did a few different variations of it, uh, but the couple that I really liked, or I should not say liked, that is the wrong word.
That were interesting. That I found fascinating, although ethically problematic. There we go. Big fan of shock therapy. IRBs were not a thing back then. Yeah, yeah. This would not fly past the IRB these days. So you know, they would take people and you know, in the first iteration have them, you know, kind of physically put that person’s, you know, hand on a shock plate and then they’d walk over and they’d have to administer shocks and the shock board would be labeled from like mild to moderate to severe to [00:38:00] like XXX, like lethal.
And, um, and interestingly, you know, people would go all the way up the board if they had an authoritarian figure standing behind them that basically said, hey, the research has got to go on. And the perfect, the person would have to try to quit three or four times, even though they were told at the beginning they can stop at any point, but because they had this person, speaking of white coats, this person in a, in a white coat, authority figure telling you you have to keep going for like the equivalent of like what’s 20 bucks today.
People walked in and found out that they would end somebody else’s life if an authority figure told you to. And the second thing was that they did other iterations where they separated people, okay, you don’t have to touch their hand anymore, there’s no more physical contact, we’re gonna put you in the same room, you can see and you can hear them, right, and that rate went up because there’s disconnection.
They put them in a different room, now they can only hear them, they can’t see them. And so every step along the way, if an authority figure had told you to do something, in other words good people will do bad things in bad environments, and the further separation you have from the people you’re interacting with.
The more likely you are to cause harm. And so when you’re talking about a private equity company who exists, God knows where, [00:39:00] has never seen a patient, doesn’t even know the doctor that they, you know, work with supposedly, like if they passed you on the street, they would not know you. Right. And so there’s like 57 degrees of separation and they’re, they’re driven by profit.
And so naturally, good people, I bet the people, if you met those people at the top of those companies and you had dinner with them, you wouldn’t be like, this is the worst human being I’ve ever experienced in my life. But because they’re separated from the people that are supposed to be getting help at the bottom of that, you know, separation, you know, interaction, relationship, you know, they will do harmful things.
Um, which is extremely scary.
Will: Maybe we actually do need IRBs.
Dr. Jimmy Tuner: No. And how about that? We should create private equity IRBs. Yes.
Will: Um, and then just wrapping this up, going back to, you know, what I was saying initially with what I’ve seen lately, a couple, a few different, you know, private equity companies that own a large swath of emergency departments.
It’s obvious that. This model [00:40:00] it’s working better in certain areas than others, you know I mentioned dermatology ophthalmology where it’s gained a foothold and seems to be here to stay But in other areas you can’t you can’t just treat Medicine the same way and in emergency medicine, you know there you have to see everybody yeah, no matter what and a lot of what private equity companies do is they’ll They’ll favor certain insurances or, you know, they’ll de incentivize people from seeing, you know, low income patients.
And… And you can’t do that in emergency medicine. And so you get into a lot of, uh, trouble, like ethically and also financially because you are, you’re just starting to lose money. And so we’re, I think we’re already seeing that it’s not, it doesn’t work in something like, like healthcare. Yeah. I’m like, well, this is something that’s so important to patient care.
It just, the model, it just, it’s not, not [00:41:00] working
Dr. Jimmy Tuner: out. So. I couldn’t agree more.
Will: I don’t know. It’s uh, we’ll see where it goes. I don’t know. It’s kind of a depressing conversation, but I haven’t been able to talk about this on the podcast yet. I feel sad.
Dr. Jimmy Tuner: That’s right. It’s an important conversation to
Will: have though.
It is, for sure. Um, before we get into our game that I’ve prepared for you today, um, I do want you to tell one of these stories that you sent us, which I think a lot of people can relate to, um, about your time as an intern.
Dr. Jimmy Tuner: Um, Yeah, yeah, so when I was an intern, right, so I’ve already told my, I mean I’m just producing a massive amount of confidence in my clinical ability, because I’ve already told my lumbar, you know, shaking hands puncture story, and now I’m talking about a citrullide story that I botched.
Uh, but yeah, so we had a patient come in and, um, and the patient was, Very sick, she was septic, and you know, long story short, um, I’d never put a central line in before, and so I’d built this thing up to be like this procedure that like an anesthesiologist of course, I can throw a line in [00:42:00] in like four seconds because that’s what we do, like we put lines and tubes in and you know, stabilize and save people, that’s literally what my job is, and um, and so at the time I’m like, oh man, like I have to be really, really good at this, and so I’d seen people do a few.
Um, but I hadn’t done one yet. This was my very first one. And so we took a look at the patient’s neck and, you know, the upper level’s like, yeah, you know, like the carotid’s like right there, like that’s probably not the best one for you to do to start with, you know, let’s, let’s look at the groin. And so we look at the femoral site and I mean this thing is like, you could drive a Mack truck through it.
It is absolutely massive. And so, you know, she’s like, you could do that one. And uh, and so I put the, put the probe on, I gown up, I’m like all sweaty and of course, you know, I’m nervous. Um, and so like my gloves are sticking to my skin, I can like barely get them on, and uh, do the central line, you know, get access, I get, you know, Get some blood and I’m like, oh, great.
Like, you know, this is going well. I thread the, the, you know, the wire and then I dilate and then . When I pull the dilator out, I take everything with me. And so, [00:43:00] oh no, what I didn’t tell you is that this patient’s I n r was like 47. I mean, it was super therapeutic, like way off the charts. Um, it was not 47 to be there.
It was just very high even. I know that’s,
Will: that’s way too high. What’s, what’s r i n R is your ability to clot your blood. Oh, basically,
Dr. Jimmy Tuner: yeah. Yeah. So it’s a, it’s a normalized ratio. Tells you about blood clotting, so this patient’s blood does not clot, right? And I just put a giant hole in her ephemeral vein.
So naturally my, my, uh, my upper level’s like, well, uh, put some pressure on that and, uh, you’ll never do that again, you know? And, uh, and so like naturally I held pressure, but like I was like mortified because it’s the first time I’d ever done it. I stayed two hours after my emergency medicine shift, it was while I was in the emergency department, to do this procedure, um, and so like, man, like I turned that like one situation into meaning like I’m going to be a terrible anesthesiologist and like generalized it to, you know, mean this one instant defined who, you know, who I was as a physician.
Yeah, this one first
Kristin: time you’ve tried something. I
Dr. Jimmy Tuner: know. Yeah, yeah. That’s how you think though. Yeah. [00:44:00] But nobody talks about medicine that way, right? Like, so now when my residents make mistakes. Like, knowing what I went through and how humiliating that was, um, I was telling them, like, you know, personally, like, I never make mistakes.
And, like, you know, I’m joking with them, right? Like, I make mistakes all the time, still to this day. And, um, but because no one normalizes that, you know, it is challenging because perfection is expected, um, but we’re human, right? And so, you know, I made this mistake. I generalized it, catastrophized, you know, stayed up all night, like, just perseverating on it.
Super healthy. I’ve seen that
Will: before. I know. Yeah, I, my, that’s the thing, when I was, uh, first learning cataract surgery, uh, you know, within my, my first 10 cases that I did alone or with an attending, but I did the whole case myself. I had two complications and, and I was like, convinced I was, I was never gonna do, I’m like, I’m done.
There’s no way. No one’s ever gonna hire me. I am gonna go to jail. All the things. Dr. Death. It’s right. [00:45:00] Might as well be Dr. Death here. So it’s… But
Kristin: those mistakes, they do stick with you. I’ve seen, you know, even once you’re in attending or whatever. We’re talking
Will: about it, like how many years later,
Dr. Jimmy Tuner: right?
And the funny part is, is that like My nickname at work is Dory, like the forgetful fish. I’m extremely forgetful. And so it just kind of like goes to show like you always remember the bad ones, right? I don’t remember every single save I’ve ever had or difficult airway I’ve ever had that, you know, I was successful at, you know, uh, getting, but man, I remember the failures.
Yeah. Well, and you
Kristin: know what, not to take everything back to private equity, but I can’t help it here. I mean, that is what you’re talking about of that distance between, right? When you’re the one. touching that patient, doing the procedures, it does stick with you. You think about that person that night, you know, you wonder the next morning, how are they doing?
You go and you check the chart. I mean, it’s, it’s on your mind, it’s on your conscience. So, you know, when you’re in that situation, you’re going to take better care of the person, you’re going [00:46:00] to care more about their outcomes, you know, rather than So I think even that story, you know, goes to show that the more distance you have between yourself and the patient, it might
Dr. Jimmy Tuner: not be a great thing.
Yeah, no, I completely agree that that is 100 percent true in my experience.
Will: Well, I’m glad you ended up still pursuing anesthesiology despite,
Dr. Jimmy Tuner: uh, that experience. It turns out I don’t suck at my job.
Will: It turns out you can be really good at your job. And practice really works. All right, so I, uh, devised this little, uh, short game that we’re gonna play.
Um, I, I, you know, I tried to relate it to what the person’s, like, an expert in. I’m a little nervous, I’m not gonna lie. Well, well, don’t be. Um, because I was like, okay, this, we gotta make it, like, financial related, but then I remembered, like, I don’t have any, like, financial knowledge. And, and so, um, I, I kind of hedged a little bit.
And so we’re gonna play a game that is, uh, called. Personal loans. [00:47:00] Personal loans. Got it.
Dr. Jimmy Tuner: Personal loans.
Will: Alright, so, so for this game, uh, we’re talking about borrowing or loaning personal items. Alright? Not money. Personal items. Alright. Alright, so for each of these scenarios, Jimmy, you are going to answer if you would, in fact, loan or borrow that item.
Okay? Let’s do it. Alright, first one. This is easy. Would you borrow… Your kid’s spoon to have a bite of their ice cream sundae.
Dr. Jimmy Tuner: 100%. 100%. So would I. Absolutely. I
Kristin: would prefer my own, but if there weren’t one available, then yeah, sure. You
Will: would prefer, yeah. Yeah. Gotcha. Would you loan your toothbrush to your spouse if they forgot theirs while traveling?
Dr. Jimmy Tuner: You know, this is a really interesting one because I kid you not, alright, I probably shouldn’t admit this publicly, but, uh, we were at my in laws literally like two weeks ago and, uh, maybe even more recent than that, and, uh, I brushed my teeth first night, [00:48:00] like, I don’t know what happened. Like the toothbrush monster came along and like devoured my toothbrush.
I have no idea what happened to it. And so, uh, so would I loan it? Uh, probably not, but I definitely borrowed one.
Kristin: There you not loan you my toothbrush. You wouldn’t? No. You wouldn’t do that for me? I wouldn’t. No. No. That’s disgusting. Like, your toothbrush, it really gets in there. You know? Like, if your mouth is just I Not your mouth, but people’s
Dr. Jimmy Tuner: mouths are disgusting. Desperate times call for desperate measures. That’s
Kristin: right.
Well, I would say, especially because it’s a toothbrush, I would say, let’s say we’re at a hotel, I would say just go to the front desk and get a toothbrush. Or I would say go to any corner of a city and find somewhere selling a toothbrush. What if we’re camping? Then I would say use your finger or go find a stick.
A stick.
Will: Well, first of all, you would never go camping. You would not.
Kristin: That is true. I hate camping. I know that’s going to be a controversial opinion, but
Will: I do not like it. That’s okay. Had to come out [00:49:00] eventually. Alright. So, there, we’re a little bit split on that one. Okay, that’s good. Would you let your friend borrow your deodorant at the gym?
Hmm.
Dr. Jimmy Tuner: That would hmm. Yeah. Not mouth. That’s a little, that’s a little, you know, it’s funny that that seems like it should be less gross, but I don’t think I would. Oh, really? I
Kristin: have, many times, led my
Dr. Jimmy Tuner: friend and not my spouse? I don’t know.
Will: Yeah, it could be.
Kristin: Could be. Also, men’s pits are more disgusting than women’s pits, generally
Dr. Jimmy Tuner: speaking.
How smelly is my friend? How smelly is my friend? That’s probably going to be the question that’s going to make or break it. And, and how,
Kristin: how wet? How sweaty
Will: are they? I have certainly borrowed your deodorant against your will. Yes,
Kristin: that’s the key. I was going to say, I think it’s more like stealing. I did not tell you.
Will: I did not tell you. And I made sure I didn’t leave any hair
Kristin: behind. Well, and I bet you smelled like a delightful flower all day.
Dr. Jimmy Tuner: I did. It was, it was, it was lovely. It is interesting how they smell very different. They do. They do.
Will: Yeah. They do very much. Okay. Would you loan [00:50:00] a fellow anesthesiologist your phone who forgot theirs so they could have something to do during a six hour case?
Dr. Jimmy Tuner: So they can pay Candy Crush. That’s right. Okay, got it. So you
Kristin: have to go six hours without your
Will: phone. That’s right. They said, Jimmy, I’m desperate. I don’t have my phone. I left it at home. Can I, can I borrow yours for this case? Because what am I going to do, uh, you know, while they’re running bowel for three
Dr. Jimmy Tuner: hours?
You know, I, I think that, um, what I’ve noticed in my life is that the moments that I am happiest are generally when I am without my phone, uh, you know, or don’t have the ability to use my phone. So say I’m playing a sport or I’m so engaged in something that, like, I’m not even paying attention to it. So, you know, for, for the welfare of my friend and for my own happiness, I, I probably would let them borrow my phone.
Will: Yeah. It would’ve to be someone you very much trust to have access to your phone. Yeah. As long as I
Dr. Jimmy Tuner: have access to the internet in other ways. Like my email potentially. Yeah. Uh, that I could [00:51:00] occasionally check. There you go.
Will: He is such a nice guy. Yeah, he’s a nice guy. I don’t know if I would, I don’t know if I could do that to
Kristin: you.
Could not. Somebody you’re pretty
Will: addicted to your phone would, I would, well, not that, it’s like the privacy thing. I don’t know. Yeah. Thought you, you got terrible
Dr. Jimmy Tuner: things on your phone. Yeah. You’ve got terrible, terrible things on your phone.
Will: I have terrible things on my phone. Absolutely.
Dr. Jimmy Tuner: And they could use your ex account.
I
Will: don’t yeah, right. I can’t have anybody looking in my DMS on Some of those group chats anyway All right
Okay, here’s one Would you loan your car to an out of town guest visiting your home for the weekend?
Dr. Jimmy Tuner: 0% chance .
Will: I’m alright.
Dr. Jimmy Tuner: I, yeah. So you’re a car guy. That’s why I asked though. I’m a huge car guy. Yeah. So, uh, no, and in fact we are going to the beach and my wife’s, my wife’s a teacher and so she’s going back to the classroom full time.
It’s, uh, it’s been a few years. And so we just happened to schedule the beach trip on like the weekend that she’s due back to go full [00:52:00] time for class. So she’s like gonna go down Saturday, Sunday, and then Monday, have to come back Monday night. And so we were trying to figure out like I’ve got, we’ve got three kids, uh, you know, a lot of beach stuff, like how in the world are we gonna make this work?
I, I was, I am not willing to drive my car to the beach, so I was going to have to like rent a second car or like borrow it or something like that, so like I’m actually going to be driving my in laws second car to the beach so that my car doesn’t have to go, although I will argue that it’s not because I’m like trying to keep it super nice, it, it is, uh, it’s a very small four door sedan, uh, and so it would also be quite useless because I, like, you could pack like two suitcases and it’d pretty much be full.
I Gotcha. Mm hmm. Mm hmm. Sure. But no. I wouldn’t, I wouldn’t unless, and it’s a manual transmission. So 98 percent of people couldn’t drive it anyway. It’s very convenient. Yeah. That’s why. right?
Will: Yeah, right. Yeah. Well done.
Kristin: What kind of a car are we talking? What is this car? Yeah, what is
Dr. Jimmy Tuner: it? Do you want to share?
It’s the most ridiculous [00:53:00] name ever, but it’s a, uh, it’s a CT4V Blackwing. So it’s a Cadillac. And if you drove by one, you’d have no idea what it is, which is why I love it. It’s a sleeper.
Will: All right, well that, we’ll leave it at that. Well, uh, that was Personal Loans. Well done. Love it. And so… Did I win? Sure, yeah.
You won my, uh, my, uh, my respect and admiration for sitting through that. Not sure
Kristin: how well you fared with your wife, but,
Dr. Jimmy Tuner: you know. Yeah.
Will: That’s right. Now we know a lot more about you, though. That you are willing to share toothbrushes, but not your car. Or deodorant. That’s true. But you’re forthcoming with your phone.
That’s, that’s, I was impressed by that. I was honest. Alright, uh, well, let’s, we’ve kept you for so long already, uh, so, um, we want to make sure that you get to talk about the things that are going on in, in your life and anything you want to discuss. I know you got, you got a lot of things, you’re, you’re a busy guy.
So give us a little quick rundown of what’s going on, you [00:54:00] want people to know about. Yeah,
Dr. Jimmy Tuner: so, um, you know, things are, are interesting, right, so I still practice anesthesia, but then you mentioned, uh, the work that I do for ATTEND, co founding that, um, which is super exciting. Uh, with my story, naturally, my North Star, my ethos has always been doing what’s right for other doctors because a lot of us don’t know what’s going on.
I didn’t know what was going on back then and so building a company that is actually doing what’s best for, for people so that they can do what they do best, which is take care of patients, um, you know, I’m incredibly passionate about and so, yeah, the Attend for Doctors app just launched, I mean, within like the last, You know, three or four weeks, um, so super excited to, to help people with that.
You know, they can get help with their student loans or disability insurance, some of the topics we talked about today. Um, and then, yeah, we’re still hanging out at the Money Meets Medicine podcast, which you came on and, you know, graced our, graced our presence with, uh, and so if they like listening to podcasts and, and enjoy that, then they can head over there and, you know, obviously enjoy it.
Aisha and I banter about medicine, um, so yeah, super exciting things going on, um, but uh, [00:55:00] there’s a couple
Will: places they can check them out. Yeah, and that’s helloattend. com, is that right?
Dr. Jimmy Tuner: Hello. attend.com or attend for doctors. It’s in the Apple App store, which I always say that and then like I’m gonna get like 14 emails from people.
They’re like, but I have an Android. Mm-hmm. . That’s right. And I’m gonna be like, I hear you. Like we’re working on, it’s coming, but like 95% of doctors have
Will: Apple. So you you recognize the, the problem there, I’m a failure. And that’s attend as an attending, like an attending physician attend A T T E N D.
There you go. Well, uh, Jimmy, thanks again for coming on. Um, it’s always a pleasure to, thank you for making me feel uncomfortable by forcing us to talk about, uh, money. It’s a very important thing. It’s good for you. Yes, it’s good. It’s like exercise, but exercise just feels bad, uh, sometimes, but, um, uh, it’s, it’s important and necessary and, uh, we all need to be a little bit better at it.
So thank you again for, uh,
Dr. Jimmy Tuner: for coming on. Yeah. Thanks for having me.[00:56:00]
Will: All right. Let’s take a look at some of our, take a look, take a listen. Do we listen? Take a gander, take a take a take a listen. Let’s a listen to some of memory lane. One of our, uh, uh, medical stories from a listener. Uh, so we have Bridget who says, I had a, I had to have a sleep study done a while back. It was my first, my, it was my perfect sleep.
Hell, . Oh no. Perfect sleep. Everyone has a sleep. Yeah.
Kristin: Sleeping is hard. You know, the older you get especially, it’s harder to sleep. You gotta have things just right.
Will: It’s too warm, too early, too bright, too noisy, with the college kids across the street drag racing and their bass thumping. Too weird having someone watching your every move.
That would be very weird. I have had a sleep study and it is not a good night’s sleep. Yeah. You’re connected to wires and…
Kristin: Which seems to defeat the purpose, don’t you think? Wouldn’t you want to study someone sleeping like in their natural… Yeah, you would think so. Like you want to study their normal sleep, but then you gotta like be in their house and watch them sleep.
That’s weird, [00:57:00] too.
Will: Exactly Wake up standing someone’s standing over you just watching it. It’s like having a toddler Since you’re all hooked up for the study They ask you to just speak up when you want to use the bathroom in the night I asked to get up, but they didn’t hear the first time I told the nurse or tech and she said she’d turn up the microphone shortly after I got back in bed I finally relaxed and let rip the loudest fart Oh no!
And immediately hear on the com, I’ll be right over. I had to explain to the nurse that no, I didn’t call out, I just farted. Oh no! They thought the fart was asking for help. Which could have been in a slightly different way. What an awkward thing to have a sleep study. It’s like, it’s not something that we ever, that we Expect to be monitored doing.
Yeah, right But I
Kristin: guess here go to sleep when you’re [00:58:00] your most vulnerable and you’re supposed to be relaxed And but first let’s put all these uncomfortable things on you. And also a stranger is gonna watch
Will: you while you sleep. Absolutely Thank you Bridget for that wonderful story And shout out to sleep medicine doctors for putting people through that important though And what if what a fun episode a fun guest Learn some things.
Dr. Jimmy Turner on, uh, talking about, talking about finances. Yes.
Kristin: People shouldn’t be afraid to talk about it. You know, that’s how, that’s how we learn more about it. That’s how we, you know, make things more equitable. If everybody would just talk.
Dr. Jimmy Tuner: He’s right. There’s like a little bit of a,
Will: like a taboo type of thing.
And I’m not necessarily talking about like telling everybody how much you make, but just like talking about what you do with your money and. Like, you know, giving tips and learning from each other, you know, but it does it just it can feel I don’t know Overwhelming it can feel [00:59:00] like like like you it can make you feel bad about yourself I think if it’s not done the right way because you feel like you’re not doing the right thing
Kristin: Oh, right.
Yes, especially for you, like, ambitious, overachieving perfectionists.
Will: You know, that applies to you, too. You just described yourself just as much as you described me. Oh,
Kristin: but yeah, I mean, I don’t think there should be any reason not to talk about things like that. I’m not a fan of taboos in general. I think things should be able to be discussed.
Will: And if you guys have any stories about any funny, like, financial based stories, uh, any, like, I don’t know, mid level marketing schemes, um, anything, uh, anything fun and interesting and exciting related to personal finance and medicine, please let us know. There’s lots of ways to reach out to us. You can email us, e You can do what now?
E email us. Email us, [01:00:00] knocknockhigh at human content. com. You can visit us on all the social media platforms. We’re on everything. You can also hang out with our Human Content Podcast family on Instagram and TikTok at humancontentpods. Gonna have a barbecue over there later. Maybe a little get together, a little family reunion.
Uh, every so often. It’s gonna be great. Also, a shout out to the great listeners. All of you. You’re all wonderful listeners. Like 99. 9 percent of you. Are wonderful listeners. I’m sure there’s probably somebody out there. That’s just like Some stinker’s in there somewhere. Just to, yeah. Uh, but, uh, Where you’re like, hate listening.
Yeah, so, I’m sure there’s always somebody, you know, like, anyway. Thank you all for leaving the wonderful feedback and reviews. We love that. We love hearing what you have to say. If you subscribe and comment on your favorite podcasting app or on YouTube, we can give you a shout out. Like Mickey Howard 5791 on YouTube said, I’m a musician.
Slash former music teacher and cellist, but I’ve always been super interested in all things medical. So I found Dr. Shaban’s [01:01:00] story fascinating Violin MD who’s the violinist and slash Rheumatologist and I literally listened to this podcast to and from my appointment with my ophthalmologist Look at that.
Wonderful. Yeah, I love it. Thank you for going to see your ophthalmologist You should do the same
Who am I gonna see? My partner, I guess? Yes! You
Kristin: work with like 10 ophthalmologists. I do work with them.
Will: That’s right. Any of them could do it. Full video episodes of this podcast are up every week on my YouTube channel at DGlockenflecken. Uh, we also have a Patreon. Lots of fun perks, bonus episodes, or react to medical shows and movies.
Uh, hang out with other members of the Knock Knock High community. We are growing rapidly, and we’re active there, we’re interacting. Early ad free episode access, interactive Q& A livestream events. Get togethers, much more. Patreon. com slash [01:02:00] Glockenflanken or go to Glockenflanken. com. Speaking of Patreon community perks, new member shout out to Mistress Macabre.
Mmm. I love that name. Yes, I want to know more. It’s great. Mysterious. Shout out, of course, to all the Jonathans. Patrick, Lucia C, Sharon S, Omar, Edward K, Steven G, Roskbox, Jonathan F, Marion W, Mr. Grandetti, Kaitlyn C, Brianna L, Dr. J, Chaver W, Jonathan A, Leah D, Kay L, Rachel L, and Anne P. A virtual hand out. I do all
Kristin: of those.
To you all. In one breath next time. Yeah.
Will: I think I could do that. Maybe not. I don’t know. It’s a growing list. Patreon roulette! A random shout out to someone on the emergency medicine tier. So shout out to Dan Kay for being a patron. Thanks, Dan Kay. Thanks, Dan. And thank you all for listening. We’re your hosts, Will and Kristen Flannery, also known as the Glockenfleckens.
A special thanks to our guest, Dr. Jimmy Turner. Executive producers are Will Flannery, Kristen Flannery, Aron Korney, Rob Goldman, and Shahnti Brooke. Editor and engineer, Jason Portizzo. Our music is by Omer Ben Zvi. To learn about our Knock Knock Highest Program Disclaimer and Ethics Policy and Submission Verification License Terms, they [01:03:00] have released terms.
Go to gawkinplugin. com, reach out to us at knockknockhi at human content. com with any questions, concerns. What could you possibly be concerned about? We’re perfect on this podcast. Or fun medical puns or jokes. We’re Limericks. Magnakai is a human content production.
Goodbye.
Hey, Kristen, do you know why I got into medicine in the first place? To spend your
Kristin: evenings on documentation,
Will: of course. Uh, no. Actually, that never even crossed my mind. Weird. I got into medicine to actually take care of patients, to be able to form relationships with them and care for them, to listen to them, to actually look at their eyeballs while I’m treating their eyeballs.
Kristin: Well, I would hope that you look at where you’re treating.
Will: It’s an important part of being an ophthalmologist. And it’s easier than ever with the Nuance Dragon Ambient Experience, or [01:04:00] DAX for short. This is AI powered ambient technology. It’s just in the room with you, and it helps you be more efficient and reduce clinical documentation burden.
It basically lets you get back to being a physician and practicing the way you want to practice.
Kristin: So it’s like having
Dr. Jimmy Tuner: a Jonathan.
Will: It really is. To learn more about the Nuance Dragon Ambient Experience, or DAX, visit Nuance. com slash Discover DAX. That’s N U A N C E dot com slash Discover D A X.
