Glauc Talk: Match Day Statistics, Identity Theft, & Testosterone Replacement

KKH Trailer Wide


Singers: [00:00:00] Knock, knock, hi! Knock, knock, hi!

Will: Hello everybody, welcome to Knock, knock, hi! I almost said knock, knock, I. Knock, knock, hi! With the Glockenplein. Maybe it’s wishful thinking. Like, I wish I could be talking about eyeballs right 

Kristin: now. Here with me. Thank you. Welcome to Knock Knock. Hi! 

Will: With the Glockenfleckens. I am Dr. Glockenflecken. 

Kristin: I am Lady Glockenflecken.


Will: and Kristen Flannery. And we are This is Glock 

Kristin: Talk. 

Will: This is Glock Talk. I did forget that, that we had, we had named it that last time. Yes, these 

Kristin: ones where it’s just the two of us 

Will: talking about stuff. 

Kristin: Glock, 

Will: talking, glock to glock, that’s what we’re doing. And um, before we get into some exciting things we have planned for this episode.

Uh, we had a case of identity theft. 

Kristin: We did. Yes. Sadly. It’s true. 

Will: It’s a funny case of identity theft. Yes. It’s not classically [00:01:00] what you think of it. Like our credit scores are okay. Right. Right. Uh, bank accounts. Yeah. Are non infiltrated. Social security numbers. Exactly. Fine. All that’s fine. But, uh, why don’t you tell the story?

Kristin: Okay. So we have, one of our daughters, our younger daughter, she’s, um, she’s, she’s, she’s She’s got a lot of initiative, you know, she’s a make it happen kind of girl, which I can, I can appreciate. It’s a good quality to have. It is, yeah. Uh, but for her, no is just sort of a suggestion, you know, maybe, maybe kind of a, just someone’s opinion.

Will: Yes. 

Kristin: And so it doesn’t 

Will: figure out a way to make it a yes. 

Kristin: Yeah, she doesn’t it doesn’t deter her. It just Causes her to select another path toward her goal. So, you know, it’s an admirable quality 

Will: It’s our youngest by the way when they are 

Kristin: an adult but uh as a parent it can be somewhat challenging right because There’s times where no is very important.

You need them to yes So so it’s always this ongoing thing [00:02:00] And now that she’s getting older, she’s getting even more, you know, clever about it. Um, so, you know, we, it’s been basketball season here, and by the end of a season, anytime we sign this child up for organized sports, she’s all about it at the beginning, then she kind of loses it.

Towards you know the middle towards the end and then you know by the end of it She’s just like I am done with this. I don’t want to go anymore I just can’t do this anymore 

Will: to be fair to her basketball season in our town forever is Quite long 

Kristin: and she is 

Will: It’s like three weeks too long. She was eight years old this season.

Yeah, she was eight years old, and she really enjoyed it, and she’s pretty good at it, but, uh, yeah. Yeah, it was just too long. It was like, like me doing, uh, a, one of my rotations. We’ll say, like, psychiatry rotation. And I thought it was very interesting at first. By the end of it, I was like, you know, Let me do something else.

Can I please do that? And every, every residency rotation was the same way. That’s why I became a comprehensive ophthalmologist, because at [00:03:00] the end of glaucoma, I was like, please no more glaucoma. Right, you want a variety of things. So anyway, I get it. I get it. Yeah, 

Kristin: she’s like that. Uh, and so, you know, since the last few weeks, she’d been begging us, like, Oh, do I have to go?

I don’t want to go. All these things. Okay. And of course, we always say, Yes, you have to go. You made a commitment. That’s how this works. Your team members are depending on you, no, you know, nobody gets to sit out if there’s only five kids there and that’s not nice. So you know, that wasn’t working. She was running up against resistance and just asking not to go.

And so she took it upon herself, uh, to pretend to be me by texting you. 

Will: Yes. 

Kristin: So she, I mean, This was 

Will: in the middle of my clinic. I was at work. 

Kristin: Which she knows you’re distracted. 

Will: Yes. 

Kristin: So, by the way, 

Will: this was actually, this was a Saturday? Yeah. So this was before you got a Saturday clinic. Right. That’s why she was able to do this.

’cause if she was at school, obviously she wouldn’t be able to do this, right? Yeah. But this was Saturday. I had a Saturday clinic, believe it or not. 

Kristin: He does work some Saturday. I was on, I was 

Will: on call and when I’m on [00:04:00] call, I do a Saturday clinic. 

Kristin: That’s right in the morning. She had a game that afternoon. So she texts you while you’re at work and she says, will, and she’s texting from an iPad, which is obviously a different number than my phone.

So she goes, will. I can’t find my phone, but I need to tell you. 

Will: These are all separate texts. Will text. 

Kristin: I looked at this immediately and I was like, this is not how I text. This is not my style. I can’t 

Will: find my phone. Send, but I need to tell you. Send. 

Kristin: She says, Will, I can’t find my phone, but I need to tell you.

She puts her name is tired. Her cold is getting worse. Her toenail got chipped off also. And then he bought it. 

Will: Well, okay. So I’m like in the middle of like a busy Saturday morning clinic. So I just like, I see this and looking back on like, okay, clearly like this, these are weird texts. Like it’s not the way Kristen typically texts, but I responded.

I said, did she tell you [00:05:00] she doesn’t want to play? Because I assumed that this was about the best because she’d been complaining about basketball lately 

Kristin: So she put well, she doesn’t want to play but she feels bad and then 

Will: and then I said well she was running everywhere last night because 

Kristin: fine there was 

Will: like a School function she was with her friends.

They were just going crazy running around 

Kristin: right and then here’s the kicker. She goes I don’t know if she should go or not, but it’s up to you. This is the child, she’s 8 years old, just like, passing it off to you, but I don’t know, you know, you make the final decision, but here’s some information. 

Will: And I, so I totally bought it, I totally bought it, and uh, um, and so we got home, it turns out I 

Kristin: had no idea this was happening, meanwhile, I had no idea this had been sent, that you two had had this conversation.

Will: Turns out she was actually like sick and so she ended up not going to basketball, but this was [00:06:00] um, uh, we’re going to have a tough time when she’s a teenager. I know, if this 

Kristin: is like kid stuff, what’s it gonna be? Eight years old 

Will: and she’s already impersonating us to each other and doing it, you know, 

Kristin: I mean, pretty well.

Well enough to fool you. Which, eh, it’s a low bar. Because you’re not that observant. I wasn’t paying close 

Will: attention. It’s not one of your strengths. So anyway, that was our case of identity theft. 

Kristin: Yeah, I’m a little concerned. We’re gonna have to like, put alarms on all the doors and windows. 

Will: I don’t know.

Know what we’re going to do. I mean, she’s, at least she’s, she’s quite smart. And so hopefully, hopefully she will use her powers 

Kristin: for good and not evil, but you know, TBD. 

Will: Okay. Well, you know, if we’re going to get, if we’re going to be subjected to identity theft, I’d rather it be that way than any other way.

So anyway.

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Alright, we always start off with some healthcare news. 

Kristin: That’s right. 

Will: Alright, so. What’s 

Kristin: going on in healthcare? 

Will: Well, uh, Match Day. 

Kristin: Mmm, big, big day. It was 

Will: a few weeks ago, and we’ve talked about it a little bit on our other episodes and stuff. Uh, but, uh, some of the statistics are out. People are talking about it.

Alright. Um, I, I do want to shout out Brian Carmody on, on, he’s got a blog, Sheriff of Sodium, but he’s, uh, got a big following on Twitter, X. And, um, and he talks all about USMI. Uh, step one, step two, uh, trends and the match. And like, really, like he is like the authority. It’s [00:08:00] very interesting, uh, niche to like find yourself in.

Uh, but so he’s where I go whenever I want to hear someone like evaluate the match. We actually need to get them on the podcast because it really is, it’s kind of fascinating to look at this very important process in medicine, right? Because these are, this is how. It shapes the future of medicine, like where are students going into, what kind of doctors are 

Kristin: we producing in this country, 

Will: what kind of doctors are we making?

So anyway, uh, some of the big things, uh, with the match, every year it seems like there is one specialty that really gets hit hard with unmatched applicants. 

Kristin: But it’s a different one every year? Yeah, 

Will: well, it seems to be the case. So last year it was emergency medicine. 

Kristin: Okay. 

Will: There were, uh, they had the largest increase in unmatched applicants.

Applicants. So that means that residency programs are not filling all of their spots. And there was, there were a lot of unfilled spots, which is a big deal. Right. Not only for the future of your specialty, but also just for being able to [00:09:00] do the work of the hospital, right? You need You need cheap labor and and residents are surely cheap labor but uh, so last year was emergency medicine and people attributed that to just the pandemic like they Emergency medicine was hit hard There’s a lot of lack of respect toward emergency medicine, so it just like, it really cooled off in terms of students wanting to do emergency medicine.

This year, can you guess what specialty it was? 

Kristin: Um, well, is there, when it happens every year, is it random, or is it like there usually is a reason? 

Will: You know, I don’t know if anybody knows the answer to that question. I’ll just tell you, because you have no context to why this would be. Uh, pediatrics. Oh. Yeah, pediatrics, uh, had the biggest increase in unfilled beds.


Kristin: Okay, so let me ask you, is it unfilled because people are ranking programs and programs are ranking individuals and there are enough individuals to fill all of the spots, but the matching is just not [00:10:00] happening, or is it just there are not enough residents applying? 

Will: I think, I think it’s that there’s not enough, not enough people are applying.

Kristin: Okay. 

Will: Yeah. And maybe it’s a combination of both, but I think it’s just fewer applications, fewer people, students deciding to go into pediatrics and, and you can, there’s all, you know, people have all kinds of, can have all kinds of theories about why this is. Um, I think it, it ultimately comes down to money, right?

As most things do, because all the highest paid specialties. They always fill. Right. Right. So all your surgical subspecialties, everything that’s, that’s procedure based typically fills. And then because they’re, they’re, I mean, those are the higher paying specialties, they get reimbursed higher. And then, uh, the other end, this year you have pediatrics had the biggest spike in unfilled positions, but family medicine’s always down there at the bottom, uh, internal medicine is always, uh, down there at the bottom as well.

So there’s been a lot of discussion on social media [00:11:00] about like, what’s going on? Like, I’m sure pediatrics, the whole field is probably like, Oh my God, this is a terrible thing. Um, I think it all really comes down to like reimbursement. And it actually made me think of the conversation we had with, um, Katie Porter about, uh, what people lobby for.

Right? Yeah. 

Kristin: So yeah. Higher, higher paid, like surgeons and stuff tend to lobby for reimbursement. Increased 

Will: reimbursement. And then. 

Kristin: Pediatrics, family medicine, and they lobby for things like, you know, gun violence issues. 

Will: Exactly. And, and so I, you know. Um, I think the, the advocacy thing like that may be a small part of it, but ultimately our healthcare system just values procedures over anything else.

Kristin: Well, it’s a profit based system, and so those are more expensive. 

Will: Right. And so, so, and, and, and, you know, people can talk about, you know, their motivations all they want, [00:12:00] but like money is going to be a motivation, you know, especially with how much debt all these students are, are, are graduating 

Kristin: with. 

Will: So, I, I don’t know how you, how you fix that.

That’s like way above my pay grade, trying to figure that out, but, um, economics has gotta be a, uh, a part of it. And so I have a couple stats for you regarding reimbursement. Okay. Alright, so, adjusted for inflation, physician reimbursement has declined 26 percent since 2001. Even though like cost of everything’s going up since 2001.

Adjusted for inflation 26 percent decrease in physician reimbursement. That’s across the board. 

Kristin: Okay, 

Will: hospital reimbursement. 

Kristin: Mm hmm 

Will: has increased 70 percent 

Kristin: Okay So explain to me the difference between those two things because you know a layperson like myself That all just gets lumped in to the city you work at the hospital.


Will: well, so 

Kristin: you don’t 

Will: right? Thank God for that Has an ophthalmologist where? We have a type 1 hypersensitivity [00:13:00] reaction to hospitals. So, um, so you can, whenever you bill insurance for the stuff you do, alright, there’s always like physician fees. Yeah. 

Kristin: So 

Will: that’s, that’s paid to the, the person providing the healthcare.

So physicians. So I do a cataract surgery. 

Kristin: So we don’t, when we pay for a doctor’s visit, we are not paying the doctor. We are paying the hospital. 

Will: So, so there’s two parts to it. 

Kristin: Okay. All 

Will: right. When you bill, there’s, there’s, there’s physician fees and there’s also facility fees. Okay. So you are paying part of the bill, the overall bill that you get from a hospital, there’s going to be physician fees that, where that money will go to the physician and there’s going to be facility fees, which go to the hospital.

Kristin: But like the bill is coming from the hospital. Okay. They’re the one doing the Yeah, because, 

Will: right, well what happens is they, they, it goes to insurance and insurance will pay something. But yeah, the bill The bill that I get in the bill comes directly from a hospital, yes, or a practice or whatever. So the 

Kristin: hospital [00:14:00] is the one that is having to like 

Will: Yeah, they get the money.

With the insurance 

Kristin: company, with the patient, with, you know, they’re doing the in between for all the billing. 

Will: Yeah, hospital will get all the money and then, but some of that will go to the, yeah, exactly. Okay. So, so basically, the way our healthcare system is set up is the physicians, their, our reimbursement is going way down, year after year, going down.

I mean, sometimes it goes up, but, but when you adjust for inflation, it’s going down, basically. Right. 

Kristin: Right. Right. 

Will: But that’s the opposite for the hospitals. And that’s, that’s like So the 

Kristin: hospitals are keeping more money. Yeah. Physicians are getting less money. 

Will: And so what you, so obviously what you have now is less, fewer physicians are staying in private practice and they’re just going to hospitals because that’s where all the money’s going.

So that, so it gets to be this huge problem, especially I would say in like rural communities or really anywhere, it’s just becoming harder to have an independent physician owned practice. Right. So these small private practices are going away. Because they just, they can’t keep up with the [00:15:00] costs and the decreasing reimbursement and everything’s moving to hospitals.

Kristin: Where’s the reimbursement coming from? Government? 

Will: Like physician reimbursement, where does that come from? It’s, it’s, it’s Medicare. That’s the biggest, the biggest thing. I mean, there’s always, you always have the, the private, private, um, insurance companies. But most of the billing is to Medicare. And so it’s the government that’s setting, that’s deciding, okay, this year we’re going to slash reimbursements 3 percent for these services.

So, so we’re talking mainly Medicare here. So anyway, uh, 

Kristin: So you are incentivized as a physician to go work at a hospital because they are keeping more of the reimbursements and so they can pay Yeah. More to you than you can if you’re in private practice? Well, 

Will: yeah. Exactly. It’s, your costs are going up in private practice and because your reimbursement is going down compared to hospitals, it’s making it harder to hospitals, 

Kristin: they can counteract.

Will: Yeah. I mean, this is, yeah, you could go be an employee at a hospital because [00:16:00] most of the money is being, you know, is flowing there and reimbursements continue to increase for hospitals. So it just, it just, and the big picture here is just like, you’re losing, we’re losing small private practices. And we’re gaining more of these big hospital networks, and that’s not really a great thing, I think.

So, because we need small, we need independent owned practices, especially in like rural communities and outside the big urban centers, we need people out there practicing medicine. That’s becoming harder and harder to do, so. 

Singers: And 

Will: The um, and going back to the, to the advocating thing, like, you know, that this is why you see so many physician groups advocating for increasing reimbursement, um, but ultimately it’s going to require, I think, a change and just.

Where we value care, right? So value based care. Yeah, I don’t know the best way to do it, but There’s just so much [00:17:00] emphasis on like procedure oriented things that’s driving reimbursement compared to what primary care physicians do more of And just you know, it’s kind of the backbone of medicine type of stuff.

So anyway, I don’t know So it’s it’s difficult for pediatric pediatrics this year. We’ll see who it is next year I don’t know. 

Kristin: These segments always make me very depressed. 

Will: It’s a good way to start these episodes, isn’t it? 

Kristin: Hooray! 

Will: Alright, so, so here’s the question I have, that I’ve thought about. Like, so what would I personally lobby for?

So we’re talking about what you advocate for. 

Kristin: Okay. So 

Will: if I was a lobbyist. 

Kristin: As an ophthalmologist? As an ophthalmologist. 

Will: For ophthalmology. All right, so but I’m not but I can’t do like reimbursement or anything because obviously what I would lobby for is like You know tearing down the insurance companies.

Kristin: Well, yeah you as a person, but I have some very ophthalmology 

Will: specific things that I would do 

Kristin: Okay. 

Will: All right. Here we go Mandatory minimum sentencing of contact ones of users. What do you think about that? 

Kristin: I think I probably would have done some time [00:18:00] if you had your way. 

Will: Absolutely. You would like I’m 

Kristin: pretty good about it I’m pretty good.


Kristin: Occasionally Here’s what Kristen does when she, 

Will: and it’s not just that you, and it’s not just that you sleep in your contacts, this is what you do. You come up to me and be like, Will, I slept in my contacts last night. You taught me. 

Kristin: Yeah, because I know it bothers you. You taught 

Will: me about it. You know that if I knew that you, I’m gonna start checking your contact lens case.

Kristin: I don’t have one because I wear dailies. 

Will: That’s right. See 

Kristin: i’m pretty good. I change them every day. 

Will: Okay, 

Kristin: most of the time I take them out It’s really just if I fall asleep unexpectedly that I end up sleeping in them 

Will: Anyway, I just think congress should maybe pass a law that allows us to arrest people for not using context appropriately.


Kristin: Okay, that seems reasonable. Sure. All right, 

Will: totally reasonable. Here’s another one if you get If you get metal in your eye from not wearing safety glasses while you’re metal grinding or doing metalworking, then you have to wear safety glasses for a week straight, wherever you go. 

Kristin: Everywhere.

Will: Everywhere. Grocery store, post [00:19:00] office, uh, wherever else you go, you have to wear safety glasses. 

Kristin: Okay. How about that? Do you have to sleep in them? 

Will: Um, uh, for a second offense. Yes. 

Kristin: A second offense, you have to sleep in them. Yeah. 

Will: 24 seven. 

Kristin: Don’t you think that will just make people hate wearing safety glasses?

Will: All the more reason to wear them whenever you’re metal grinding so you don’t have to wear them, uh, 24 7. I’m just, look, I’m just, I’m just telling people if you elect me as president of the United States, these are the types of things, I could do executive actions, executive, yeah, I could, I could just 

Kristin: I think you might find some resistance.

To these ideas. 

Will: I think by saying these things though, maybe that maybe I’m tanking my future, uh, political career. Oh, well 

Kristin: then by all means continue. 

Will: Kristen really doesn’t want me to, I’ve been making a lot of jokes lately about running for office. 

Kristin: No, no. 

Will: So we had, we had our, we had a live show and I made a joke about it during the live show.

Yeah. Thunderous applause. I’m just saying. 

Kristin: I think because it was a hilarious joke. 

Will: All [00:20:00] right. Well, I’ll still think about it. 

Kristin: People could see what a ridiculous idea that was and it amused and delighted them. 

Will: Okay. Well, let’s take a, so I have a little, um, activity for us to play. 

Kristin: Okay. 

Will: Alright, so let’s take a break first, we’ll come back.

Hey, Kristen. 

Kristin: Yeah. 

Will: AI tools are everywhere now. 

Kristin: That is true, and they’re here to stay. That’s 

Will: right. Well, have you heard about Precision? 

Kristin: What, what is it? This is 

Will: great. This is the first ever EHR integrated infectious disease AI platform. 

Kristin: That sounds useful. Infectious disease, 

Will: it’s a hard field. You gotta figure out when to start antibiotics and, and try to, to decrease resistance and how long to keep the patient on.

It’s really tough. 

Singers: Well, 

Will: this is a, an AI tool that automatically highlights better antibiotic regimens. It empowers clinicians to save more lives while reducing their burnout. 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 [00:21:00] KKH.

Are you ready, Kristen? 

Kristin: As ready as I can be. So we’re going 

Will: to do a segment, new segment called Why is it like this? All 

Kristin: right. There’s 

Will: a lot of weird things that happen in medicine. 

Kristin: Very weird. 

Will: Uh, from, uh, medical training or just health care or just whatever. 

Kristin: Yep. It’s a whole world. 

Will: And you have a bit of an outsider’s perspective on it.

Kristin: Yep. Like an inside outside. Yeah. Yeah. A little bit of both. Right? Yep. 

Will: Um, and so what I want you to do is choose a thing. 

Kristin: Mm hmm. Mm hmm. 

Will: Then ask why is it like this? 

Kristin: Okay? 

Will: Why do you do the things you do and I give you why is 

Kristin: it like why is it? Not why are you like? Oh, 

Will: well that that could be a different segment Why?

Whatever really like why are you like this? Why do you do this? Actually, that’s a good that’s a good segment. Let’s say that. All right I gave you a lot of prep time for this. 

Kristin: Yeah, a whole, like, hour and a half. [00:22:00] 

Will: Told you this morning we were doing this. So, um, so yeah, let’s do it. Why is it like this? What do you got for me?

Kristin: Um, why is it like this? Why do, in your healthcare training, why do you have to do away rotations? 

Will: Why does that bother you? 

Kristin: Because it’s really annoying and disruptive. 

Will: Okay. In what way? Give people some context. 

Kristin: Okay. Because Okay. Usually, now there’s non traditional students, of course, typically the majority of students are like in their late 20s, early 30s when they’re in residency in med school.

Maybe early 20s if you’re talking med school. But anyway, it’s the time in life where young adults tend to, you know, partner up, maybe start a family, 

Will: right? 

Kristin: You’ve got a lot of important things going on outside of your career at that time. Mm 

Will: hmm. 

Kristin: Um, and it makes it [00:23:00] very difficult on the family members, the people who live with you, the people who are trying to, uh, do life with you, when you just up and disappear for six weeks, across the country sometimes, um, or even just, you know, to a different town that now you can’t, you You know, live at home.

You have to go live, live in that other town during the week and commute on the weekends, things like that. It’s, it’s, it makes it very difficult for the other people involved 

Singers: when you 

Kristin: have to just go away. 

Will: So, yeah, so this was a, so this was a bigger, a big problem, uh, both in med school and residency for us.

Kristin: Yes, 

Will: because we 

Kristin: had a med school baby. 

Will: So med school, we had a 

Kristin: residency baby. So 

Will: med school, we were at Dartmouth. And Dartmouth is 


Will: very, it’s a very small community. And so what they would do is for different rotations. For like [00:24:00] OB GYN, for pediatric, like for inpatient pediatrics, I went three hours away to Portland, Maine, for um, 

Kristin: You had to go to Nashua for something.

For OB GYN, 

Will: I went like an hour south to Nashua. Uh, some people went, I mean, I chose to do a San Francisco rotation as well. 

Kristin: Yes, you did. You made that choice. 

Will: But some, a lot of them aren’t. aren’t, like, choices you can make. Right. So, they, they, like, you’re going down there. That’s the only place. So 

Kristin: And just in general, medicine, not even just away rotations, but medicine is very You have to move around a lot, and it, and, and it takes people away from their support systems, from their social networks, from, you know, just like, rips your roots up, and you have to keep re establishing roots in all these different places.

I mean, Match Day is a good example, right? Everybody just found out where they’re gonna move to, and that’s part of the, The, like, big emotions of Match Day is, is you, you have to move, so why is it like this? 

Will: So [00:25:00] the reason, I mean, the mat, well, that’s a whole other thing, but the reason that, like, you have to do these rotations in different areas is just because To get accredited as a med school and a, or a residency program, you have to be able to show that you can provide an, a, a specific threshold of educational experience.

And if you’re in a small enough community, sometimes you can’t do that at that location. And so the, so Dartmouth is like, okay, hey, licensing body for, The LCME, that’s what this was. They say, okay, look, we can do OBGYN because we’re, we’re, we send patients to Nashua, New Hampshire, or we send them up to Portland, Maine, or up to Burlington, Vermont, or not there because they have their own med school up there.

But, uh, um, you know, all these places to, to give the students experience. Right. And so it’s, it’s out of necessity. For like being, just having enough clinical opportunities to accommodate all the med students. 

Kristin: Why not just [00:26:00] have your own clinics? If you’re going to have a med school, why not be sure that you have enough of those rotations, 

Will: like at the place?


Kristin: the place. 

Will: Because, um, it’s, there’s just not enough and at the place, it’s a, it’s a, there’s, there’s more med students than they can accommodate, like in the OBGYN, the, the obstetrics, you know, clinic department, basically. I’m 

Kristin: just saying, I feel like maybe we could focus on solving that problem rather than just say, ah, we’ll just ship them away.

Will: It’s just, yeah, I think it’s, It’s easier in places like Boston, right? Because if you’re like living in Boston, you could do, there’s like, there’s multiple hospitals, multiple hospitals. Right. But if you go to places like, and by the way, who is it that sent us to Dartmouth in the first place? 

Kristin: You know, you didn’t have to come.

Will: So anyway, this is, I think, much more of an issue in a rural area. [00:27:00] And then going to residency, 

Singers: you 

Will: know, what, what, what really was a, a big wrench in, in the, in the gears of our residency experience was that I had to do, I think it was 10 weeks, I think it was 10 weeks. in Des Moines. So I had to go two hours away to Des Moines, Monday through Thursday, and then I was home Friday through Sunday.

Kristin: Yes. 

Will: Listener, let me tell you about our life. At that point, we had two kids at that 

Kristin: point. And we shared a car. We could only afford Oh 

Will: yeah, that’s right. 

Kristin: Well, actually, that car, it didn’t have a car payment. So, like, we couldn’t afford to just buy another car at that time. What a car that was, 

Will: too. It was a 

Kristin: piece of 

Will: junk.

Don’t, do not besmirch the Honda element. We don’t need to get into this 

Kristin: right now. That could be a segment. Oh my goodness. Anyway, that car is the reason I had neck surgery. I stand by it. Anyway, we shared a car, and we had two children, 

Will: and 

Kristin: I had a [00:28:00] career. Whatever. 

Will: Right. And I had to drive and the children were in Deines in daycare 

Kristin: because I had a career.

And it is impossible if you have children in daycare or ever have recently, you know, it is impossible to find a daycare spot. So once you have one, you hold onto it. 

Will: Yeah. 

Kristin: For dear life. And you do not give that spot away. 

Will: I borrowed a car. Remember that? You borrowed 

Kristin: a car. And what else did we have to do to make this happen?

Will: My mom came, 

Kristin: yes. Your mother had to come up 

Will: from 

Kristin: Texas and live with you in Des Moines for 

Will: 10 weeks. She didn’t have to do that. The backstory to that is I had just diagnosed with testicular cancer and had surgery. And so, um, she, um, So there was all of this, like, 

Kristin: you need rights, 

Will: and then 

Kristin: you’re having to move away, right, at that time.

And then, your program did something that is, is better than most programs, which is, um, they provided an apartment in Des Moines [00:29:00] for, um, Um, you to live in, for the residents to live in, which I think some programs do that, but they made sure that it was an apartment that had, I think, two bedrooms or something?

Like, the idea was, we understand that some of you have families and so, no problem, we’ll just make it so your family can go with you and live with you in this apartment. 

Singers: Yeah, 

Kristin: and that was like the band aid, the solution to this problem. 

Singers: Isn’t that easy? 

Kristin: Which for some people 

Singers: Uproot your life and just move to I suppose 

Kristin: that worked, but I feel like there’s a lot of old fashioned assumptions built into that of like, okay, so I’m not working.

I can just move somewhere for 10 weeks. Um, we couldn’t take our kids out of daycare for 10 weeks. We would lose our spot for when we came back. So yeah, we just had to live apart for 10 weeks and then your mom had to come help us. take care of you, the cancer survivor, and I had to hold it down with two little babies all by myself and a job of my own, a full time job of my own.

So let 

Will: me tell you that drive to Des [00:30:00] Moines. It’s rough. That was brutal. It was bad. You saw the apartment was nice. My mom almost burned it down with candles. Yeah, well. That’s true. But anyway. Can’t leave her unsupervised. But that’s the reason. And, you know, there just weren’t enough farmers for us to take care of in Iowa.

We had to. I guess. That, so I, the rotation was at the Des Moines VA. And so we got, it was, that was a. 

Kristin: What rotation were you doing? 

Will: It was just comprehensive ophthalmology. I was just taking care of those. That was really the first 

Kristin: population was the argument? 

Will: Yeah. Well, it’s a way for us to get a lot of surgical volume as residents.

And so we did a lot of surgery and it was a, it’s like the first time you really get to feel independent as a resident. Oh, right. Cause 

Kristin: I was at a VA. I 

Will: was at a VA. The 

Kristin: rules are different. 

Will: Okay. Well, that’s a, That’s a Pandora’s box you’re opening here. Like that’s, that’s something to discuss at some point is, is just the Scope of practice.

No, no. Scope of practice. But, um, it’s just the ethics of residency training [00:31:00] and, you know, the fact that you’re, you’re learning, um, under supervision, you know, and so it’s, it’s, it’s, this is a very interesting, very nuanced discussion that I don’t think we’re prepared to have right No, we’re not 

Kristin: doing that right now.

Will: Nope. Not gonna open 

Kristin: that can of worms. 

Will: Um, All right, so 

Kristin: that’s why it’s like that. I don’t think that’s, I’m not satisfied with that reason. And I understand it, right? There is this need to see more patients, more specialties, whatever. Uh, however, let’s come up with some better solutions, 

Will: please. It just, it does add to the stress, the overall stress and 

Kristin: Yeah.

And it’s just one of many ways that the, the whole life of med students, residents, residents. What have you are not it’s not considered right like I think it contributes to mental health issues contributes to burnout like yes Maybe you get more hours in you get you see more patients or whatever But at what cost?

And I think that the cost is, is high, especially for, for those people who are not just single [00:32:00] people who can just get up and go wherever they want, whenever they want. 

Will: Well, I want to, I want to hear from people. I want to hear, uh, what did you have a, for the physicians in the audience, uh, what kind of rotations, or anybody who went through a medical, you know, training program?

What, um, what kind of hardships did you have, what was the farthest you ever had to go for a rotation and what kind of effect did it have on your family? Um, 

Kristin: And even single people, like, you still have family members, right? Like, you still have a support network, a social network, so, yeah, even those people have to, yeah.

Tell us about it. Give us your rants. 

Will: that’s the only minor gripe we have about Iowa in general. Like, we loved it there. But that was, they did have a, they had a zombie burger. In 

Kristin: Des Moines. In Des Moines. Well you got to go to Des Moines. Don’t you tell me about all the great things while you were gone and your mommy was taking care of you and you had no responsibilities other than yourself getting to 

Will: work.

She did cook for me. She 

Kristin: did, I am sure. She did your laundry. She did. 

Will: Yeah, [00:33:00] she did. 

Kristin: Yes. Meanwhile, what was I doing? What was I doing, I ask you? 

Will: And it wasn’t, I will say, it wasn’t like, it wasn’t my idea. Like, she came up, I didn’t tell her to do that. She wanted to do that because she, you know, like, you’d probably want to do that for your child too, right?

If, if they had some, Maybe not the second one. 

Kristin: Witch child. 

Will: You know what she would do? She’d be like, uh, hey, hi, Will. Um. 

Kristin: Yeah. 

Will: So I was gonna go. 

Kristin: Here’s the 

Will: deal. Here’s the deal. I can’t find my phone. I got a little 

Kristin: cancer. 

Will: My car, um, my car doesn’t work. Can you go to wherever our daughter is and, and take care of her for 10 weeks?

Kristin: Yeah. You would do it if you were retired. 

Will: Yeah, absolutely. 

Kristin: Yeah, I don’t know if I would I mean, I would certainly help That’s a big 

Will: it’s a big 

Kristin: task thing to do though. I don’t know right now That’s hard to imagine because life is so crazy and busy and stressful and I’m already like burned out So but [00:34:00] maybe you know, okay, so I’m retired.

Will: Here’s the lesson for for residency program directors Uh, make those, if you have to, because you’re going to have to. It just has to happen at some places. You’re going to have to, you know, have away rotations different places. Just really, really make it as easy as possible on the patient, the patient, on the resident and their families.

And I just. And like, 

Kristin: just don’t forget that they have families. 

Will: Right, right, like point it out, like talk about it and, and, you know, give some support there and like recognize, Hey, I know this, but this is really hard for you. This is what we’re doing to help make it a little easier. Right. I think that’s, that’s, that’s the solution there.

Sure. There we go. We did it. We solved it. One that Kristen’s not, we’re not real happy with, but you know, you do what you gotta do. All right. So, um, the last thing I want to talk about is April. April is testicular and young adult cancer month. 

Kristin: Yes. That sure is, and that’s a thing we know a thing or two about.


Will: a little bit. Can I give you some statistics? I know 

Kristin: about both of [00:35:00] those things. 

Will: That’s right. So, cancer statistics for adolescent and young adult cancers, so AYA cancers. This was from, um, the data from 2020. So first of all, AYA is anybody between the ages of 15 and 39 years old. So that’s, that’s the designation for AYA.

When you’re Whenever you turn 40, you’re officially an adult. 

Singers: Hey! 

Will: An old adult. An older adult. You’re an old adult at 40. Not a young adult. You’re an old adult. Oh boy. Um, about 80, 000 young adults between 20 and 39 are diagnosed with cancer each year in the United States. 5 percent of all cancers are diagnosed in people in this age range.

Alright, so 5%. About 9, 000 young adults die from cancer each year. Cancer is the fourth leading cause of death in this age group. Behind only accidents, suicide, and homicide. It’s a big deal. It’s the leading cause of death from disease among women in this age group and is second only to heart disease among men.


Kristin: heart [00:36:00] disease, just 

Will: to give you a scope of the issue. So, um, 

Kristin: so cancer is the leading biological thing that can cause death in this age group. 

Will: Right. And so the, um, What I wanted what I thought I’d do is just talk a little bit one thing I because I’ve talked a lot about my cancer and history and everything I thought I could talk about and you could also chime in on your experience of My testosterone replacement journey.

Kristin: Mm hmm 

Will: because it has been a it has been a wild ride. 

Kristin: Yeah 

Will: So 

Kristin: yes 

Will: after I had my first orchiectomy, I was told by that my urologist that I’d be fine in terms of my hormone levels. Testosterone, like, I was like, do I need to be on testosterone replacement? 

Kristin: Right. It’s just like, well, now I, you know, half of, half of the mechanism is gone.

So it seems like that should be a problem. 

Will: He was like, no. No, you don’t need that. In fact, I, I really never got my levels checked because of that. Like it, it just Well, it’s 

Kristin: bad and you never go get [00:37:00] I did back then. 

Will: I, I went regularly to my oncologist, but even my oncologist never checked me. 

Kristin: They said you didn’t need to.

Will: And, and so I, for like about four years, I just attributed my like fatigue and crankiness to just being in medicine. Right. But I don’t think that was the whole story. No. That was part of it, part of me, it’s like part of my genetics is that way, but also The 

Kristin: crankiness. The crankiness. In particular, yeah. Um, but yeah, every med student is tired and sometimes cranky.

Cause it’s a hard, stressful time of life. 

Will: But I think I also, in looking back, had low testosterone. And that was confirmed Right before I had my second orchiectomy for cancer, when they did check my testosterone level, and it was very low. It was, it was 

Kristin: much lower than it 

Will: should have been at the age of 

Kristin: 30, 

Will: whenever I had the second, second one.

So, and like, I was like, damn, [00:38:00] like I could have I could have been 

Kristin: feeling better all this time. Yeah. 

Will: And plus I could have been like hulking out like really big muscles. Like I could have really been, you know, 

Kristin: you’ve got to, you’ve got to have been juicing some biological. genetic constraints about how successful that would have been, but sure.

Will: Oh, because I’m super tall and skinny. 

Kristin: Name one person in your family that’s hulked out like that. My brother’s pretty strong. just not that body type. He’s strong, yes, but. 

Will: Okay, I guess you’re right. All right. But anyway. I 

Kristin: think, you know, you had some delusions of grandeur about what could have happened.

Will: Well, it also doesn’t help that I went into ophthalmology, which is a notably very weak specialty. Your 

Kristin: fingers are quite strong. 

Will: We are the weakest out of all the specialties, actually. Us, us in pathology, we’re very Actually, no, they do some heavy lifting, I think, at some point. Their 

Kristin: telescopes weigh Their telescopes.

Telescopes! Not telescopes! Sorry, I’m so used to our daughter 

Will: How 

Kristin: far away are your, are your body parts, people? Their microscopes are quite hefty. 

Will: I [00:39:00] imagine like a 400 foot lane 

Kristin: with a 

Will: telescope looking at a liver. I don’t know. Microscopes. Yeah, so 

Kristin: microscopes are hefty. Maybe radiology. 

Will: Anyway, we’re very weak.

And so after I got my, uh, my, my, my second orchiectomy, obviously at that point, I was Like we were planning on it. Like I had to be on testosterone replacement. And tell 

Kristin: the people why, because some people, I didn’t know. 

Will: Because I had no testicles left. 

Kristin: And testicles 

Will: make testosterone. 

Kristin: Yeah. 

Will: The latex cells, shout out latex cells.

I still remember some stuff. 

Kristin: You do. 

Will: Yeah. Uh, I think that’s right. I hope, I hope that’s not, I hope that’s not wrong. That’d be funny if that wasn’t right. Oh my god. And I just 

Kristin: said telescopes and you just said that. Yeah, 

Will: we’re trying here, folks. 

Kristin: We used to be smart. 

Will: So, uh, so I had to be on testosterone replacement.

And. And I had really good insurance in Iowa, like, I had that good hospital insurance, that good resident insurance. And so, um, I got on the gel, that was the first one. 

Kristin: Yep. 

Will: It’s like [00:40:00] Andrew Gel. I don’t know. Just it’s a gel. Gel packets. 

Kristin: Yeah. 

Will: I hated it. I hated it. It was, 

Kristin: your body laughed in the face of gel packets 

Will: every day.

I had to rub the stuff on me and I couldn’t touch, you had 

Kristin: to be careful what you touch. 

Will: And we had, we had three females, three, three women in the house and so I had to, had to. You know, stay away from them for, I don’t know, 20 minutes. 

Kristin: Our daughters were very small at that point. And so, you know, how do you explain to a one year old that you can’t go up and was the 

Will: worst part.

Like, I couldn’t, they would come up to try to hug me. And you’d 

Kristin: have to be like, no! And 

Will: they don’t understand. And this was every, every day. I was putting this stuff on and so I I did that for like three months and was like I there’s no way I can do 

Kristin: Do anything either? Well, I mean very little. 

Will: Yeah, it helped in that.

I wasn’t getting hot flashes. So I had some my body And so I moved to the injections yeah, and the injections were booty were [00:41:00] great For a while because they were super cheap. That’s like the cheapest options like once a week, but you get swings Yeah, swing like I feel really good Really good for a couple days and then it’ll go down.

Kristin: Yep. I got to where I would read 

Will: I think you did 

Kristin: it on Sundays Yeah, I wanted to be like Sunday evenings or something as you wanted to be feeling good for the work week But then I made our weekends miserable. I was 

Will: feeling real bad for For family time on the weekend. You were so 

Kristin: cranky. It’s difficult to be Be around when, when you’re like that, because.

You need that. Like, I was surprised at all the things that testosterone does, you know, and it is a very potent, uh, I don’t know, it affects your mood a lot. 

Will: Yeah, and that’s the problem with, with those injectable ones, because, uh, it, it was, it’s been around forever. Like, it’s just, literally just putting testosterone in your ass muscle, and, uh, and there’s a wild swing.

So, it’s just peaks and valleys, that’s what you get. So, but I was doing, I did that [00:42:00] for, God. Four year four or five years a long time a long time 

Kristin: and our understanding was that that was that well Those were our choices. I 

Will: never had those two things. I didn’t see a urologist I was seeing an endocrinologist for a while and an oncologist and no one ever thought hey Maybe we should send him back to a urologist to talk about this stuff 

Kristin: So and let’s be honest doctors are not very good patients.

So you were not always 

Will: Yeah. I didn’t look into it. Following up and doing things as 

Kristin: much as you 

Will: should have. But, but that’s also like, I mean, you wouldn’t expect a, your average patient to be like, let me research all the different things I could, like, you want a doctor to be able to, to, to help 

Kristin: you assume that they know and they would tell you if there was something.


Will: no one ever mentioned like, like what are the different options for testosterone, you know? So, so anyway, it wasn’t until I had a, a, a keynote. conference. Yup. I was, I was doing a, a keynote presentation with Chris and we were together at a urology conference. And I just, like, asked about it, like, oh, you’re, they were like, they were shocked.

You’re like, you’re doing, you’re doing [00:43:00] those injections every week? Like what are you doing? Yeah. Like there’s, there’s so many better things. And so now I’m doing this thing called Testapel. Yep. Which is, I go, I go every three to four months and I get a whole bunch of pellets, uh, loaded up into my ass.

Kristin: Looks horrible. Like, I went with you to one appointment. All right. And I couldn’t look, but from the little things I could see by accident every once in a while, it was like this, this hollow steel tube, and then there was a lot of blood, and I, uh, deduced that I guess that’s how, that’s the delivery method is the tube by which the pellets get in there.

Will: The funniest part about those, those, uh, appointments is that. Like, when the urologist comes in, she, like, when she comes in, I’m like, ass up, bare ass. Sunnyside 

Kristin: up. 

Will: And I’m like, hey, how’s it going? 

Kristin: Yep. 

Will: How’s your week been? It’s just, 

Kristin: just 

Will: casual conversation with my ass in the air, so, um, that’s fun. [00:44:00] But it’s much better, and what I’ve also learned urology conference.

I guess the urologists really like me. I don’t know. I mean this it’s a ball thing, you know, I guess the what they told me was that like Urologists, it’s very rare to have what I had. We have two separate cancers Testicle and you have them removed I thought it was like a 1 percent of people that get it in one testicle getting the other one But apparently like a couple of urologists like we I’ve been practicing for 30 years And I have only seen one patient like you.

Kristin: Right. Well, I mean, that might be one percent, right? That might be how the numbers work out. It could be, 

Will: but, but it’s, it’s, it’s, basically, it’s very rare. And when you lose both testicles, it’s extremely hard to get a normal testosterone level. 

Kristin: Right. So all the protocols for how you treat testicular cancer Most of them are assuming that there is one testicle still left and all the numbers, all the insurance, you know, whatever the insurance companies are going by, you basically just like don’t fit the mold of what people are used to [00:45:00] doing for this.

And so it’s been very difficult to get the right treatment for you because you’re a special unicorn. I have 

Will: maxed out the amount of pellets I can get. I’ve asked. Like the little things that they put in there. I can’t get any more. Because insurance 

Kristin: won’t pay for more? No, they just 

Will: won’t, they can’t 

Kristin: fit more.

Oh, like there’s no space. 

Will: There’s no space. Don’t 

Kristin: you have another butt cheek? I mean, 

Will: I could, I don’t know, that seems, I don’t know, maybe I could do a second butt cheek. But I’m feeling okay, like things are going okay. I feel like it’s 

Kristin: still like, it’s much better than it was. But I feel like there’s, it’s still like, not quite where ideally you would be.

Will: Oh, and by the way, The health insurance, trying to get them to pay for any of this stuff. It was, it was a long, long process. You know how many times I had to prove to them, like short of just going over there, pulling down my pants and being like, look, feel for yourself. I have no testicles. 

Kristin: I think you could have been arrested for that.

Will: There’s nothing here. Please. Hey, uh, you [00:46:00] know, Cigna, come over here. Get 

Kristin: in here. 

Will: Take a feel. Take a 

Kristin: good look. 

Will: Look, I just, there’s, it’s. Empty set. There’s nothing there. Like what? I don’t make my own testosterone, folks. I need this. And I need a lot of it. And you’re a 

Kristin: large person. 

Will: Oh, that was, I, I, I, I almost, I wanted to send my, you know, get like a CT scan just to show.

Kristin: Please reference. Do you see testicles 

Will: here? Like there’s no, there’s nothing here. There’s nothing here. So anyway. I did not go over there and pull my pants down. 

Kristin: Yep. 

Will: I would have been, it would have been within my right to do it though. I mean, 

Kristin: arguably, I would agree. 

Will: It was, it was a disaster. 

Kristin: Legally, maybe different.

Will: So, so, shout out. But yeah, we’ve 

Kristin: spent our young adulthood, all of it, dealing with, Things like that and and so do so many other people that are 

Will: right 

Kristin: experiencing adult adolescent young adult cancer So 

Will: this April, you know, if you you have patients that are That are dealing with [00:47:00] this, you know, just talk to him about it And if you have patients that have had testicular cancer, maybe ask about those symptoms of low testosterone and see if 

Kristin: yeah He’s a physician about 

Will: it.

Kristin: I’ve had quite a lot of you know, like biology and even we didn’t realize Oh, this is something we should be asking about so because it’s just stuff that a lot of people experience normally, right just whatever, but uh, but yeah should ask about it and also Don’t forget to consider how young adult cancer might be different from your patients who are who you are used to seeing which are Gonna be older.

Will: Old adult cancer. 

Kristin: Old adult cancer. Yeah, I can say that because this year I am one I’m aging out of this age bracket. That’s right. Oh, you’re turning 

Will: 40 this year How exciting. 

Kristin: Oh, I know. But that was another thing, right? Like you, you, uh, you might have different questions. The cancer, it’s going to affect your life in different ways than when you’re, you know, cause you got like little kids and a job and things that maybe your older [00:48:00] patients don’t have.

So, you know, consider those things also. 

Will: Alright, that’s it. So, April, Testicular Cancer Month, and, uh, uh, Adolescent and Young Adult Cancer Month. So, um, you know, just, for those of you your 

Kristin: checks! 

Will: Do your che Oh, yeah, do your checks. I know that’s 

Kristin: controversial for some reason. Feel around, 

Will: feel around those testicles.

No one knows your balls better than you do. Alright, so, feel them. If you feel any, like, weird lumps. Or big swollen testicles, or it feels different. If it feels different, because we all know kind of what they feel like, it feels different to you. I’d go get checked out. Even if it’s 

Kristin: tiny. Yours was tiny.

Will: Mine was tiny, but I had a very clear little nodule. It definitely felt like my testicle was trying to grow another testicle. So I went in and, you know, sure enough, cancer. So there you go. Well, let’s take a quick break. We’ll come back with a fan story.

Hey, Kristen. 

Kristin: Yeah? 

Will: Notice anything different about me? 

Kristin: You look the same as always. [00:49:00] 

Will: Uh, I’m covered in mites. 

Kristin: Uh, well, you don’t have to tell 

Will: everyone that. Maybe you need a mite too. What do you think? I, 

Kristin: I Prefer to be mite free. You know what these things are? 

Will: They’re demodex. I 

Kristin: know. They’re enormous. 

Will: Have you ever had red, itchy, irritated eyelids?

Kristin: No, but that does sound very uncomfortable. It 

Will: could be caused by one of these little guys. Now, they’re a lot smaller in real life. 

Kristin: Well, that’s comforting 

Will: at least. But it’s, it’s, they’re called demodex and it’s, uh, yeah, it can cause problems with the eyelids. They’re mites that live on your eyelashes. 

Kristin: Just chomping on all that goo.

Will: Now, it might seem gross, But you don’t want to get grossed out by this. 

Kristin: Okay. All 

Will: right. You got to get checked out. 

Kristin: That is very sensible. Go to your eye 

Will: doctor. Ask about demodex blepharitis. All right. That’s really what you got to do. Or DB, if you want to be a little shorthand with it. 

Kristin: Yeah. Make it sound like you know what you’re talking about.

Will: To find out more, you can go to eyelidcheck. com. Again, that’s E Y E L I D CHECK. COM to find out more information about these little guys. 

Kristin: Tell them Dr. [00:50:00] Glockenfleck and sent you. That’s 

Will: right. Demodex blepharitis. All

right, let’s look at a story. Uh, so, so this comes from a listener named Mike. So Mike says, um, Canada, this is great because it’s, Mike’s given us, given me some like healthcare stuff to look into. 

Singers: Yeah. So Mike’s 

Will: from Canada. He says, so Canada doesn’t have the whole PBM issues of pharmacy benefit managers.

Um, but one company is trying real hard. So basically trying to like. Just take advantage of the system. Yeah, you know, just try to, uh, corporate, corporatize the pharmacy system in Canada. Uh, it says they are called Shoppers Drug Mart, or SDM for short. So, I’m going to have to look this up, SDM, so he says, um, that my wife loves, uh, that every time I pass the SDM in Canada, I give it the finger.[00:51:00] 

Just doing your own little daily, you know, that’s something that we should probably all do to like CVS. You know, just pass by, give it a little, give it a little, uh, you know. Just stick it to them a little bit 

Kristin: before you park in their parking lot and go in and get your prescription 

Will: I I do not use I I don’t have a community pharmacy nearby So unfortunately, I’d have to use one of the chains, but I don’t use CVS.

They’re CVS is like 

Kristin: they’re the worst 

Will: They’re there. Yeah, they’re like no noticeably They’re worse than everybody. I mean, they got the long receipts. They got the 

Kristin: Long receipts? Yeah, you’ve 

Will: never seen the 

Kristin: No, I know what you’re talking about. Why does that make them the worst? 

Will: It doesn’t. It’s just one thing.

Kristin: Seems. That was not what I was expecting you to say. Why do you need 

Will: long receipts like that? I don’t know. No, they’re one of the giants, the PBM giants. They’re like, I think it’s Aetna. They’re, yeah, CBS owns Aetna. And so they’re all about the, they’ve got one of the big PBMs. Yeah, it’s express scripts. I want to say anyway.

Anyway, they’re they’re they’re in it. They’re they’re like the the American the [00:52:00] shoppers drug. 

Kristin: Okay All right 

Will: Okay. So anyway So he says that he he makes sure to give the SDM in Canada the middle finger every time he passes by one They also learned that one of my wife’s colleagues steals one 10 item from them 

Kristin: Now, 

Will: 10 in Canada, he says, uh, Mike says, that’s like 7 cents in American 

Kristin: money.

Well, I think it’s a little more than that. Maybe 

Will: a little bit more, but, um, uh, steals one 10 item from them just out of pure frustration. Uh, but obviously the lesson here, uh, we don’t do stealing from a foreign. But you know, you, it just gives you a sense of how, how angry people are about this shopper’s drug mart.

So I, he’s, he’s encouraging me, Mike is to like look into it and try to make some content about it if possible. I’ve never, I’ve never gone into all in on the, uh, the Canadian pharmacy situation. I feel like I got enough to worry about on the U S side. 

Kristin: Right. Maybe we need a research trip to [00:53:00] Canada. 

Will: Oh yeah, maybe so.

Kristin: Yeah. 

Will: Could, uh, could go, uh, check out some Shopper’s Drug Mart in, in Canada. I’ve never even heard of it. 

Kristin: Yeah, I know. You should go. You should film there. We should do, I don’t know, someone give us a reason to come to Canada. Like someone, will someone cover our travel? 

Will: I’ll look into it, Mike. Thanks for the recommendation.

Uh, send us, uh, any stories or, or content suggestions, knockknockhighandhuman content. com. Uh, and let us know what you thought of the episode. Let us know what you think about Glock Talk. What glock, what, what glock talk topics do you want us to talk about? Let us know. Email us. You can visit us on our social media platforms or hang out with us in the human content podcast family on Instagram at human content pods.

Thanks to all the great listeners, leaving feedback and reviews. We love those. Uh, we can give you a shout out. If you leave us a nice little review, like at GRMPEqueer on YouTube said, [00:54:00] Always good to see the Glockenfleckens. Good people. Oh, I appreciate 

Singers: that. That’s 

Will: very nice. Uh, full video episodes are up every week on YouTube at DGlockenflecken.

Lots of cool perks on our Patreon. 

Singers: You 

Will: gotta check out the Patreon. It’s awesome. React to show on medical, uh, react, re, where, where we react to medical shows and movies. 

Kristin: Are you okay? Are you having a stroke? Tell me if you’re stroking out. I will help. 

Will: Oh, I’m not. I’m not. I’m not. Hang out with other members of the Night Night High community.

We’re there. We’re active in early ad free episode access, interactive Q& A, live stream events, upgrades on tickets to our live shows, that’s another one, uh, patreon. com slash glockenflecken or go to glockenflecken. com. Speaking of Patreon community perks, new member shout out to Vank Zosen. Oh, I love it. I love that name.

Vank Zosen. That’s a couple of antibiotics. That’s like, that’s like the broad spectrum. It’s like a joke that I think I used in one of my infectious disease skits. Oh, okay. It’s always like, you always like Van Gogh’s. It’s like the broad spectrum thing that I’m sure infectious [00:55:00] disease doctors hate because it’s like broad spectrum and Right.

And promote antibiotic resistance and stuff. It’s like lazy, boring. Yeah, a little bit. That’s like the connotation, right? So, Vank Zosen, thanks for being a member and thank you for that name. I love that. Uh, shout out to all the Jonathans, as usual. Patrick, Lucia, C. Sharon S, Omar, Edward K, Steven G, Jonathan F, Marion W, Mr.

Grindady, Caitlin C, Brianna L, KL, Keith G, JJ H, Derek and Mary H, Zanna F, Jenny J, Mohamed K, Aviga Parker, Ryan Mohamed L, David H, Jack K, Medical Meg, Bubbly Salt, and Pink Macho! A virtual head nod to you all. Patreon roulette. Random shoutout to someone in the emergency medicine tier. We got Eleanor F. Thank you, Eleanor, for being a patron on Patreon.

I love our little growing community. 

Kristin: I know. Isn’t 

Will: it 

Kristin: great? Yeah. We got a role for 

Will: everyone. It’s fun. Alright, so just tell us what you want to do in our little town and we’ll make it happen. 

Kristin: You know what we need is we need an intern. 

Will: A patron? A what? 

Kristin: You said we have a role for everyone and I could use an intern.

Should we have 

Will: a [00:56:00] match? No, I don’t, I don’t 

Kristin: mean a medical intern. I mean like a, like a 

Will: business intern. You want to, if you want to be a Lady Glockenfleckens intern, you can apply, I guess. It’s a new job we just decided now to have. Thank you all for listening. We’re your hosts, Will and Kristen Flannery, Glockenfleckens.

Our special, our executive producers are Will Flannery, Kristen Flannery, Aron Korney, Rob Goldman, Shahnti Brooke, Editor and Engineer, Jason Portiza. Our music is by Omer Ben Zvi. To learn about our Knock Knock Highs, Program Disclaimer, and Ethics Policy, what was that email we got? Did we get an email?


Kristin: wants you to, to, they want to learn about it. 

Will: Someone just sent an email. We gotta find it. We gotta, I wish we could get it. I don’t know who it was, but it said, uh, um, we, I would appreciate more information about the Program Disclaimer and Ethics Policy, please. The licensing terms. Very serious about it.

Submission verification, licensing terms, HIPAA release terms. You can hear all of those, or see all of those, not hear them. I’m not going to say anything about them. You can go to Glockenflecken. com to learn more. Or reach out to us at knacknacki at human content. [00:57:00] com with any questions, concerns, or fun jokes.

Knacknacki is a human content production God, what a struggle that was, my God. Sorry about that. I’ll be better next time. Bye, everyone! Goodbye!

Hey, Kristen? Yeah? What do you think about my Dax co pilot? He’s 

Kristin: very cute. Almost as cute as mine. 

Will: Oh, he’s great. He just sits right there 

Kristin: I know. 

Will: Can I tell you about Dax? 

Kristin: Yeah, tell me. Oh 

Will: man, it’s fantastic. The Dragon Ambient Experience from Nuance. They call it Dax co pilot. It’s cute. Yeah, he helps with documentation burden, reducing burnout.

In fact, 80 percent of patients Say their physician is more focused using the DAX copilot. That’s, that’s huge. That’s pretty good. We all want to be able to connect more with our patients. 

Kristin: Right. 

Will: And all the documentation we have to do now, it makes it almost impossible. 

Kristin: Yeah. Easy to burn out. Absolutely.

That’s your job. And 

Will: 85 percent of patients say their physician’s more personable and [00:58:00] conversational. 

Kristin: I like that. 

Will: I want to, I, I need help being conversational sometimes and DAX is one of those things that can help you get there. So, uh, to learn more about the Nuance Dragon Ambient Experience or DAX Copilot, visit nuance.

com slash discover DAX. That’s N U A N C E dot com slash discover D A X.