¶ Effective Communication in Medical Care
I've seen doctors have really bad communication skills . Yeah , this patient has cephalohematoma of this and the families are like I don't know what that means . I think part of communication is understanding who you're talking to .
So in the military we call it Barney style , like Barney Fife . No , the Barney the dinosaur .
You see , baby bop , please and thank you are like magic words . Barney , you're being silly . What did you say , punk ?
When I don't understand something , I need you to break it down . Barney style . Explain it to me like you're trying to explain it to a child .
That's where the power is at , though . You know , when you don't explain things to people , there is a sense of Well , I understand this more than you do . We tend to revere people more If we don't really understand it , but we think the person is a good guy and stuff . My right side hurts . It's right up here . I think it's your gallbladder .
It could be your gallbladder , it could not be your gallbladder , but you trust that person .
You're good at your job because you know how to do it . You're great at your job if you know how to teach others to do it .
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I got a whole bunch of different things going on . Let me just quickly tell everybody , as I said in the previous episodes , sandwich generation . Here I'm here , there's some people who are listening to the show . You know exactly what I mean . You're in that late 30s , 40s , maybe even 50s . You're taking care of your parents , but we got a big trip coming up .
We're going back to Ghana , taking the parents there for an extended trip , maybe three months or so , and see how it goes . Um , but it's a lot of pressure , right , when you're packing not just for yourself but you're also packing for your parents and they can't really help you that much . And it's crazy , you know .
It's just like you're trying to pack medication . You're trying to pack all these different things that you anticipate . Um , ghana has a lot of things that we have here , um , you , but you know , sometimes from an electrical standpoint or from a tech standpoint , they have it , but it's just in a different voltage .
So those are things that I'm trying to keep track of . We need some durable medical equipment . So that's going to be a pain in the butt to get packed , but we're almost there . No-transcript them kind of . Help them reach the finish line of , you know them coming to United States , particularly my dad .
He came to the United States on a boat right , and then spent all . Yeah , he spent like . He spent like three weeks on a boat going from Ghana all the way to Elizabeth , new Jersey , right and um , from there he ended up in New York and kind of made things happen .
And then , you know , my mother came shortly afterwards and then , you know , we kind of just the dark O's just started populating the United States and you know , you just like you , don't you like your parents or your parents they got everything on lock , right .
And then you start to realize as you get older , I started to realize as I got older , I'm like , oh , they really don't have this on lock . And you know , maybe about 15 years ago I think , the first time I really realized that I needed to take care of things was in fellowship . When I finished fellowship and I found out that my dad had prostate cancer .
He was very nonchalant about it but he also seemed like he was in the dark about things . And that was the first time that I had to change the trajectory of what I was doing on the basis of my parents . I've never had to do that before , right , it was always just like I got to go to school , just make it happen and that's it .
You get further and further away from your parents . That's just how life is . My dad did it when he was in his mid twenties .
He left Ghana , came to United States a whole new world and started that's just what I'm going to do , um , but when my dad got sick , I was like , oh man , I got to , I left fellowship early , actually , and and came home and started doing locums and decided I was going to stay home .
And when I stayed home , I started looking at all the bills and I was looking at all these bills that were not paid or these bills that were in arrears . You know my dad . He's very hardheaded , he's very stubborn , but he's a very proud man , he's he works very hard .
So I was like asking my dad about all these different things and trying to get an answer out of him sometimes can be really difficult . But basically what it boiled down to is that he was scared through this whole process . So I took him to his doctor , the urologist , and we figured out what the plan was going to be .
We got a second opinion and we figured it out and I would change my locum schedule to make sure that every time he got his radiation treatments I was there for it , and then I was able to make a plan with my sisters so that they could help him , and it worked .
I was able to make a plan with my sisters so that they can help them , um , and it worked . And that's really the basis of me kind of doing locums right out of fellowship , falling in love with , wow , like I can make my work wrap around my lifestyle .
That's something I wasn't used to at all , um , so from that point , you would have you would have been able to do that if he had gone the traditional route .
No no , are you the only doctor between ? You're the only boy right .
You're your sister , I'm the only boy , my sisters , my three older sisters . Out of my three older sisters , my youngest sister , she's a nurse anesthetist . Um , my mother is a nurse . Uh , was a nursing aid . Um , so , in terms of medical background , was a nursing aide .
Um , so , in terms of medical background , um , kind of medical adjacent with my mother , and then my sister became a nurse and then I became a doctor and uh , yeah , it's um , it's a little crazy .
So then , throughout that process , you know , you know , over the next several years it goes from okay , dad , let me help you with prostate cancer , to mom , dad , I think you know , like , even small things , like I had a Jetta , a 1999 Jetta , so this is around 2012 now I had a 99 Jetta .
So I was like , you know , when I started doing locums , I go to different States and when I come home , like I really needed my car , but at the point where I gave my parents the car , it was like 135,000 miles on it . You know I had been through Kansas City , jersey , atlanta , miami . I was like just keep my car Right .
And I just started noticing like just more and more , like taking over with their lives , taking them to their doctor's appointments , and and then , even when I got married , same thing , like it was just helping them more and more .
And now it's like you start to realize like 10 years ago you guys should have tried to move back to Ghana to kind of finish the circle right , to kind of retire and stuff , but they just economically couldn't do it or financially or you know , just emotionally couldn't do it . So now we are finishing that and I don't know how long they'll stay .
They'll probably stay for several months and then come back . But we here and we leave tomorrow .
Actually , Well , tomorrow technically wouldn't be tomorrow when the recording goes out .
Yeah , but we ain't got to tell them though . For everybody listening tomorrow is that whenever it is tomorrow for you , that's when I'm out . So but that could have been a week from now or a week later , actually , or a week before , I don't know , um . So , if anybody's listening , if you know what I'm talking about , you know , let us know what .
If you are part of the sandwich generation or , um , if you have similar dreams or hopes to like kind of help your parents out and you're not sure exactly what to do , but low-key . The other thing too is , um , we got a caseworker from my parents insurance and they helped us . There's this program called pad , like the prescription .
Basically it's a prescription help for old people , right , oh , you know folks , and you know my , my dad has a history of clots and he takes Eliquis , which is a blood thinner , and that shit is expensive as hell , like a 30 day supply , like those are the things that I've been helping my parents with and my sisters .
Like , when you think about , like there's this huge donut hole , right , like where , if you can kind of think of prescription coverage , almost like a donut right , there's a in between , right , like you know , there's a hole in the middle and then , before you get to the hole , there's , like you know , the donut .
Well , that part of the donut you can imagine is coverage right , and then , once they reach a certain point past that , once they keep you know using medications , there's a hole there that doesn't cover anything anymore , and that was that came out . Uh , medicare part D came out when I was in medical school , so this is during Bush's time .
This is Medicare part D , and that was the big issue is it provides a good amount of coverage , but there's a portion where , if you go past a certain amount of coverage like , you're on your own .
Insurance has got to be the biggest scam ever Insurance across the board , home insurance , car insurance .
A man woke up in the morning from his hotel room , left his hotel room and was going to a meeting and got shot in cold blood on video and nobody gave a damn about him . And it mainly is because he worked for an insurance company , right , he was a CEO of an insurance company . That is how bad the public sentiment is on insurance companies , right .
And you know , like I said , like we value life I'm a doctor , you know , you're a basic human being , so you value life but a lot of people are pissed off at insurance companies , that ire , that upsetness . When it's pointed to that CEO , it's like , well , whatever , you know people rather talk about how good looking the guy is .
Let's not disregard the fact that it happened in New York .
Let's not disregard the fact that it happened in New York .
Hello , I've just shot somebody . I did it on purpose .
Hey , shut up down there .
Where in New York in general it's very much . You didn't see nothing . You can't say nothing .
You didn't hear nothing . Word , word , word . But we saw this , though we saw it .
We saw it , we just not going to say nothing .
That's , and that's crazy because that's , first of all , it's just New York culture in general , yes , but even across the board , even if it had happened in other , in another state , I feel like we've become so desensitized to human beings in general .
Yes , yes , we've become a very voyeuristic type of world where we in essence , want to watch the dumpster fire but we really don't want to participate , right ?
Like you'll see , people get into these fights , they get knocked out , someone is in a seizure and , like the camera won't is staying steady on the person , which means the person is still watching , still , you know , keeping a camera on that person while the person is going through a seizure and stuff .
Or you know , the whole thing with the woman on the train , the New York train getting put on fire , like this is crazy , you know , but I can't . But can you officially say that , like , let's say , this was 20 years ago or 15 or 30 years ago , people would actually do something . I just think that's our nature , right , we just want to watch and see what's
¶ Healthcare Communication and Simplification
going on . So , yeah , I mean , I think the insurance situation is bad and I think that you know a lot of people like when you think about insurance companies and what they do in essence . They take a whole bunch of money from you , right , you could be a state , it could be you as an individual , or you as an employer or what have you and they give you .
Whatever they give you back is less in value than what you gave them , right ? So if you give them $100 , they give you , in essence , $20 worth of coverage . That's how they make their profits .
Well , yes , and then , when you think about it , so the deductibles , like you're telling me , in order for me to use the thing that I already paid for , I have to pay more .
Yeah , it's crazy .
What are you doing with the money that I already gave you ? I haven't used it in . Let's say , I had insurance for five years . I haven't used it in five years . I need it now , today , and you're telling me that I have to give you more money . What did you do with the past five years worth of whatever I gave you ?
Don't you see the big ass nice building . That's the tallest building in the city .
I know that's , but it's like that's what you're using the funds for . It's like it's a scam .
It's a legalized Ponzi scheme . I think that's the best way everybody can describe it . It's a legalized and a federally upheld Ponzi scheme and at this point it's too big to fail upheld Ponzi scheme and at this point it's too big to fail .
Yeah , so it's crazy . It's crazy . There was something I was going to say to lead us into the pit , but I know you had to .
Before we get to the pit real quick , there is a email that we got from Dr O . Let me read that real quick .
So Dr O has her own podcast , but she reached out to us and this is a comment about the episode that I recorded with Dr Jordan and his book about purpose and he says I hope your holiday season was rejuvenating and that the new year is off to a promising start .
Just wanted to drop a note to say kudos to you and Renee on your latest podcast on navigating purpose and Renee on your latest podcast on navigating purpose . It really spoke to me as I prepare for a career transition and influence how I reflect on my meaning , the past and purpose , the future . Keep up the great work , take good care . Sincerely , dr O .
So just want to give a shout out to Dr O . She knows who she is . I hope you start your podcast . I wish you all the luck with that or restart your podcast . I wish you all the luck with that and the episode with Dr Jordan Grumet . That was a really good episode . I think he , he , you know how like . I still find it really like .
I was listening to a podcast yesterday , the Joe Budden podcast , which is like what's a rapper's rapper ? And what I mean by that is , um , who's a rapper ? That when they rap and when they put out lyrics like other rappers like aspire to be , to , aspire to get to , and they can quote their lyrics , just like that Right .
And I kind of look at it like in terms of podcasting , like is there a podcast that I listened to that I'm like man , I just want to be just like that person .
Right .
Um , that that part is um is very interesting , Right , but with Dr Jordan , whenever I listened to his podcast , when he comes on the show , whenever he writes his books , he's somebody that , when I listened to him , like damn man , like he is very good , he's an excellent communicator , right , like he's really good at communicating and he was able to communicate
verbally as well as in a written form . That yo purpose is in two forms and I'm going to give a book review very shortly , but he's a he's an excellent communicator and , uh , I'm glad that people really , you know , like that show .
So I'm going to have to read the book .
I need to work on my communication .
I'm not even going to lie .
Communication is half the battle , yo , communication is half the battle . Pr , as you know . You know , I've seen it , I've seen doctors have really bad communication skills .
Like I've seen doctors will talk to patients , families and be like , yeah , this patient has , you know , cephalohematoma of this and broken this , this , this or the families are like I don't know what that means . You know , and I think part of communication is understanding who you're talking to .
And it's okay to kind of just like make things a little bit more lay so that people understand . And it's the same thing with podcasting Like how can you express and reach the people who are listening right now and help them understand things ? Like , yeah , I'm with you , I understand what you're talking about , and go from there . So boom .
So in the military we call it Barney style . So you know how .
Barney style yeah .
Remember .
Barney Like Barney Fife . No , oh , barney , barney the dinosaur . You see , baby bop , please and thank you , are like magic words , are they ? They help people get along together and that's a kind of magic . Barney , you're being silly . What did you say , punk ?
Okay , I love you .
Yes , but you know how he used to break everything down like oh this is , you know , happy and happy is da-da-da-da-da , and just kind of just break it down to lamest terms , like you're explaining it to children . That's how we say it and it's like I need you to break it down . When I don't understand something , I need you to break it down Barney style .
Explain it to me like you're trying to explain it to a child .
I got you , I got you . Well , that's , I agree with you . I always say so . It's funny . You mentioned that I say talk to me like I'm a fourth grader , or actually no , I say talk to me like you're a four-year-old , like I'm a four-year-old .
Yes .
You know , explain to me , even like my financial advisor . Explain to me like I'm a four-year-old . I don't understand what you're talking about . Am I broke or do I have some money ? Help me out ?
I don't need you to tell me the technical terms .
And you know , look , I didn explain things to people . Sometimes it's like there is a sense of , well , I understand this more than you do and there is like like we , we send , we tend to revere people more if we don't really understand it , but we think the person is a good guy and stuff . You know , it's just . That's just the way how it is .
Like you go to your , your mechanic . If you go to your mechanic and they tell you something like , I'd say , the majority of people , 99 of people , do not understand what the hell the mechanic is talking about . But you know , if they seem like a nice guy or girl , you know they'll be like all right , well , yeah , just go ahead and fix my cv joint .
That's probably doesn't need to be fixed . You know , right am right , am I lying ?
No , it's true , you just trust them .
You just trust them , and that's it , you know the same thing works in doctor . Yeah , the same thing goes with doctors . Like you have someone that comes in my my right side hurts , is right up here . My right side hurts , it's right up here . I think it's your gallbladder .
And it could be your gallbladder , could not be your gallbladder , but you trust that person to say , yeah , it's . This is the reason why , like you don't have the ability to review the test , you know , and even if you looked at the test , how do you know to interpret that ? This is the reason why you're having pain .
You just have to trust that that person , who's interpreting everything and has gone through school , understands the you know , everything that makes you have pain in that area . It's , it's scary .
I feel like there's a difference , right ? So you're good at your job because you know how to do it . You're great at your job if you know how to teach others to do it .
No doubt A hundred percent , I agree . If that makes sense , I don't know , the ability for you to teach something is . The ability for you to teach something shows a certain level of mastery .
So me and Renee would go back and forth about this in med school , like she like , when we would study together , like we like , I study well , by myself , renee , I don't know how she does it , but I would study on my own . And then right before a test , right , let's say , a test will come at the end of six weeks . So we would do what's called blocks .
Right ? So you would study neurology or the brain or the neuro system for six weeks and in between that time you would have some quizzes and some tests . But at the end of six weeks was the big block examination . So me and Renee , like the night before , we would go to another school .
There's a library there that was open 24 seven and we would just study with each other and ask each other questions . And you know she would . You know she was just finishing being a teacher . So she would say , like , teach it to me Like you know I'm one of your students , or explain this to me Like I'm one of your students .
I had to get really frustrated about that , but what she was trying to help me to understand is that . Well , I understand that you can memorize it and I understand that you understand it .
But if you can verbalize it , speak it and take it from what you see on the textbook to how I can understand it or help me to understand it , then you definitely got this and that was the key for me .
You know and um , you know , as I said in a previous episode , med school wasn't that I didn't have that many difficulties with med school in terms of the academics , you know , the , the emotional , the financial things . Those were really crazy . But from an academic standpoint like I don't know why , but it just it worked um and I'd do it again if I could .
Actually it was fun , I say it all the time I say I say that about the military , I'm like it was like the best , worst time right , I know what you're talking about .
Yeah , yeah .
It's like yo it sucked , but I would do it again You're at the top of your game .
Yes , yeah , you're at the top of your game , no matter where you are in your career . You've seen patients your age or younger get seriously injured , have a long-term illness or even have a mental health issue that affects their ability to work . Now what if that was you ? No , for real . What if that was you ? Without disability insurance ?
How are you going to replace your paycheck ? In episode 176 , jamie Fleissner of Cephalife Insurance explains why the best time to buy disability insurance is during your residency .
Most people , most physicians , acquire their disability policies during residency , and there's several reasons . First of all , when you're younger , you're able to obtain the insurance because they ask you a whole host of medical history and so you usually don't get healthier over time .
Usually you get less healthy over time , so when you're healthy , it's easier to acquire the coverage . Number two it's also less expensive because it's based on your age and your health . You're not getting younger or healthier over time , so you're at the ideal time . The earlier you get it and the younger you are , the less expensive it's going to be .
So , whether you're a resident or you're an attending , it's never too late to protect your income . Renee and I , we use Set for Life Insurance to find a disability policy that fit our needs and budget . So what are you waiting for ? Check out setforlifeinsurancecom Once again . That's setforlifeinsurancecom .
¶ Navigating Financial Challenges in Medical Training
So , with that being said , med school . When we're talking about it now , there was a Twitter post that came up .
This is a tweet back in 2024 , right . That says how does anyone survive the time between medical school and residency financially ? Why does everyone say just take out a relocation loan ? That's not the answer to this recurrent problem in the medical world . Well , I'm sorry , Dr Amos , that is your problem and you got to deal with it .
So , basically , what happens , guys , if you're not familiar , if you're going into , if you're in med school and you don't understand what this person is talking about ? This is someone who probably has already finished med school and is in residency , or someone who's about to go into it . The point is this there is a gap .
Once you finish , once you , you match at a place right , so this is around your fourth year of med school . Once you match at your training spot right , so you match , I think around February March , something like that , I don't know . Spot right , so you match , I think around February March , something like that , I don't know .
There's a lag right Of about three to six months where , like , you have to be able to now secure housing , you may need a car , you may need to do a whole bunch of different things in this new city while you're still living in your old place right . Here's my example . So I was going to be doing my residency in Atlanta , georgia .
I still lived in Kansas City , missouri , right . So I was a fourth year I was living in Kansas City , missouri . I matched in residency at Morehouse School of Medicine in Atlanta , georgia . I was starting July , right ? So now I got to find housing in Atlanta , which means I got to put down a security deposit , right .
So , depending on where you match at , that security deposit could be , you know , a couple of stacks , right . Let's be honest , it's going to be a couple of stacks , right , three thousand maybe . Then you know you got to also come up with first month's rent , which is a stack , possibly maybe a stack and a half Right .
Rent , which is a stack , possibly maybe a stack and a half , right . Then you know , depending on the state of your car , you're going to need a car , or you may not need a car , or maybe your car may need to be fixed . You're going to have to move , right ? I got to move from Kansas city to Atlanta , right . So I'm going to pack up the Jetta .
You know , with 120 , 130,000 miles on it , is it going to fit everything ? I can't put a couch in there . Low key . I didn't have a couch in Atlanta or in Kansas City , right . But you know there's things that I got to move and stuff , right .
And remember the way how I'm paying for med school , the way how I'm living from med school is off of a loan a student loan , right , a refund check , right . The majority of that of that student loan went to go pay for my education , like tuition , and then whatever's left come back to me in a check and that's how I pay my rents in med school .
So the question is where are you finding this money to get that house or to get that apartment , all of these different things ? And then , not to mention , when you graduate from med school , you're probably graduating in May , right , or June . So there's another month where it's like what are you doing during that month of June as you start July ?
And then , not to mention , don't forget , like when July 1st starts , when residency starts , you don't get a check . July 1st you might not even get a check . July 15th you might get a check like late in July . July 15th , you might get a check like late in July .
So that has been an age old issue for decades , which is what do you do during that lag time and lately , what people have been saying is take out what's called a relocation loan .
And that could be like a private company where you go to like SoFi or whoever , and you go to that company and say , hey , yo like I need a loan , here's my credit score , here's the , let me get , like I don't know , five stacks so that I can do all these different things . And then you got to pay it back and go from there .
Or you know what I did is you put it on credit cards . You know some people ask their family hey , mom , dad , or you know , my rich uncle or Kiara , let me borrow some money , you know . And then they do that and they pay them back .
Or some people just you know they know that as they're going into their fourth year of medical school , they're going to need a lot of money .
So they take a higher amount of student loans , knowing that they'll take to tuition , but the rest of the money that they get as a refund they'll use that to kind of build up their coffers so that when it's time to get ready for residency they have something to go .
No-transcript , almost their own type of loan programs where they're saying , hey , we'll give you a $10,000 loan and we'll make it like 1% we're not here to make money and you can pay that back over five , 10 years and so forth . I think that's better so .
I think that's the best thing Realistically do most of the loans .
¶ Medical School Expenses and Study Methods
So I know you obviously have your student loans which you've used to pay for your classes and whatnot . The debt that you leave school with as a doctor do you ? Is that majority school related or is that because you have expenses that you that aren't being covered ?
I don't know . I mean I think it's both , but the majority of it is your tuition , right ? Like tuition , the majority of your student loans are going to pay tuition . Tuition is $60,000 , $70,000 .
Some medical school is $90,000 , right , which means that you probably , let's say , for a year , if your tuition is $90,000 , that means you probably have to take out for that year maybe $110,000 or maybe $105,000 , right , Because you'll need $15,000 to live , right .
So you take that $15,000 divided by two and that will be what you'll use for rent , food and all those different things . Get a computer stuff , the scope , textbooks , things like that .
How likely is it that there are doctors that do choose to work in addition to going to school ?
That happens , but I tell you it's a small percentage . So if you look at the stats right now , the stats show that the majority of people who are in medical school right now come from very privileged backgrounds . The majority of people in school , yeah .
So , like I had a part-time job , I was in the study hall , right , and I would just stay there making sure that people like check in and check out and it wasn't real , but like to have like a real , like part-time job .
That there's a notion in med school that if you're working in med school like working like employed , gainfully employed you're working your way out of med school , right , because the amount of studying that you have to do is hella hard , right .
So if you have to put that on hold to go and do a part time job or even a full time job or however you make it work , it's going to be really tough .
So what I , what you normally see , is people will do like a full timetime job or a part-time job , maybe during the summer breaks , okay , or if they have a job , it's something that allows them to study .
But the amount of information that is thrown like Kiara , I'm not joking Like the amount of information that's thrown at you over a six-week span , or however it may be . It's crazy Like the tech , not even textbook , like notes . I remember I had like a . We would have papers right .
So we , the way , how we did it , we did it , we studied based off of what we call systems right . So the traditional med school curriculum is all right , kiara .
You go to school and you're going to learn biochemistry , you're going to learn physics , you're going to learn physics , you're going to learn chemistry , you're going to learn anatomy , and those are all like separate subjects and you have to show mastery of that .
And when you take a test , you're just taking a test on bio and then you take a test on anatomy and that's it right . That's how you prove as you're moving through .
What my med school did which I think a lot more medical schools are doing now and this is where I thrived is let's relate all of that stuff to the human body , and that was a breakthrough for me .
So for me , you know , in college I'm like you know , we're studying biochemistry , but I didn't really understand why it was important to understand biochemistry , right ? So you're trying to understand all of these reactions . But if you don't understand why you need to understand it , it makes it difficult to want to memorize it .
So for us , it's like well , the reason you need to understand this is this is how diabetes works . Or you , as an athlete , you want to know why , like , your legs are burning at the end of a 400 , that's biochemistry . This is the reaction that occurs while you're running . This is the reaction that occurs when you don't take your medications for diabetes .
Do you see what I'm saying ? So when they started doing that , it was just like what ? Yes , I understand this now . This makes so much sense , right ? So when we study let's say we do we're going to study the kidneys . Well , we studied the anatomy of the kidneys . We understand the patho pathology , right ? So what can go bad with the kidneys .
We understand all these different things with the kidneys and the amount of papers that we would get . Like would stack up binders like this thick . You can't close the binders , right , and that's a section .
And then you do it times 12 , right , you do the neuro , you do the kidneys , you do the cardiovascular , you do all these different things like just stacks of information that you have to all understand . At the end of six weeks you take a test and all that stuff . It's crazy . So to imagine having to study all that stuff and rinse and repeat all that stuff .
Imagine there's people who have families , kids , and then you throw on top of that some people may have jobs . Like I don't know how they do it , it's tough , it's real tough .
I'm actually wondering now , because I'm not calling you out on your age or anything . I'm saying that things are different now , right , so everything is . It's easier in my opinion . Right , Because I could just , instead of carrying around binders , now I could just create folders or sections , whether it's on my Google Drive , Microsoft Notes or whatever .
How , and I'm hoping a listener can answer . But how do you think they study now ? Is it like a control find thing ? Like if I'm looking for a specific thing that I need to really focus on , can I just control , find it ? Because before you're writing your notes .
Yeah , yeah , I think there's still a small segment of people who write their notes , but I think the majority of everything is electronic now . The question , though , is you know there's studies that show that when you look at something on a screen like , do you retain that as much as when you actually are physically reading on a piece of paper ?
Absolutely not for me .
Yeah , for me the same thing , so that's one thing that they have to deal with . But , yeah , like they're not lugging around these big folders anymore , right , like everything is on an iPad or digitally . And then like , how do you keep notes accurately ? Right , no-transcript , electronically , that can help them understand the body systems and how the body works .
It's really , it's phenomenal . I'm really happy for them actually for that , because I think it's better than how it was for us when we had to figure it out . So , I think it's . It's really good .
I think you're going to get really well-trained doctors now , because now they can understand the full scope of things , because there's so many different ways to test your knowledge . So the question , though , is you know how , how do you retain a lot of stuff ?
And I think , just in general of education , you know , like , like , like if you go to a college campus , like there's college professors who are saying that , like because they don't have books anymore or because they don't really write essays anymore , like the level of education or the the their understanding of you know , the student's understanding is going down , but
the students don't recognize that , and I just think there are certain things that you just have to go through that I think we don't let students go through and they're missing out on it . And I do think writing stuff down and having to write an essay written out or even just typed out with your thoughts , there's something to be said about that .
There's this certain amount of work that goes into that that you can't replicate , but that could just be me saying get off my lawn .
No , I don't know , I'm not that far behind you , but I agree , I do find it a little easier for me to write things out versus type them out . I feel like I understand it a little bit better . My brain takes you know , it's easier for my brain to process it as I write it in my words .
I think that you know that kind of leads . Is that where you're going with this ?
I was .
Yeah , I think like all of this stuff leads into what I've been watching and what I think is one of the best medical shows in a long time .
¶ Medical Drama TV Series Discussion
Now I'm only two episodes in , but I got my bootleg HBO max account going . Nobody's going to know how I got a bootleg , but I got a bootleg HBO account and you know you got one too , Kiara .
No , no wait , I paid for mine . I didn't know . I need you to send it .
Who are you sharing your password with , though right ?
I am , I'm not going to lie .
Remember the Wild Wild West days , like 10 years ago , even five years ago , when you could just share a password with like an entire family could have just one password , like 15 people just have one password .
I know Now they charge you .
I would have my family come by and like log in on my TV . I'm like , oh , just come in , like come watch TV , you know , just log in or whatever , and then they leave . And I'm like just give me the remote , just give me the remote , don't try to log out , just go .
Yeah , I'm here messing with everybody's algorithm .
Right , that's true , people can find out either what you are into , which could be oh , that could be a little crazy , or you're just messing up their kid's algorithm . But this show , the Pit , is no joke . Um , this show , the Pit is no joke . Um , it is . Um .
I would say if , uh , if it'd be a show that I , if I had an opportunity to put out a show , this is the show that I would put out . Right , and it's the Pit is . Obviously it's a play on words , but the Pit is an ER .
This is basically an ER replica , a more realistic version of the TV show ER that was from the early nineties into the , you know , early two thousands that everybody loved . That's the show that inspired me to go into medicine . It's so close to that . It has Noah Wiley , you know he's heading the show .
But basically what this show is is let's talk about what happens in the ER doctor's shift , and every episode is an hour of his shift . I'm only two episodes in , so his shift started at seven in the morning , I think .
So hour two , we're like from eight o'clock to 9 pm or 9 am , and you're basically watching everything that occurs , and in the show he is an ER physician , that is obviously he's got to be at least 10 , 15 years in . But he's interacting with colleagues . He's interacting with medical students , residents . So this is obviously a teaching hospital .
So there's residences , residences , residents there , excuse me , and it's a hospital that appears to be , you know , one of those hospitals that's a public hospital where there's , like , just a lot of people with insurance , without insurance .
You know , there's so many different things that are going on , but what striked me big on this show is there's a lot of just like frank , realistic things that occur in medicine that I think a lot of people would be shocked to find out . There's a scene in there where he just talks about end of life issues with a patient's family .
You know there's a guy who comes in . He's in his late 80s , he lives in a nursing home and he's coming in with pneumonia and now he has sepsis because of it , a really bad infection , and he has an advanced directive that says that he doesn't want to be intubated , he doesn't want to be on a ventilator , he doesn't want dialysis or anything like that .
But if he needed some IV antibiotics or some IV fluids , that's okay with that or anything like that . But you know , if he needed some IV antibiotics or some IV fluids , that's okay with that . So like that's actually very , very vague what I just told you . It sounds like it's very clear , but it's actually very vague .
So he comes in , where he obviously needs antibiotics and he also needs fluids , but it's very clear that he doesn't want to be intubated , he doesn't want to be on a ventilator . So what happens ? When he comes in and you can give him antibiotics , but it looks like he won't leave the ER without being put on a ventilator , right ?
And then what happens when kids get involved ? So his kids are there and they're saying or at least there's one sibling who's saying I'm not ready for him to go , please put him on a ventilator . And that's always the hard part of medicine , which is what do you mean ?
You're not ready for him to go , like your dad has already said that he's he wants to go under these circumstances , if they arise , they have arisen , right . We understand that you're supposed to help him make these decisions when he can't , but he's already made the decision . So now this is almost like a push pull type thing .
Now it's like well , I get what you want , which is you don't want to see your dad go , but dad has already said what you know in what capacity he wants to go . So that conversation is very clearly laid out in the show .
They spend a good like 10 minutes on that and it's it's very like black and white , you know , and there's some gray areas in there , but it's very like up front in front of you . That I found very fascinating and I think the public would be very interested to be like , or shocked to know , like damn , like you guys just have conversations about that .
Like someone lives and dies , that's it , yeah that's rough yeah , it is rough . It's rough . That's the type of conversation I have literally every day on the trauma service , because we see people fall .
I've never seen the show .
I'm actually going to try it . I think you'll like it . I think you'll like it . It's not salacious yet right . So it's not like Grey's Anatomy , where you're finding out people are sleeping with each other . Yet there's a little bit of some people's previous lives , that kind of show up on the show .
But it's purely , at this point , the first two episodes , purely medical , purely like the interrelations that occur in a hospital how people interact with each other , surgeons interact with ER docs , how administration deals with you know , you know er . These things are very interesting also .
But that's my biggest concern is just what's going to happen if it continues like this . Will the public find it interesting after a while , or will they get tuned ? Will they tune out ?
do you think maybe , um , the pit was actually created for a specific audience , like directly your audience , I guess specifically .
That'd be really cool if it was right . Like if it was , that'd be great , because I think , like if you look at the shows now that are on TV , like Chicago Med , grey's Anatomy , that is definitely not for us right Like this is for the public , not for us , right ?
Like this is for the public and the TV show has a job to do , which is we want to make money . So you got to make something that the public wants , right ? And public likes to see sex lies , you know , in videotape . So you got to make it .
You got to make it salacious , and it's extremely boring in a medical , you know , in a hospital , I'll be very honest with you , I think it's boring . Um , so they got to make it so that it's entertaining to people .
So the fact that they're making this show very realistic , like I talked about in a previous episode , like when they , for example , someone's heart stops , you know , like you do chest compressions and sometimes you may have to shock the heart , depending on what type of rhythm that you see .
On ER , it was notorious Like they would shock people on a systole and on this show , like they went out of their way , um , kind of going through like the fourth wall , right . I was just saying , hey , like we recognize that you guys used to kill us on er for shocking people in asystole , right , but yeah , we don't shock on asystole .
So they're making things very realistic on the show so that doctors and other medical professionals be like yep , that's exactly what happens , you know . But but it's still very realistic , I think .
I'm going to tell you right now if it's , if the show is not for doctors , the fact that they even put that in there says a lot , yeah . Yeah , cause it could be . It could be meant for doctors , because , as as a regular person , I don't even know what that means .
Yeah , yeah , and the audience probably doesn't care , but the fact that so many doctors or so many medical professionals are like , hey , why are you shocking on this , it means they were listening . But I agree with you . I think the public in general does like what are you talking about ? Just make this happen . Mm-hmm , entertain me . So it's good .
I recommend it . Guys . Let's see how it goes . Um , I'm not going to do like an episode by episode uh review , but I think it's something that's worth you know people watching right now .
Let's see all right , so um , really quick . I want to have us update on the new york strike all right .
So the new york strike , the folks in New York . They were going to strike because , in essence , let's just keep it a buck .
¶ Healthcare Workers' Strike and Public Perception
There's a lot of turnover that occurs at these hospitals . There's not enough staff . So what ends up happening ? The doctors who stay , the residents , have to do so many things . Like you know , you have to do evaluations on patients , history and physicals on patients , but you probably have to end up .
A lot of these places have to draw blood , have to transport your patients from the ER to their you know room or take them from the ER to the CT scanner or wherever you may have to go .
But it's a very taxing job and what you end up finding out is , once the hospital finds out that they can do more with less , they usually don't like to make moves to recruit more doctors or recruit more medical professionals because it costs them money .
So if you can do the same work with five doctors when you normally need 10 doctors , well , that's five less doctors you have to pay for , and those five doctors usually ain't going to say nothing and they're going to get the work done . Pay for , and those five doctors usually ain't going to say nothing and they're going to get the work done .
Well , now doctors are speaking up and they're saying look like , I want to see my kids , I want to watch the pit , I want to go exercise . You know what I'm saying ? Yeah , I don't want to be here all day , or I don't want to be here all night , so you're going to find somebody else or you're going to find more people recruit .
So that , in essence , was the gist of the strike , or the proposed strike , and New York has kind of stepped in and Mayor Adams , who's got a lot of issues , mayor Adams has stepped up and said that they're going to try to make this work where they come together and try to figure out something in the middle .
So at this point , right now , the strike is not happening . So we'll see . If anybody who listens to the show is involved or knows a little bit more about the strike , write us and let us know , because we're very interested to know what's it like on the ground .
Well , with that being said , New York's not the only state that has had strikes , we know this , this seems to happen often .
It's not going to be the last . It's not going to be the last .
I feel like 2025 pretty much started off with a bang . Let's talk about the Oregon strike .
So this one is nurses and doctors who are striking . They're on day seven of their strike .
As of the time of this recording or the people who are being striked against are saying that they made an offer of a 20% raise over three years for acute care registered nurses up to $5,000 in ratification bonuses for acute care registered nurses , whose contracts and increases for physicians that could exceed $20,000 to $30,000 for those working full-time Providence .
Also stressed that it's typical nurse working full-time makes $125,000 per year and that many full-time representative physicians already earn more than $300,000 a year . I think , as the public , you have to . If you're reading this or you're trying to figure out why doctors are striking and you may not understand it and you may not have sympathy .
You have to think about like why is that statement out there ? Would you want to guess , kiara , why that statement is out there ?
What I want to make . I feel like it's trying to create the way I'm reading it , perceiving it is . It's trying to create internal chaos . That's how I'm interpreting it .
I think you're onto something . I think it's trying to create external chaos . We see this in athletics all the time , right ? So when you see basketball players or when you see baseball players , when they strike right , they will strike mainly because you know the union that they have wants to get certain types of things .
You know maybe they want to get concussion protocols , or maybe they want to get better health care . You know when they retire , or maybe they want a better pension , right ? Or maybe they just want more . You know they want more of the cut of what happens when people pay their tickets , right .
Usually it's like a 50-49 split .
Maybe they want more of that , right ? If you're in basketball , they want more of a split . Like people are coming here to see me as LeBron James more so than they really want to come see the Lakers . I want money F you pay me , right to come see the Lakers . I want money F you pay me , right . Those type of conversations occur .
What we end up seeing from the public is when you have those type of situations , the public oftentimes sides with the billionaires , not the millionaires .
Right .
So if you say that Shaq is making $30 million a year but he wants to strike so that you know he can get , you know pension or get healthcare when he retires , the public sentiment is you make $30 million playing basketball .
Like , how can you not manage your money so that when you retire , you have money to retire right and take care of your healthcare Poor you ?
Oh , I see your point . Okay , I'm following Right .
But the public sentiment is never like but these are billionaires who have the money to pay a $30 million salary to this person and you're trying to be cheap and not give them this pension .
That , in essence , is not really for Shaq Shaq doesn't need it but it's for the person who's making maybe $200,000 , right , it's for that basketball player who's making $200,000 or you know , $100,000 . So I'm just making numbers up . Do you see what I'm saying with the billionaires , not with the millionaires , which makes no sense .
So , for me , the way how I perceive things like that , it's when they say things like that they're saying listen , you have nurses and you have doctors who are striking but public . Let me let you know , they're making $125,000 a year , or the doctors are making $300,000 a year . Why are they striking , you know , hint , hint , hint . It's not us , it's them .
They're being greedy , right , but they don't specifically tell you why . Okay , yeah , if a doctor makes $300,000 a year , but they're working on average 90 hours to a hundred hours a week , what's the effect of like how much when you break down the hours ? Is that really a $300,000 salary , right ?
If all your weekends are gone , how effective is that salary really ? Right ? And I think that's the key is , most people think that , well , doctors make a lot of money , hence they either deserve to be abused , um , or you know you signed up for this , this is on you , right ?
I think that's the sentiment usually , um , but it's never really a situation of , well , yeah , if you want to ask for money , for more money , like , go ahead and ask for more money , because I think most people who , if they were working Like they , would want to get paid more they would want to get more across the board .
That's right , but when you see other people it's almost like a crabs in a barrel type thing . When you see other people who are making more than you , and even though they're in the same employed status of you , we tend to criticize them more than our bosses , and that part I don't understand .
So I think that's the whole sentiment of that statement , which is basically yeah , like we know , situations are bad , but yeah , they're high paying complainers . Basically that's what they're saying they're high paid complainers .
So it saying the high paid complainers so that it makes it hard to sympathize with them , or empathize .
Yes , so once you get the public not behind you , then the companies or the hospitals are going to win .
Well , realistically , from the outside looking in , just regular person , it's a little nerve wracking when you read things like that , when you read that doctors and nurses are one working in like really shitty conditions but also striking because they're being underpaid and they're understaffed .
Um , because could you imagine I mean not from you , your point of view , because you're you're doctor one and two , you're also locums , so you come in and you fill these spots temporarily , but from the outside looking in , could you imagine if I went to my doctor and they were on strike ?
yeah , like your appointment tomorrow is canceled because your doctor is on the is in front of the hospital , in front of the clinic right now . Or imagine you go into your clinic and you see a doctor on the , on the picket line .
What you going to say , you know like you don't be here tomorrow , should I reschedule ?
What's what's going on ? You know what I'm saying , like you're reading my results .
Come on , like I need to know if I'm you know so , right , should I pick up the sign with you , right , right .
Hey , listen , but these are real , these are big time things . Because this is what's going to happen , right ? Because as more and more doctors are employed , they're , in essence , high paid blue collar workers , and blue collar workers strike . It happens . It happens in an automotive field , it happens in anything . They're going to strike .
I think we've talked about this before , where I I think a lot of people forget that doctors are blue collared workers . I did not think of doctors .
They don't forget . People do not want to think of doctors as blue collar workers . I guarantee you , right now , when we put this episode out and people listen to this , they will have a major issue with that and I will tell them you are a blue collar worker , you are , you are a blue collar . They know and they know that you're deep down . They are .
They just don't want to admit it .
Doctors are blue collar workers . I think it just all it is .
¶ Changing Perceptions of Medical Professionals
But it is a blue collar job and because we're so used to hearing blue work , Um , but you know , there's a sense of like if you own your own private practice .
That's not what I'm talking about . But if you are employed and you work for a hospital , you don't own your patients right . You wearing a . You're wearing a coat that has your name on it but has a logo of something else , right , like ? Your healthcare insurance , your disability insurance , your retirement , all that stuff is taken care of by the company .
So , in essence , what do you own , right , right Like you're a high paid ? You're not an executive , because the executives they make decisions about what happens with the hospitals . You don't .
So the hospital is essentially the hospital itself . Is the white collars Absolutely Right ? The everybody else is the blue , the .
CMO , all those people that see something before it . Those are the white collar jobs . You know that's fine , but I do think that the doctors , the med students , they need to know you are entering into a blue collar job . It doesn't change the fact that this is still a dope job , it's just that you got to look at it differently . It's the same way .
Musicians who come in now , like they make shorter music . Why do they make shorter music ? Because they realize that people's attention spans are shorter . So when they make music they're like why do I need to make a five minute track when I can just make a two minute track and still get the same accolades ? It's less work . I , I get paid the same right .
You know Spotify is stealing money from me anyway , so let me just make shorter songs and shoot to the top of shorter songs . Same thing with athletics . Same thing , you know , like why do I need to play 84 games in the NBA when , like , I'm going to beat up my body , I'll just play 60 something ? Or in baseball .
You know , like all of these different things , people adjust to what the conditions are .
And I just think that people just need to understand that that's the way you need to adjust in medicine . It's still great . I think across the board I'm seeing that in the newer generations , not necessarily whether they're older or younger , but just in general . Things are changing , because I did come across a feed and I can't remember which .
I believe he was a football player . I can't remember what his name was , but he actually opted to not play a game to be there for the birth of his child .
Oh yeah , yeah , I don't remember his name , but yeah , that was huge .
It's like back then it was like look , I got to play this game , right , yes , and I like to see it . I like that people are out there with whatever field it is , they're whatever field it is , they're putting their foot down . They're like no , I'm not missing this .
Like this is my thing . Y'all are just going to have to fuck up . Yeah , and I think a lot of it has to do with , I think there's a sentiment of like the company , they love me as much as they need me , basically Right . And once they don't need me anymore , then it's on me , right . So once they don't need me anymore , then it's on me , right .
So if you don't show up for your , your , your child's birth , you know , if you can help it and you can be there , then be there , right . But like the notion of the game over you know , the birth of your child , like I don't know . You know , I think that that sentiment is changing . So you know , I was there for my kids , you know , and I there wasn't .
I can't imagine anything that would have derailed me from being there for my kids .
We have to remember that we're all replaceable . Yes , so if you die today , another trauma surgeon is going to get called up and be like hey , we need you to come in . You know what I'm saying ? Well , if I die today , good luck trying to replace me . Oh my goodness , oh my damn .
Yo Kiara , you are irreplaceable .
I'm telling you right now yes , you are .
Everybody I can't .
I can't function without Kiara .
So I'm just letting y'all know that . But you get what I'm saying . Like in the military , I'm like I see people who are , like you know , very gung ho about , oh , you know , I have to be at work . I have to be at work . You know , my daughter's recital is today , but y'all need me and it's like , first of all , they rotate you every three to five years .
Okay , so you're not that irreplaceable , Because they literally have somebody replace you every three to five years and if you go today , tomorrow they will fill your spot .
Right .
And that's across the board . Like people forget that , like that , like you're , you're not irreplaceable . I mean I , I'm not irreplaceable , but other people are very replaceable .
yeah , I mean we I've always said that , or not me , but there's , you know , there's a famous youtuber , ali abdal he said it , but I'm sure he got it from somebody else which is , you know , united states . You know , in the health care system , it really is the system that's taking care of people , as opposed to individual doctors .
If you go to a third world country or a country where the system is not as robust as us , yes , it falls on the individual doctor to kind of take care and save people . You , as a doctor in the United States , you're saving people , but it's really a system , a network that's helping .
So , yeah , I think the expectations have to change , but , yeah , I do believe that you know , when this goes out , there's going to be people who are going to be angry with what I'm saying , and but I do think if they take a moment to have some levity and think about it , they will come to their senses and be like , yeah , he's right .
No , we don't need them , canceling us .
Nah , well , he's right . No , we don't need them canceling us . Yeah , well , you know , that's the best part about podcasting is like you can't shut us down . So you know . All right , y'all , we are at the end of the show . Docs outside the box uh , once again , thanks again for listening to the show .
Listen , we read every comment and review , either on youtube , email , text message . So we appreciate everybody writing to us and letting us know your thoughts about our show , our comments , our takes or what's going on in your life , and we'll share it on the show . And we really love to hear from you guys .
You guys are really a vital presence on the show and you're the reason why we keep coming up and showing up . So we appreciate you all . So , kiara , let's bid adieu to everyone . We'll catch everybody on the next episode of Docs Outside the Box , y'all , peace .
Bye .