Glauc Talk | How Do Health Insurance Companies Avoid Accountability?

KKH Trailer Wide

Transcript

Will: [00:00:00] Today’s episode is brought to you by Dax Co Pilot from Microsoft. To learn about how Dax Co Pilot can help you reduce burnout and restore the joy of practicing medicine, visit aka. ms slash knock, knock high. Again, that’s aka. ms like Microsoft slash knock, knock high. 

Preston: You ever have that attending who.

It’s just an absolute fountain of knowledge and you wish you could just sit down and have coffee with them and be that third person in the room while they discuss those things. Yes. I am not that attending, but I do like to follow them around. And I wish that there was a podcast where I could emulate that kind of energy and have this third person feel like they’re in the room with us.

Going into the nuances of what it means to be patient with someone, how to be therapeutic, but also being able to delve into off topic and candor things, candid things about what it’s like to 

Margaret: be 

Preston: a [00:01:00] resident. Candor 

Margaret: things. Candor. Talk like humans do about, with candor. Do you hate Mondays like the Cat Garfield?

I do. I do 

Preston: hate Mondays. 

Margaret: Well, we want to make it better for you. 

Preston: How can you make Mondays better for me? 

Margaret: Maybe you can listen to our podcast, How to Be Patient, where you hear Preston and I be talking about psychiatry. 

Preston: I have to be very patient with Margaret. 

Margaret: Because I’m advanced, because I’m a couple years, I’m a PGY 4 psych resident.

Preston, you are PGY 

Preston: 2. 

Margaret: Which is two less. 

Preston: Margaret and I are not normal residents, we’re cool residents. So if you want a boring podcast. I’m going to get hazed for that. I would avoid our show. But if you want to tune in, check in with us every Monday, and we’ll be posting new episodes where we talk about topics ranging from Cognitive behavioral therapy to vitamin D, how I feel about Fortnite and everything in between.

Margaret: Fall, 

Preston: Andrena fall, 

Margaret: the Lizzie McGuire of it all.[00:02:00] 

Preston: Hi.

Will: Hello, everybody. Welcome to Knock Knock High with the Glaucomfleckens. I’m Dr. Glaucomflecken, also known as Will Flannery. 

Kristin: I’m Lady Glaucomflecken, also known as Kristen Flannery. 

Will: Uh, this is our episode of Glock Talk today. That’s 

Kristin: right. 

Will: You know what’s coming up? 

Kristin: What? 

Will: Ophthalmology match. 

Kristin: Ooh, big day. 

Will: It happens earlier than the other matches.

Kristin: Yeah, I never really understood that. 

Will: Uh, well, it’s a different program, uh, and, like, it’s a, it’s a, it’s its own entity, the [00:03:00] ophthalmology match, and all the other specialties, or most of the other specialties are, they all happen on the same day, ophthalmologist does it differently. Because we got to be different we can’t be touching that’s 

Kristin: why I don’t ever understand We can’t be like really an explanation 

Will: be like around right and in the same vicinity as other specialties That’s 

Kristin: your you guys have like social anxiety body 

Will: medicine, right?

Do you remember the top like five on my rank list? 

Kristin: Oh, this is getting pretty far away at this point, a lot has happened since then. Let’s see, I remember Michigan. 

Will: Okay, yep, Michigan was number one, Iowa was number two, where I can do it matching. You know the difference between the two, why I chose Michigan over Iowa?

I’ve told you this before. 

Kristin: I can’t remember. 

Will: Because Michigan had a better ophthalmology. Oh, sorry. Michigan had a better, um, uh, uh, ultimate frisbee scene. Oh 

Kristin: my God. 

Will: Yeah, that was it. 

Kristin: Well, then you went, you ended up getting matched to the correct place then. [00:04:00] 

Will: I think it’s a totally, I could not separate the two.

When were you going to 

Kristin: play ultimate frisbee during residency? I did, I did play. I found a team in Iowa 

Will: and I would have found a team to play with in, in Michigan as well. But it ended up being okay, because I really liked the team I played with in Iowa. But anyway, those are my first, my top two, and it was very hard to separate those two, and they’re both very good.

Kristin: Yeah, uh, I don’t remember what came after that, do you? 

Will: Third was Wash U in St. Louis. Oh. Fourth was Uh, UC Davis, 

Kristin: could 

Will: have gone to Sacramento, what do you think about that? No, no thoughts, no thoughts whatsoever. Uh, fifth would have been, uh, Chicago, UIC. 

Kristin: Okay. 

Will: Yeah. So, anyway, those are my top five. 

Kristin: Yeah. 

Will: And I was, I was happy with my, with my outcome.

Kristin: I was sad at first, but then once we got there Why 

Will: were you sad? 

Kristin: Uh, I had some preconceived notions about what life in [00:05:00] Iowa would be like, um, and in Iowa City, where we were, it was not at all like that, and it was actually lovely, and we had a wonderful time, and it was very difficult to leave at the end of it.

Will: Yes, that’s true. Um, But anyway, yeah, it all worked out. All worked out. Good luck to everybody, uh, matching ophthalmology. I think urology is the other one. Something about balls. They just all want to do the match, like, a little bit differently between the urologists and the ophthalmologists. 

Kristin: What other balls are there?

Will: Uh, there’s, 

Kristin: There’s that little ball at the back of your throat. 

Will: That’s the uvula. Uh huh. And there’s no specialty dedicated to the 

Kristin: uvula. 

Will: I guess, that, that doesn’t really count. Are there, are there other balls? Is it eyeballs, testiballs? 

Kristin: Testiballs. 

Will: Uh, I mean, ovaries are, Are there any, oh, ovaries are ball ish.

Lady, lady balls. 

Kristin: Lady balls, yeah. Um. 

Will: Um. What 

Kristin: other ball shaped 

Will: structures? The pituitary gland is kind of ball ish. Kind of, kind of, yeah. 

Kristin: Uh huh. 

Will: It’s, it’s like a, [00:06:00] it’s more like a rugby ball. It’s a little bit oblong. It’s got like two Well, so are the 

Kristin: ovaries, are they not? 

Will: I mean, I guess they’re all oblong except for the eyes.

Even the eyes are not perfect spheres. Mine are probably oblong. There are no perfect spheres in, in the, in the body. 

Kristin: That’s, that’s actually very interesting because there are perfect spheres in nature, aren’t there? 

Will: Yeah. I mean, I, I don’t know. I mean, a perfect sphere is No, there are no perfect spheres in the 

Kristin: sun.

I don’t know the moon. Are they? They’re probably not perfect spheres either. 

Will: Good question. Are there perfect spheres in nature? I don’t know, but definitely not in the human body. 

Kristin: Yeah, 

Will: unless like maybe gall stones 

Kristin: Gall stones, kidney stones, 

Will: kidney stones, gall stones, stones could be bladder stones. You get stones everywhere.

Kristin: Yeah Tonsil stones. 

Will: Tonsil stones? You know? Did you ever have your tonsils removed? No. Did you have surgery? No. No. I don’t think they do that anymore. I 

Kristin: don’t think it’s a real thing anymore, right? Like, didn’t they discover that they just grow back? It’s like 

Will: bad. 

Kristin: You tend to have [00:07:00] whatever was causing that problem.

They didn’t actually address by removing the tonsils. Yeah, something to that effect. 

Will: Just unnecessary surgery. Yeah, what about 

Kristin: lymph nodes? Are they, are they balls? Like individual nodes? Lymph nodes are 

Will: circular, but they are, no, they’re not perfect spheres. No. No, they’re ball like. 

Kristin: Okay, 

Will: so there’s actually more balls than I thought of.

Kristin: Yeah, there’s not perfect balls, but 

Will: you know If we were if we were ranking the human balls I still think I think I and then testicle would be like one and two. 

Kristin: Of course you do given your personal 

Will: My personal experience. Yeah, I think that’s what most people if this is a family feud topic 

Kristin: Yeah, 

Will: be like name a human body ball.

Kristin: Of course. 

Will: That would that was it be 

Kristin: those are the only two that are external 

Will: What would be the first thing people would say 

Kristin: Uh, testicles. 

Will: Testicles, yeah. Because we call 

Kristin: those balls colloquially. We don’t call our eyeballs just balls. 

Will: Okay, but not, not me. I would say, I would say [00:08:00] eyeball first. 

Kristin: Bubbles!

Bubbles are perfect spheres in nature. Thank you, producer Rob. 

Will: That’s a good one. Yeah. Bubbles, and those are like naturally occurring things. Yeah. And you have 

Kristin: Like outside in the water, 

Will: ocean. 

Kristin: There’s probably some ocean spheres. What’s a, I wonder what a perfect sphere in the ocean might be. 

Will: The closest thing to a perfect sphere in nature is considered to be the sun.

Kristin: There you go. 

Will: Okay. 

Kristin: I guess that. 

Will: There you go. That’s good. You named it. You named the only perfect sphere in nature being the sun. I’m proud of you. 

Kristin: Well, I miss bubbles. 

Will: Bubbles are, I guess that counts. I mean, it’s, it’s more just oxygen underwater. Ooh, 

Kristin: are atoms perfect spheres? 

Will: Uh, alright, I think we can probably, you know, move on from this.

Alright, uh, I think we should, uh, do healthcare news right off the bat. 

Kristin: Okay. 

Will: So, uh, We’ve talked a lot, a lot of people have talked about, obviously, the, the [00:09:00] United Healthcare CEO murder and then the, the, the uproar about health insurance in general, uh, leading to the, um, uh, the Blue Cross Anthem policy surrounding anesthesia being rescinded.

All right. That was the thing that happened. 

[music]: Right. 

Will: Um, but now, um, This is always so predictable. So anytime that there’s like this big backlash against like health insurance, which obviously honestly doesn’t happen as much as it I think it should, uh, there’s like the backlash to the backlash. There’s I, what I think is just the health insurance industry, like doing what they do to try to regain some of their PR, which is finding someone else to blame about the health insurance industry.

Of 

Kristin: course. 

Will: So, uh, Health 

Kristin: insurance 101. 

Will: Yes. So somebody else, it’s not, it can’t be the health insurance company that is the cause of all of our pain and suffering in healthcare. It’s got to be somebody else. [00:10:00] We only do great things in health insurance. And so who is it that usually gets blamed? 

Kristin: You guys!

Will: Yeah, the physicians, it’s so I think they’ve been hard at work recently, trying to get that message out there to, I don’t know, whoever’s willing to take up that mantle on social media about, look at physicians, look at, you know, everybody’s so mad, look how much they’re paid. So And this is like, it’s a hard thing to address as a physician, uh, especially on social media when there’s no nuance, uh, and so, I mean, I’ll try to do it here.

So if we take the, the pie chart of, of healthcare expenditure, physicians are like, depending on who you ask, like 7 to 8%, maybe like 9 percent at the most of healthcare expenditure. 

Kristin: Right. 

Will: Very small slice. 

Kristin: Very small. Also. They have debt from becoming a physician. 

Will: That’s another reason. So, so, you know, it’s, it’s easy to say, let’s pay physician, [00:11:00] let’s, let’s cut their reimbursement, by the way, our reimbursement does get cut every single year, Medicare reimbursement gets cut, health insurance.

Typically does pay a little bit more than Medicare, but that also gets cut. And, and so we are every year where we’re getting less and less money from the things we do while other entities, namely hospitals, get more and more 

[music]: so 

Will: that, so the, the, the pie is being redistributed every year. So we are getting paid less, especially when you consider inflation.

Um, and, uh, and also like nobody thinks about how. Connected education, medical education is to reimbursement, right? Like you can’t, you can’t make med students take out 300 grand plus it’s because it’s just getting higher in loans and then, 

Kristin: and then not pay them enough to pay those back. 

Will: Yeah, I mean, not so much not [00:12:00] be able to not pay them enough, but just like we’re getting such a late start.

Kristin: Yeah, 

Will: and we’re, we’re very highly educated, very highly specialized. So we, I think we should get paid a lot of money for what we do. 

Kristin: Yes. It takes a long time to learn those skills. 

Will: And we’re not, we’re not actually like making that high salary. Most of us until our thirties, usually early thirties at the earliest.

Kristin: Right. You 

Will: know, to mid thirties. So, 

Kristin: so at that point you have a lot of catch up for like retirement accounts and you can’t fully catch up on something that uses compound interest, right? Like you’ve missed. 

Will: Yeah. 

Kristin: Or like. If someone just graduates college and gets to work and opens their retirement account, they’re 22, 23 years old, right?

You guys are 32, 33 years old before you’re able to do that. That’s a lot of loss savings. 

Will: And I’m not saying this to like make people think like I, we don’t make a lot of money because 

Kristin: Right. Nobody needs to feel sorry for you. Don’t feel sorry for us. Yeah, obviously. [00:13:00] 

Will: I’m doing just fine and physicians are doing just fine, but the idea that’s put out there that physician compensation is the problem is nonsense.

Kristin: Right. It’s a tactic that the insurance companies are using to distract from how much money they are actually making. 

Will: And here’s, here’s the last point I want to make about this, and this relates to the, um, the topic of Blue Cross deciding to only cover a certain amount of anesthesia during a surgery based on guidelines that they want to follow.

[music]: Mm hmm. 

Will: And, um, the backlash that occurred from that, which resulted in them rescinding that policy. There was a lot of stuff coming out on social media about surprise billing, overbilling. Like physicians, the reason we’re doing this is to protect you from the greedy doctors who are charging too much for their services.

Kristin: Yeah. 

Will: [00:14:00] And what, and here’s another thing that is not coming out in that discussion is that the vast, the majority of physicians are employed by UnitedHealthcare and hospital systems. There are fewer and fewer physicians out there that are in private practice that even have the ability to, to fraudulently bill.

And, and also, since we have electronic health records, all of that stuff is automated, like, it’s, it’s increasingly more difficult because there’s a, a massive electronic paper trail to commit fraud and bill more than you’re supposed to bill, and Like, there’s time stamps for everything, for when a surgery starts, for when a surgery ends.

It’s like, you can’t, it’s not just so easy to just, like, overcharge someone these days, and so. 

Kristin: But how does that jive with another complaint we have, which is, [00:15:00] you can’t read your bills. It’s so hard to read like to tell what cost what amount of money. 

Will: Yeah I mean that that’s part of that is just how complex our health care system is and and who you’re getting a bill from and Where and and which hospital and so I think it’s just that’s that’s more 

Kristin: Where you can be?

Where fraud can squeak in because people are not understanding. Like, sure, everything is documented, but not in a way that everyone 

Will: can see on their bill. I mean, sure, but it’s also easily discoverable, and you’re just asking for trouble. 

Kristin: Who would it be discovered by? Like, who can read those things? Who’s looking at those?

Audits. 

Will: There’s audits that are done by CMS, by regulatory bodies. They’ll come in periodically. What’s 

Kristin: CMS? 

Will: Center for Medicare Services. Oh, 

Kristin: okay. 

Will: Uh, they’ll come in. Oh, right. They, they have, so 

Kristin: Dr. Oz is auditing everyone. Great. . 

Will: That’s right. Exactly. . [00:16:00] So, uh, yeah, they’ll come in and they’ll, they’ll check and Right.

If they, especially if it’s, if, if you’re like way off, if you’re a physician and you’re billing way more than a physician that does the same work as you. That’s a red flag, and it’s gonna, it’s gonna, someone’s gonna notice that, and is gonna come after you, and that’s how people get discovered for committing Medicare fraud, so all these arguments that health insurance company and people that support health insurance, which I still will never understand why our physicians, like our own people, We’ll be like, Oh, you know, this is, they actually, you know, that they don’t actually make a lot of profit from claim denials and they don’t, this, I mean, Are 

Kristin: those people being paid by the health insurance companies?

Will: Uh, well, there’s some of them that do get, um, uh, uh, consulting fees from, from UnitedHealthcare and others. So, but it, it just, [00:17:00] it’s silly to, to, to, to say that they’re, cause they’re the ones that are in power. They’re the ones that are employing physicians. They’re the ones that are making all these policies.

Kristin: And more and more, they are the ones that you have to get permission from to even do your job. Yeah, 

Will: so, I don’t know. Now I’m just like, kind of, now I’m all amped up. 

Kristin: Yeah. 

Will: Let’s fight the system. I don’t know. So anyway, let’s take a break. We’ll come back. 

Kristin: Gotta get your blood pressure down.

Will: Hey Kristen, you just got disability insurance recently. 

Kristin: Well, I got it renewed, yeah. 

Will: How does it feel? 

Kristin: It feels pretty great! 

Will: Yeah, it’s such an important thing. 

Kristin: It really is. 

Will: Especially for physicians, because 

Kristin: Yeah. 

Will: I use 

Kristin: my hands. You need your hands. 

Will: I need my feet. 

Kristin: You need your feet. You need your eyeballs.

Will: Eyeballs too. Yeah. It’s like literally everything. Like there’s so many things that could happen, and having that peace of mind of having disability insurance is really important. And uh, so let me tell you about Pearson Rabbits. 

[music]: Tell me. This 

Will: is a physician founded company [00:18:00] by Dr. Stephanie Pearson, a disabled OBGYN, and Scott Rabbits, a disability insurance expert.

Now they’ve come together and have helped more than 6, 000 physicians get disability insurance. 

Kristin: That’s pretty cool. Wow. Just. 

Will: An advocate for physicians as well to like help people not have this massive oversight of like thinking you don’t need disability insurance because you really do when you’re a physician.

It’s the 

Kristin: kind of thing you got to buy when you’re healthy for when you’re not. 

Will: That’s right. To find out more and get a free one to one consultation, go to P E A R S O N. R A V I T Z dot com slash knock knock. Again, that’s www. pearsonravitz. com slash knock knock to get more information and protect your biggest investment.

You.

All right, Kristen, I got something fun for us to do a few things. Um, so first I liked, uh, this is a segment I call TikTok recap. 

Kristin: Okay. 

Will: So people. Love [00:19:00] T. Mm-hmm . That’s what the kids are calling it now. T. Mm-hmm . Right? That’s the T. What’s the T, right. Do I sound like an old person saying this? 

Kristin: Yes. You do. , 

Will: but that’s what, but why?

That’s what they call it. The T. 

Kristin: It’s the way you’re saying it. . Am I supposed 

Will: to say it? 

Kristin: People love T. 

Will: Oh, not, is that what 

Kristin: the kids are saying? T. 

Will: Is it that, did I say it, called it the T? Like no, you 

Kristin: said T 

Will: like the Internet’s. 

Kristin: No, you said T. 

Will: T. That’s why I I, I think that’s fine. Anyway. 

Kristin: Moving on. 

Will: All right.

The T. T. The 

Kristin: TikTok T? 

Will: Yes, the TikTok T. So, uh, I figured what we could do, yeah, I’ve made like 400 skits now. Yeah. And so, um. So many. I went through and found skits that I, that were very popular, 

Kristin: but 

Will: also generated some controversy. 

Kristin: Okay. 

Will: I thought we could talk about them. 

Kristin: Let’s talk. 

Will: So, every now and then, we’ll, I’ll bring up [00:20:00] one, and, uh, And 

Kristin: you’ll spill the tea.

Will: I’ll spill the tea. Exactly. So, this one today is, um, a video I did, uh, um, that was, I forgot the name, the exact name of it I put on YouTube, but on TikTok, it was about whenever a physician answers a phone call and hears the word, or really anybody that takes care of patients, hears a phone call, that says, You remember that patient you saw last week or yesterday or last, and that, the fact that that is this like pit in your stomach, you just, it’s like you’re on a roller coaster and like, oh man, immediately because we’re so perfectionist, the immediate thought is, Not oh really did they did they call you to tell me tell you that they love the health care that I gave them so much Like that would be a healthy way to think.

No, it’s always worst case scenario. 

Kristin: Yeah, 

Will: and so in this video [00:21:00] I’m some unnamed physician answer a phone call and it’s an emergency physician. They’re like, hey I would tell you that you know that patient you saw last week And then Enya starts playing, and it’s just, it’s just the, the thought process, there’s no words, I’m just like, I drop the phone, and just have this look of horror on my face, I start crying, eating ice cream out of the carton, um, I end up Googling, um, what is prison like, and malpractice lawyer near me.

Kristin: Right. Okay, I have, I have two interjections here. One is, that is every single day living with anxiety, just so you know. And do You’re telling me 

Will: I, you’re telling me I have anxiety. I’m a very, I’m a very even keeled person. 

Kristin: No, you’re not. You’re so uptight. What are you talking about? You are an [00:22:00] uptight person.

You are very high strung. 

Will: Explain. 

Kristin: This is a different topic for another time. Maybe we’ll get into this on the next episode. My question here was do you think that surgeons 

Will: I’m type B personality. I don’t know what you’re talking about. You are 

Kristin: not. Really? You think that? Oh, okay, good. I was, I brought up the anxiety because I have anxiety.

I was trying to garner some sympathy from you, like, or empathy, right? Of like, this is. I know, 

Will: I’m so sorry. This is 

Kristin: what my life is like. 

Will: Okay, so go on. What was your point? 

Kristin: You’re infuriating even when you are, it’s like sarcastic empathy. Okay, my, my question though, second, second interjection. You said that the healthy response would be to assume that someone was calling somebody else to talk about the great healthcare that you gave them, which I would argue is maybe also not healthy.

I think the healthy [00:23:00] response would be just neutral curiosity, but do you think surgeons Can relate to this video that you made or do you think they do think they’re calling me to tell me how great I did on that surgery? 

Will: I think it’s, yeah, it’s a universal reaction for all physicians. All right. Surgeons, um, I mean any, any physician.

Even 

Kristin: neurosurgeons? 

Will: You’re saying that they have, their ego is so massive that 

Kristin: they would assume that they were 

Will: getting praise from a phone call. 

Kristin: Yeah. 

Will: I don’t think so, because, I mean, that’s just what society is like now. You’re much more likely to hear the things you did wrong than the things you did right.

Nobody calls you 

Kristin: to tell you you did a good job. 

Will: Yeah, most reviews, that’s why we have to beg people to give positive reviews on social media, because, It’s so easy to get a negative review that you need like 20 of them, uh, positive ones to drown out like one negative review that you might have. [00:24:00] People just love complaining about things.

Yeah. I mean, myself included. We all do it. We all love complaining. So, uh, so I put that video out there and it’s a hit. I knew it would be. Like, sometimes I make a skit and I’m like, oh, this is, this is good. Like, I know I’ve made like a good piece of content. Sometimes I’m, eh, not so sure. 

Kristin: Mm hmm. 

Will: That’s when I, that’s when I show it to you.

And see if you like, if you give a little. 

Kristin: Yeah, that’s, that’s, 

Will: uh, If, if, if, if I know, that’s when I know a skit is gonna take off, is if, Kristen, if I get any kind of positive reaction out of Kristen. 

Kristin: Okay, you’re making me sound really mean. No, no, it’s just, 

Will: no, it’s not, it’s not that, it’s, it’s, it’s, because you’ve heard all my jokes.

Kristin: Yes, a million times. 

Will: So if I say something new and fresh. 

Kristin: Right. 

Will: And, and, and it, it makes you laugh, like, I know that’s, that’s like a really good joke. 

Kristin: Yeah. 

Will: And I need a harsh critic. I don’t need, I don’t need someone, no, I, I love it, I do, I really [00:25:00] appreciate that, it’s not like you’re trying to be a harsh critic, you’ve just, you’ve just heard a lot of my stuff.

Kristin: I’m just reacting, honestly. 

Will: Yeah, and so if I get a And I’m also 

Kristin: not in healthcare, so I don’t get all the jokes. 

Will: That’s true, that’s the other part of it, that’s part of it. So if you 

Kristin: can make me laugh, then anybody’s gonna get it, probably. 

Will: Yeah, that’s, that’s a much better way of putting it, yes. 

Kristin: Yeah. 

Will: So, uh, so anyway, this one though, I was, I was like, yeah, I got, I got something here because this is a really, it’s a, it’s a universal topic for people that see patients.

And, um, and so the reaction I got was, was generally that it was like, oh yeah, this is exactly what’s some people outside of healthcare, I think we’re a little bit like they were not confused by the video, but didn’t quite. Like understand that part of it really that’s surprising 

Kristin: because I think that’s a universal issue I mean, I think it’s maybe amplified in health care But everyone can relate to like having your boss call you and say hey that report you turned in or whatever It might be well 

Will: what I found out [00:26:00] was that there was one An ethics professor that actually made that video the topic of a lesson like a whole class 

Kristin: about 

Will: whether or not making those types of jokes about like being worried that you’re going to get sued or that you made a mistake is ethical from a coming from a physician.

Kristin: What was their Uh, argument about it might not be ethical. 

Will: Uh, because it’s, it’s like, you’re only concerned about the fact that you might face repercussions for a, for a mistake versus Versus the actual health of the patient. Like that what you 

Kristin: should be worried about when you get that call is that the patient might not be okay.

Will: Yeah. 

Kristin: But who’s to say you’re not also worried about that? Right, 

Will: exactly. I 

Kristin: guess it, because it wasn’t featured as a worry. 

Will: I guess, [00:27:00] because that’s not as funny. I mean, that’s like. The fact that I hurt a person is obviously at the forefront of my mind, but I can’t make jokes about that because that’s not funny.

Kristin: That’s, that’s the thing. It’d be interesting to speak to that ethics professor because it also gets into the ethics of being a healthcare content creator. You would not put that in a video because it is not funny to joke about. Right. Patients not being okay. 

Will: Right. That’s always, that’s, that’s at the root of the anxiety.

Is that 

Kristin: right? That you did something to harm the patient. Right. That’s the, that’s the underlying assumption in the video. Mm-hmm . That it goes unsaid because it is assumed. 

Will: And so anyway, that was, and then, you know, I, I would get, I got a few other comments that are like, you know, this isn’t funny or this is, you shouldn’t be joking about this type of thing.

And so I was a little bit surprised by that. I wasn’t expecting to, to get any kind of [00:28:00] pushback from that. Yeah. I’m interested 

Kristin: to hear from anyone who has that opinion to, to see like, Why? 

Will: I don’t know. I mean, I still stand by it. In fact, I made that video a few years back, and there’s some things that, like, I could have done better, and so I re remade it in, like, three, just, like, three years.

Maybe five months ago. And so I put it back out there and I totally like refilmed it. And yeah, it was like, it was like one of my first 20 tick talks and I just wasn’t that good at making videos back then. So it was just kind of clunky and not real great. 

Kristin: Right. 

Will: So anyway, that was, that was a tick tock recap.

Kristin: Yeah. Well, to the ethicists out there. The underlying assumption is that you are concerned that you have done something to have harmed the patient, and that is why you are thinking all these other things. 

Will: And granted, like, I, I’m, this is all, you know, 98 percent of people, like, got it. Right. [00:29:00] Right. So it’s, it’s, and I didn’t, and the only negative reactions I got were from other physicians.

So it wasn’t even like patients be like, I know this is alarming that my doctor thinks this way. 

Kristin: Right. 

Will: Um, 

Kristin: I do think that’s, um, it’s good though, too. It’s good that other physicians are thinking about and bringing up the question, right? Like you want you, your profession is one that is held to a higher ethical standard than some other professions.

And so it’s good that people in that profession are considering the ethics. 

Will: It still makes me laugh when I think about like Googling what is prison like. 

Kristin: Yeah, I mean, that’s just that’s just a funny thing to do. Come on. 

Will: Anyway, all right, um, that’s, so that’s, I like that, the, the TikTok recap, because I’ve got, I’ve got other examples.

Kristin: I’m sure you do. 

Will: Yeah, I mean, some people out there really don’t like [00:30:00] doctors trying to be funny. Yeah, 

Kristin: you’re, you’re a fairly beloved But polarizing character, I feel like, in social media, because most people do feel seen and understood by your content, and so they, they love it, and that in turn makes them love you, um, and then a very small minority of people, um, I’m trying to choose my words carefully here.

Maybe don’t get your jokes or something, or they don’t, they don’t think that, right, comedy has a place in medicine. And so those people are very outspoken about that when they have, you know, when you put something out that they’re reacting to. And there’s always either like, I really love this or this is garbage.

And 

Will: the question that I always have to answer for myself is. Is the criticism legitimate enough where I need to take this content down and I have done that a couple times. I’ll actually, we [00:31:00] can, you know, in future episodes, we can talk about those instances as well. Yeah, I 

Kristin: mean, I think it’s to your credit.

Will: knew, I was like, no, like this is, I understand what they’re saying, but the vast majority of people are getting the point that I’m trying to make. And that’s the biggest thing. Is it clear enough? 

Kristin: Right. 

Will: What I’m making fun of, who I’m making fun of. And who 

Kristin: you’re not making fun of. 

Will: Exactly. Is it, is the message clear?

And in that case it was. 

Kristin: Right. I think it’s to your credit, I have seen you, like, sure, nobody likes criticism and your initial response is usually like to bristle, right, at being criticized, which is everyone’s initial response. But then you, You are very thoughtful about, is this valid criticism? Like, I have seen you kind of mull that over, we’ve had discussions, and you know, and then when you are All the mental 

Will: anguish that you guys see, don’t see behind the scenes.

I’m just flogging myself sometimes in self punishment. 

Kristin: Is that supposed to be a joke? Because that’s a fact. [00:32:00] Metaphorically flogging, there’s no literal flogging happening, just to be clear. 

Will: Kristen, take the belt, give it to me, I deserve it. That sounded bad. It did. That was a 

Kristin: different direction than intended.

Let’s 

Will: take another break.

Hey Kristen, I know you’re a big fan of Demodex mites. 

Kristin: Uh huh. 

Will: You know the eyelid mites? Yeah. They’re on your eyelid. 

Kristin: Uh huh. They’re just 

Will: right there in your eyelid. Yeah, 

Kristin: thank you. 

Will: Well, what if they flew at you? 

Kristin: Oh God! 

Will: But what if they jumped? What if they jumped? Would that bother you even more? Oh, it’d be even worse.

Would that be better? 

Kristin: Jumping bugs are always worse. Well, I have 

Will: good news for you. They, they’re not jumping. They don’t jump at you. But they are there and they can cause like crusty, flaky, itchy, red, 

Kristin: irritated 

Will: eyelids. So I can tell you’re a little bit grossed out. 

Kristin: It’s a 

Will: disease. It’s called demodex 

Kristin: blepharitis.

It sounds like no fun. 

Will: Well, it, but it’s pretty [00:33:00] common. And a lot of people don’t really know about it. 

Kristin: Yeah. 

Will: But I mean, these like they’re, they’re, they are kind of cute. I gotta admit just a little, just 

Kristin: a little cute. Maybe a little cute. 

Will: Regardless, you shouldn’t get grossed out by this. You should get checked out.

Kristin: Okay. 

Will: I go to eyelidcheck. com for more information. Again, that’s E Y E L I D check. com to get more information about these little guys and Demodex Blepharitis.

All right, a couple more things for you. 

[music]: Okay. 

Will: Most embarrassing small mistake you’ve ever made. 

Kristin: Should I go 

Will: first? 

Kristin: I don’t know. Do you want me to go first or you go first? 

Will: Why don’t you go first, if you have something. 

Kristin: Um, the only thing I can think of, I’m sure there are many, but the only thing, it must have been the one I was most embarrassed by, because this is what pops to mind first, but one time in grad school, we, you know, they bring in [00:34:00] Visiting professors, and sometimes they’re very prestigious in the field, right, and well known and whatnot, um, and we would have brown bag lunches, you know, where we all bring our little sack lunch, and ramen noodles, that’s all we can afford, and the Speaker comes and gives a talk on some topic, 

[music]: right?

Kristin: Uh, and it’s a valuable opportunity because you get to have knowledge and you also get, it’s usually a smaller group, right? So you get like to actually interact with these very big names in your field. So this guy, It was a very, very big deal. And all the faculty beforehand made sure that we understood how big of a deal this person was.

And we got a little lecture. Basically, it was kind of like the grad student equivalent of when you, your kid goes to somebody else’s house and you give them a little lecture about how they should be behaving in front of somebody else. Um, we [00:35:00] got that little lecture. And another thing about these brown bags is that the grad students would take turns.

We got assigned, you Leading the brown bag because it’s supposed to be developing our skills at doing this. Right. So this particular one happened to be my turn to lead. And so I was leading, you know, we’re having a discussion and I’m noticing towards the end that it’s getting to be time to leave. And I am trying to be respectful of this person’s time, right.

And moderate the discussion in such a way that we can move along. And so. There was a lull. In the conversation, and so I took that as an opportunity to say, all right, well, let’s thank our guest, right? 

Will: I love the all right, well. All right, well. All 

Kristin: right. 

Will: Welp. Welp. 

Kristin: Slap the knees. Slap the 

Will: knees, get up. Yeah, 

Kristin: I won’t keep you any longer.

So I do the all right, [00:36:00] well. But it turned out he wasn’t done speaking, so what I had actually done was I was so nervous about moderating that I had not paid attention to the content of the conversation well enough to realize that he was still kind of mid thought and the lull in the conversation was because he was still speaking and formulating his next, uh, thought and I just completely interrupted that and tried to end the whole thing.

In front of my entire department, 

Will: what happened? 

Kristin: I was publicly ridiculed. 

Will: Like in the moment? 

Kristin: No, in the moment, uh, some, some of the faculty who had more expressive facial reactions, uh, horrified, were horrified and their nonverbals told me so. Uh, and so I turned bright red cause that’s what I do. And, and.

backtracked and tried to allow him to finish [00:37:00] it what he was saying but oh it was really embarrassing and then everybody made fun of me after 

Will: okay 

Kristin: well 

Will: you know yeah i like that it’s a small it is a small mistake all right can i tell you mine yeah um okay I’ve never told you this story. I think I’ve heard that story once before.

Probably that 

[music]: day. 

Will: Yeah. Um, so this one, I was in my, um, I forgot, but I think it was some outpatient rotation. I honestly can’t remember which one it was. I was a med student. 

Kristin: Okay. 

Will: Third year, attending, was in the room. I was doing an exam, like a cardiac exam, a stethoscope. I remember I had gloves on.

Sometimes you wear gloves when you’re examining people. Um, and I, right in the middle of the exam, was concentrating very hard, patient was lying down, I was concentrating so hard on trying to like, hear, I think the patient had a murmurs, I was trying to figure out like what I was listening to as a med [00:38:00] student, and I drooled.

Kristin: On the patient? 

Will: Fortunately not. 

Kristin: Ugh, were you wearing a mask? The drool, 

Will: it landed, no this was, you know, before. I know but 

Kristin: like you got the little surgical masks, I guess 

Will: you don’t, you don’t 

Kristin: do that 

Will: in 

Kristin: an 

Will: exam room. Right, yeah. Okay. 

Kristin: Okay. 

Will: Uh, fortunately, no, I drooled on my gloved hand. It landed very lucky, but I know the attending saw me because they were just sitting, standing right on the other side of the table.

I was just like, I guess I like, cause I was leaning over, you know, and like my mouth was like partially open. Yeah, you 

Kristin: are an open mouther. 

Will: And I was, and, uh, And I, I was just concentrating so hard that it just, saliva just came out of my mouth and I very, I’ve never ended an exam so quickly in my life. I didn’t, I didn’t like bringing attention to it.

I didn’t, I just [00:39:00] like. 

Kristin: You did the, alright, well, alright, . 

Will: Alright. Well, I put my other hand on top of my hand, s hand. 

Kristin: Mm-hmm . 

Will: To hide it. And, uh, not that it did any good and , that was it. I was, oh my goodness. I was just, and that was just so, felt, so fortunate that I did not, um, drool all over the patient. Yeah.

Which would be a lot worse, but it would 

Kristin: be, 

Will: I was mortified and it was like. Only like halfway through the rotation. So I still have to work with that. Did he 

Kristin: say anything to you? Never said 

Will: a word. Okay. 

Kristin: Well, that’s nice. 

Will: I don’t even know what my grade was or I didn’t look at my evaluation. You never looked him in the eye again.

That’s right. That was the most embarrassing small mistake I’d ever made. 

Kristin: Can I tell you something? 

Will: Yeah. 

Kristin: You drool pretty much every night. 

Will: Oh, I drool. Yeah, I know. I drool. Yeah. 

Kristin: Yeah. 

Will: I’m a drooler. 

Kristin: You’re, because you got the open mouth all the time. 

Will: Yeah. It’s just, especially 

Kristin: when you sleep Jaw. 

Will: Yeah, jaw like eye.

My anatomy, my jaw drops. Mm-hmm . Yeah. 

Kristin: I know why 

Will: some people do that and some people don’t. I 

Kristin: know. 

Will: [00:40:00] I wonder if it’s like an anatomy thing. I don’t know. Breathing thing. I 

Kristin: wonder if it would do that. If your face was a perfect sphere. 

Will: You have a little bit more of a spherical space face than I do. Mine’s.

Mine’s very long, 

Kristin: right? Yours is elongated and mine is. Square. 

Will: Tell us, tell us, uh, facial anatomy people, do sphere faces, are they more able to keep their jaw closed? The things that come up in this, in these top, in these conversations. You never know. Um, okay. That’s it. That’s all I got. 

Kristin: Alright. 

Will: Any other thoughts?

Kristin: Nah. 

Will: Okay. 

Kristin: I, you know, you asked me that and you put me on the spot. 

Will: Yeah. 

Kristin: Which, when that, when when I get put on the spot, I just go blank. 

Will: Yeah. 

Kristin: And so every single time you ask me that, I sound like I have no thoughts. 

Will: Oh, you’ve got lots. As a person I know you’ve got lots of thoughts. I have 

Kristin: many thoughts, 

Will: but you don’t have time for 

Kristin: many of them are not relevant to this discussion.

So I’m filtering . [00:41:00] 

Will: Well, what have we learned today, Kristen? 

Kristin: We’ve learned you’re a drooler. 

Will: Yes, everybody knows now my, my, my propensity for drool. 

Kristin: Yep. And we’ve learned that. Never happened 

Will: again, though. I keep my mouth shut when I’m examining patients. 

Kristin: Now, you know. The more you know. You learn so 

Will: much as a med student.

Kristin: Right. 

Will: Some things you didn’t know you’d have to learn, but there you go. 

Kristin: Like how to not drool. 

Will: Yes. Um. 

Kristin: We also learned about, uh, yet another. Predatory practice by insurance companies, this time predatory against the physicians. 

Will: Yeah, the way they, the way they, um, they, Try to, to direct the narrative away from them toward other people.

Kristin: Yeah, it’s really classic scapegoating. 

Will: I hate it so much, 

Kristin: but pay attention for it. You’ll never be able to not notice it again. 

Will: That’s right. Well, thank you everybody. Uh, let us know what you thought of the episode of Glock talk. What topics do you want us to talk about? Uh, we’d love to hear from you.

Email us knock, knock high at human dash [00:42:00] content. com. This is on social media platforms. Visit us 

Kristin: on social media. 

Will: Are you 

Kristin: going to drool? 

Will: I know I got, I got a cough drop so I can get through this episode. Uh, business on a social media platforms, uh, human content podcast family is over on Instagram and TikTok at human content pods.

Uh, thanks for leaving reviews. We love to see those. You can, uh, visit your favorite podcasting app or on YouTube at Glaucomfleckens. That’s our YouTube channel. That’s where all these video episodes go up. That’s 

[music]: right. 

Will: We can give you a shout out like at. Andrew Spoyer 7183 on YouTube said don’t do that tip of the week compilation please oh yeah that’s a good idea 

Kristin: yeah 

Will: do all that don’t do that eyeball tips of the week 

Kristin: yeah 

Will: a lot of that 

Kristin: is a good idea 

Will: full video episodes as I mentioned up every week on our YouTube channel at Glaucomfleckens we also have a patreon lots of cool perks bonus episodes direct to medical shows and movies hang out with other members of the knock [00:43:00] knock high community Got a growing little community there early ad free episode access interactive Q& A live stream events.

We just did one the other day 

Kristin: We did it was really fun. 

Will: Awesome. We had a while back at Preston. 

Kristin: Yep, 

Will: Preston Roche 

Kristin: That’s right. Press 

Will: row on tik tok. He joined us. Be sure you check 

Kristin: out his podcast how to be patient. Yeah, patreon out now 

Will: Oh, yeah, that’s right. Yeah. Yeah, check it out. It’s great Patreon. com slash Glaucomflecken, or go to Glaucomflecken.

com, uh, Patreon Community Perks, we gotta do this. Love Patreon Community Perks. New member shoutout, Jack S. and Haley R. Thank you, thank you for being patrons, and shoutout to all the Jonathans as usual. Patrick, Lucia C, Sharon S, Edward K, Steven G, Marion W, Mr. Grindaddy, Kaitlyn C, Brianna L, Mary H, Kay L, Keith G, Jeremiah H, Parker, Muhammad L, David H times 2, Kaylee A, Gabe, Gary M, Eric B, Marlene S, Scott M, Kelsey M, Joseph S, Dr.

Hoover, [00:44:00] and, oh, that bubbly salt. Patreon Roulette. Random shout out to someone on the emergency medicine tier, Beth Y. Thank you, Beth, for being a patron. And thank you all for listening. We’re your hosts, Will and Kristen Plainer, also known as the Glaucomfleckens. Our technical producers are Will Fetter and Kristen Plainer, Aaron Korney, Rob Goldman, and Shahnti Brooke.

Editor and engineer is Jason Portizo. Our music is by Omer Ben Zvi. To learn about Knock Knock High’s program, disclaimer, ethics, policy, submission, verification, and licensing terms, and those HIPAA release terms, go to Glaucomflecken. com or reach out to us, knockknockhigh at human content. com with any questions, concerns, or fun medical puns.

Knock Knock High is a human content production.

[music]: Goodbye. Hey,

Will: Kristen. 

Kristin: Yeah. 

Will: You know, we love Dak’s co pilot here. 

Kristin: We sure do. 

Will: It’s, it’s great. 

Kristin: Love it. 

Will: Little Jonathan in your pocket. 

Kristin: Yeah. 

Will: I know, right? You 

Kristin: see. 

Will: Yeah, helping out with, uh, [00:45:00] admin burden documentation. One of the things I really like is, is it can like organize your notes for you. 

Kristin: Yeah. 

Will: Like, I, I don’t know if this might come as a surprise to you.

My notes sometimes, not the most organized. Yeah. I mean, you know, I could use a little help and Dax is there to help me with that. 

Kristin: That’s right. 

Will: While also, by the way, like looking at my patients when I’m talking to them. 

Kristin: I love it when my physicians are using DAX in my appointments because they just have a better conversation and report.

It’s just a better overall appointment. 

Will: And one thing that people might get a little bit concerned about with AI products is safety. 

Kristin: Yeah, 

Will: but DAX Copilot is backed by Microsoft’s robust like security. I feel great about their security, uh, and, um, HIPAA compliant. HIPAA compliant. And so it’s, my patients are safe.

I know the documentation is safe and it’s just a great thing. 

Kristin: Yeah, very helpful. 

Will: To learn about how DAX Copilot can help you reduce burnout [00:46:00] and restore the joy of practicing medicine, visit aka. ms slash knock knock high. Again, that’s aka. ms slash knock knock high.