Transcript
Will: [00:00:00] Today’s episode is brought to you by Microsoft Dragon copilot your AI assistant for clinical workflow. To learn more about how Dragon copilot can transform the way you work, stick around after the episode or visit aka.ms/knock knock high. That’s aka.ms/knock knock. Hi.
Kristin: Hey Will. Hey, what’s up? I’ve been thinking the US healthcare system.
It needs some improvement.
Will: Yeah, it’s, it’s, there’s room for improvement
Kristin: for sure. Yeah. It’s a confusing, scary place for everybody involved.
Will: Absolutely.
Kristin: Physicians, families, patients, everybody.
Will: Everybody. And I’ve experienced it from both sides, right. I’m a physician, I’ve also been a patient, so I wanted to use my platform to give people practical education.
Really the only way that I know how. By making, so Dr. Glaucomflecken, really fun and super uplifting Guide to American Healthcare is Out and it’s a free resource that includes all my videos from the 30 Days of Healthcare Series, [00:01:00] alongside deeper explanations, also reliable facts. Emphasis on reliable. Yes.
All right. Uh, uh, figures, uh, numbers, insights into how each of us can fight for a more humane, better healthcare system. I. Also it has jokes. Did you mention the jokes? I did. I jokes. Okay. Yes, definitely jokes. Well,
Kristin: this guide is great for anyone looking to learn more about US healthcare, but especially if you are experiencing it from the clinician side for the first time.
That’s right. We really hope you’ll check it out.
Will: Get the free guide sent straight to your inbox by signing up for our mailing list. Glaucomflecken.com/healthcare Enjoy.
Kristin: Knock, knock,
knock, knock. Hi.
Will: Hello. Welcome to Knock-Knock. Hi, with the Glaucomflecken, I [00:02:00] am Dr. Glaucomflecken, also known as Will Flanary.
Kristin: I’m Lady Glaucomflecken, also known as Kristin Flanary.
Will: We’re excited for you to join us today.
Kristin: Are you. Are you excited? You’re, you’re course I’m in a funk this morning.
Will: What do you mean you’re
Kristin: real crotchety?
Will: I just, she’s
Kristin: like, nothing matters. Who cares
Will: what, because I’m like, I’m like, I’m in my feelings or something.
Kristin: No, no. I don’t know what’s gotten into you. This is unusual.
Will: I just, I woke up tired. Just very, very tired.
Kristin: Yeah.
Will: And it
Kristin: Did you go to bed too late?
Will: No. No, I don’t think so. I, I wa I don’t know. I watched, uh, the White Lotus season finale.
Mm. Which was sad.
Kristin: Oh, and then you went to bed with sadness, and now you woke up with sadness. If
Will: you, if you go to bed with sadness, do you wake up with sadness? Is that a central tenet of psychiatry? I don’t know.
Kristin: I mean, maybe you do, right? Like you, your brain is at work processing your day all night,
Will: so Could be.
I did see something funny though. [00:03:00] I thought I’d share with you, so occasionally, I think one of my favorite places to go on social media lately is Reddit.
Kristin: Yeah. Is that social media? Does it count?
Will: Sure. Yeah. There’s, yeah, there you have, it’s social. Yeah. You have communities there, and I don’t know how
Kristin: media it is.
Will: Well, they’re separated into subreddits. I think maybe that’s why I like it, because it’s, it’s like a, it still feels like a. The way social media should be.
Kristin: Mm-hmm.
Will: Like a little bit more primitive. Mm-hmm. But you can share links to like, articles and stuff, but Right. All the interactions are, you know, just
Kristin: text based text.
Will: It just, just people talking to each other. Exactly. Conversations, people joking with each other. Uh, and so humor still exists over there? Yes, it does. So there’s a couple of subreddits I, I like to look at every now and then, and sometimes I get like video ideas too, people talking about different things.
Two of them are the residency [00:04:00] subreddit.
Kristin: Mm-hmm.
Will: And the medicine subreddit. So I did an A MA for the medicine subreddit, like, yeah. And thats just couple years ago. That’s just like
Kristin: everybody, right? Medicine. Yes. Anybody in medicine at all.
Will: Yeah. Yeah. I mean, anybody, I think for those two, anybody can join and like mm-hmm.
Look at the post and everything. Um. But anyway, so I, I, so, so I was on there and I saw, I saw one, uh, this was from a user named Magic Monkey.
Kristin: Okay.
Will: And the title of it,
Kristin: I’m, I am Afraid I, I can see this title. You just pulled it up. And I don’t know where this is going, and I’m very afraid. It’s
Will: just so some, some posts are, are like shit posts, you know, like just people, you know.
Kristin: Being mean to each other?
Will: No, no. Just like, um, like telling, it’s like all jokes and, oh, it’s not meant to be taken seriously. Gotcha. Some are like serious posts. Mm-hmm. So this one, and you can label your, your post as like a meme. If it’s just [00:05:00] a meme, if it’s, if it’s a serious post. Anyway, this one was posted as with the, with the, with the subtitle, like, sir, like this is a serious post tag on there.
This is residency. See? Um,
Kristin: and either we need to bleep or now’s the time if there are young children around that. Perhaps you should turn the volume down for a sec.
Will: Sure. Uh, the title is My Farts and Shit Smell Like My Patients Shit.
Kristin: I don’t know what to say to that.
Will: And he says, I’m not even joking. It smells like either the necrotizing fasciitis wounds or their stool.
Am I colonized? That was the question.
Kristin: Colonized meaning bacteria. Yeah. Okay.
Will: Like you, you take care of enough patients. Yeah. In the hospital. It
Kristin: like gets inside your body. Does
Will: it? Does it get inside your body?
Kristin: Your skin absorbs the smell.
Will: Now I thought I had heard like every single thing. [00:06:00] Every concern.
Yeah, every worry, every source of anxiety. This was a new one for me. I am on medical, social media. Always everywhere. Yes. All the time. I’m keeping tabs on all the things that people are talking about.
Kristin: Mm-hmm.
Will: The fact that a hospital environment can make your excrement the same as. Other people in the hospital is a new one, and this person is very concerned.
But what got me laughing were some of the comments.
Kristin: Okay,
Will: so the first one, you must be a terrific physician to carry a small piece of your patients with you everywhere.
Kristin: Oh,
Will: uh, in nursing we call it deja.
Which, so this is like a thing, like this is not an original thought. Like obviously Right. [00:07:00] People have heard of this, like nurses are like, it is like, oh man, it’s like what’s coming outta me smells like what I smell every day. And, and so then as you scroll down, people were like, you know, wondering, okay, well what’s the source of this?
Kristin: Yeah.
Will: Like trying to investigate this thing medically. Right. And what do you think it.
Kristin: I mean, do you mean, do you think, my question was venture guess was, well, my question was, is it actually happening or is it just kind of
Will: like a psychosomatic psychosomatic, you know,
Kristin: like I don’t question that he’s smelling that smell. Yeah. But like, is it actually, if you analyzed
Will: Yeah.
Kristin: His sample. Would there be something in it?
Will: Well, some people were surprised by this, the original poster, like saying like, he’s some kind of pooh sommelier.
Kristin: Oh my gosh.
Will: To be able to, but it’s, and really is the thing. ’cause there’s different smells. We’ve talked about smells in the hospital. Yeah. There’s like, like different. [00:08:00] Poop smells too. Sure. Like
Kristin: any parent based on what disease you have, parent knows.
That’s true.
Will: And like with certain diseases, like c diff and stuff. Right. Um, uh, a lot of people think it’s, it’s the food.
Kristin: Oh, interesting. The hospital. Hospital food. Hospital food. Mm-hmm.
Will: Because that’s like the common right denominator.
Kristin: Right.
Will: Of, you know, what the, the staff eats. What I mean, as some, some people won’t go near the hospital cafeteria.
Yeah. But, um, uh, I think that’s probably the most likely.
Kristin: Yeah. That makes sense.
Will: Hopefully healthcare workers are not being colonized by,
Kristin: I feel like
Will: the patients
Kristin: you would know, right? Like you would have symptoms.
Will: Yeah. I mean, is it, I don’t know. Yeah. You know, oral transmission, right? It’s something
Kristin: that has landed this patient in the hospital.
Then if you get it, it seems like you would at [00:09:00] least not feel good.
Will: I do remember, you know, in my. There were certain floors in the hospital that had a very distinctive smell.
Kristin: Mm-hmm.
Will: In fact, I think back in the day I wrote a Gomer blog article about a certain floor at the hospital that had like a very distinctive smell.
[music]: Mm-hmm.
Will: Um, and, and so I, I think it’s. It’s gotta be the food. It’s just that’s gotta be it. Yeah. What else could it be? Right. So anyway, uh, that was a new one for me. I wanted to share with you
Kristin: sometimes that there’s
Will: a thing called Deja p.
Kristin: Deja p. Sometimes I do, this is not about poo, but I do smell things from earlier in the day.
Will: Mm-hmm.
Kristin: Generally, they’re not good things. It’s like the pets did something, or the children, even though the smell has. Been taken care of and is now gone. Mm-hmm. It’s like, it’s like smell, memory, like it’s just still in there, you know, memory, it’s still in my nose.
Will: Memory is like very tied to
Kristin: Right. The [00:10:00] olfactory parts of the brain.
Strong, like very primitive. Yeah.
Will: I could channel my inner neurologist. That’s right. Yeah. I think, I think that’s a big one. Uh, but I, there maybe there are like little smell particles that are like stuck in your nose. Yeah. Maybe so. And so it just, it, it makes everything kind of smell funky or off. Right. So, I dunno.
Yeah.
Kristin: Anybody that knows if smell particles stick around, please tell us, because I am curious,
Will: gimme some smell experts here. Have you had Deja P Tell us what, what you feel like you experienced from your deja. But the thing with Deja P is that, I mean, deja vu is, is like you feel like you experienced something, but you never actually experienced
Kristin: it.
Right?
Will: So this is, in
Kristin: this case you did experience it,
Will: so, so I, I don’t know, just, uh, you know, another, uh, form of trauma that medicine, uh, inflict on people voice upon the, the healthcare workers. Oh, you poor [00:11:00] people with your dejavu. I don’t have that. I, I don’t know. I was thinking in my job as an ophthalmologist, what’s the worst smell that I, yeah.
Kristin: Are there any,
Will: I would say, do I smell? No, generally eyeballs are quite generally very clean for the most part. Yeah.
Kristin: Does conjunctivitis smell, that’s the grossest eyeball thing I can think of. It doesn’t
Will: really, no, there’s not, yeah. You know, I, if, if there’s a bad enough pseudomonas infection, you might smell it, but Okay.
It’s. The, the, the, the strongest smells are when you sit down with a patient at the slit length.
Kristin: Mm. Mm-hmm. Mm-hmm. And so
Will: it’s the bad breath.
Kristin: Mm-hmm.
Will: It’s the body odor. Body odor. You’re, you’re just very close to somebody hygiene
Kristin: smells.
Will: Yeah. Yeah. And so I, as you know, I am an extremely hygienic person.
Kristin: I, I dunno what to say to that either.
Will: How dare you?
Look at me on YouTube. You’re look how
Kristin: [00:12:00] picture of put together.
Will: Look how well kempt I am right now. Okay. Anyway, I always try to make myself at least smell acceptable.
Kristin: Yeah, that’s true.
Will: And you know, you
Kristin: only smell bad when you just finished a workout and you haven’t showered yet. So I will give you that.
Will: And I brush my teeth.
Kristin: Yes, you do. And you floss. You’re, you’re religious flosser. I’m a
Will: very big oral hygiene kind of guy. A part of that is just fear of going to the dentist.
Kristin: Mm-hmm.
Will: And so I don’t want anything bad to happen to my teeth. Um, to necessitate some horrific thing that the dentist will have to do to me,
Kristin: such as a cleaning,
Will: oh, it’s terrible.
But, um, people on the other side of the st of the, of the, uh, of the slit lamp, not so much sometimes. Mm-hmm. Well, can I tell you could, it can be cing. It goes
Kristin: both ways.
Will: What’s so, what do you mean
Kristin: when you’re a patient in a close encounter like that?
Will: Yeah.
Kristin: Also the. The physicians sometimes have a little [00:13:00] Oh, sure.
Funk coming off of ’em. Oh yeah.
Will: I mean, you know that I kind of, I would, I don’t doubt it.
Kristin: I appreciate it when they’re wearing a mask, if they have to get real close.
Will: Oh yeah. Yeah. ’cause then we don’t have
Kristin: to worry about this issue,
Will: you know? That was like, either way they
Kristin: can’t smell, I can’t smell. Yeah.
Will: You know, when, when everybody was masking all the time.
Mm-hmm. I, I’d say that was actually a, a huge benefit to, to, to just the, everybody masking.
Kristin: Yeah.
Will: I, I, I never had those smells so. You know, now not so much.
Kristin: Yeah. It’s,
Will: it’s, it’s back. You really get in, get in deep with the, with your patients.
Kristin: I wonder if you put in like an Altoid or so some really strong, like peppermint.
Will: Mm-hmm.
Kristin: If you were just like sucking on a mint, if that would overpower. The
Will: smell of the other thing. I think that might also bother people. Like I think it is very strong. Anything, any strong scent. It’s like, even if it’s like cologne or perfume.
Kristin: Yeah, yeah.
Will: It’s just really in that small [00:14:00] area. It, it’s, it’s tough.
Kristin: Right.
Will: So it’s not always night like bad smells.
Kristin: Yeah.
Will: You know, sometimes I could just, I could just, the fact that you can tell a, what a stranger had for lunch.
Kristin: Yeah.
Will: It’s just, that’s kind of gross. It’s, you know. You know, be able to smell your lunch on you. Yeah. But, but that’s not necessarily like a, like a noxious awful smell.
Right. It’s just kind of a weird social thing.
Kristin: Right,
Will: right.
Kristin: Yes.
Will: So I’m, I’m used to it now. It’s just like part of the gig. Yeah. But we do have a, a sneeze guard on the, on the, oh, that’s good. Yeah. Oh, I’d
Kristin: never thought about that. ’cause somebody could sneeze right in your face,
Will: which. I think has happened usually with it like it’s like a kid, like a little kid.
Oh, you, yeah. You’re just lop of a sun right in your face.
Kristin: Our dog did that to you this morning. Uh, yes. Sat woke, walked, woke up this morning.
Will: That was great. Really enjoyed that. So, um, uh, yeah, the sneeze guard and it does help actually [00:15:00] blocks a lot of the scent as well. So, and we have That’s good. It’s, it’s a, since Covid, we, when.
There was like a wimpy little sneeze guard. Mm-hmm. But Covid, we got this. Yeah. Then you gotta get
Kristin: the heavy duty guard. We got
Will: like an industrial sneeze guard. Yeah. For the slit lamp that hangs on the slit lamp. I love it because it’s much more,
Kristin: I mean,
Will: coverage area, you should be
Kristin: doing that all the time anyway, given
Will: sneeze guard, everywhere we go.
Kristin: Well, for the slit lamp.
Will: Yeah.
Kristin: Given how close you are, anytime you’re that close, I feel like put a nee guard in.
Will: Yeah. No one wants
Kristin: to get sneezed on ever.
Will: These are the things we discuss in ophthalmology as opposed to real issues in healthcare.
[music]: Uh,
Will: all right. Should we, let’s take a quick break. Okay. All.
Hey, Kristin.
Yeah.
Will: I’ve been, you know, grossing you out about these dex mites, although I’m not sure why they look like adorable.
Kristin: Well, these are cute, but it’s the real ones that kind of freak me out a little bit.
Will: Yeah. But I have some new facts to share with you. Oh, great. About Dex.
Kristin: Alright. [00:16:00]
Will: These mites have likely lived with us for millions of years.
Kristin: Oh.
Will: Yeah. Does that make you feel better?
Kristin: No.
Will: Like they’re passed down through close contact, especially between mothers and babies.
Kristin: Oh, wow. Such a special gift for our daughters.
Will: They’re born, they live, they crawl around and then they die on your eyelids and in your lash follicles. Their entire life cycle lasts about two to three weeks, all spent on your eyelids.
Kristin: Well, thank you for that. This
Will: isn’t helping, is it?
Kristin: No. How do I get rid of them?
Will: Well, it’s, it’s. It’s fun to gross you out, but we do have all of these, it’s really common, but there is a prescription eye drop to help with these now.
Kristin: Okay.
Will: That probably excites you.
Kristin: That makes me feel better. Yes.
Will: Any way to get rid of ’em, right?
Kristin: That’s right.
Will: All right.
Kristin: Sign me up.
Will: Visit Mites love lids to learn more about deem aex ble, which is the, the disease that these little guys. Mm-hmm. Cause mm-hmm. Sure. Again, that’s M-I-T-E-S. Love lids, L-O-V-E-L-I-D s.com to learn more about [00:17:00] Dedex and Demodex blepharitis and how you can get rid of it.
Speaking of issues in healthcare, uh, we ran the 30 Days of Healthcare series we did on Instagram and Facebook.
Kristin: That’s right. We had run it on what, TikTok and YouTube.
Will: Mm-hmm. Yep.
Kristin: A couple years ago.
Will: Yeah. Back when I first made it, so like in case you’re not sure what we’re talking about, uh, every day of a whole month I made a video about the healthcare system going from like.
What is a deductible and
Kristin: mm-hmm.
Will: What is a co-payment, co-insurance, all the way to like more complex things like pharmacy benefit managers and no surprises, acts and Yeah. DIR fees and pharmacy and stuff like that.
Kristin: And they were all in your style? They were all just Yes. Comedy skits,
Will: all these skits and, uh, and it was, it was, it shocks me because you, you think that, like, since I posted all of these on prior on TikTok and YouTube
Kristin: mm-hmm.
Will: That [00:18:00] people are gonna be like calling me out on that. Like, oh, you’re just, this is all old content.
Kristin: Right? No, people don’t,
Will: but man, people do not cross platforms. No. You like, people have a pla, a preferred social media platform and they will stick to it.
Kristin: That is why we decided to release it on Instagram and Facebook because it’s a whole different set of people, lot that have seen it yet.
So a lot
Will: of, a lot of people have not seen it before. I got great feedback, uh, a couple times. I was like, I kinda cringed to myself a little bit because, uh, really just one time and that was the very, uh, I think it was the last episode.
Kristin: Oh, I know. Yeah.
Will: Yeah, this was, this was Oopsies a little dicey. So the last, the last episode of the 30 day series was like, uh, okay, what can we do to fix it?
Kind of thing. Yeah. So it was like a, a, an all hands meeting between all the Jim type characters.
Kristin: Yes. Timothy, Christopher,
Will: Christopher Bethy,
Kristin: Bethy. Yeah.
Will: Uh, maybe, uh, Jonathan was in there as well. One, yeah. Um. [00:19:00] Anyway, all of these, all of these folks who are, like, they were all the, the, the kind of the straight man in all the skits.
Kristin: Yeah.
Will: Uh, you know, interacting with the, the, the ridiculous, terrible executives. Executives in healthcare and pharmacy and all this stuff. So, um, but during that skit, uh, Jim repeatedly. Wants to like resort to murder.
Kristin: Mm-hmm. Mm-hmm. Mm-hmm.
Will: Uh, to solve the issues in healthcare. Mm-hmm. And so it certainly, uh, plays a bit different.
Kristin: Yep. Hit different now
Will: ever. Sure.
Kristin: Did.
Will: Ever since the actions of Luigi, uh. Obviously I filmed that in, uh, 2023, I wanna say Yes.
Kristin: Back when. That was a ridiculous
Will: scenario, a ridiculous thought, um, that was
Kristin: worthy of comedy, and now it’s, uh, less so.
Will: So I, I, I, I, I just like, I was rewatching these as they were coming out.
’cause some of them I hadn’t watched myself [00:20:00] in like two years. Yeah. So I watched that one and I was like, Ooh. And some people on Instagram were like, oh, uh. Some people like kinda joking like, oh, you might wanna rethink the post in this one. I’m like, no, you know what? I’m gonna let it let it ride because you know, it’s, you can’t get mad at me for, this is all based on humor, comedy, but
Kristin: yeah,
Will: I understand it.
That’s a little, the context is a little bit different.
Kristin: Yeah. Well, and because they hadn’t seen it before, they may have thought that you. Just filmed this, you know, possibly that you wrote it after that and you didn’t. But it, it was a bit of an oversight, I think, in retrospect. Maybe we would’ve thought about that a bit more.
Will: I, there were there, and there are a couple of topics that I would’ve liked to include. I. That’s like in, in a future iteration of the when. Mm-hmm. However, I, I do like, you know, healthcare related content in the future. I didn’t really talk much about Medicare Advantage.
Kristin: Mm. Yeah.
Will: Which [00:21:00] really was, you know, Obama, you know, the, um, affordable Care Act.
Yeah. It really paved the way for Medicare Advantage for like insurance companies to start getting all this government money. To fund their version of Medicare.
[music]: Hmm.
Will: That’s what Medicare Advantage is. Mm-hmm. So it’s like basically government sponsored health insurance, private health insurance plans.
[music]: Mm-hmm.
Will: And it’s been a disaster. Mm-hmm. It’s just like that part of the Affordable Care Act. It just really just paved the way for so much of the greed and
[music]: the
Will: stuff that sucks because, you know, yeah. I think a, I didn’t know at the time that that would happen. A lot of people probably did, but, um, anyway, it’s one of the,
Kristin: yeah, we didn’t have that in there now.
Didn’t have that. But now I feel like who knows could, what the healthcare system’s gonna look like. Uh, if you were to film this again, we’ll see. Maybe I’ll be, it’s changing. Every day I’ll
Will: be making a video about what tariffs will do to the healthcare system. [00:22:00] I dunno how much we, maybe we import like IV fluids.
And I, I’m, I’m not sure like what we, I, I have no idea how it’s gonna affect healthcare. I don’t think
Kristin: tariffs are the biggest issue. I think it’s gonna be more of like all the research that’s being defunded.
Will: Yep. That’s a big one.
Kristin: And like. The c, d, c. Yeah. And all of its services that are being defunded.
Will: I don’t think I’m gonna make a video about tariffs because I don’t really get tariffs.
I, you know what, like I’ve, I’m reading all these social media posts and people are like, are like, tariffs are good, and other people are like, tariffs are bad and I don’t know what’s going on. And so I assume we’ll just find out because not like any of us have any, any power over, you know?
Kristin: Uh, I mean, maybe not individually, but I feel like collectively
Will: like voting
Kristin: well and you know,
Will: just
Kristin: [00:23:00] protesting or advocacy.
Just, just
Will: raising a stink.
Kristin: Yes. Raising a stink
Will: ra, raising a back to deja de deja, stink. Deja deja. P raising a bit of deja.
Kristin: Yep.
Will: So other healthcare news, uh, you know, the pit, they’re gonna do a second season.
Kristin: Yes.
Will: That’s, um, apparently going to be based. On the 4th of July weekend.
Kristin: Yeah, I saw your post about this.
Will: Yeah. So
Kristin: ophthalmologist guaranteed
Will: there. Absolutely. Better be an ophthalmologist on the pit.
Kristin: Yeah. Any of the pit writers are listening.
Will: I’m happy to help. I, yeah. Yeah, you could. Come on.
Kristin: Yeah, do little consulting.
Will: Like right now, I look like a guy that was in the emergency department on 4th of July weekend.
Kristin: Little ragged. Rougher around the edges
Will: just ’cause they need a haircut. That’s all. But yeah,
Kristin: you had to skip your haircut.
Will: We’re gonna see some open globes. We’re gonna see some, uh, ferns
Kristin: to the face. And the hands we’re
Will: some very, uh, scared looking [00:24:00] ophthalmologist trying to navigate an emergency department.
I really that in
Kristin: there.
Will: They want mean that’s your, you know, I think they, they need to bring a, a little bit, it doesn’t have to be a comedy, obviously. It’s like a serious show. Yeah. But come on, the ophthalmologist can be the levity. That’s where you, that’s, that’s gonna be your little, your light moment, uh, is, is an ophthalmologist.
What they could do, just have them go around just asking people for things.
Kristin: And
Will: then everybody’s like, like, you know, trying to actually like, do lifesaving work. Yeah. And the ophthalmologist is like, where’s the tono pin?
Kristin: Mm-hmm.
Will: Can you, uh, do you have any eyedrops here? Uh, how do I order? I, I’ve, I’ve, I’ve not been trained on your electronic health record
Kristin: system.
Yeah.
Will: So I need you to do everything for me. Is that
Kristin: what you do when you go to the hospital?
Will: Well, there’s one hospital that we take call at that I, I cannot log into their system. So what I have to do is [00:25:00] write, like hand write.
Kristin: Mm-hmm.
Will: My consult note.
Kristin: Mm-hmm. And I
Will: hand it to the, the person at the front desk.
Oh my goodness. Be like, can you please scan this into the, oh my gosh. Record system. I, I’m not in there. I can’t, I can’t log in. Can,
Kristin: can you not get in there?
Will: Uh.
Kristin: On-call physician that works there? I,
Will: I don’t know. I, I, I, I mean, it’s probably possible, but it would require probably a lot of, I’d have to do like a eight hour training session training and
Kristin: stuff.
Yeah.
Will: That’s not worth it. Or, or the, like, the one or two times per year that I go to that location. Yeah. I can just hand write a note and have them scan it’s, and besides like, no one’s gonna read it. Yeah, no one’s gonna read it. I, you know, you know how many notes. So something scary thing about all the notes I’ve written throughout like residency and like hospital notes, like consult notes.
Mm-hmm. Wonder how many, what percentage people have actually looked at.
Kristin: Hmm. That’s a good question because I bet [00:26:00]
Will: it’s below 50%.
Kristin: Yeah. Is it mostly for like liability purposes that we have everything documented and insurance?
Will: I think liability is what drives the note bloat. The extreme amount of documentation that occurs.
Kristin: Mm-hmm.
Will: Yeah, because we have a, a. A lot of liability issues here in the us. Um, and people are terrified of that kind of thing.
[music]: Right.
Will: Uh, but I mean, you’re just, you’re told, you know, you gotta document everything and so it’s there in case someone needs it down the road, but mm-hmm. I, I, I. I just doubt that anybody’s ever read any of my
Kristin: notes.
Well, that makes all the residents listening feel great.
Will: Not even it’s, but, uh, maybe part of it’s because we always also use a ton of acronyms that no one can decipher. Mm. So maybe it’s partly our fault too.
Kristin: Yeah. You could spell those out.
Will: All right. Let’s take one more break. I have, um, a little activity for us.
Kristin: Okay.
Will: All right. Here, we’re back. Tell, tell the [00:27:00] people what I just handed you.
Kristin: Um, it’s a, it’s a hefty book.
Will: Mm-hmm.
Kristin: It’s first aid for the U-S-M-L-E, step 1 20 25.
Will: Hell yeah.
Kristin: A student to student guide.
Will: Are you familiar with this book?
Kristin: I remember you having a version of this book. Yeah. A long time ago.
Will: It was probably about, uh, half the size of that.
Kristin: Mm. It’s gotten bigger. Huh? It’s
Will: gotten a lot bigger. And that is like the med student bible.
Kristin: Yeah.
Will: So when you’re studying for your exams,
Kristin: right?
Will: Like thats the thing?
Kristin: Yes. This, this was your copy back in the day was a well worn, the edges were afraid.
Will: Yep, yep. And I had, I had notations in there and there was mm-hmm.
Just a, I’m not a big highlighter, but you’re a big highlighter. I can tell you. I know you’re a big highlighter.
Kristin: I, I do pen more than highlighter. I will underline and like make notes. Yeah. Yeah. I like to color code so I can find quickly though. Yeah. A highlight.[00:28:00]
Will: So, uh, I’m toying around with this idea of, of, of making skits around different, like diseases
Kristin: Yeah.
Will: And just things that are in this book. Mm-hmm. That’s why can you
Kristin: remember things that are in this book? That’s
Will: why I bought the book
Kristin: because
Will: I don’t remember anything. And so I thought, you know, like, because I had talked about this on, uh, uh, knock, knock Eye episode as well, but mm-hmm.
Uh, you know, I. I’m enjoying doing these New England Journal of Medicine things where I, I get a trial, I, I make mm-hmm. I try to make that seem funny and engaging so that people will pay attention to it.
Kristin: Yeah.
Will: Well, I thought like, let me do the same thing for like body medicine.
Kristin: Yeah.
Will: Right? Mm-hmm. Not just eyeballs, just because people, you know, people probably get tired of like, hearing about eyeballs and so let me, maybe I could do some stuff about like cardiology and like GI and rheumatology or mm-hmm.
Which I’m not even totally, some of these areas
Kristin: that you have, uh,
Will: pediatrics Yeah. All [00:29:00] those things historically glossed over. And so, um, and so I, and I can have the characters like mm-hmm. Explaining this thing in medicine in a way that’s fun and engaging for people and that people might, you know, take something away from it.
So, uh, I thought we could, like, I just wanna test my knowledge here. Okay. Okay. So I want you to just randomly open that book to a page.
Kristin: Okay. And
Will: then pick something. Pick a pick something and I’ll just tell you what I know about it.
Kristin: I’m not even
sure what I’m looking at. Okay. A good one. Here we go. Um,
Bradford Hill criteria.
Will: Pick another page, please.
Kristin: Okay,
here we go. What a what? So this is in the musculoskeletal skin and connective tissue. Okay. Section anatomy and physiology. Subsection.
Will: Okay.
Kristin: Um, common in [00:30:00] parentheses, fibular, peroneal Neil L four S two. I dunno, am I saying that correctly? You don’t remember?
Will: Oh, it’s just like, what is the anatomy? Oh, you’re cheating, you’re looking.
Kristin: Okay.
Will: Um,
Kristin: yeah,
so, so it wants to know innovation cause of injury. Oh. And presentation slash comments.
Will: I don’t like this game.
You made it. I
know. I didn’t think about it. Um, this is the first time this book has been opened so far. Oh, okay. And it’s harder than I thought. Okay. Uh, let’s try another one.
Kristin: Okay. Here’s some.
Will: Okay.
Kristin: Oh, nope. That’s gonna be too hard too. I don’t know if you know
anything in here.
Where’s the eyeball section?
Will: No, no, it can’t. It doesn’t have to be eyeballs.
Kristin: That’s the only thing you have any hope for. Oh, here we go. Some public health.
Will: Oh, okay. Let’s do public [00:31:00] health.
Kristin: You wouldn’t have known this back in the day, like youve learned health in step One more. I know that.
Will: Okay.
Kristin: That’s pretty good.
I’m glad that there is. Yeah. Um, okay. What is capitation?
Will: Capitation is when a doctor will receive a, like, set amount of money from either like a health insurance, usually it’s like a, you know, the health plan that the patient’s on, we’ll give the doctor like a set amount of money to do their healthcare.
Kristin: Mm-hmm.
Will: And so the whole idea with capitation is to try to, to decrease costs. Because the, the physician, the team has to be, um, economical with their medical decisions.
[music]: Mm-hmm.
Will: And not order too many tests or, you know. Mm-hmm. Um. I think [00:32:00] the, some, a lot of people don’t like the capitation model just because it’s pretty restricting.
Kristin: Yeah.
Will: And then you end up, what if something really bad happens to the patient? Right. And like, you know, or it’s a more complex
Kristin: patient.
Will: Right. And so then, then you have to like, you know, like lobby for more money. And so, uh, I don’t know. I think it’s, it’s primarily used, I, the context I’ve heard about it is in, in like primary care.
Kristin: Okay.
Will: Right. So, yeah, I know a thing that
Kristin: was pretty good. Physicians says physicians receive a set amount per patient assigned to them per period of time.
Will: Oh yeah. Okay.
Kristin: Regardless of how much the patient uses the healthcare system used by some HMOs.
Will: Yeah. So like that, that would be a popular thing for like young.
Patients, right? Yeah. Who don’t have a whole lot going on. Sure. So even if like the patient only comes in for like a physical once a year, you still get like a certain amount of money, and so mm-hmm. Maybe the idea is that that amount, that money you [00:33:00] get is supposed to offset some of the other patients that have to use more of the healthcare system.
Kristin: Right.
Will: I don’t know. I could see the, I could see the issues and flaws with that though. Yeah. All right. Gimme something else. Well, I’m gimme something else. Well,
Kristin: I’m pleased to know that this. This whole section is public health sciences, healthcare delivery. I’m really glad that that is something that med students are learning about now.
I
Will: could totally do and see. So this idea of this content idea I have is that, so I, I do a video about capitation, about the capitation model. Yeah. And I could totally. Figure something out where like, um, like ortho thinks it’s like decapitation. Yeah.
Kristin: The opposite of decapitation. Yeah. You put a head back on.
Will: Yeah. And then he’s upset because like he’s doesn’t do spine and there’s a lot of spine work and something like that. And, and what does that have to do with the long bones?
Kristin: Mm-hmm.
Will: Uh, so yeah, see, it’s just easy. This stuff writes itself. Okay. Okay. [00:34:00]
Kristin: Um, okay, so you want another one? It’s hard to find one that I think you’ll have a chance at,
Will: but you won’t know unless you ask me.
Kristin: I know, I know. I know what you know.
Will: Dude. You don’t know. You don’t know what? I know.
Kristin: I’ve been with you the whole time. I know what you still know.
Will: Okay, gimme one more.
Kristin: Okay. Alright. Mr. SmartyAnts?
Will: Mm-hmm.
Kristin: Crypto Srid.
Will: Ooh, cryptosporidium.
Kristin: This is on topic.
Will: Cryptosporidium is a bacteria that, uh, gives you severe deja poop.
Kristin: Yes,
but not really.
Will: It’s, it’s a GI bug.
Kristin: Yes.
Will: Um, that’s all I can tell you.
Kristin: It says severe diarrhea in aids.
Will: Oh yes. So it’s more, yeah, so that’s like the classic people who are [00:35:00] immunocompromised are more likely to get cryptosporidium. So it’s an uncommon mild
Kristin: disease in immunocompetent hosts.
Will: Right. So yeah, you got a normal immune system, just a little bit of, little bit of the runs.
Mm-hmm. So that’s it.
Kristin: Uh, what’s the treatment?
Will: Oh. Nothing. Do
you load? No. You is there, there’s something. Uh, how about, um, let’s do like, uh, uh, doxycycline.
Kristin: No,
Will: I have no idea. What is it? mRNA Isol?
Kristin: No, but that seems like you’re getting in the right ballpark. Maybe based on the, what is it? Etymology of the words.
Well, prevention first of all, like by filtering your water.
Will: Sure.
Kristin: Uh, but, oh geez. I dunno how to say this. It. What is it?
Will: Ni not God. I haven’t even heard of that. NI oxide, Ida oxide.
Kristin: You give that for the severe disease and or [00:36:00] immunocompromised. Oh
Will: man, that’s a new one. I ain’t even heard of that. This is why this book is like twice as big as it was whenever I was, yeah, there’s new
Kristin: stuff, man.
People.
Will: There’s too much new stuff.
Kristin: Yeah,
Will: I wanna see, I wanna see what the first edition of First aid, how thick that was. Yeah, it was like 30 pages. It was the same
Kristin: size as Pocket Medicine.
Will: Yeah, exactly.
Kristin: God, you
Will: know, pocket medicine.
Kristin: I told you I’ve been here the whole time. Dang. Hello.
Will: Dang. You’re so good.
Believe you. Pay
Kristin: attention.
Will: I still have my pocket medicine. I
Kristin: know. I used it as a prop. It is a,
Will: it’s a prop. It’s a prop. All this stuff. I don’t know what happened to my fir I, my, I know, actually I remember my first aid book. It fell apart.
Kristin: Yeah.
Will: It, it was, it was like in two different pieces. As I said, it was very well
Kristin: worn.
Will: Yeah. And so I, I’m pretty sure I got rid of it. And that was before if I had known, if I’d only known,
Kristin: maybe there’s a version on eBay that you can, I’d be making
Will: comedy videos based onte on, on First Aid.
Kristin: Yeah. You
Will: maybe I would’ve kept it. Kept it. But whatcha gonna do,
Kristin: how are people supposed to learn all this now?
Like if there’s so much new stuff? That’s my
Will: question. Two, [00:37:00] I don’t know how students get all of that stuff in their brain.
Kristin: Yeah. And it seems like they shouldn’t have to anymore. Right. Like with AI and Google.
Will: Yeah.
Kristin: I feel like that’s gonna cover a lot of what you need to know. So what are the new skills gonna be, you know, that will be important for med students to have?
Will: I don’t know. Uh, but also like everything they have in that book, there’s like so many mnemonics.
Kristin: Mm-hmm.
Will: Some of them are a bit of a stretch.
Kristin: Mm. Yeah. Yeah, I remember that. From your med school days.
Will: Not always helpful.
Kristin: No,
Will: but whatever you gotta do, I would. I came up with some, I don’t even remember them now, but I came up with some wild mnemonics
Kristin: that, yeah,
Will: that would only be useful for me personally.
Right. Your own brain. Uh, and so you just, you gotta do what you gotta do to try to cram all that stuff in my head. In your head. Yeah. And then you can imagine why when I started ophthalmology residency, it’s just a big dump. Yep. I just, I just, just, you just had a
Kristin: big dejavu. Deja a deja
Will: dumped it right [00:38:00] outta my brain.
Alright, that’s it. That we’ve, we’ve, we’ve, uh, that’s the most
Kristin: poop talk we’ve ever had in an episode. I think that’s, I don’t know if anyone’s still listening.
Will: That’s all the first aid I can handle for now, for today. Um, so let’s, let’s call it, uh, okay. Thank you all for listening. Uh, let us know if you have any other, uh.
The tips on how I can use first aid in my content. What, how did I get to this point? Anyway, uh, you can email us, knock knock high@humancontent.com. Visit us on our social media platforms, hang out with us and our Human Content Podcast family, Instagram and TikTok at Human Content Pods. Thanks to all the listeners leaving wonderful reviews and feedback.
We love those. Uh, if you subscribe and comment on your favorite podcasting app or on YouTube at Glaucomflecken by the way, we can give you a shout out like. At Tarzan’s mom on YouTube said, lady Glaucomflecken, I love your reasoning behind and practicing of teaching chat, GPT, polite language. Bravo.
Kristin: Well, thank you [00:39:00] Tarzan’s, mom,
Will: and thank you Chad.
GPT.
Kristin: Yeah, this was about how I feel like maybe we should be using polite language when we use Chad GPT, because maybe that’ll train the models to be nicer.
Will: So that’s it. Very thoughtful of you. I’m sure.
Kristin: I don’t think you mean that.
Will: I’m sure the, the AI program really appreciates it.
Kristin: Well, no, I, it’s not about them.
It’s like, you know how technology just sort of starts to devolve into the worst of humanity. Yeah. So let’s try to put in more of the better parts of humanity. See if maybe we can counteract. Some of that
Will: valiant effort. Don’t know if it’s gonna work, but it’s a great idea.
Kristin: Oh, I’d like to try.
Will: Full video.
Episodes are up every week on our YouTube channel at Glaucomfleckens. We also have a Patreon. Lots of cool perks, bonus episodes, react to medical shows and movies. I like the pit. We gotta get some pit going in there, hang out with other members of the Knock Mac High community wear there and active in it.
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Kristin: Yeah.
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We’re your host Will and Kris also knows the Glaucomfleckens. Our executive producers are Will Kristin Blair, Aaron Cordy, Rob Goldman, Ashanti Brook, editor Engineers, Jason Portis. Our music is by oer. Bens v
Kristin: uh uh, Emmy Award-winning. Yes, O Mayor. Bens V
Will: and Emmy Award-winning Ashanti Brook.
Kristin: That’s right
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Yeah,
Kristin: it’s disappointing.
Will: Knock-knock. High is a human content production
knock.
Hey, Kristin.
What?
Will: You want an assistant?
Kristin: I would love an assistant. I bet you would. I don’t want just one though. I want many,
Will: many assistants.
Kristin: Yes. I’ve got a lot of work.
Will: Well, I can give you something that does the work of many assistants.
Kristin: Okay.
Will: Have you heard of Microsoft Dragon Copilot?
Kristin: Oh, I have heard of this.
Yeah.
Will: This is an AI assistant for clinical workflow.
Kristin: Mm-hmm.
Will: That’s amazing. It’s, it transforms the way clinicians work. Uh, it’s like a little Jonathan. Yeah.
Kristin: Doing,
Will: doing lots of things for you. Uh, one of those [00:42:00] things is, is helping you get information faster.
Kristin: Oh, yeah. That’s nice. Yeah.
Will: This is what I, one of the things I love most about it, like, you just ask and you can get answers on a wide variety of clinical topics mm-hmm.
With citations, sometimes, like we don’t, we have to like do research to like. Yeah, try to jog our memory about certain things. You, there’s a lot to, to think about in medicine,
Kristin: right? And new stuff coming out all the time.
Will: Well, Microsoft Dragon copilot can just make that process faster and give you citations that lead you, you can look up the latest evidence about things, guidelines.
It just, it just makes that whole process seamless.
Kristin: I like it.
Will: To learn more about Microsoft Dragon copilot, visit aka ms slash knock-knock high. Again, that’s aka ms slash knock-knock high. Thanks for watching the episode. You can find more on that playlist over there If you prefer to listen or you just had your eyes dilated, you can binge full episodes wherever you get your podcast or join the party over on [00:43:00] Patreon where you get early access episodes.
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