Glauc Talk: Cyber Attack, Couples Therapy, & Mesothelioma

KKH Trailer Wide

Transcript:

[00:00:00] Knock, Knock, Hi! Knock,

Knock, Hi!

Will: Hello everybody, welcome to Knock, Knock, Hi! Colon Glock Talk. 

Kristin: Colon! Not that kind of colon. 

Will: I am Dr. Glockenflecken. Will Flannery is my other name. 

Kristin: I’m Lady Glockenflecken, also Kristen Flannery. 

Will: We’re doing something different. New format. Oh, I’m so excited. Like, as they like sirens. Woo! Woo! New format. Cho! 

Kristin: I thought they were warning sirens.

Will: No, like, good sirens. Are there good sirens? I don’t know. Is that a thing? 

Kristin: Uh, I don’t know. I don’t think so. I think a siren’s 

Will: always bad. Yeah. Okay, forget the siren talk. Anyway, we’re trying something different. We’re switching things up a bit. Uh, we’re real excited about that because, uh, well, I’ll tell you what I think the genesis of this is.

What? Uh, we never get to talk to each [00:01:00] other. 

Kristin: That is true. We are passing ships in the night. Taking care of children and a house. 

Will: And careers and everything. And so, um, we thought, You know, why don’t we just like spend some episodes like talking to each other about things? 

Kristin: This is the only way people can get us to talk to each other is if we do it through 

Will: work.

That’s not totally true. Just kind of a little true. A little kind of totally true. 

Kristin: That’s been the case forever though. It has. That’s how we met, sort of, but work at the time was school. Work, yeah. Studying and stuff. Studying. 

Will: But then the question is, okay, well, if we’re gonna have episodes where instead of like an interview We just talk to each other.

Yeah. What do we talk about? 

Kristin: You’re going to have to be a little more interesting. Oh, 

Will: I am so very interesting. Uh, especially when I talk about only healthcare related things. Oh 

Kristin: yeah, love that. 

Will: So we had to compromise. Because life is about compromise, folks. Marriage is about compromise. And I get [00:02:00] 50 percent of the consideration, right, Kristen?

Kristin: I thought after I saved your life 

Will: I gave you like an extra 25? At least. Okay, maybe that’s true. Yeah. But So what we’re going to do is, um, we have, we’ve, we’ve devised, uh, uh, different segments that we might incorporate. I’ve, we’ve got a running list of like, so far, like 10 or 15 different segments we could potentially do.

Yeah. Um 

Kristin: This is, this is a fluid, flexible 

Will: Yeah. You’re, you’re all along for the ride, folks. Uh, and we are figuring this out. Um, but I think it’s gonna be fun. Yeah. Uh, but we are going to have some, my 25 percent of the partnership. Yeah. I wanted to make sure we have some health care stuff in there because like it’s like the majority of my brain, right?

And that’s what you guys are used to hearing. So oh, we’re gonna we’re gonna have some health care stuff. Maybe some life advice I don’t know 

Kristin: Are we qualified to give life advice on 

Will: some things? Maybe I give eyeball advice all the time 

Kristin: You’re qualified for [00:03:00] that. Sure. 

Will: I mean we’ve we’re qualified to give marriage advice 

Kristin: Who, I don’t know.

Will: Do you have to have a specific certification for this? I don’t know. I mean, take it or leave it. 

Kristin: We’ve been, we have been together Disclaimer! We are 

Will: not certified to give any kind of advice outside of eyeballing. We’re not licensed. But that’s okay. We’ll have fun with it anyway. 

Kristin: Yep. We have been together 18 years though, so we’ve learned a thing or two.

Will: I guess the point is there will be some health care stuff, some medicine stuff, some non medic of medicine stuff. Life stuff? Yeah, just all kind of whatever comes to our mind and whatever you guys suggest you want to hear from us. If you have any, um, any suggestions or thoughts about it. So, uh, should we get to it?

Kristin: You know what? I think at this point in the introduction, everyone just thinks we have no idea what we’re doing. Okay. We 

Will: know, we do know what we’re doing here. We have a plan. I have a document that’s, that’s helping us along, uh, and we love, we love the interviews. So it’s not that, that we don’t enjoy doing the interviews.

Interviews are not 

Kristin: going away. We will see. Still be doing interviews, 

Will: right? [00:04:00] Um, we’re just like to play. Yeah, we’re 

Kristin: gonna we’re gonna play with our podcast 

Will: All right. Well, why don’t we get going? Okay. All right, then we’re calling these, uh, knock knock high Glock talk. All right, here we go.

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 reduces clinical documentation burden. To learn more about how DAX Copilot can help you reduce burnout 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. com slash discover DAX.

So our first segment because we’re doing segments now. Yep. Segments. That’s right. Um, uh, just like a, like a news show, like a, like, we’re 

Kristin: I’m really resisting the urge to make the sound. What? You know that what’s that called? The [00:05:00] No, no, no, no, like that. Star wipe? Badoop, badoop, badoop, badoop, badoop, badoop, badoop, breaking news!

Will: What kind of news shows are you watching? Like old timey. That’s You know what I’m talking about? It’s 

Kristin: almost like Morse Code. Like what’s the, uh, 

Will: the Porky Pig? 

Kristin: That did sound a little Porky Pig like. That was unintentional. I 

Will: thought that’s what you were doing. What are you talking about? 

Kristin: Oh, someone will know what I’m talking about.

There’s a 

Will: segment sound effect. Yeah, from like way old timey news, you 

Kristin: know, where it would like interrupt the broadcast. You haven’t watched TV in a while. 

Will: Moving on. All right, so we’re gonna start with health care news. Okay. All right. We got to talk What’s 

Kristin: in the health care news? 

Will: So this is a big big one.

All right, the change health care cyber attack I’m gonna assume, by the way you’re looking at me, that you have roughly 0 percent knowledge of this. 

Kristin: Look, I gotta be honest, and maybe this will be good for this segment. I [00:06:00] actively avoid the news. Okay. All right. So I hardly ever know anything that’s going on in the news unless it is so big that you must be living under a rock.

So all the burden 

Will: is on me for this. That’s right. So you’re going to, you’re going to 

Kristin: explain it and I get to be, you know, the audience who may or may not have heard about this. 

Will: So actually this is not, this is a common refrain that I’ve been hearing on social media is like, no one is talking about this.

Okay. And so you’re not alone. Um, this is a really big news in healthcare and medicine. Um, Change Healthcare is a payment cycle management company. So basically what they do, they connect the payers, which is like United Healthcare, Cigna, Blue Cross, insurance companies. They connect the payers It’s kind of 

Kristin: generous to call them payers, but go ahead.

Will: With, with, uh, healthcare professionals. So physicians, medical practices, hospitals. Kind of like 

Kristin: a credit card [00:07:00] swiper company. 

Will: If it sounds like I’m describing a middleman, it’s because I am. Because that’s one thing that U. S. healthcare is really good at. 

Kristin: So change healthcare is like, it’s like square for healthcare.

Will: It’s a company that helps medical practices get paid. Okay, from the payer part. 

Kristin: Yes, they handle the the financial transaction. 

Will: Exactly. So on, and so Change Healthcare is one of these companies. They’re like the biggest one out there. So they handle 15 billion transactions every year. That’s a bunch. The reason they’re so big is because they are owned by United Health Group.

Kristin: You’re a fave. 

Will: I know, you know, so United Health Group is a I think it’s the 10th or 12th largest company in the world. Okay. Just to give you a scale type of thing. 

Kristin: Largest in terms of like the size? Money. Revenue. Yeah, absolutely. 

Will: And underneath UnitedHealth [00:08:00] Group are all these little subsidiaries, right?

UnitedHealthcare is one of them. Uh, ChangeHealthcare is another one. So UnitedHealth Group, back a few years ago, they purchased ChangeHealthcare, this company to do their, all their transactions. They turned 

Kristin: their cost center into a profit center. 

Will: They, it was a, like a 12 billion deal or something like 8 to 12.

And the billions, this is monopoly money. None of this makes, I mean, you can’t even fathom these amounts of money. Right. Right. So, um, anyway, UnitedHealth Group. They bought Change Healthcare, and what happened was, um, on February 21st, there was a cyberattack. 

Kristin: Okay. Bum, bum, bum. That’s never, never fun. This is bad, yes.

Is that what you want? 

Will: No, the cyberattack, uh, and what they did, it basically put, it, it shut down Change Healthcare. Essentially at least temporarily for now. I think that’s still mostly shut down. They had to like shut down So to stop the spread of [00:09:00] this this cyber attack, it’s like ransomware attack, which okay I’m not a like a you know, IT guy So don’t don’t hold me to any knowledge about like the actual Uh, in fact, I, I did find a, there was an article that was put out by somebody that actually talked about all like the, the IT related things with this attack and I, it almost put me to sleep.

I, I don’t, it’s very complicated, but ransomware sounds bad, right? Yep. All right. So. 

Kristin: Something’s being held hostage. 

Will: Something like that, right? So. The interesting thing is that you haven’t heard about this out there, like the, the mainstream media, like there’s not a lot of information coming out about this, but.

If you talk to people in like healthcare circles, uh, healthcare professionals, this has been a huge problem. Yeah. Cause they can’t 

Kristin: get paid. I assume. They can’t 

Will: get paid. And so I put this video out, uh, about United Health Care and the United Health Group, and, [00:10:00] um, basically the, the idea is that they’re kind of upset that they got hacked, but also not really because then they don’t have to pay people.

That was the, that was the idea. Oh, boy. Um, and the comments I got on that video, there was so many people talking about how they’re not getting paid, how they can’t fill prescriptions because lots of pharmacies, 67, 000 pharmacies use change healthcare. And because it’s all shut down, people aren’t able to, you know, You know, pharmacies can’t check a patient’s insurance benefits.

They can’t process their claims, so they can’t get paid. And this is like shutting down medical practices. Like, this is like, this is a big deal, uh, and will absolutely affect So you 

Kristin: think it’s like a cover up that it’s not being talked about? You think United Health Group owns the media? 

Will: Why, you got a Mafia company?

I had no idea you were so inclined to conspiracy theories. Conspiracy Kristen over here, going with the I am 

Kristin: not inclined to conspiracy theories. I am [00:11:00] very cynical though. 

Will: So I, I don’t know. I, I, I think, um, I think it’s, it’s probably just so complicated that because so many things in healthcare are complicated and the middleman aspect of it.

So like, you never hear about pharmacy benefit managers in the news whenever they do terrible things. So this is like, how do you, No one is directly interacting with the 

Kristin: middleman, so it doesn’t make the news. Right, exactly. So, 

Will: um, it’s, uh, it’s, it’s causing, and I actually just heard, and I probably want to do a video, a follow up skit about this as well, but, uh, United Health Group is now like offering a laughable amount of compensation to some people.

Like medical practices 

Kristin: laughable as in like that’s not nearly enough. Yes, it’s 

Will: like like like it’s a couple thousand dollars a month Yeah, where these medical practices are losing at least 50, 000 a day like maybe even five [00:12:00] hundred thousand dollars a month in medical revenue to the practice They just can’t you can’t function you can’t if you’re not bringing in money.

It’s a business. It’s a business, right? And so it’s um There’s a lot of anger and, uh, nervous energy around healthcare related to this, and it’s a big problem. Um, it made me think, what were some of the other, like, cyber attacks? Has this happened before? Uh, and 

Kristin: Wait, before you do that, what are they attacking?

Like, what, what data are they after? 

Will: No, we don’t know just that it’s just that there was a Actually, I don’t think I don’t know if we know exactly what they’re what they’re what they took or which is the fact that this 

Kristin: Because like the on my mind is well, is that patient data is a health care data that they have that yeah Whoever they are 

Will: they had well, whoever attacked the system they had because they were in the system They have access to all this patient data So I don’t know if we know [00:13:00] exactly what was stolen, but they had the, they had access to it.

And so looking back at probably the biggest health data, patient information breach that there was in recent history was in 2015. There was an Anthem attack. So Anthem is Blue Cross Blue Shield. And this was, um, I vaguely remember this. I was, uh, say 2015. What were we doing? 

Kristin: Having a baby. Residency.

Residency. So I couldn’t remember. No, 16. It all runs together. All 

Will: of it. All runs together. So in 2015, I was, yeah, I wasn’t like thinking about really anything outside of like what was happening in my own life. Um, and, but there was this huge, uh, data breach, uh, with Anthem. Something like 78 million people had their medical information stolen.

I vaguely remember that. Yeah, that includes, uh, like social security numbers, your birthdays. Yeah, I think 

Kristin: I remember [00:14:00] that because I was I got a letter. It’s who we had at the time for our insurance. 

Will: Yeah, yeah. So, so, that was at that point the largest, like, healthcare data breach, like, ever. And comparing it to what just happened with Change Healthcare, uh, Change Healthcare manages or has information on one in three patients in the U.

S. 

Kristin: Which is 

astronomical amount of 

Will: data. How do you know if, so, like, which companies 

Kristin: What would that be? Like, people don’t know about whether they interact with Change Healthcare or whether their data does, but they do know who their insurance companies are. So which insurance companies would that be?

Will: Well, I think probably all of them use Change Healthcare in some form or fashion, but United Health Group owns the company, but I think lots of, lots of companies use the service of Change Healthcare. So, uh, I don’t know if people are getting letters 

Kristin: know if you’re one of them. Well, that’s, 

Will: that’s the thing.

Like, a lot of the, the people are noticing problems. Like, they can’t get their prescriptions. They can’t, [00:15:00] uh, they’re not able to, to receive bills or billing issues are coming up. But they have no explanation for why this is happening. Yeah, so it’s everybody’s kind of in the dark and there’s not a lot out there Which I found kind of surprising whenever I put that video I started seeing those comments like is that why this is happening and this is happening like well, it might just be u.

s. Healthcare But this is making it worse. Yeah And so as part of that skit that I made, also, I, I, I inferred that the, the resolution of what this could be, uh, would end up being like, you know, what’s going to happen to basically United Health Group? Like are they going to have some kind of big fine levied against them or legal action?

And my joke was like, well, they, they own like the federal government, so, so probably not. Well, let’s go back to the, the 2015, like what happened to them, right? Can you guess? 

Kristin: I feel like 2015 was a whole different set of rules than what we operate under in [00:16:00] 2024. 

Will: Not when it comes to the power of these, these corporations though.

Oh, well sure. Yeah. 

Kristin: Does it just quietly go away? 

Will: So, they settled, uh, there was a settlement with the Department of Human, Health and Human Services. Mm hmm. Guess how much? 

Kristin: I have no framework for this. Um, uh, a hundred million. 

Will: Sixteen million dollars. 

Oh boy. 

Kristin: A hundred million was, I was trying to be low.

Will: Sixteen million dollars, which is like a Tuesday morning. Yeah. Of, of operating, like, revenue. 

Kristin: So a tiny little hand slap, maybe not even the hand, just a finger. And 

Will: then there were, there was about a hundred private class action lawsuits filed against Anthem, which is what I think will probably end up happening in this case as well.

And, uh, the total settlement for that was 115 million. 

Kristin: Yep. 

Will: 78 million people were affected and they settled for 115 [00:17:00] million. So, it just goes to show ya, like, mmm. 

Kristin: Everybody got like a dollar fifty. 

Will: Exactly, yeah. And, um, so, anyway, that was kinda depressing when I saw that. Yeah. Uh, so that’s what’s happening with the, with, if you hear about change healthcare.

I don’t know. I don’t, I don’t know what’s 

Kristin: What, what do we do about it? What, now I’m just depressed. This is why I avoid the news. Give me something to work with here. 

Will: think we all, uh, have to go completely offline. 

Kristin: Okay.

Will: Well, like this is, this is gonna become more of a problem because, well, first of all, we’re, you’re not helping, we’re making this is the wrong direction because we’re, we’re just so much more of a digital society now, obviously, but also healthcare is consolidating. In a way that you have a day to preach and it’s going to affect more and more people.

Change the channel. You know, our [00:18:00] kids have no idea what that means. 

Kristin: I know. They were very confused about what live television is. 

Will: Yeah. Well, so we got YouTube TV. We’re totally changing the subject here, which is fine. We’re done with change health. Do you have any follow up questions for me? No, I would like to move 

Kristin: on.

Will: Uh, we’d love to hear you guys thoughts. If you have thoughts about this change healthcare, how is it affecting you? Actually, let’s get some stories going. I would love that. We could share some of those. That is the one thing 

Kristin: I feel like we could do is like, let’s get people talking about this so that it is in the news and people don’t just get screwed over.

Yeah, let’s mitigate it. 

Will: Absolutely. So, uh, how is it affecting you as either as a patient or as a pharmacist or a physician or whoever you are and whatever you do. Um, but yeah, so going back to Yeah, 

Kristin: YouTube TV. 

Will: We bought, we got YouTube TV. Yeah, why did we, 

Kristin: there was something we had, we wanted to watch. Was it the Super Bowl?

Will: It might have been the Super Bowl. Yes. 

Kristin: So that, yeah, switched us over. 

Will: And, um, [00:19:00] because we were on my parents, uh, Oh, that’s right. 

Kristin: ESPN. Yeah, that’s right. That’s what it was. I was 

Will: using my parents account. 

Kristin: As a 30 What, 8 year old man, physician, well 

Will: compensated physician, I was still like, I 

was 

Will: still mooching off of my parents, uh, uh, cable subscriptions, I don’t know, it wasn’t like I was, like, purposefully, I was just, it was, it’s a legacy thing, 

Kristin: right, you had been on it and never got off, 

Will: but anyway, with YouTube TV you can, you can flick channels, right, you can 

Kristin: see live TV.

Yeah, and they had no concept. It blew their mind. What that was, the, the, the little TV guide, you know, the scrolls, they’re like, what’s happening? 

Will: It’s very confusing to them. 

Kristin: So we tried to explain and they’re like, well, is it on Netflix or what? No, no, no. It’s just like broadcast, you know, on TV. Exactly. I don’t get it.

They just couldn’t comprehend. 

Will: So, um, let’s go. [00:20:00] Should we do another segment? Okay. All right. Let’s go on to, um, our next segment that I think you’ll enjoy. 

Kristin: Okay, what is it? 

Will: It’s called this is why you’re wrong. 

Kristin: Mm hmm. I will enjoy this 

Will: So here’s what we’re gonna do we each come up with a Something it can be anything you want Something that we probably something we’ve talked about before or that you know about me right now about you just one thing 

Kristin: I have to limit it to one way you’re wrong.

We’ll do it again down the 

Will: road. Well, actually it depends on how this goes And then you have to we have to tell the other person why they’re wrong about their opinion of that thing All right, you want to go first or me? 

Kristin: Uh, I don’t know. Okay, I’ll go first. I mean, I know what I, what I think you’re wrong about, but I’m not.

You go first to show me how the segment’s gonna work. 

Will: You’re wrong about scary movies. 

Kristin: Mmm. 

Will: You are absolutely wrong. They are. Okay, well, first you have to tell our listeners. So here’s, here’s [00:21:00] Kristen’s, here’s your opinion of scary movies. That they are pointless. That they have, they offer no, uh, no value to society.

Well, you’re, I feel 

Kristin: like you’re paraphrasing and putting it through your own lens, but okay. 

Will: Essentially, that’s what’s, that’s what’s going on here. And I’m here to tell you that you’re wrong. 

Kristin: I just don’t, that’s not exactly my stance. My stance is why would anyone do this to themselves? 

Will: Okay, let me tell you why.

I’ll tell you why, like, you should, you should have more appreciation for horror movies. Uh, because it, it, it, it gets your adrenaline going, so it helps you to, it, it’s exciting, so you get that rush of, of epinephrine, you know, as you’re being scared about a movie, but also, It’s, it’s like a, it’s, it’s like a escapism, alternate reality type of thing.

Why would I want to escape to a horrible reality? No, it’s like, it makes you think, what would I do in this situation? It puts you in a situation where, like, obviously you’re safe. You’re not going to actually be [00:22:00] in that situation. All right. But you, you get to, in a safe way, think about how you would react if someone was chasing you in the woods.

Kristin: Okay. I’ve got, I’ve got two things. 

Will: So it’s, it’s like a, my point is it’s, it’s a, like a mental exercise type of thing. It makes you, it gets you thinking more than, than some other you want 

Kristin: to do that? 

Will: Like I said, it gets wrapped up in the adrenaline, the excitement. And that’s, that’s something your brain likes.

Your brain likes having So you 

Kristin: have to be scared to have adrenaline and excitement. 

Will: Oh, there’s other things you can do, absolutely, but it’s, it’s also, I mean, you can forget about your daily life. For, for, for, it’s just something you can, like I said, it’s an escapism combined with that, that, that pump of adrenaline that you get.

And you can think about, okay, like, wow, what if, what if, what, what would I do differently here? 

Kristin: Okay. Two things. 

Will: All right. 

Kristin: Maybe three. And people who also, who shared these [00:23:00] traits with me are going to know immediately 

what 

Kristin: I’m going to say here, which is one, anxiety. What you described is just what plays in my mind every moment of every day.

I always think about what could go wrong, how I could get around it, what I would do, where is my family, how do I get everybody safe? Like, that’s just a Tuesday. 

Will: Okay, but the difference is, When you’re watching a scary movie, you’re experiencing that in a safe environment. I’m 

Kristin: experiencing my own anxiety in a safe environment.

We live in a very safe place. But you’re 

Will: talking about threats that you think are, like, potentially going to happen. Yes, but they are 

Kristin: unlikely threats. That’s how anxiety works. Like, if it’s not an unlikely threat, then it’s not anxiety. It’s just, okay, your circumstances. Right? So like, I go to a movie theater, I sit down, I’m clocking all the exits.

Where are they? Which one’s the closest one to me? Okay, how [00:24:00] many, how many adults are in between our children so that we could shield them if we need to in the event of open fire? Who in this audience looks like they might be the one to open fire? Like, I’m, that’s just, all day long. I’ll do it all. So why, you want to talk about escapism, why would I escape into more of that?

So that’s one thing. The other thing is, I feel like my nervous system, my sensory system, and I don’t mean nervous as in anxious, I just mean like, my senses, they’re like ratcheted up to like an 11 on a scale of 1 to 10, right? Like you know this, I smell things you can’t smell, I taste things you can’t taste, like all of my senses are just like Like, dialed up, so I don’t want more adrenaline or epinephrine.

That is unpleasant to me. And then the third thing is empathy. When I watch a movie, [00:25:00] and we have a daughter that does this, and you enjoy it in her, but For some reason, don’t extend to me the same grace about it. I feel like I am that character, like it, I really get into it, you know, you can just sort of melt into this perspective because I have a high degree of empathy.

And so. It’s easy to imagine what it’s like to be in that situation, what it’s like to be in that perspective, to the extent that I, you feel what it would feel like. You can create your own virtual reality. And that’s not, kind of, and that’s not pleasant, like, in, for horror movies, right? It’s great for other kinds of situations, but for horror movies No.

Will: Okay, counterpoint. Wouldn’t it be interesting to know what it would be like to have a giant shark chasing after you? 

Kristin: No, I don’t care to know that ever. I would be very happy to never find that out. 

Will: Someday I’m going to try, I’m going to help you understand what You’re just 

Kristin: like so emotionally blunted 

that [00:26:00] a 

Kristin: horror movie is what it takes to get you to feel anything.

Will: Okay, that’s fair. That’s fair. Horror fans help me out here. How do, there’s got to be, I got to find some op eds or something. I’m sure. I 

Kristin: understand logically your argument that it’s a way to experience in a safe environment. Yeah, it’s a way to explore a fear. You’re not buying it though. In a safe environment.

On a personal level. For me, it doesn’t work because that’s already what I do all day long and it’s tiring and it’s unpleasant. So we just have different experiences of the world, which predispose us to like or dislike. Oh, man, your brain is 

Will: complicated. All right, let’s switch. 

Kristin: Look, I’m smarter and I’m better at feeling things, so.

Will: Tone down that limbic system you got there. 

Kristin: I know I would really like to. 

Will: Just turn it off. If you could switch, just, uh, switch off that limbic 

Kristin: system. Sometimes I would do that. It would be nice. Okay, why you’re wrong. 

Will: Yes, let’s hear it. [00:27:00] Actually, let’s take a break. Okay, quick break. Quick break, we’ll come back, and then you can try to tell me why I’m wrong, which I’m never wrong.

Hey, Kristen. What’s up? I gotta tell you about Precision. Tell me. This is really cool. It’s the first ever EHR integrated infectious disease AI platform. 

Kristin: Oh, that sounds interesting. 

Will: Yeah, it’s for any specific patient, it’ll automatically highlight better antibiotic regimens. 

Kristin: Okay, so it can maybe help you treat the patient better and then also gets at this antibiotic stewardship issue?

Will: Exactly. It basically empowers clinicians to save more lives while reducing burnout, just making their jobs easier. Nice. To see a demo, go to precision. com slash KKH. That’s precision spelled with an X instead of an E. So P R X C I S I O N dot com slash KKH.

All right, let’s hear it. Okay. Why am I wrong? 

Kristin: You are wrong that being early [00:28:00] is correct. 

Will: So your stance, explain to the people, cause we, we go, Oh my God. Oh, this is a good one. This is a good one. 

Kristin: Yeah, 

Will: so tell, tell people the situation. Okay, 

Kristin: you get very stressed out 

Will: Mm 

hmm 

Kristin: if you are not at least five minutes early to something.

I am. At least five minutes. 

Will: I’m a very punctual person. 

Kristin: So on time for you is early, which I know a lot of people share that opinion But I think it’s wrong. 

Will: We’re talking five minutes, 

Kristin: right? But that is early. You have a time that something starts, right? And if you get there at that time for you, that’s late, right?

For you, on time is a little bit early. 

Will: So what is on time for you? 

Kristin: For me, on time is 

Five 

Will: minutes 

late. 

Kristin: Five, ten minutes, like, it’s, it’s that time ish. I have more of the like Mediterranean style. All right. You guys don’t know this, 

Will: but Kristen, when we sit down to record these episodes, [00:29:00] like we start, we have a start time because our guests will arrive.

And I’m always sitting, I sit here at least five minutes early, usually about five minutes early, I’ll sit down. And then I just watch that clock. And without every single time, Kristen just busts through the door. 10 seconds, sometimes, sometimes like right, like absolutely right on the dot and it stresses me out.

I don’t know how you can live like that. 

Kristin: Cause here’s what’s going on. I’m doing 5, 000 things at the same time all the time, so No, your 

Will: brain is doing 5, 000 things. Yes, but 

Kristin: also me. Like, when I get up in the morning, I have to help the kids. Like, I’m not saying you don’t do these things, I’m just saying these are the things that I am doing.

Okay. Okay. You’re usually helping the kids downstairs, I’m helping the kids upstairs. Sorry, I’m hitting my mic. We need to fix this. 

Will: I fix it, you don’t know this, but I fix the mic before every time we record. I know, it’s gotta loose. And then you, [00:30:00] you’re so, you’re so hard on the mic that it loosens up. I try very 

Kristin: hard to sit still, sit on my hands.

Go ahead. Okay. I’m a fidgety person. Now you’ve made me lose my thought. Okay. Right. So you’re helping the kids downstairs. I’m helping the kids upstairs. Like they get up at different times, school starts at different times, they’re doing different things at different times. Okay. Doing all that. Then I’m usually tossing in a load of laundry, towels, sheets, something.

Then I’m monitoring like when that needs to get changed over also. Um, I’m getting my makeup on, doing my hair, getting dressed and You poo poo all of this, but all, you’re a white man. All you have to do is roll out of bed and put on some clothes and you are socially acceptable. And the same thing is not extended to any other group.

Let me tell you. All 

Will: I’m saying is You have to do all these things. Start five minutes earlier. 

Kristin: Okay. No, no, no. [00:31:00] So I’m just saying I’m doing a lot of things at once. And so I’m always trying to squeeze all the juice out of those tasks, right? So I’m, I’m oh, I want every last second that I can get because the, the second is going somewhere.

I’m not just sitting up there twiddling my thumb, just being late. I’m trying to. Maximize my productivity in the amounts of time. You’re sitting down here five minutes early, just staring at a clock. What good is that doing anybody? I’m at least like getting some things done. Here’s also, here’s a hot take.

I think being early is rude. 

Will: For what? No. 

Kristin: Mostly if you’re, if you’re showing up to my house or anywhere. Okay. I guess it would come from very, 

Will: very different perspectives on this, because if you, if you’re late in healthcare. Like that’s a big deal. 

Kristin: You don’t want to be late to like, there are certain things that like you expect to happen on time.

Sure. [00:32:00] Appointments, jobs, sure. Whatever. 

Will: Like, like this job, like recording a podcast. 

Kristin: We are our own boss. 

Will: We have producers who are waiting on us. And I get here on time. Every time. You do. You do. 

Kristin: I show up on time. It’s, I am ready to roll. 

Will: But our, the argument here is, is it okay, is it, is, um, showing up five minutes early versus five minutes late?

Well, I 

Kristin: don’t show up five minutes late. I show up right on time, and it irritates you, which just doesn’t make sense to my brain. Like, I know, because we have our divisions of labor, right? One of the things you do is you come down and get this set up. So I know that’s covered. I know I don’t have to be doing that.

So I’m doing other things upstairs, running the house and, you know, whatever. And then I know that when I show up, you’ll already have it ready. So no one’s gonna have to be waiting [00:33:00] on me if I show up right on time. I mean, I’ve got, 

Will: we’ve been married a number of years, and so I’m used to this now. And now what I’ll do is, and maybe other married couples do this, who have this type of, of one person that’s very punctual, one person loves to be as late as possible.

That is not true. I do not love 

Kristin: to be as late as possible. I am consistently zero to ten minutes late. And mostly five. That’s my most consistent. Anyway, what 

Will: I’ll do now is if I know we want, I didn’t want to be, I need to, we need to like go somewhere. We want to be on time. I will tell you at the wrong time that it starts.

Kristin: Correct. With my blessing. Like, that’s fine. If there’s a hard start time, then that actually helps. Me because then I end up inevitably trying to get a few more things done before we go If you have to 

Will: be somewhere like 9 a. m. Yeah, I will tell you okay, this thing starts at 8 30. No, it takes 30 minutes 30 minutes.

It has to be 30 minutes. I’ve learned 

Kristin: especially if there’s travel time 

Will: Yes, I’ve learned when you know, and so 

Kristin: [00:34:00] here’s the other thing with this. I think there’s a sliding scale of When it’s important to be right on time. I think there are things that it’s like they’re kind of a little softer It’s more of a soft start and then there are things that are more of a hard start You know, like I’d like a physician’s appointment with their patient.

That’s you should try to be on time We’re giving a keynote. You ever been late to a keynote? No, I’ve never been late to a keynote Right, there are like hard I have my strategies for getting there. Is it 

Will: possible though that you know how much it hurts your husband? That you want to do something No, I just think you’re wrong.

That’s the whole point of this be compassionate to your punctual husband. No, I 

Kristin: want to help you grow and expand your horizons and your comfort zone. You will not make me I will 

Will: never once be late in my life. 

Kristin: I’m not saying you have to be late, you just don’t need to be stressed out about whether I will be late.

I’ve 

got it covered. I’ve 

Kristin: lived a very successful life so far. But yes, I think it’s rude to show up early sometimes, like if you’re throwing a party, some of these more like casual things, and [00:35:00] especially if you’re coming to my home, and you show up earlier than the start time, get out. Come back later. 

Will: This is like a big healthcare thing though, and I think that’s part of it.

Well 

Kristin: yeah, I’m not in healthcare. 

Will: Because like Every day when you go into the hospital, you are essentially like relieving somebody else from work, right? And so if you like have a shift that starts, if you’re working days and someone’s working nights and you get there late, that’s so disrespectful and makes everyone hate you and they make TikToks about you.

That’s, that’s an 

Kristin: example of a hard start. You need to be there right at that time. I think this is 

Will: the reason you tell me it’s because you couldn’t do anatomy lab. I think this is the reason you couldn’t be in healthcare. 

Kristin: The older that I have gotten. You 

Will: would not be able to show up on time. You get terrible reviews and then you get fired.

You would be fired very quickly from a healthcare job. 

Kristin: Listen, you’re painting me poorly. I show up on time when it’s a hard start. But this is my whole point is that a lot of things [00:36:00] are not a hard start. Okay. They’re more of a softer start and you can kind of, you know, five or ten minutes either way is fine.

Will: This is, uh, I don’t think we’ll ever agree on this, but I think every, I think if we polled our audience, I think the vast majority of people would be on my side on this. 

Kristin: Maybe, because we live in America, but if we went somewhere else, then they’d be on my side. Like, if we’re in Spain or Italy or something.

People 

Will: don’t care about start time? Okay, everybody from Spain and Italy, how do you feel about starting on time? Are you, do you get there on time? Are you early? Well, just the definition of what is 

Kristin: on time. is, is different. That’s the core issue here. An Austrian has a certain definition of being on time, which you would be very comfortable with.

On time is on time. On time is on time. There’s only 

Will: one definition of on time. Nope. This is, this is absurd. Absolutely absurd. I’ll just do one more segment. Okay. Okay. This is gonna be hard for me. I’m, I’m really kind of not looking forward to this. I’m, I’m kind of disappointed that I even came up with this idea.

This was your idea. Uh, it’s [00:37:00] called organ discovery. Okay. So you choose some part of the body. An organ, organ system, an appendage, I don’t, whatever, whatever you want to choose. And I have to tell you about a disease that has to do with that part of the body. Now the reason I’m not looking forward to this is because I’m an ophthalmologist.

Mm hmm. Remember the last time, you know the last time I even thought about, like, the bladder? 

Kristin: I know, I’m, I do know, and I’m very disappointed because we spent all that money on your medical school, we are still paying off. And most of it went out the window. 

Will: So we’re going to discover some things about some organs and I’m going to do my best folks.

I’m going to try as hard as I can to just reach back into the depths of my memory. I’m going to say a route around in my hippocampus and try to come up with something about. Whatever you say. Okay, I gotta 

Kristin: warn you. I am not going to be kind. 

Will: I wouldn’t, I wouldn’t, I wouldn’t expect you to. Okay, let’s go.

Okay. What you got? This might be the only time we ever do this. 

Kristin: [00:38:00] Mesothelium.

Will: What did you just say? 

Kristin: I might have made it up. 

Mesothelium. Mesothelium? 

Kristin: Is 

that 

Will: a thing? 

Kristin: Epidugal. 

Will: I thought you were going to say, like, heart. 

Kristin: I told you I wasn’t going to be kind. 

Will: That, that’s, okay, can we, can we work up to this? 

Kristin: Isn’t that part of, is it a skin layer, skin cell, something? What is that? Why do I know that?

Or is it like the tissue between? You’ve 

Will: heard about it because of mesothelioma. 

Kristin: Well, see, there you go. That’s easy. 

That’s easy.

Will: Okay. 

Kristin: Look, it’s just your idea. You did not give me any boundaries or restrictions. 

Will: Well, okay, so we’re going to talk about mesothelioma. Okay. All right. So, meso I’ve never heard of, I don’t know if I’ve heard of someone described as, [00:39:00] let’s talk about the mesothelium. Oh, what do you 

Kristin: say? 

Will: I, I don’t know. But mesothelioma is a disease, okay, that affects the lung.

Okay. Uh, it’s a cancerous lesion. Most famously, You, you hear about it with, um, asbestos poisoning. Okay. Okay. So that was like, uh, 9 11, the, you know, all the, the towers came down, all the, all the, um, uh, the first responders, they were inhaling all that, all that dust. And then a lot of them ended up getting mesothelioma.

And so it was, it’s a big. You’ll hear like the lawyers talking about it like malpractice, you know, type of things or not malpractice, but um, you know, Lawsuit. Workers comp. Workers comp. There you go. Building, whatever. Codes, don’t use asbestos, whatever. So mesothelioma. I think, if I recall, it affects like the, the space between the [00:40:00] lung and the chest wall.

The space between. It’s like the plural space. Yeah. Um, and you get these lesions that can cause like a collapse of your lung. Because if you have a space in there, the lung can’t be attached to the chest wall. And so 

it 

Kristin: What now? How do you spell that? 

Will: And uh, and then, and then you get a chest x ray because all of a sudden you’re like, you can’t breathe very well.

And it shows these lesions in that area. And then you treat it with, um, I had, I think. I have to assume it’s chemotherapy, maybe surgery, if you can remove it, but probably chemo, radiation, um, and it’s, if I recall, it doesn’t have a great prognosis. 

Kristin: I wouldn’t think so. It doesn’t sound good. 

Will: Yeah. Yeah. But, um, uh, so that’s, that’s all I know about mesothelioma.

God. 

Will: How about, like, leg? 

Kristin: Well, again, I Neck. My [00:41:00] brain is more complex than yours, I think is how you phrased it. Do 

Will: you have a lot of anxiety about mesothelioma? 

Kristin: Sure, now I do. 

Will: don’t think we have asbestos, I don’t think they make houses with asbestos anymore. 

Yeah, 

Kristin: I’ll just try to avoid breathing in. 

Will: All right, that was organ discovery.

There you go. That was not as fun as I thought it would 

Kristin: be. It was for me. And tell us Wherever you’re listening, whatever the comments are, tell us if he’s right or wrong, because I don’t know. Yeah, 

Will: give us I’m pretty sure I just told you everything there is to know about mesothelioma in that 90 seconds of knowledge that I have.

Also, someone, 

Kristin: give us the term for that. What was the noise? 

Will: A ba dee a ba dee a ba dee? No! Oh, the collapsing lung? 

Kristin: Yeah, someone tell us what that’s called. 

Will: That, and then the, uh, the sound of, um, Yeah, I would say that’s probably fair. I was going for like a whoopee cushion. Yeah. Like, you know. Right, 

Kristin: deflating.

Yeah. I don’t think the lungs sound like that 

[00:42:00] though. 

Will: Let’s have some pulmonologists weigh in on this. How’s my lung collapsing sound game going? Alright, that does it for organ discovery. Tell us what you think about that one. Um, alright, um, let’s take a quick break. We’ll come back with a fan story.

Uh, hey Kristen. 

Kristin: Yeah. 

Will: How many mites is too many mites? 

Kristin: Uh, for me, one. 

Will: Well, I have eight. 

Kristin: That’s way too many. 

Will: That’s a lot of mites, right? 

Kristin: No one wants that many mites. 

Will: You know where you find these guys? I’m afraid to know. On your eyelids. 

Kristin: Yeah, I don’t want that. I 

Will: know, but like, if you ever have red, itchy, irritated eyelids, or if you get a crusty, flaky buildup on your eyelashes, Could be because of Demodex Blepharitis.

Kristin: Ugh, no. 

Will: It’s caused by these guys. I don’t know. Demodex mites. I It’s just a thing that happens. They’re usually not this big though. Well, that’s good. Usually. Usually? They’re much smaller than this, but they can still cause major problems. And so you need to [00:43:00] go get it checked out by an eye doctor. Okay.

Don’t get grossed out. 

Kristin: Get checked out. Get 

Will: checked out. All right, don’t get grossed out, get checked out. To find out more, you go to eyelidcheck. com. Again, that’s E Y E L I D check C H E C K dot com to get more information about demodex 

blepharitis.

Will: All right, let’s take a look at some of our favorite medical stories sent to my listeners. So, we have a story today from Brittany. Brittany says, I am a pediatric infectious disease doctor and love your skits. Thank you, Brittany. My five year old recently asked for a turtle for her birthday. Get some strong We gotta unpack that on a future episode.

I don’t think 

Kristin: reptiles belong in a home, that’s all. At least not my home. 

Will: Because we got a kid that loves her reptiles. Yeah, 

Kristin: this one’s touching a nerve. 

Will: Alright, I’m pretty sure my infectious disease certification would be revoked if I got her a turtle. [00:44:00] See? Yeah, I think you’re, in your heart, in your soul, you’re an infectious disease doctor.

Could be. So what could I get her instead of a turtle? When I’ve discussed with my colleagues, there’s a pretty universal look of horror at the idea. I settled on a rabbit as I felt the risk of aerosolizing the rabbit was reasonably low and could be mitigated. 

Kristin: Aerosolizing? Like, like turning the rabbit into aerosolized particles?

No, no, like the rabbit, 

Will: like spreading tularemia or some of the rabbit things. 

Kristin: Aerosolized diseases from rabbits. Yeah, 

Will: exactly. She’s like, I think there’s a skit in here somewhere. I’m not talented enough to pull it off. All yours if you want it. I think I’m going to run with that, actually. That’s a good one.

I, I got some recommendations, like I should do a petting zoo with infectious disease. Uh, a pet pet store would be really good. 

Kristin: Or even just our, our own situation. If your kid wants one of these pets. 

Will: That’s, that’s a good one. [00:45:00] Uh, I, I do actually think you identify, you would identify very much with infectious disease because it seems like they’re constantly scanning for threats.

He’s just looking for 

Kristin: trouble. Yep. 

Will: So thank you for that, Brittany. Send us your stories. Knock, knock, hi, at human content. com. I wonder if 

Kristin: there’s a higher incidence of anxiety in infectious disease doctors, like, and which way that goes. Is it the chicken or the egg? 

Will: I have no idea. What do you, what do you infectious disease doctors think?

Let us know. A bunch of anxious people end up 

Kristin: as infectious disease doctors or does becoming an infectious disease doctor make you anxious? 

Will: There you go. And that’s that’s that’s our episode for Glock Talk. I feel closer to you now. I feel close. I still 

Kristin: think you’re wrong on all. All 

Will: right. This was fun.

Horror movies are good for society and you need to be on time. That’s that’s all I’m saying. 

Kristin: Well, being early is rude. So, 

Will: send us your ideas. Hey, do [00:46:00] you have any ideas for segments? We’ve got more coming, by the way. But if you have your own thoughts or things you want us to talk about, we’d love to chat with each other.

Yeah. Tell us what you think. Who’s right, who’s wrong. Lots of ways to hit us up. You can email us, knockknockhighhuman content. com. We also have all the social media platforms. Uh, we have our Human Content Podcast family. You can see all of their offerings at Human Content Pods. Thanks to all the wonderful listeners leaving feedback and, uh, subs, subs, leaving, I almost said leaving subscriptions.

Don’t leave those, snatch them up, snatch up a subscription to our stuff. Are you drunk? God, I don’t know. It’s. We’ve been recording for a while. Uh, if you, if you comment on your favorite podcasting ever on YouTube, we can give you a shout out. Like, at old Dion 9863 on YouTube said, I would vote for president Glockenflecken solely for the hope of having a president that actively antagonizes insurance companies.

Hell yeah. That’s the only thing on my platform. I will make a life as hard as [00:47:00] possible for insurance companies. Is that enough? Is that enough for you all to, to, to get me elected? I guess we’ll see whenever I run. Eventually 

Kristin: when I’m dead 

Will: full video episodes are up every week. That’s another, it’s like the segment.

We could do. . We gotta try. I could try. You can do when I’m dead, I got . What would I do over my dead body? Things I could do when my wife is dead. Check out my YouTube channel at DGlockenflecken for full video episodes. Lots of cool perks. If people don’t 

Kristin: know by now, we have a very dark sense of humor.

That’s fine. That’s what you’re signing up for, people. 

Will: Um, Patreon. Cool perks. Hang out with other members of the community where they’re active in it. Early ad free episode access. Interactive Q& A livestream events. Much more. Patreon. com slash Glockenflecken. Or go to Glockenflecken. com. Speaking of Patreon community perks, new member shoutout to Ken S, Alyssa L, and Jack K, Dina W, Nico D, Jonathan G, got another Jonathan, uh, David H, and Tiana S.[00:48:00] 

Welcome. Yes, and shout out as always to the Jonathans, a virtual head nod to you all. Patrick, Lucia C, Sharon S, Omar, Edward K, Steven G, Jonathan F, Mary and W, Miss Sturger and Daddy, Kaitlyn C, Brianna L, KL, Keith G, JJ H, Derek N, Mary H, Susanna F, Jenny G, Jay. I can’t do it, Jenny J. Mohamed K, Aviga Parker, Ryan, Mohamed L, David H, K, Medical Meg, Bubbly Salt, and Pink Macho.

Patreon roulette. Random shoutout to an emergency medicine tier folksperson. Nicole G! Thank you for being a patron. Sorry, I can’t talk right now. Uh, thank you all for listening. We’re your hosts, Will and Kristen Flannery. Our executive producers are Will Flannery, Kristen Flannery, to say thank you for our guests today, Kristen and William Flannery.

I don’t know. Whatever, this is different. Our Executive Producers are Will Flannery, Crystal Flannery, Aron Korney, Rob Goldman, and Shahnti Cortese. Our music is by Omer Ben Zvi. To learn about our [00:49:00] Knock Knock Highs, Program Disclaimer, and Ethics Policy, Submission, Verification, Licensing, and Terms, and if released, Terms, go to Glongonplugin.

com or reach out to us at knockknockhighathuman content. com. If you have any questions, concerns, well, whatever, I don’t know, just send us stuff. Knock, knock, I is a human content production. 

Knock,

knock, goodbye.

Will: Hey, Kristen. Yeah. Healthcare workers are struggling these days. I 

Kristin: know, there’s a lot of burnout. A 

Will: lot of administrative burden that’s driving that burnout. Yeah, it’s certainly a major contributor. Clinicians spend up to two hours on administrative tasks for each hour of care provided to the patient.

Kristin: Yeah, that should not be the ratio. That’s not sustainable. No. 

Will: Fortunately. We have the Nuance Dragon Ambient Experience, or DAX for short. 

Kristin: Oh, is that why you’ve got your little friend there? Oh, you noticed. Oh, he did? Yes, 

Will: this is the [00:50:00] DAX co pilot. He’s very cute. Isn’t he? He’s got wings. He’s there to fly us to a world of less burnout and more efficiency by giving us this AI powered Ambient technology that sits there in the room with you while you’re with the patient and it helps you document the encounter so you can spend more time developing that patient clinician relationship.

Kristin: That’s right. You don’t have to be looking at your computer. It’s capturing it for you. It’s 

Will: great. To learn more about how DAX Copilot can help reduce burnout 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.