The Checkup with Doctor Mike - The Day Dr. Glaucomflecken Died

Episode Date: April 5, 2026

I'll teach you how to become the media's go-to expert in your field. Enroll in The Professional's Media Academy now: https://www.professionalsmediaacademy.com/Follow Dr. Will Flanary here:YouTube: https://www.youtube.com/@DGlaucomfleckenPodcast: https://www.youtube.com/@GlaucomfleckensIG: https://www.instagram.com/docglauc/TikTok: https://www.tiktok.com/@drglaucomflecken00:00 Intro1:46 He Died26:05 Comedian Doctor37:20 Young Doctors On Social Media1:04:10 Med Students Selling Snake Oil1:17:20 What's Wrong With Health Insurance1:29:46 Debating Anti-vaxxers1:42:00 Eye Myths1:53:37 Strangest Case / Best Tips2:04:22 Curing Blindness / LASIKHelp us continue the fight against medical misinformation and change the world through charity by becoming a Doctor Mike Resident on Patreon where every month I donate 100% of the proceeds to the charity, organization, or cause of your choice! Residents get access to bonus content, and many other perks for just $10 a month. Become a Resident today:https://www.patreon.com/doctormikeLet’s connect:IG: https://go.doctormikemedia.com/instagram/DMinstagramTwitter: https://go.doctormikemedia.com/twitter/DMTwitterFB: https://go.doctormikemedia.com/facebook/DMFacebookTikTok: https://go.doctormikemedia.com/tiktok/DMTikTokReddit: https://go.doctormikemedia.com/reddit/DMRedditContact Email: [e-mail] Producer: Doctor MikeProduction Director and Editor: Dan OwensManaging Editor and Producer: Sam BowersEditor and Designer: Caroline WeigumEditor: Juan Carlos Zuniga* Select photos/videos provided by Getty Images *** The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/health professional **

I'm really excited to be sitting across from you today. Because you died. I did. I had a cardiac arrest in my sleep, and my wife did 10 minutes of chest compressions. The fear afterwards was something unexpected. I was afraid of being alone anywhere. It wasn't just me. My wife, I would wake up in the middle of night to find her checking to make sure I was breathing.

She would check to make sure the kids were still breathing, and they were fine. Why did your heart stop? Yeah. No, it's a good question. I get asked that a lot. I don't know and nobody knows. Welcome back to the Checkup podcast. My guest today is Dr. Will Flannery,

an ophthalmologist and one of the most successful doctors on social media. Will has amassed millions of followers by making comedy videos about different healthcare specialties all under the handle of Dr. Glockham Fleckin. If you work in healthcare, there's a very good chance he's made a few funny jokes about your specialty, mine included. When I ask my fellow medical professionals who they like to watch online, they always say it's Doc Glock. Considering he's maybe the most trusted and beloved medical influencer in the eyes of my peers, I wanted to speak to him about how he got his start, the mistakes he's made along the way, and the mistakes he sees others make who try to follow in his footsteps.

He also opened up to me about his incredible frustration with the American health insurance system. It not only impacts his patients on a daily basis, but has caused him and his family, incredible personal stress when he was recovering from testicular cancer for the second time. Oh, and the day his heart stopped. Yeah, did I forget to mention that? He literally died. You know what? Let's start there.

Please welcome the very much alive Dr. Will Flannery to the Checkup podcast. I'm really excited to be sitting across from you today because you died. I did. Yes. You died and yet you're here. Yeah. Yeah. So not only are you a physician, but you're someone who's had to deal with many physicians

across your life for the death, near death, semi-death experience? I think it's like 99% death. 99% death. I was like on the brink, yeah. A cancer diagnosis. Yeah, yeah. That's a lot of things thrown out one person who's in the medical space as a physician. Was it easier for you to go through all of this knowing what you?

you know from your career, or did it make it even more frustrating? Oh, I'd say it was definitely easier. Okay. Going through it as a physician, just because I just had a sense of how the system works. I learned a lot about the medical system, actually, and being a patient, really, for the first time, I dealt with a lot of the insurance side of things with my cardiac arrest. So back in 2020, in May, had a cardiac arrest in my sleep, and my wife did. 10 minutes of chest compressions.

And the recovery from that, I always tell people, was fairly straightforward, to be honest. Like I went to bed one night. I woke up in the ICU a couple days later. Really, I didn't know what was going on. It was my wife that lived through all of that, right? And so when I say it was easier for me as a physician,

it was infinitely harder for my family, you know, because they were going through something that they'd never seen before. Obviously, my wife had never done chest compressions anybody. And so it was big challenges for them. And then together, we went through all the health care system issues. And I know you say it very casually now, because you probably said this story numerous times.

I've heard it when we were working together, American Heart Association, amongst other times. But that's heavy in terms of not just a medical diagnosis to have your heart stop, wife perform, PPR, wake up in an ICU, but then also coming back from that, while you may not have known what happened, were you having fears that this could recur? Oh, yeah. I was, the fear afterwards was something unexpected. I was afraid of being alone anywhere. I never would have gone somewhere to like speak at a conference because I'd have to be in a hotel room by myself. That lasted for months.

and it wasn't just me. My wife, I would wake up in the middle of night to find her checking to make sure I was breathing. She would check to make sure the kids were still breathing and they were fine. And so the fear took a while for that to kind of dissipate. And at this point, I don't really think about it. For a long time, I thought about my cardiac arrest.

I thought about it every time I exercised. I thought about it every time I just moved a little too quickly. I'm sure if you felt the little twinge in your rib or something. Yeah, exactly. Or when I, you know, take a shower, I'd feel my defibrillator or the leads, you know, going into my chest. And so, you know, but that over time, it just became a new normal.

And, you know, life is still different for me and my family, but we've kind of settled into this new normal for us. Given that there were so many issues with insurance companies dealing with bookings, caregiver support, traumas, how is the health care system specifically tailored or perhaps unprepared for dealing, helping you deal with those mental challenges? Did they ever check in and ask you questions about your mental health or was it just, okay, you're getting a defibrillator, this is the plan? No, no, not really. And I honestly, and maybe this is more of a personal flaw. I don't, I didn't seek any of that out. You know, because my thought was, that's a lot of patient.

pressure you're putting on yourself. It is. And I'm not saying it's the right thing to do. Definitely not because I can't tell you how many times my wife's like, you need to talk to somebody about this. And that's part of my personality. I'm generally actually a very introverted person. And as physicians, one of our big flaws just generally is we're perfectionists. And sometimes we try to do too much or we think we can do too much on our own. And so, So, you know, I have received help from people. And it's honestly what we talk about more at this point now years later is this issue of co-survivorship with my wife.

She's a big advocate for this because, yeah, a lot of attention was placed on me. No one, you know, asked if I needed to see someone, you know, mental health-wise. I can't even remember receiving any documents or, you know, brochures or anything. If they did, what would you have said? I would have thanked them for the information. I love the brutal honesty. I would have thanked them for the information. I probably would have said, yeah, let me think about this.

And to be honest, probably wouldn't have thought much about it. And I probably should have. but what I think is very interesting about this story is that through the cancer diagnoses that I received, testicular cancer, and the cardiac arrest, nobody ever thought to ask my wife how she was doing. That to me is just as alarming as far as just how the health care system operates

because, as you know, when someone responds to an out-of-hospital cardiac arrest, usually it's a loved one. and we're always asking people to do CPR, just learn how to do. We've taught together, we have taught people how to do chest compressions. But we also need to be giving people support when they do it

because it's a traumatic thing to do someone. On a mannequin is one thing, right? But doing it in person to somebody, especially when you're not in the health care system. You've never seen that. You've never done it. That's hard. And this goes probably,

further than just cardiac arrest scenarios. When someone gets a terminal cancer diagnosis, a hospice diagnosis, people that are around them are just as impacted, if not more so. Oh, yeah. And while I think there's definitive reason to blame the system, what I hope doesn't happen, because I've seen this weaponized by people who don't like doctors, where they say it's the doctor's failure that this is happening. I think it somewhat puts an unfair burden on physicians to say, okay, we need you to create some sort of relationship with the patient. We need you to diagnose this scenario. We need you to give a differential.

We need you to give treatments, treatment options, institute those treatments, reassess those treatments, write your notes and make sure it's documented, fight for the insurance company. And then, oh, and you didn't ask how someone else in the room was feeling. It's a lot of things we're putting on a single individual's plate. Absolutely. And I'm thinking of how do you envision a world where the system can be better at that while still not necessarily physician blaming for all these problems? Yeah, I think to that point, that's a great point.

I think you listed like 57 different jobs, something like that. And that's probably undercounting on this. Yeah, right, there's probably a few more you missed. In the moment, it can be so simple as like offering someone a cup of water. warm blanket. So that's really sometimes all it takes to make someone feel better about the healthcare system in general

is that those little really quick small personal interactions. But honestly, I think we need to give patients a framework of how to think about themselves as a co-survivor of medical trauma or medical illness. and and give them that agency, let them know like, okay, these are the things that, you know, you can do to help your family member, to help yourself, questions to ask. I, you know, we are so focused on the patient because we have to be.

It's our job. Right. So I think, you know, us doing small gestures, but also giving patients family members, you know, this, you know, kind of inside information. okay these are things that you can think about and that could help you how to organize your thoughts how to you know because in listening to you know Kristen talk about her experience you know she she had trouble just thinking and and collecting her thoughts and in the state of of grief i didn't die but i mean almost did and and and that just going through the trauma of that we need to help

people navigate that yeah i think about it uh in the ways we have certain checklists where a person, let's say, is admitted to the hospital. We have these transitional of care visits. In primary care, we do this often. So when a patient is discharged, they have a follow-up within two days, seven days, 14 days. We have different structures based on how long they were in the hospital. And they're supposed to follow up.

And we have a nurse, call in, check in on them, schedule the appointment, and it's part of the checklist of what we do. And sometimes these checklists can become invasive and problematic. But I think a good checklist item to include, like when someone has a heart attack, for example, part of the rehab process is getting them into cardiac rehab. That's just they have a set number of visits with cardiac rehab where they progressively increase the tolerance that their heart can take on. But here, one of the checklist is, did we check in with the caregiver that's supporting that person?

Did we give options at the very least? And I don't feel like that's ever been discussed until. I've heard it with you guys. Yeah. It's such a important part of advocacy, you know, for what we do. Because, you know, seeing what it does to family members and navigating the health care system, just by yourself as a patient is hard enough. And even doing it in a group is, you know, putting your heads together, trying to figure this out.

It's really challenging. How did you handle this conversation with your children? Little by little, you know, they were five and five. eight when the cardiac rest happened and fortunately they did not you know on the 911 call Kristen told the the dispatcher you know my kids are in the next room I don't want to scare them that was her what she said and the dispatcher told the team that responded they came upstairs and one of the the paramedics gently closed the door to their room and we've found out after we met with them a few weeks later,

was that she had, that first responder had made eye contact with our oldest daughter and just sitting up right in bed. Something that she like still remembers. And fortunately though, because of what that paramedic did, they did not actually see me being carried by their bedroom downstairs. And then over time,

It's been slowly, you know, answering questions in an age, you know, in a very age-appropriate way. So, you know, in the moment it was dad got sick. He had to go to the hospital. And then I think the next question after that was, mom, what's for breakfast? So, you know, it's... The resilience is strong. Yeah. And then over as they've gotten older, because, you know, five and eight, that's pretty young.

Yeah. as they've gotten older, they've asked questions. It's like you can tell they've been thinking about it for months sometimes. It's like, you know, what was wrong with his heart? Do I have something wrong with my heart? And then you just answer him truthfully. And, and they, as they age and they become more mature and they can process, you know, the severity of things that happen like that.

But it's been a process. You know, a lot of people think that, you know, you survive, you go home after a few days. That's great. That's the end of the story. Everything's back to normal. No, no, we're still, you know, still things come up. Precautions and. Yeah. And just in thinking about it. Yeah. And like what, you know, what happened to me when I'm 34 years old. And so those conversations still come up. And now we're, you know, six years, almost six years out. I'm not asking the question because I'm somewhat aware, but I feel like I'm doing a disservice to the audience

by not asking why did your heart stop? Yeah, no, it's a good question. I get asked that a lot. I don't know and nobody knows, which is in talking to other survivors, young survivors, actually not uncommon for people not to have a great answer. The best term in medicine, idiopathic.

Yeah, that's right. Yeah, we love that, right? And so I don't know. I had all the testing in the world. genetic testing that didn't show anything. Obviously my kids were tested and my parents had genetic testing too. Like do they have something that could have been passed on to me? Everything looks okay. So, you know, not sure. And that's something I've had to grapple with, right? Fortunately, I have a defibrillator. So you have a backup plan. I got a backup plan just in case.

It's a, the battery is about halfway out at this point. So looking forward to five years from now, going back in and get a replacement. But, you know, it is what it is. Does that make it more or less difficult? Because I could see people handling it in a different scenario. They say, look, I have nothing wrong with me. So this shouldn't recur again. On the flip side, I can see someone saying,

if we don't know, anyone could just have this happen. I think it's for me personally, I think it's better that because I, having gone through you know my medical training med school everything the body does weird things

you know there's so much that we don't I think a lot of people don't realize that there's just so much we just can't explain we want to we just don't know and I recognize that and I think in going back to your earlier question about you know has does being a physician

you know help with something like this I think this is one area where it might help because I know how rare something like this is. I know what this defibrillator is going to do if it happens again, but we have no reason to think it will happen again. And so for me personally, I think I'm better off, just knowing that my heart just kind of had a hiccup one day and maybe I had a PVC at the wrong time and just wanting to be fib. I'm not sure. Has it changed how you live your life? yeah i'm like uh well one thing i don't want any arguments anymore with my wife so that's you know

that's what happens whenever she saves your life kind of thing yeah it's like a pocket it's a card it's a it's a card you know you have that's um and i'm fine with that you i'll accept that uh but it's it has changed um it has changed how i think about the future i'm a little bit more easy going when it comes to, you know, spending money, just doing, doing fun things, you know, not, not worrying so much about some of the, like, daily little things that, you know, you, you, you worry about whenever you're trying to build your life and build up your reputation, your career and everything, and just, that sounds cliche, just living a little bit more and more freely. and it's also changed how I've how I've interacted with my patients.

How so? I am much more open to talking about health insurance, health care system. We don't get a lot of that education, right? And so it can be a wake-up call when you got under practice and you're dealing with prior authorizations for the first time. And now I feel much, having gone through it and, you know, advocated, for change and all this stuff, like I feel much more confident

and comfortable like discussing these things with the page, rather than saying, oh, can just call the billing department. Like, they'll talk with you about that. You know, I take it upon myself to educate myself about how much things cost that I'm doing for these patients and being willing to discuss it

because it's just a big black box for people. And, yeah. Being someone who has a comedic background has dying, changed your sense of humor. Oh, man. You know what? I don't know if it has,

it's changed what I've joked about. Because it wasn't until I went through all this that I started making a lot of content about the health care system. But I really started to go after the health insurance companies. Right. I put a fake poster on the wall that has like a, you know,

company's mission statement that just says be evil. Like I, you know, before the cardiac, I don't know if I would have done that. Yeah. And so that firsthand experience really changed things. So it changes the content. I would say my, you know, the way I do comedy and my style is, it probably hasn't changed, but certainly the content has. Yeah.

Yeah. It's an interesting thought because of how perspective shifts so quickly and then how long lasting that perspective shift can last. And with us being in healthcare, it's usually not our time practicing healthcare that shifts the perspective. It's our own life experiences that probably, at least in my experience,

has shifted it the most. I had a shitty situation with my mom happened when I was in medical school, watching my dad go through medical education, more so than I reflect on what my day-to-day is like in the office. Is that the same thing? I mean, it's so, it's personal, right?

And that's going to, when things affect the people you love and care about, like that, what is more impactful than that, right? And so I totally agree with you. Yeah. So in working with the people who helped you get through all of this, who stands out? What person in this journey, besides obviously close family members, meaning more so in the health care system,

that was like, wow, I didn't expect this person to show up as strongly as they did. The first person that came to mind was my residency program director. Really? And it wasn't the cardiac rest. It was the cancer diagnosis. So when I was a senior resident, I had my second bout of testicular cancer. So I already had lost one testicle. All right.

Now I get to lose the other one. And all the questions that came up with that. And my residency program director could tell, like the second time around, it was a struggle. because it's like cancer again four years later like what is happening what's going on with me and and what he did is he just he gave me the space he just said take the time you need and he also slipped me a $20 bill to let me you know hire a babysitter you could probably get in trouble for that but I don't know it's like 10 years ago now he's like he like handed me some money he's like get a babysitter you and your wife like go out for dinner just the two of you

He's a great guy. And I love it. Is he older? This reminds me about grandma giving a dollar. It was a little bit like that. It was like so he's definitely, you know, he's like in his 60s now. But it was just so thoughtful. It's like he's thinking about like the human side.

The human side of things. Not just, you know, who's going to cover me in clinic or who's going to stout. Which would have been easy to do so. Right. Yeah. And I think it's really, and now I tell students that and, you know, premeds. And when I talk to them, I'm like, you know, you want to go somewhere where people can react to major events in your life in that way. Because in your 20s and 30s, that's when life starts happening, right?

Family members get sick. Accidents happen. You might have loss. You might get a divorce. You might, you know, have, you know, a baby, you know, complications, whatever might be. You want to be somewhere. surround yourself with people who will understand what that's like on a human level. Yeah.

And just be a real person who cares. And so, that meant a lot to me. Yeah. There's a statement that rings true that I've repeated a couple of times from a TV show writer we were working with where he says, in any given moment, most people are not sick. So they kind of write off all these concerns people have who are sick or that the health care system's flawed. But it's guaranteed that everyone will get sick. Oh, yeah. Or will need the

health care system. And that's when everyone's like, oh, it's too late now. Right. I needed to think about it back then. Right. Like I, you know, when I was 20, 20, when you're 25, you've never had any health issues, you feel invincible. Yeah. Nothing's going to hurt you. And then all of a sudden, your testicle starts to grow another testicle and it's like, oh, wait, this isn't supposed to happen. Right. You're a cancer patient. Is that what happened in your case? Yeah. Yeah. Yeah. Yeah. It's just, you know, a little self-exam one day. I was like, oh, I don't think this is, I don't know.

You're like, it's not supposed to have mitose on itself. Yeah, no, you're not supposed to have three of these things. So, you know, that's what's the doctor. Were you regularly doing exams? Is that how you caught it? No, I'm just a man who is very familiar with. No, because we used to advocate for regular self-testicular exams, and then we kind of moved away from it now.

Oh, oh, yeah. Because every time I would post on social media about doing, self-exam, I would hear from someone, well, the USPSDF, you know, their recommendations. I was like, you're really going to tell like a 20-year-old not to be familiar with their testicles? Like, let's be honest here. What are we doing? Oh, that's funny. Well, that's interesting that you went back to the cancer diagnosis, because I thought, you know, surely you would have come across someone on your path of near death that was, and I did. You know, the, the, it was, it was like,

My partners, it's funny because it was not, actually here's one. Here's one is my ICU nurse. Where you wake up. Yeah, first person I remember waking up because this was the height of COVID. So Kristen couldn't be in the room with me. They couldn't be in the hospital basically. And he, first person I remember asking me questions, trying to get me to remember my life, facilitating FaceTime calls with Kristen.

And also, he was the first person. person to ever ask Kristen how she was doing. Wow. The first person ever check in with her. So he means a lot to our family. Yeah. Wow, that's powerful. When West Jet first took flight in 1996, the vibes were a bit different.

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I want to help my kids, and I want to give back to the community. Ooh, then it's the vacation of a lifetime. I wonder if my out of office has a forever setting. An IG private wealth advisor creates the clarity you need with plans that harmonize your business, your family, and your dreams. Get financial advice that puts you at the center. Find your advisor at IGPrivatewealth.com. And now this has emboldened you to come on the quest of fixing the healthcare system. Doing what I can as an internet comedian ophthalmologist. Yeah. How does one

become a comedian ophthalmologist? Because usually people select optomology because they're like, oh, top of the class, I'm crushing it. I want a great lifestyle. I want to make a million dollars. I think you tell one joke publicly. That's it. That's all that's what takes. And then you're a comedian ophthalmologist. But you're doing this at a scale that's really setting the new standard. Because when I was growing up, doctors in media, there was two, three. And the huge majority of them were not doing a great job in terms of putting out good information, let alone funny information. Do you remember from your education a comedian physician or someone that told jokes who was a doctor? Like now we have Kenjong.

Not really. Yeah, we have, yeah, we have him now. But even, you know, Kenjong, you know, he left practice. Right. So the idea of. Robin Williams, uh, patch out of this situation. It's pretty close. Um, the idea of someone who's like at a practicing physician, like being funny online,

I was, I mean, when I first started Glock and Fleck and because I have a stand-up comedy background. So I was in high school college, like I was, it was amateur stuff. So I was never like seriously pursuing as a career. I went the much easier route of becoming a doctor. Which I laughed, but that could be true in some ways. In some sick ways, I tell it as a joke, but honestly, like, you know, seeing how hard comedians work.

Like, that's not. So, and so, yeah, I, there was also, there's always been this professionalism issue. Which I think is why a lot of the doctors in media, just kind of boring, right? Just didn't... Robotic. Yeah, exactly. Because that's what they were taught to be to the public.

Like you are, you're put on this pedestal, this pillar of the community and respected. And the only way to stay that way, to stay respected, is you can't tell jokes. You can't show emotion. You can't, you know, be yourself.

And so in doing comedy as I was a resident when I first started doing this, I was anonymous at first because I was afraid how it would be taken. What was your stage name? I mean, so I didn't, once I got into med school, I'd moved away from like stand-up comedy.

And so when I did the occasional stand-up comedy as a resident, which was like in rural Vermont. So it's like, you know, maybe like three or four people would show up. It wasn't much. I was at Dartmouth, pretty isolated area. I was just myself. I was not Glock and Fleckin'

it wasn't until social media I started doing, you know. Which, by the way, can you explain why Glock and why? Yeah, why didn't choose an easier name to say? Yeah. Well, because I was a second year resident and I was like, I need something

that's, this is going to be a comedy, medical, I knew it was going to be medical comedy. And so I was just, my mind was 100% ophthalmology at that point. It was like, what's the funniest word in ophthalmology? So Glockmfleckin. That was, it was either that

or Dr. Sudofofacodonisis. and that was a bit too much. That's hard to say. I mean, both are hard to say. Yeah, so Glock and Fleckin is a real thing, though. Yeah, tell me what that is. It's a, when someone has angle closure glaucoma, eye pressure sky rockets,

and things inside the eye, for lack of a better way to describe, or easier way to describe, but just kind of die off. And so you get these grayish white plaques and flex on the lens, on the surface of the lens that accumulate from the denatured lens protein

that are called Glock. Who named this? It's hilarious, isn't it? Is this a person's name? Fortunately, no, because otherwise Dr. Glock, the real Dr. Glock and Flaken would be quite mad at you. Would have been very upset with me because now when you Google Glock and Fleck and guess what comes up? Not the scientific discovery.

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all about their content and businesses. This is the program I wish existed when I was getting started. Click the link in the description to learn more and I'll see you in the class. So it must have been just like a German word. Yeah, this is a German word. It's kind of funny. You know, naming stuff in medical lingo is so strange.

Because sometimes it's like, oh, Latin, it came from a historic thing. But then they go, oh, no, this is spaghetti and meatballs. Yeah. And I'm like, what is the guy, hungry? Well, how great would it have been to be, like, a medical professional in, like, the 1700s? Oh, yeah. You get to name everything after yourself. Yeah.

Yeah, like, like the ligament of, of my. You know, I don't know. Like, you know. Where would that ligament live? Oh, I don't know. Somewhere near the spleen. I don't know. Useless.

You just go. Well, you know, that's typically kind of the way it worked with these naming conventions. You know who would crush in that era? What's that? R.FK. Oh, yeah. I mean, no one to fact check you and you could just walk around saying this is the ligament of Robert. Oh, he would have had 40 humors by now.

We'd be draining all of that. That's right. Oh, my God. And we laugh about it probably as a way of coping. Well, I mean, yeah, that's what we do. Because that's all we have at this point. That's why I started doing comedy in the first place. Was it a coping thing?

Yeah, it was because it was, you know, I had gotten away from stand-up and then I had the cancer diagnosis. And I was a cancer patient for the first time, which fortunately, you know, I just had to have an orchiectomy. So I had surgery, that's all the only treatment I had to have. But just really, because I was, again, perfectly healthy. to cancer. It was like just psychologically, there's a big deal.

And I had to deal with that. Really, the only way that I knew how was by telling jokes. Something that, you know, with the comedy background, always been a bit of a class clown. I don't know if that surprises anybody. And so that's when I started doing medical comedy for the first time. Yeah. And it was just, you know,

when you're faced with something in life that's like beyond your control of like you get a cancer diagnosis, or family member gets sick or whatever, like you feel like control of your own life is taken away from you. And then what comedy does, at least for me, is it just helps me feel like I'm back in control.

Like I can take that thing, that awful thing, whatever it is, and I make it mine again. Add jokes to it, presented us something completely different to others, and we share a laugh about it. Right. So powerful to be able to do that. Which is why so many people in the medical field

have a wonderful sense of humor because you kind of have to. Yeah. Right? Yeah, it creates order amongst chaos and compassion in a way where it doesn't feel like it's pity. Right. It's like a pleasant compassion because you're all laughing together and enjoying the moment. Right.

What was the first time that someone in your medical sphere, perhaps someone who's an attending, a preceptor, got wind of your comedy? What was that interaction like? It was my residency program director. Because he's a very funny guy. And I felt comfortable like showing him. you know, some of the things I was saying, and I felt comfortable doing that. I wouldn't have felt comfortable with some of the people higher up, you know, who may have taken issue with some of the things I was saying, but I felt comfortable in that relationship. And he was very supportive.

You know, he loved it. He just come up being like, I saw your tweet. You know, it's really good. If there was, I mean, he seems like a really reasonable person, but if they were like, shut it down, what would you're um yeah i would have oh yeah i would have and fortunately he didn't you know because i i wasn't taking too many big swings um but i i've said some things or in the early days i had to learn how to be find the line as a physician that's not exactly something you're just kind of born knowing where the lines are but it's so important uh not just from the coping side of things. I say this at conferences and perhaps it's cheesy, but I always ask a room full of young students usually, and I say, who do you think benefits the most from a laugh? What patient population

loves to laugh? And they all raise their hand. They say pediatrician, because kids love to laugh. And I'm like, no, no, no, all patients love to laugh, not just pediatrics. And the people who are most sick, sometimes having had the laugh in the longest. Absolutely. So it's important, but then it's also so dicey because man if you cross the line it can get you in trouble that's why you know people always ask me you do are you what do you do with your patients like people like can you give me tips on how to be funny with with patients like in the exam room and I always make it very clear I am not dr. Glock and in clinic right because you know we don't have that much time right to spend with patients but I will say if you can make a patient laugh,

even if you spend 10 seconds with that patient, if you share a laugh with someone, that is the easiest way to build long-lasting rapport with somebody. Is that the emotion, what it does in your brain, the endorphins of just having a genuine laugh. But I'm not like in there like, you know, like roasting. I'm not roasting United Health Care like in the lane.

You know, I do crowd work. Because we're there to do a job. But I've got little things I say. It's all dad humor. Because to your point, yeah, you got to keep it very generic. You don't know, you might, but if it's a new patient, you don't anything about this person's values, how they were brought up, where they are politically.

And so you got to keep it very, very basic. And that's fine. And it just decreases the tension in the room. and you got that patient for life, if you want. You know, it's something I get worried about when I do a presentation on what my journey has been like in social media. Some senior clinicians, C-suite executives

are like, well, we don't want all these doctors making content. And while on one hand, I'm like, no, no, we do because we need to fight back. But on the other side, I'm like, oh, man, everyone's making content. Like, there's bound to be a disaster. And like one disaster might be worse

than 100 successes. So how do we balance that? How do you balance that? Well, so this is a great point because the influence of social media has grown so rapidly, especially in the medical field, that I don't think we've caught up in how we just navigate that from an educational standpoint, how we think about physicians as content creators. because, as you said, it is so important. People get their information from social media,

much more than they get it from actually seeing a position in person. Yeah, things like vaccines, that's always a better conversation to have with someone face to face. You can actually talk with somebody about it. What are their concerns? But that's not feasible for everybody. Because you might not get that opportunity. Right, you might not get that opportunity.

And so we have to do something. Otherwise, the chiropractors will take over. What happens if they do? We all have vertebral artery dissections, Mike. Yes, we're all, all of us. And then my clinic's going to be overrun by homonymous aminopia, and it's going to be a big mess. Oh, my God.

So, but seriously, it's, it's, I think we, I think we're catching up on, I don't want to sound like, like, you know, old guard, nude guard, but basically, you know, that thinking of social media is not professional. You can't show yourself. You can't express yourself on social media as a physician. It's not, you know, not okay. That thinking is going away slowly.

And I think it's partly because we have people who have grown up in social media. Right. Who are now ascending to leadership positions and understand the importance of it. And now I think that ethics of social media is the next, we probably should already be having that conversation. We are having that conversation, but it's becoming a more important conversation of what you, where are the lines? Because I don't think students these days even, while they're thinking about it, they don't have good guidance of what does it mean to have a social media? Like the fact that we're answering in common sections for Ivy. league institution students of what they should be doing as social media or even practicing

physicians. You should not be getting advice on a YouTube comment section about your practice. Right, right. There should be some guidelines that are reasonable. It's no longer okay to just day one of orientation be like, do not have a social media platform. Because when I was coming in, the whole thing was like delete it during your interviews. Yeah, yeah. Or go private or yeah, yeah, exactly. Like, do not let anybody know where you are on social media. Do you think program directors and school admission counselors are still checking people socials? Oh, yeah.

Oh, they are. Oh, absolutely. I mean, you're, yeah. I mean, maybe what they're looking for has changed. I think, yeah, and I can't speak to what they're looking for because I'm not on those committees. I mean, I know some people on those committees, but it's, I do think they're looking for, you know, just professionalism. And the question is, what does that mean? Right.

That's the question. What's like the worst most long term? What does professionalism mean? You know, are you spreading misinformation? Are you, well, right. You know, or are you making fun of the wrong thing? Are you, you know, making fun of patience. And so it's, I think that's probably what they're looking for.

I think the problem is everyone's got a different definition of professionalism. Right. Especially the people who are usually in charge are usually older and don't have experience to know even what to look for when it comes to professionalism online. Right. Because I can easily see a provider looking at my content who's 60, late 60s, early 70s and being like, this is so unprofessional. And then on the flip side, I could see someone in that same age demo just because they've been accustomed to seeing my content, being like, this is what we need. We need more of this. And it's so strange to think how two people

in the same position can look at it and have 180 approaches to it. Yeah. It, it, And we need to, and I don't know if there's a right answer, right? I know what, we can have guidelines, right? We can have guardrails for like what we feel like is an okay thing to talk about and to do on social media as a position. I think it has to still stay somewhat general, though, because you don't want to step on people's expression of who they are and what they like to do.

but there are some basic things we can do. We can not make fun of patience. Very, I mean, that's something that I still, I see a lot on social media still. And as a self-described internet comedian, ophthalmology person, is a job title I've given myself. I think I'm the only one.

Again, I only have to tell one joke, folks. Like, just one joke and then you qualify. We're a small club. So my mind's always in that space and the algorithm feeds me. Anybody who's starting doing medical comedy. And some people do it really well and respectfully. Some people don't. And so a very basic thing is just thinking about the quote unquote hierarchy of the medical field.

As physicians, we cannot put out anything on social media that can be even perceived as making fun of a patient. even if you personally don't feel like it's an okay thing to say, all right, that may or may not be true, but it's how it will be taken by actual patients. And I say this as someone who's made these mistakes. Like I said, it was a learning process where the lines are. You know, I have been frustrated by patients in the past. I have said things I shouldn't have said and I've deleted things and I have apologized. because I knew that was the right thing to do,

because I listened to those concerns. And so there has to be a certain level of humility when it comes to being a content creator because you're not going to have the perspective of someone who has a chronic illness who's been seeing a dozen different doctors, you know, trying to figure out what's going on. You know, everybody's got a different perspective

on the healthcare system. You're not going to know what that is. you're not going to come from that place. And so you've got to listen. But that's one basic line that I follow. And that's why you see in my content, no patient characters at all. I keep it all punching.

But even with doctors, you've gotten some questionable critique on. I remember, I remember you did a skit about an overworked family medicine doctor and some angry internet people came at you with pitchforks. And I remember writing like,

I'm a family medicine doctor. I know how shitty it is. And I think this is totally appropriate and a valid way to, especially knowing who you are because you weren't like a new person on the internet. So how do you deal with someone

perhaps seeing the negative side of what you're doing? So that is, if there's one specialty, I've had some pushback from. Is there family medicine? It's family medicine. Yeah.

And I get it. I understand. because the character I have is overworked, it's underappreciated, and it can sting to have someone who is not a family medicine doctor, pointing that out. Now, I think it's in a sympathetic way, right?

And so I stand by the characterization, but I do understand why someone would be a little, would prickle a little bit at at that characterization. And so, and that speaks to this hierarchy even within the healthcare, within physician specialties.

You know, I can make fun of orthopedic surgeons and neurosurgeons all day. Because they're, you know, they're doing well. They're doing well, right? Making good money. They, you know, surgeons are, you know, people have this idea of like,

oh, surgeon, that's the top of the medical field. I think RFK even tries them. Yeah. I recently went for surgery. Like what better thing could you be than a surgeon kind of thing? So it's like that respect, the societal respect is there that has been kind of eaten away by policy, by government of people that do primary care, pediatricians, family medicine doctors. And so it's it can it can feel, you know, a little bit uncomfortable to like see someone like. me making fun of that. But what I'm very careful to do is not undermine their intelligence

and the importance of what they do. So in those videos with family medicine and with all the specialties, even ortho, I try not to show ortho as this like idiot surgeon because honestly they're smarter than all of us probably. Sure. By putting in some like actual medical knowledge, and let me tell you, as an ophthalmologist, really hard to learn actual, like, orthopedic surgeon knowledge where I could pass as an orthopedic surgeon. I'm like doing research. I mean, at the end of the day, all specialties are hard for one reason or another. Exactly. And if one person spent enough time in each one, they could probably learn it.

Right. But we don't because we have capacities as humans. Right. And so even this whole idea of, like, not punching down. I think when I'm talking about physician specialties, I feel like I'm kind of more punching across like I'm punching you which I wouldn't want to do because you're a much better puncher than me um and and so I think that's still okay uh as long as you don't people don't feel like they're being taken advantage of and that you're belittling what they do as a physician and um the the most important thing with satire is there has to be some truth to it and so yeah I might make fun of your

specialty, but if you can look at that video and be like, okay, that's true. That's actually, yeah, that's kind of how it is. Then you're good. That's, that's okay to do that. I think what you're saying is very valuable in the sense of, I think about it like a medical treatment, right? You wouldn't give someone antibiotics just because, right? You would only give it if the risk benefit analysis was there and it was in your patient's favor. And with any treatment, there is absolute and relative contraindications. So I think of social media and posting on social media

with those same rules in mind. There are absolute contradications. Don't make fun of patients. Absolute contraindication. Don't give individual health advice because they're not your patient. You didn't examine them certainly through the comment section.

You didn't get all the information. Yeah, like those basics. And then there's relative ones that are a little bit more vague and require nuance and are individually decided upon, which is hard when there's a lot of It's really hard.

That's where that line is, right? Yeah, and that's where we have to be okay with some learning, growing pains. Yeah, we do. So it's tough because I see that as someone who's also made content for a while. It's very easy to do something wrong with good intentions.

Correct. And a lot of times, intentions to the worldwide web that's so huge aren't seen and are not evaluated with intentions in mind, which in some cases, Maybe doesn't matter. But that's why the takeaway is really complicated. And it brings me to this conversation of this medical student, Nick Baumel, I think his name is.

He got in trouble recently for making, he does skit-type videos. And he's done a couple that have gotten people very angry, making content in the OBGYN space, critical of the field, critical of women, perhaps in poor taste. And initially, when I saw this come across my feed and I was watching this happen, my first thought, and I'm curious if you had this thought as well, is this person even in the medical sphere? Because I don't know who this person is. You always do have to question that because there are people making skits in scrubs all day long that I actually thought were medical professionals and they weren't. So I've had to check myself on that before I got really angry. So I checked out and I realized this was in fact someone who's a student. And then second, I started thinking, okay, let me absorb this and let's see how this lands.

First, I thought about this principle of don't make fun of patience. And it actually brought me to the time when, I don't know if you remember this, when TikTok was kind of in its infancy, in infancy, there was a CMA, I believe, that did a skit to a sound on TikTok making fun of a patient's breathing. And it went crazy viral. I don't know if you remember this. And she was kind of like, and making fun of the patient faking it or something. And we covered it. The whole premise was basically don't make fun of patience, et cetera. And it brought me back to that.

I'm like, well, this person's clearly doing something at the harm of patience. And then I started thinking, okay, they're trying to be funny. They're trying to be a comedian. Maybe we need to be okay with towing this line. And I started almost making excuses for why this was okay, putting myself in the content creator shoes. And then I started zooming out. And I said, let's think about this from every other possible perspective, which I like to do as much as possible.

Here I'm thinking, okay, if I'm a patient and I'm seeing this, how does this make me feel? And is it unreasonable to think that this person has really bad intentions? And I think the answer to that is it's not unreasonable. It's a fair take to see this and be disgusted by it, grossed out by it, to think that this person doesn't have your best interest in mind. And then the final takeaway why I think ultimately it is bad content, bad video, not right for a medical professional to do, is that if this person ran a pizzeria and made a skit that was seen as bad by some group of people, those people would not visit that pizzeria. And it's not like this person was truly harmful across some sort of comedic line. It would hurt their business. But this is a medical professional where you might end up in their care.

in the emergency room because the health care system sucks. And now you have no choice but to get care from a person who you believe is actually harmful to you. And I feel like that's the line that no longer made that content okay for me. And I'm curious that that lands the same for you or similar. Yeah, no, it does. It does. I saw one of the videos. I understand there were more.

Yeah, there was a few. Yeah, I saw one of them. And immediately it was like, no, like this is not okay. and it turns out like shortly after that it was deleted like the whole account was removed it was misogynistic it was doing everything that we've been talking about you know of of pointing punching down and you know i do want to acknowledge that we are we're two men talking about this right and so we we can't put ourselves into into every space you know especially with this this type of content you know, we're not women. And all the issues of women not being listened to and, you know,

being taken advantage of and, you know, suffering harms by the medical system are all very valid. And so I saw that content. And yeah, misogynistic, not appropriate, definitely crossed the line of professionalism. And, you know, there's, there is this tendency to, you know, to, you know, historically, for us to, like, weaponize professionalism against physicians who are trying to make content or be funny or give information or whatever. And that's because we do have a higher standard of professionalism. We have to maintain on social media. We are not your run-of-the-mill stand-up comedian, you know,

who can say whatever they want because that is their job. No, our job is to take care of patients. And so, yeah, we have to find what that line is and not cross it. And that easily crossed the line and was unprofessional. Yeah, I think that's what you're pointing out there is so valid. From a stand-up comedian's perspective, if that's your primary job, it's more important to try and go past the line to know where the line is. But if your primary job is being a health provider or a physician or a nurse and people are

under your care, now it's more important to never go above the line, even if it means being less funny and less optimal on social media. Exactly. And that's the lesson that's not taught to students. Like when I say to folks, they say, what's a good way to start on social media? I say, experiment. Try things that you're passionate. It's never go extreme as possible because ultimately that's not the message we want to send.

It's the opposite. Be as conservative as possible while injecting a little bit of your human sense. Absolutely. Because the dopamine is real when you have a video that hits. And so there is this feeling that you get when you have a video that everyone's laughing at. Like you're getting all that positive reinforcement. And even and then you just want to keep going. Well, then, you know, maybe you push a little further. And that gets even bigger. So you can see how someone can go down a path that leads to crossing. this professionalism line. It's like a drug. It is. It is. And so,

and these are the things we need to, you know, be letting these students know whenever they're pre-meds and med students who are starting social media platforms because we need doctors on social media.

But we also need to not do anything that will undermine the public's trust in us. That is first and foremost. Second most important thing, like don't get fired. Like don't lose your job because we need you to be practicing patients.

We need doctors, right? And so just, you know, we have to, but we have to be thinking in terms of like if I post this, and I still do this to this day. I think, okay, how can this be interpreted from different viewpoints? I do the best I can. Like, what would a patient think about this?

What would a health insurance executive think about this? I'm okay making them upset. That's punching up. But by thinking about it from a different perspective outside of yourself, I think it's helpful because then you could think, oh, I can see how this could be seen by a patient as, you know, maybe they wouldn't want me as their doctor or they might be hurt by this. And then you don't post it or you change it or, you know. And so we need internal guardrails with ourselves, but we also need to be,

having these conversations that we're having with people when they start medicine. Yeah, I think that this idea of trying to be perfect on social media is not real, but also this current Nick situation that we're discussing right now really highlights how extreme social media has gotten. And the reason I think that is because there's so many people in the comments when the initial videos came out and doctors were posting that they were upset, that this shouldn't be professional, there should be some action taken. There were people in the comments saying the opposite, defending him saying like, no, this is no big deal. I think it's because they've seen such

terrible stuff online from famous creators that are not perhaps in the healthcare space, that they don't realize that in the healthcare space, we need to be even more conservative than the traditional person in content. And they don't understand why because they've never been put under, not the microscope, but under the pressure of having to take care of another human, or perhaps they haven't been taken care of by a human

who comes in acting unprofessionally or rude. And the second that they will, I think they'll recognize why that content is not right. Yeah, you know, and honestly, I think if you ask 99% of medical professionals, is this okay to post? I think we'd all, I hope that the vast majority of us agree, like this is not something you do.

And that's where I think the tough line is, because if we agree it's bad, what should happen to someone at this point in their career? And there's been both good and bad statements by medical boards, not necessarily for this case, but for doctors getting in trouble for misprescribing medications,

opioid scams, hurting patients, not losing their ability to practice medicine or perhaps just being temporarily suspended or put on some observation, where it's like, what is the line if you've set all that precedent for people who have truly harmed patients for someone making a mistake?

Yeah, yeah. And that's tough. That's where consensus is important from an unbiased party to come in and evaluate the situation. from a 360 approach, because we don't know what the whole situation is. Yeah, and you could argue that these videos, like, did cause harm. Of course.

Right? Like, absolutely. And so, but there's, this is where there can be like a little bit of nuance to this conversation, which is not a place that you can often find nuance on, yeah, you know, in the comments section of social media, right? you know and I could honestly see great arguments for like posting content like this and you disqualifying yourself from ever being a physician to also like having some corrective action to prove like you are you can professionally see half the world's population right

and and so what we saw on social media was kind of people take taking one side or the other. People taking one extreme side to the other. Which is understandable. Right. But at the same time, we don't know, has this person made content like this before that was deleted? Was there inappropriate statements made to other classmates? Because how easy is it to make a judgment then? Oh, this is a repetitive situation, making inappropriate statements to classmates.

Yeah, we're not in the med school. We're not, we don't know what the situation was. None of us on the internet, us included, can really, say like what should happen here. Right. And it's not our place. It's not our place. We can talk about why this never should have been posted, the harm that it causes people. For sure. That is really what we need to be focusing on. And the people in charge of letting the student graduate or match or whatever, like it'll be up to them based on the whole picture

to decide, you know, what is appropriate here. And I give credit to Mayo Clark. Like they posted right away a response that they're investigating and that this is going to be some action taken. And I think that's the most fair thing that you can do in a scenario. And who knows how it plays out. Like if someone, if someone violated a code of conduct, which I'm sure this did, you know, is there grounds for expulsion. How do you argue against that? Yeah.

Right. And so, you know, I agree with you. I saw the response from Mayo. And, you know, they're going to, you know, do what they need to do to, you know, you know, in the situation. It's a very complicated world because, again, as I'm telling physicians, hey, you should show your humanity, don't be afraid to show yourself. Some physicians, maybe when they show themselves, they show too much.

And besides be normal, which I don't even know what that means anymore, I don't have good advice. And that's why I think we really need to, it needs to be. Because the head of health and human services does not follow any reasonable conduct or scientific integrity. Exactly. In fact, if he was a student in that school, he would get expelled week one.

And yet he's in charge of all of us. So it's why we need to have, and there needs to be like actually explicit curriculum around this subject. It cannot be like day one of orientation and be like, you know, don't make fun of patience. Like it's great. I've been saying that.

It's important. There needs to be more. We need to show examples. We need to show, we need to actually spell this out to people. We just didn't happen many, I guess. We don't, but now we're unfortunately, we're now in a place where we've seen people post things over the years that have gotten them in trouble and have been deemed unprofessional. And so all of this needs to be made available to people early in their career. Be like, because we can't, although we don't

know there's some like where the line is, it can be subject to interpretation. there is a line and we do know when it's crossed fully, you know. And so that, at the very least, that's where we need to. When the weather cools down, Golden Nugget Online Casino turns up the heat. This winter, make any moment golden and play thousands of games like her new slot, Wolf it Up and all the fan-favorid Huff and Puff games. Whether you're curled up on the couch or taking five between snow shovels, Play winner's hottest collection of slots.

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med students, not just with social media, but them seeing RFK Jr. at the head of Secretary of Health and Human Services, Dr. Oz at CMS, doctors that are selling out, selling snake oil, miracle cure all products, what have you,

you know, like the whole supplement scam, they're seeing all these people enrich themselves and get extremely successful. Will this play out in the same way that we've seen the hierarchy of specialties form in medicine? Where it's not a surprise that the top-picked specialties are the highest paying. So now are the bright students going to go into the field of snake oil as the new specialty?

That's such a bleak future. I'm worried about it. I mean, you have AI at your disposal. You can weaponize AI in any way you wish. You can literally get AI to be your lawyer for you to be evil. You can say, like, I know what science says, but make this argument still hold strong to the average. Like, you can literally feed it that way. Yeah.

Yeah. I fundamentally, even to this day, when you see med students match on match day, which just happened recently, right? It's so much fun to see the reactions. And then you go to a commencement and you see the joy, the energy of these people who are starting out on their careers. I still think in every single med student, they're, they're, they're, they're, they're, they're, motivation, like their drive is for the right reasons. I'm going to push back. Do you think every student?

I think so. No, maybe I'm just like being optimistic. Roast colored glasses a bit. Okay, maybe a little bit. And I want to defend, I want to be on your team. You honestly,

you think that there are incoming med students. They're like, the minute I get a request to hawk a supplement, they don't think that far, you think they're... I mean, you just, there's numbers. Sample sizes, you know? All liars exist in data sets.

That's how I think. True. Okay. It's amazing. Yes, it's not 100%. But with social media influence, that's when all that stuff starts coming. Right. And so that's why early on, we need to like get a hold of this. Yeah.

And talk about these things. It's not being talked about. And all of a sudden, you get 6,000 followers on TikTok and just you get inundated with, oh, we'll pay you $10,000 to sell, you know, extends, whatever the hell it is, right? And you're a poor med student who's going into $300,000. Who among us, right? And so these companies, this way of thinking is,

It's praying on the insecurities, the financial insecurity, the fear of, is I going to take over my job? I better start making money now. I think that's all, it's all external. It's all external pressure. I am probably just me being optimistic. I think the vast majority of us that go into medicine at our core don't want that. We want to do the best we can for patients in our community or whatever, whatever special. you're going into. And then it's this external pressure from the education system, the amount of

debt we're in, our inability to feel like we have agency and our jobs, private equity, insurance, consolidation, all that stuff that's making it more difficult to just practice medicine and have the type of life that you wanted because we make good money. Like you go into medicine in part because it's safe and you know you're going to like have a good. living and also be able to do this wonderful thing helping people. I still think that's maybe not in some people, but in the vast majority of it, there's a nugget of that still there. And then it's all those external forces that just eat away at. Yeah. I could see people getting fed up. I could see. I see who's getting successful. Even in the social media sphere, the people who

have the best financial outcomes are often the people who have like pretty crappy intentions. And that works so well for them, you know. And they then just fully lean into it and say, oh, well, it pays to be hated. Or you have the Gary Breckas of the world who's not even a physician going out and giving health advice and people weaponizing it with private equity and finding ways to make this person the face of their new industry. And then they weaponize the fact that we work with pharma companies. when it's totally reasonable to work with pharma companies

because of historic faults of the past where doctors would take kickbacks from opioid manufacturers or whatever it was. And they point at us, they say, you're the problem. Whereas like, no, no, no, the thing you were pointing out back then with the opioid crisis or these specific examples, those are the problem. We're happy to point those out.

But you selling a red light bed for $60,000 is also the problem. Yeah. And how you get that to the general public is really tough because you need to get their attention first. And if you don't have their attention, you don't have anything. Right. So misinformation sells. It views, it gets views.

It gets, the more outlandish you can be. Like, I could get millions of views. I could just start sending my perennium. And like, and I could make a video go viral. Everyone would love to see my perennial. So, but it, and so the point is, like, it's, it, you can gain a following so much faster, as you said, like to talk about these things. And to make outlandish claims, like in ophthalmology,

I could put out a video where they started out saying, glasses are making your vision worse. And people be like, what? I wear glasses. It makes me, yeah. And then I could sell whatever kind of glasses I want. Be like, no, these glasses or do this or get a, get a blue light, whatever. And who's there to check you?

Right. Now what? No, people are going to, a few people will show up in the comments. But in general, it's not going to deter me because I got the money for it. And so... So what's the deterrent that we create for that? That's the million-dollar question, right? Probably billion or trillion at this point, but yeah.

I mean, one way to do it would be just shaming people, but that doesn't feel good either. And how effective is that when shaming them, you giving them attention in airtime and now? The algorithm shows it to more people. Right. So even if 5% of people only fall victim, the more people, that's a bigger number. The platforms have to do it. They're not medical platforms. And why would they do that too?

Because it's bringing in, it's bringing in money. And science needs discourse. I mean, we need people to come in and have wild ideas. They just need to be tested. Yeah, right. We reach the point. I mean, science, actual science, evidence-based medicine, it's hard to make it fun. and engaging.

It can be done. Right. We do it, right? Lots of content creators do it. But it's, it takes work and it takes thinking outside the box. How do we, how do we make research fun? You know, how do we, how do we make it to where, like, accessible to the public? These are things we haven't thought about really in a long time.

It's just, you know, how many, when you, when an article is posted in JAMA, is published in JAMA, like how many people outside of the medical field are going to see that? Zero. Right? And so... Unless New York Post clips some absurd headline from it. Right. Which is not even accurate.

But the misinformation peddlers, like, they're not publishing in JAMA. Of course. They're just putting it out on their channel for millions of people to see and to accept as fact. Well, do you think it's worse when a doctor spreads misinformation or when it's a non-medical person spreading misinformation? Oh, it's so much worse than it's a doctor. Why?

because because then you're you're weaponizing your credential to you're trying to to to you know you're showing people like I can talk about this I have these letters after my name you can believe me even though everything they're saying is nonsense I think that although it's still harmful for people who are not medical professionals at all to be selling supplements I feel like there's a limit to how much damage that can do that whenever you add an MD to the end of the name

it kind of takes the guardrails off of it and you're you can look like you disagree with me. No, I'm curious if you how you've managed over these years in your social media success to not be lured into an avenue of pursuing a crappy product or a miracle cure all product. Like what's

giving you the right path. So I ask myself two questions. Is this product good for patients or good for medical professionals or both? And I have to convince myself using evidence, using all the tools that have been given to me by the health care education, by medical education, that that is true. and if I do my due diligence, and that's what it takes. You have to, and these things that are not evidence, it's very easy, very obvious.

Like any supplement for the most part is. You can convince yourself. Confirmation bias is strong. I guess you could. You could say, oh, vitamin D is so important, you know, and a lot of people are vitamin D deficient. So like, what's the harm? Yeah, yeah.

You know, that's a good point. Because I've sat down with people I disagreed with, not just on this channel, but in real life. And I met with people who sell a lot of questionable products. And it starts with this, oh, well, you know, I had a small group of patients who didn't want to buy products because they didn't trust them. And I said, you know what, let me go out and make a product that you could trust

because it was just for them. And then, like, more people started just buying it. And then now the more people are buying it, I outsourced to an agency. Now the agency's kind of running with it. And before they know, they're kind of in this thing. And not to make them sound innocent, but it's, It kind of happens without this very clear line that you're crossing. There is no clear line.

It's just at some point it's like, whoa, how do I get here? I mean, I think if you're convincing yourself that something is good, then you're probably not following evidence. Or maybe you just not don't know how to interpret it. Or you know, you're cherry picking, you know, stats and studies. And how do you stop that from happening? I mean, it's going to be hard because there's a lot of money. Yeah.

That's going to draw people. How do you handle conversations in real life? You do conferences, you meet people where you meet someone. You know they're either spreading misinformation or selling something questionable. Are you friendly? Do you ask them about it? What's your approach usually? Honestly, in the things that I do, I don't know if I come across a lot of those people.

Yeah. Because I try to be very particular with where I go, like who I speak, like, you know, I don't want to draw, give attention to those types of situations. And so, and to the point where, like, if I'm speaking somewhere and I'm like, I asked them, like, do you have any sponsors? Like, let me see your sponsor list. I want to see, like, who's actually sponsoring this thing. And I'll, I won't go. The worst thing that's happened, I would say, is like, I've given a talk where I'm very critical of, like, health insurance companies as I typically am. And I'll have a, like, an opt-in person come up afterwards and talk to me.

Like a C-suite exec? Yeah, yeah. They're like, and there have been a couple times where, you know, they want to take a photo with me. And I've obliged. Because you're human. Because I mean, like, how do you deal with it? No, no. Because they're nice to me.

But that doesn't mean I have to, I agree with what they have to say. Right. You're just being. Well, let's talk about what the health insurance companies are doing wrong these days. What's your biggest issue with the state of health insurance in our nation? Oh. I mean, not great. Like, I mean, it's understatement.

Yeah. You know, it's understatement of the year. It's, uh, we need to like, turn them back. into health insurance companies, at the very least. You know, right now they're so vertically integrated. They're owning PBMs. They own pharmacies. They own physicians.

Optum is the largest employer of physicians in this country. And that's just driving up prices for everyone and costs. And so I come at it from my own personal story. You know, I, after I had the cardiac arrest, I, one thing I didn't realize. was just how many bills you get as a patient, like dozens of bills. And some, they're coming from... Duplicates.

Yeah, there are different places, like bills that you think you've paid already, but you're not sure. And then you get like an explanation of benefits from your insurance company that looks like a bill, even though in fine print to say, this is not a bill.

And it was like, you know, I've got this stack of papers. And at first I was thinking, like, why did I not opt for, like, paperless billing? But also, it was just, it was overwhelming. And I'm a physician. I know more about this, not everything.

I know more about this than the average person, and it was still very confusing for me. And I got up all these bills. And this is basically the origin of me even getting interested in this in the first place. And there was about $20,000 that my insurance company for this hospitalization wasn't covering. And I knew that wasn't right.

And so I did the most difficult thing any American can never be asked to do. I called my insurance company. and turns out the ambulance took me to an in-network hospital but the insurance, the doctors that took care of me in the hospital were out of network.

Which is of course your fault. Right. I didn't check before I, before my cardiac arrest. Big mistake. What the hell? Toll free number on the back of your insurance card, Mike. And so I,

and so it was a nine-month battle before they finally, you know, actually here's what happened. it was obviously there's a surprise billing and now this this exact scenario wouldn't happen now because we have the no surprises act which is not perfect but it does help prevent stuff like this from happening um i called and called this in emails i posted on social media which is something i have the privilege of being able to do not everybody can do that and um finally after about nine months i noticed that my balance was zero on my hospital bills it's like oh oh oh

they must have paid for it. But I wanted to be sure. I wanted the satisfaction of knowing like the insurance company actually paid this bill. And what happened was the insurance company just put pressure on the hospital to forgive the charges.

What? Yeah. Yeah. So the hospital didn't even see any of that money. But they just forgave it. And so they were tired of dealing with me. I don't know. And so it was this whole experience,

I was like, okay, I got to start making videos about this, making content. So, you know, everything from like, what is a deductible? What is a prior authorization? You know, what is a PBM? That's something, I didn't even know what a pharmacy benefit manager was when I started practicing. I never even heard the term, which is another problem.

Like, we come out of medical training. We don't know any of this stuff. Any of these things that are dictating medical care for our patients. I had to figure all that out and started making these videos. where I could try to explain it in terms, not only I could understand, but also that just the average person. Well, sometimes that's the best way

to get information across, first learning it and simplifying it for yourself and then presenting that to the public. Yeah, and the reaction I get, because I was just posting these things on my, you know, on my channels as just of like, I was just frustrated. I was trying to like,

same thing I've been doing all my life, just dealing with that through comedy. And, but, I did start to realize like, oh, people are actually learning from this. And I realize that when it comes to advocacy and trying to like change something, medical field or whatever it is or medical, the healthcare system, I think we overlook like the impact that just education can have on it. Like I don't know if I have the right answer.

I have some ideas like, you know, breaking up this vertical integration that's happening, you know, turning insurance companies back into insurance company. so they don't own all of these different aspects of it. But like how do we go about doing that? That's way above my pay grade. Like I don't know necessarily, but what I can do is show people what the problems are because you can't advocate for a change

until you know what it is your change. And people in the healthcare system know, but the vast majority of the public, they don't know. And most, I would even venture to say in the healthcare system don't. Right. or at least no, maybe on a service level, but not some of the forces beneath the service

because that's the whole point. They make it so complicated. They make it so complicated. It's shrouded in darkness, and they don't want, the PBMs don't want people to know what a PBM does. Tell people what a PBM does. It's a middleman. That's what it is.

They negotiate with pharmaceutical companies to dictate how, expensive medications are, what medications can be on a pharmacy's formulary, and they're the go between the pharmacies and the pharmaceutical companies. And the big problem is that they're now owned by one of those two entities. Right. Exactly. So now you got, you know, the independent pharmacies are going away because you have Optum and Cigna and all these. And they're buying up all the pharmacies or pushing the independent pharmacies out of business. And they're also, they own the PBM. So they're deciding what goes on a formulary for the pharmacies that they own

all based on what kind of rebates they can get from themselves. Legal kickbacks from the cells. So anyway, this is a- Well, it started as a coupon company that became for-profit. That's how I try and simplify it. Because they promised us savings. And then they became a billion-dollar company under themselves. I'm like, wait. What? How does this work? Exactly. And I, you know, one thing I hear from people a lot is, is, well, two things.

One is, like, we need universal health care. And I get that. And you know what? My goal, what I want to see happen is accessible, affordable health care for everybody. Like, who can deny, who can go against that? Like, of course, that's what we want. But I think how we get there is where a lot of us will different. And like I, you know, people who say, look, we just need health care for all.

Like, okay, we're not going to pass, maybe this is just being being pessimistic. I don't think we're ever going to pass a piece of legislation that's going to achieve that goal in one fell swoop. And so it's going to be stepwise changes, you know, something like the No Surprises Act, which takes this very big specific problem and tries to make it better. Then we take another big specific problem. We're trying to make that better. Elizabeth Warren and Josh Hawley have this bipartisan bill,

the Breakup Big Medicine Act, which is trying to break up these big conglomerates, break up the vertical integration. Does that give us universal health care? Well, no, but it's going to make something better for a lot of people. That's kind of my approach to how I think that we can fix health care.

We do need some sort of practical stepwise solution. because I think otherwise we're just waiting for it to break and maybe when it breaks we can rebuild it differently, but man, when it breaks, there's a lot of casualties here in the system. Because I've heard people say, oh, well, the pandemic nearly broke the system. If it only broke, we would have solved it. Do you know how many people would die if the healthcare system would break

instantly on day one? Yeah. Oh, yeah. It's like from even a trauma perspective of accidents that happen on a given day, if they're not being thrilled for. So it just irritates me whenever I, you know, advocate for a change and then someone's like, oh, you're not doing enough. Yeah.

What's wrong with health care for, you know, universal health care? What about is from a very popular stance? So why you stay out of the comments section. I mean, we'll do a video on heart health. Everyone's like, are you kidding me? What about the kidney? And I'm like, man, like, I can only advocate for one cause in one video. Like, the fact that we're doing one video should be okay and we could talk about this.

Focus up, folks. We can care about more than one thing. No, that happens a lot. I don't know if you get that. We're tackling one cause. But what about this thing that you're not advocating for? There's a lot of things to advocate for. Our system's really crappy right now.

And doing it through social media is great. It's amazing how far our messages can get just because we have a big platform or any kind of platform. And so another reason, about like should should physicians you know with this whole nickbombo thing has been a lot of people are like like it's even worth it being on social media well it i think it is it has to be because misinformation we've already talked about but also our ability as health care professionals to be able to know we know what those problems are that we're having we know where the bottlenecks are we know why we're running an hour late in clinic and guess what it's not because we don't want to

see you on time right is that because we're filming skits in the back Right. Which people assume, by the way. I know. I know. And you can understand because we're the face of health care. So, which is another reason why we all, we need to be on social media talking about this stuff. Because when something goes wrong in someone's personal health care situation,

usually, you know, especially if it's like a health care system type problem, health insurance, whatever, costs. usually it's the doctor that gets blamed because like they're the ones yeah that's what you're the ones they see right you're the person so you can you get that like I understand why that happens and so what we can do is like no actually like this is what a prior authorization is this is what this is how Optum is denying using AI or algorithms to automatically deny claims and we have to do you know you know repeal appeals and all these things to try to get your care covered that's all that below the surface stuff that we need to get out to the public that's being suppressed. You know what's interesting, I had the former head of CMS, who used to be Dr. Oz's position,

and even she was honest about the fact that when she was getting care for her family, she was struggling with the same issues that she knows patients are going through, and she ran the system. So like if that's the level of complexity. And it also shows that, like, this, it should be easy to try to make, make a fix. If the genius bar can't run an iPad, we have a problem, folks. But, like, everybody, nobody likes what we're seeing. Yeah. Nobody, like, bipartisan, like, everybody should be able to agree, like, we got to, like, make all this stuff better.

This is not working. Yeah. There's a lot of powerful people, though. There's a lot of powerful people, a lot of capitalistic, powerful, that don't want to be held in check, because I think the only way you have some form of healthy capitalism is with checks in place.

And right now, these checks are not being, maybe they're not on paper, but even if they are, they're not enforced in a toothless administration. So I'm curious, this is shifting slightly. I did this debate against people who were anti-vaccine and people who are RFK Jr. Amaha supporters.

Well done, by the way. Oh, thank you. I don't know. you, before you go on, like, how you were, you stayed so calm. You went to. Oh, man, I don't know. Like, I was trying to put myself in that studio. First of all, there's no way I could have done as good of a job. It was like, you did, you did fantastic. I was just thinking, like, how this is, how is this not like just a blood bath of, like, everyone just, like, wanting to kill each other, like, literally. So, so good job. Thank you. That's sort of my question. And why did you agree to do this in the first place? I'm thinking if I should ask you the question first or tell you why I agree to do it.

Let me ask you the question first. Do you think we should be having these debates with people? Because I recently did a conversation with Dr. Paul Offutt from Children's Hospital, Philadelphia, where he believes that you shouldn't debate those who are anti-vaccine. Where do you land on this? I disagree with that. I think, and I mean, you could probably speak to this a little bit more. I don't think things like the debate, the public debate, you had, the produced, you know,

sure thing. Can I say surrounding? Can I like, yeah. There is no legal ramification. I don't know if you're, if you're, I don't want to like badmouth that situation. But okay. Please badmouth it. Okay.

Bad mouthing is where I get excited. I don't think that that format, like the surrounded format, where it's, like heavily produced, edited, I don't think that's going to change minds. I firmly believe that. I don't think... You mean the people in the room or people watching?

Both. Both. Because I honestly think the only way to change someone's mind about something as like vaccines, any big abortion, whatever it may be,

hot button topic, it's sitting across from somebody. But not in kind of this heavily produced. like surrounded things. It's in the exam room. Now, unfortunately, that's one person at a time. So like doing mass

changing of minds. And people that don't like you won't come in so you won't be able to change. Right. And so I think that's honestly, and from what I'm talking to my fellow physicians, pediatricians I know, because I've asked them this.

I've been curious. Like, how do you do this? Because I've seen people like you on social media trying in this surrounded format, trying to do exactly that. And I've heard success stories from pediatricians. But it's like in an appointment sitting across from a kid's parent and talking, just talking like normal people and, you know, giving your honest expertise and evaluation. And people have changed minds in that way.

Oh, yeah. And it happens. So I'm a bit skeptical that social media can actually. do that versus just rile people up and get people kind of angry. The reason I bring it up is because there were people in the medical community

that were upset that I did that, that they felt like this was platforming a negative message and doing it in a less than ideal format that essentially we were platforming anti-vaxxers. That was the summary. I wouldn't go that far. I honestly don't know what I'm just saying that because I'm sitting

across from you and I like you and you know but I don't think that you did anything deleterious to to the the overall message of we should be vaccinating people and that's partly because you came off very professional and calm and that was in stark contrast to some of the anti-vaxxers that you were sitting across from which is going back to how to present yourself on social media as a physician right you got to be calm You got to be professional. And so I don't agree with that assessment. And to go back, the reason why I volunteered for this was because I saw Charlie Kirk and Ben Shapiro do it the first two episodes and they crushed.

I think Charlie Kirk has like 50 million views on a two hour long plus video. Shapiro also something like 20 million. And I'm like, people love this. debate style, argumentative thing, dunking on each other. People love this. It's like the new gladiator arena for people. They love to watch this car wreck, basically, like the rubbernecking of it all. And I said, what if I go in there and I volunteer and I let them throw whatever at me

and I just don't get mad and I be empathetic like I am in the exam room and I hear them out. And when they ask me a question, I answer it as honestly as I can. And when they ask me something I don't know, I say I don't know. And I just allow these 20 or so people to have a positive interaction with someone who they imagine has horns. Because everyone in their life has told them they have horns and the advocates have told them that they have horns. And I reached out to them and volunteered for this. And they said, we actually think it's a great idea. And they set it up.

And when I got there, I was like, oh, man, I think I shouldn't have done this. Because you walk into this cold room and you know it's going to be three hours and you don't know what's going to be said. and you want to represent medicine to the best of your ability and you want to hope that your knowledge will not have a brain fart. But ultimately, my goal is to just walk away with those people, not having a negative budding of heads interaction with someone and not change all their minds, but perhaps allow them to leave and be like,

why is that guy saying the vaccines are good? Because he didn't seem like a bad guy. So I want to say that, I think I said that you couldn't, you know, sitting across from someone, that's the way to do it. I think it's possible for those people in that room that you might have sparked something to change their way of thinking. I don't think that that is possible

to anybody watching that. Interesting, okay. Because of this is, that's not the purpose for the company that put on this event. They're, well, they expected me fully to dunk on people. Because they want the theater.

They want the viewership. And I wanted a, prove to them that you can go in and not dunk on people. Oh, okay. All right. Good. Yeah. Yeah.

Well, you definitely did that. And we're the third most watch episode of the series. And that's amazing. So I wanted to have that as like a proof of concept. It's like you don't need to bring in provocateurs. Yeah. To have a good conversation that a lot of people want to watch. Yeah.

I think that's, I was hoping that could also serve as something for them. Well, I think it's, like I said, I think it was great. I would have loved, like if we could have seen. an unedited version of this? I would say it's pretty much unedited. They shortened it for time and they cut out some weird scenarios. Did you have enough time with each person?

No, no, no, because that's limited by the people raising them. And that's the format thing I didn't like. And that's suck. That's where I think it breaks down in terms of the ability to actually change minds. If you're a viewer actually watching one of these conversations

to its conclusion, I think now we're talking about a much different impact. But that's not going to get the views. You know, you, maybe it, maybe it is because, you know, it's a hot button topic. But so I think what limits the effectiveness of, of changing, mass changing of minds is just the format.

And there's nothing you can do about that. Yeah, no, I would have, your intentions were great going into it, right? I would love to have the perfect format. But being a family medicine doctor who, like, kind of the principle of which we practice on is risk reduction, not perfection. Unlike the biohackers of the world who want to fully optimize everyone's health to the max-entth degree, I want to get people to a relative homeostasis that they're comfortable with, whatever that means for them. So before it used to be that when we would advocate in family medicine for condom use,

people would be like, oh my God, you're advocating for people to have sex. They should wait until marriage. How dare you advocate for condom use? It should be abstinence only. And we realize like, okay, that doesn't work. So let's do condoms and find some risk reduction here. So I would have loved to have the format to have it be perfect, but I'm like, look, this is what I have at my toolkit of this is what people are watching.

And I desperately want to reach people with this message. What's the most ethical way we can do it and see what happens and learn from it? And I think doing the first episode, I realized the situation with the flags that people could cut me off. So in the second bout when I went back, I said, okay, now I'm not going to let them vote me out. I'm going to say, hold on, I want to finish my point. Yeah. And be a little bit more proactive and get better at it. And my hope is that young students would look at this and be like,

I'm going to do this better next time. Yeah. I learned from what he did, but I can do it better. And I think unless we do that a little bit and get outside of the comfort zone and perfection zone, that's a good point. I think it's going to be hard to learn because we won't have anything to learn from. No, it's a great point because, like, I guess the argument, even if it, let's say it didn't change any minds.

was still worth it to do it. Yeah. And I would argue it is because you're showing people. But there's a way of something happening. There's a way of just having this conversation. You can have this conversation and be calm and not result to add hominem attacks and, you know, personal things and just anger. Yeah.

So it would have been easy for both parties to get really angry at each other and just have a Thanksgiving. So I was, I was like, like, pooh. Man, like, good on you. Honestly, I was thinking the whole time. I was like, I would not be able to do this very well. And also something that surprised me is in the comment section on the 13 million view one, the comments are largely pro-vaccine, which is interesting because it's not a platform

where usually people go in to argue. And while there are some comments that are still standing with the anti-vaccine crowd, the huge majority, and it's not my platform. form. So it's not like it's my people. Interesting to see positive comments on it. I fully expect it to get roasted. Do you think we overestimate the size of the anti-vax community just because of how vocal they are? Yes, but appropriately so. Because it doesn't take a lot to start a fire that spreads widely. So we need to be very afraid of how, because it doesn't take a lot to

destroy measles hurt protection. 95% need to be vaccinated for perfect protection. Once we start getting just like a 10% change, which isn't huge. It's still, if you stop most people on the street, they agree. But you lost that percent and now lives are being lost. So you need to be appropriately worried about it. That's why I hate when the recent Surgeon General nominee is out in front of Congress and they're asking, do you believe in the measles vaccine? And they're like, well, I believe? That's literally, I think, one of the questions. And the answer was like, yes, but individuals. It's like vaccines, when you're talking about them to the general public,

this is a public health intervention. Yeah. Not an individual decision. When you're in exam room, have an individual discussion. Right. But you can answer the question genuinely and generally without having to say, but I would do something different in exam room. I would say Tylenol is great for muscle aches.

But it doesn't mean every patient should get Tylenol. You know what I'm saying? Right. But they refuse to do that. And I feel like unless we call it out, we further strengthen their ability to confuse people. Yeah. After 19 years, they're back.

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streaming April 10th on Hulu on Disney Plus. Agree. You know, it's, um, there's a lot to call out these days. There's a lot to call. What are you calling out in the eye world? Oh, man.

I'm always trying to convince people not to, well, from a education standpoint, like don't, don't sleep in your contacts. Do you sleep in your contacts? I don't wear contacts. You don't wear contacts?

Okay, good. I don't like touching my eye. A lot of people don't. Yeah, I don't know. I don't have a problem with it. Really? You're just randomly in the middle of life. Just touch my,

yeah. Get that corny at my eyes. You know, no, don't touch your own eyeball, folks. You know, I mentioned one earlier is,

is this idea, this wellness, holistic idea that the general idea is just any medical intervention is, it prevents your body's ability to heal itself. And so,

you have people that talk about wearing glasses as something that's going to make your vision worse. Like don't, no, don't put your kid in glasses. That is, it's like one of the most harmful things that you can say in my world because, you know, a kid comes in who's high hyperopic or has amblyopia. So they come in, 20, 20, 20, 20, 20, 60.

So it's like a four-year-old, five-year-old. And you have a parent who has seen all this content from people saying, you know, no, eye exercises. That's the way to do it. Like you don't need or take this supplement. You know, glasses are just going to make the problem worse. This happens. And I've heard from parents who come in, they're like,

is this going to make, is this going to harm my kid's vision to prescribe these glasses? Like, no, it's actually going to help treat their lazy eye. It's actually going to bring their eyes into alignment by prescribing, by wearing these glasses. And if you don't, if that message is so pervasive that it gets to these parents and they don't enforce glasses use with their kids,

then they'll have a permanent decrease in vision in one eye. And learning this function, I'm sure. Yeah, yeah. And so it's, that's one that's one that really irritates. me because it's just glasses it's just physics. You're just bending light to allow it to hit the retina. There's nothing harmful about wearing

correction. It's glasses are one of the greatest disability accommodation success stories and they've been around for so long. Yeah, yeah. What's, like a few hundred years, I don't know. Well, like Benjamin Franklin, was he the one that invented bifocals?

Sam's fact check. Let me know, I'm not sure, but, but It's a long time. Long enough. Long enough. And so... How did they figure that out?

The glasses? Yeah. How does... Good question. Like the first person who knew to drink from an utter and who created glasses. Same person for me. Did they ever drink directly from utters? Got to ask...

Got to ask our old friends. If you had a farmer on here recently? I did have a vet now that's a long ago. I should have asked that question. But yeah, the glasses thing is... You know, blue light blocking glasses is another thing that people. And really talk about eye fatigue and things that are not relevant. The problem with the blue light blocking technology is that it's, it's promoted as a cure for so many different eye diseases.

Like it'll improve macular degeneration, macular health, overall eye health. No, it doesn't. The only data we have that is for use of blue light blocking technology is in. is for sleeping, is regulating your circadian rhythm. That's when it can be helpful. I've had that argument with potential sponsors for the channel, where they're like, oh, we want you to, no, it doesn't do that. It doesn't.

But I've come to, I get asked so often about blue light blocking glasses that I, you know, I tell people all this. I'm like, you know, we have no data to support that's going to help with your eye strain working on a computer 18 hours a day. But it's not going to harm you. And just, you know, so just kind of let people are going to do what they're going to do. And what I don't want to do is be so anti-blue light blocking technology that they're like, oh, I don't like, I don't think I want to go back to see this person. I need them to come coming back to see me to get accurate information.

But yeah, blue light technology drives me crazy. Are there any products that people show these days that get you fed up? Oh, there's all kinds of like holistic eye drops. Oh, really? Holistic eyedroats. Oh, yeah. There's homeopathic eyed. Oh.

That's, that's, yeah, it's homeopathic. So, and you can see these at any over-the-counter, similacin is like a big brand for that. What are they? It's tap water. Yeah, but what's the promise? Oh, better vision? Lubrication, better vision, helping you with styes, you know, whatever,

I don't know, whatever it is. But, you know, you look at the ingredients. It's a classic homeopathic. It's little like, hyper diluted, whatever. Yeah, things in such small quantities that you're basically just, you know, splashing tap water in your eyes. So, which, you know, I mean. It's not going to damage something's right.

Here's one that's happened that's been in the news recently is recall. Well, that. I forgot about that one. But no, it's with all the protesting going on and with ice and everything, it's how to protect yourself from, you know, pepper spray exposure. and one thing I'll tell you, like don't use milk products. Like that's something I see on social media all the time. Milk is great because it neutralizes everything.

No, milk has harmful bacteria in it, especially if it's like raw milk or something. Right. But even pasteurized milk still has bacteria in it. And so, you know... Where did that come about? What's the milking? I think it's just because the fats in milk

can help kind of emulsify the oil, from and kind of neutralize it like capsacin and you know just to help with symptoms from it but you know if you get pepper spread you can get corneal abrasions and then you dump a bunch of bacteria on your corneal abrasions you end up with an infection and that's a big problem so um that's been a bit of interesting education interesting recently you know a lot of questions about about how to protect yourself from there where eye protection folks yeah and then tell me about the recall Yeah, the recall. Because it's happened numerous times.

It happens every so often. And this is why in general, I'm, I want people to get the most affordable artificial tears like they can find. And you hate Vizene. Don't even get me started on a Vizine, Mike. This is no. No, Vizene, I wish we could gather up all the Vizene and shoot it off into the sun. All of it.

Vizene is never good for you. Yeah. Never. No, so any redness reliever. So not just vizene. It's clear eyes, roto, that like cooling sensation you have when you put roto in your eyes,

that's a little bit of your eyeball dying. You don't want that. Yeah. So it's... Eyeball dying. You know, generally, you know, in certain terms. But the vizine thing,

it has astringent in it. And so what it does is it kind of, it's a vaso-constrictor. So it'll constrict those blood vessels, but then once it wears off, comes back worse than before. So you get into the cycle of having to keep using vizene.

So it's the aphrine of the eye. It's the aphrine of the eye, exactly. So, you know, will it help you hide your pot smoking habits from your parents? Yeah, probably, but it's not something you want to use for dry eye, any kind of eye problem. And so vizine's a no-go. Are people overusing it?

Oh, yeah, yeah. Every week I get someone that comes in. Like, I've been using this. It's not getting better. I have a drawer full of vizine. I keep it. What's the plan after, like, when they're getting the bad rebound?

Is there a rehab protocol? We just stop it and then put them on just a regular artificial tier, hydroxy-methylosellulose, like, you know, refreshed, sustained. Any one of these antihistamine treatments or you don't like those? Antihistamine is helpful for people that actually do have itching, real itching. It's not a good just lubricant to the eyes. So, yeah, the over-the-counter, all the anti-histamine over-the-counter drops are pretty effective. Yeah, yeah.

And then where's the requal? The recall happens. Usually it's with kind of off-brand drops, at least so far, every time we've had a big recall. And it's because they've been contaminated with something harmful. Last one was pseudomonas. Great. Not good. Yeah. I mean, the pseudomonas, one of the worst things you can get in your eye. And so it's why I tell my kids, like, if you're ever in a hot tub, you never submerged your head in a hot tub. Good for the fear of follicitis getting everything. Just, yeah, pseudomonas, you know, just, in, infiltrating every party. You know, when we're physicians, like we see all the worst things that can happen to the human body. So sometimes we have like unreasonable expectations for our family members.

Well, it's how like orthopedic surgeons, like I would never ride a motorcycle. Or never be on a ladder more than six feet or something. So that's yours. Don't dump your head. Don't dump your head in a hot tub. Also don't sleep in contacts. We've talked about that, really.

And tell people why that's bad. So sleeping in contacts, it prevents enough oxygen basically to get getting to the surface of your eye. And also things get trapped underneath the contact. You can have bacteria that get trapped underneath there. The contact could start rubbing up against the cornea, creating an abrasion that bacteria can get into. And so you're setting yourself up for an infection.

So most of the time, patients come in. I see an infection. Yeah, they've been sleeping. Some people haven't taken their contacts out for months. What's this like TikTok thing if someone has like 50 contacts in or something? Yeah, yeah. Why is that happening? Or is that not happening?

So at most I've ever seen three contacts. Wow. 50 is newsworthy. Yeah. But that's about it. Like that doesn't happen routinely. What's your favorite ocular condition to treat? I mean, it's boring, but cataract.

Oh, why? Yeah, it's what I do every week. Because it's what sold me on ophthalmology in the first place. because quick result quick results we can do the surgeries we do it in 10 or 15 minutes if not shorter and it's not immediate vision recovery

but near immediate like within a few days visions back to 2020 ideally and so it makes a huge impact in the quality of life I mean we can take a patient who sometimes you can have hand motion vision where all you can see is a hand in front of your face and do a 10-minute surgery

and the next day they're reading on the chart. So it's, and I saw that for the first time as a meds, you know, like, I think I could do that for the rest of my career and so far I have. Serious question. Yes. Don't laugh.

I'm already laughing. If my dog bear gets cataracts, will you fix? Will I do the surgery? Yeah. We can, right now, if he's here. Like,

let's, let's do it. Because I see cloudiness already and I'm getting nervous. Yeah. Yeah. So it's funny. I, within the past year,

I spoke at a veterinary conference. Yeah. And one of the big pet peeves that veterinarians have is when human doctors think they can treat pet problems. So wait, is the dog's eye different than a human eye? Yeah.

Yeah. No way. It's not, it looks so similar. It does. Which is a dumb guy. It does. taking off the doctor's hat for a second.

I did the same thing, though. I got up on stage in front of these people. And I was like, I showed a picture of my doc who has entropy. And I was like, I think it's fine, though. And they're all grown. It's like, oh, there's a human doctor trying to tell us about animal ophthalmology. But actually, when we learn how to do cataract surgery, we use cow eyes, you know,

to like learn certain parts of the procedure, which is also very different. but the basic anatomy might be similar, but how that anatomy works under the knife. So I could, I could wing it. I could wing it. Okay. Yeah, I don't think you'd want that though. Yeah, I want it.

And we're going to do it on social media live stream because who needs ethics. That's right. Thinking back across your medical training, what's the craziest case you've ever had? One that was, I have a sad case. was a patient, an elderly woman who came into the emergency department with an orbital cellulitis. And so orbital cellulitis is when you get an infection behind the eye in the orbital space. And that is a, there's not a lot of things that will bring an ophthalmologist in the emergency department, but that's one of them. And those patients will get admitted to the hospital.

And the question is, what kind of organism is causing it, right? and that can really affect how severe, how quickly this will progress. This patient, you know, orbital cellulitis is, it's uncommon, but common enough that you, you know, I've seen a handful of cases over the course of my career so far. I've prevented some by treating preceptal cellular.

There you go, yeah, that's a big thing, good job, nice. And knowing the difference between the two, I get a lot of orbital cellulitis referrals that end up being preceptal, but so it can be a typical to establish. But sometimes it's subjective to some level. with the patient saying that there is a lot of orbital pain. Right, yeah. So the biggest differentiating factor is the presence of orbital signs.

So that means things that are happening in the orbit that will manifest on exam, like the eye having proposis, so moving forward, having pain with eye movements is one of them, or diplopia, you know, having double vision because there's so much inflammation back there, the eye's not moving in the way it should. pupil abnormalities. So, yeah, those are the separating factors. Most of the time, it is preceptile,

and we can treat it with oral antibiotics. But in this case, a patient was admitted, and we were just, you know, all thinking, like, what, you know, how could she have gotten this? You know, what is, could have, you know, you think about all kinds of things like IV drug use can cause orbital cellulitis, you know, certainly trauma or, you know, any kind of like a bite

on the eye, something. And then after about, you know, a day of, you know, treating and thinking about this, you know, she said, you know what's interesting? My cat had the same thing who died.

And so she showed a picture of her cat. It had the same appearance to that cat's orbit. That cat had orbital cellulitis and had been sleeping with the patient. And so she got her orbital cellulitis from the cat.

And through that, we were able to, we did some investigative work to figure out like, which bacteria. What kind of bacteria can kind of, you know, cross-pollinate between species and able to get it treated. And she survived. She, you know, she actually ended up having to lose her eye from that infection, which is, you know, something that can happen with an orbital cellulitis.

But she survived. It was a disease that can be fatal if you don't kind of treat it effectively enough. So be careful of. cats as you take that. I would say if you're, you know, maybe if your cat has a like serious eye infection, like sleep. Create a little barrier. Yeah, a separate, a little separate living quarters. Treat it like a conjunctivitis. Like, oh, don't share makeup with your cat. That's right. But some of the most satisfying cases I've seen, I've seen a handful of melanoma. And the way we treat melanoma in the eye, because you have pigmented tissue in the corroid,

which is behind the retina. So it's all pigmented back there, and you can get a melanoma affecting that tissue. The way we treat melanoma in the eye is create a custom radioactive plaque that you suture onto the surface of the eye that provides focal radiation, kills the tumor,

you leave it on for a few days, and then you take the plaque off. And that's... Ideally, all the patients, treatment the patient has to have. Really cool. That's wild. Yeah, yeah.

It's very, only a few people. Not a lot of people around the country do that kind of work. And melanoma, I remember when studying in med school days, it spreads to unusual places like the eye. It has a reputation for unusual spread. Yeah, and these are typically primary melanoma. So we saw it a lot in Iowa. That's where I did my residency training.

So, and honestly, we don't know a lot about why Iowa is such a hot spot for melanoma. It's actually an ongoing, you would think it's sun exposure, but actually there's very weak association between UV exposure and chloroidal melanoma. Other types of melanoma, iris melanoma, eyelid melanoma, yeah, that's more associated with UV light, but not the corroid. We don't really know why Iowa was such a hotspot,

but we saw so many cases of melanoma there. Oh, no. For our current generation of peoples, what are some habits that we're doing, that we shouldn't be doing that are hurting our eyes. We really need to stop looking at our phone before we go to sleep for an hour. I just did it last night, so I'm guilty,

just as much as anybody else. Because of the blue light and sleepiness? Or are you thinking more... That's part of it, but also more just dry eye. Oh, yeah. So we know we've had studies that have shown that screens hold our attention so well that we don't blink.

Our blink rate goes down. And so dry eye just gets more common as you get older anyway. By the age of, I would say 60, like virtually everybody has some degree of dry eye. And when we're sitting in bed or anywhere, just looking at our phone right before bed, sure, it affects our sleep, but also it'll just exacerbate dry eye symptoms. And so I'm always telling people, you know, taking breaks. Like sometimes you have to, you have to, like, police yourself on this, right? Like, honestly, every 20 minutes, you should be looking away from a screen for like 20 seconds.

And you want to look in the distance to be able to relax your accommodative focus. And so the 2020-20 rule, basically. So every 20 minutes, look away for 20 seconds, 20 feet away. And that'll allow you to relax your eyes and just kind of the stimulus to blink and then go back to, you know, doom scrolling on your phone. Sure. Which is great for sleep. And your vision. And then what's a, I think we should be doing that's positive that we can improve our eye health.

It's just basic stuff. You know, I think everybody should, every once in a while, do a hot compress. You know, what that does? Yeah, heats up the myobium glands and helps lubricate your eyes better. I have that dysfunction. Oh, do you? Yeah, you got a little MGD, a little mybomian gland dysfunction? All right.

A little embarrassing. It's okay. You and like 100 million people have my boeemian gland dysfunction. I can't tell you how many times a day I talk about my boeumian glands. It's tough. I should have been Dr. Mybomian. I don't know why. That's a good title too.

I could have gone with that. But it's like basic things like maybe, you know, doing a hot compress, you know, not being afraid to use artificial tears, taking, you know, screen use in moderation whenever you can, taking breaks. But all these things will affect, will improve like your general health too, right? Like getting up from your desk, you know, every so often. You know, just eating healthy, sleeping better. if you wear contacts,

you know, diligent contact lens hygiene is so important. That'll prevent so many, so many bad things from happening. And, you know, using them the appropriate amount of time. I wish everybody could be in daily contacts or use contacts because dailies are always

going to be a little bit safer, but they can be expensive, but just, you know, not sleeping in them. That's the biggest thing. Yeah, so we've got to take care of our eyes. Take care of your eyes. They're important.

And don't, um, don't go to chiropractors. I love that that's your take-home message. Seriously. Where did that start? Where did this? Man, I just, you know, the algorithm is so effective on TikTok in particular that as soon as you get mad and watch an entire chiropractor video, you're going to get so many of them. And the stuff I see is so dangerous that, you know, forceful neck manipulation, you know, if you end up with a vertebral artery dissection,

that could lead to an occipital lobe stroke, which can give you a homonymous hemianopia, which would lead you to my clinic where we might have to talk about not driving anymore. And that's one of the hardest conversations as an ophthalmologist that I ever have is when I see a patient who's had a stroke, come in, do a visual field test,

and oftentimes they don't really recognize how much vision they've lost, but they've lost half of their vision. and in I think every state you have to have a certain degree of visual field in order to qualify for a license. So like patients get angry, you know, talking about this because I'm taken away,

you know, their ability to drive, basically. And it's hard. It's challenging. It's really challenging and I'm curious because this threw me for a loop with one of my last podcast guests. She's a YouTuber, very famous. She happens to be blind. And she,

very outspokenly to me told me that she does not, even if there was the ability to cure her blindness, she does not want to be cured. Is that something you've come across with people who have issues with vision? And is that what you would have expected someone to say in a situation like that? Have you ever heard of that?

No, I can't say I've ever had that conversation. That is a bit surprising. I think it would change. I think it would depend on how long someone's been blind. Well, yeah, she grew up. Right. If that's all, if that's your life, that's what you know. Then I think that's very different than patients who lose vision from a disease.

Yeah, because I think as a doctor, if a patient comes in and they're blind and there's a potential treatment for them, I would say, let's do it. But that's not my job. Right. No, let me do that. Yeah, yeah. Well, no. Meaning it's not even our job. Our job is to present the option.

Oh, yeah, yeah. And then actually ask if they wanted. Right. Which we sometimes lose track of that. Well, and that's a good point because I frequently have these conversations. Like probably the biggest source of blindness that I see is macular degeneration. And patients can slowly lose vision over time. And it does get to a point.

Some patients really want everything you can do. like we have new treatments that are coming out all the time with macular degeneration. It's a very exciting field in ophthalmology. And we have retina specialists that do that type of treatment. And we have clinical trials and all these things. And some patients are like gung-ho, like, yes, that like I'll, you know, let me know. Like, I'll try anything. But some patients who are count fingers, you know, they can't see, you know, certainly not well

enough to drive, but they are functional. Like they can do all the things that bring them joy. that are like, you know, if it would make me feel better or make me see a little bit better, I don't want to go through all that. I don't want to go through injections. I don't want to go through treatment.

Because that's, when we're talking about, you know, these types of eye conditions, that's a lot of appointments. Yeah. And so there's people that go for it, but it's a lot of people

that are content. They're happy. They have a support network. And, and yeah, they don't want to pursue. Do you hate LASIC? Oh, LASIC's an interesting one.

I, are you asking me? because I'm not wearing glasses right now. No. Guess what? I've never actually had a dedicated dilated eye exam. You're a bad person. Don't tell anybody.

I think you've already... You don't have a very big platform, do you? What platform you're just talking to this microphone and no one can hear? You're screaming into the ether. LASIC is... It's a good procedure that helps... That's helped a lot of...

There's been 40 million LASIC. I feel a politically correct answer. No, no, no, no. Well, maybe a little bit. No, it's a good procedure. It helps a lot of people. But there are a lot of people that have been harmed by LASIC that are very outspoken against like trying to convince people not to do LASIC.

For LASIC, it's very important that you do your research in terms of like seeing someone who's got, you know, look at the reviews, look at because people, this is a cash pay procedure, you know, because you're taking a 2020 perfectly healthy eye with glasses and you're doing a surgery. So you're putting those eyes at risk of a complication. Now, the complication rate is very low, like 0.5% roughly. And so if a patient is interested in it, I absolutely refer them to my partner who does LASIC procedures because it can make a huge difference in someone's life. but the risk is real of chronic dry eye. A very, very small percentage of patients have debilitating pain after LASIC, like very small

percentage. And so you have these conversations. This is why you do informed consent, especially for something like LASIC. And so, yes, it's a very good procedure that helps people. Patient selection is key and outlining the risk and benefits. But unfortunately, there's a lot of. like LASIC Mills, a lot of people that... That's why I was going to bring up these like these farms

where it seems like they do 40,000 procedures here. And I'm like, how did you do that and have informed consent? Exactly. And so that's why understanding what you're getting into as a patient is very important with something like LASIC and doing your research. Don't be afraid to get a second opinion. I would honestly recommend anybody who's willing to shell out the money for LASIC get a second opinion.

and make sure everything seems up to board and you feel comfortable with the doctor who's doing it and that you actually see the doctor who's going to be doing it before you actually get under the laser. What's a treatment? Is it maybe surrounding macular degeneration

that you're most excited about on the horizon in the ocular... Yeah, I would say gene therapy is really... interesting. And, you know, I don't personally do that work. I am a comprehensive ophthalmologist. So if someone qualifies for any kind of treatment, certainly like something like gene therapy, which we do are starting to have gene therapy for certain inherited diseases like Libra's congenital amaurosis, very exciting things, which can potentially restore vision in the future. I think that's probably the cutting edge thing in ophthalmology. Macular degeneration is great,

For a long time, we only had treatment for the wet form of the disease in the dry form where you get these big patches of atrophy in your retina. You basically just lose retina. You didn't really have much we could do about it. Now we actually have treatments that can stop the spread of that. So we're not the point of eyeball transplants, but, you know, lots of exciting stuff there. And then what about for yourself? What's the biggest breakthrough for Will?

my defibrillator hasn't gone off good knock on some wood there because i saved the hard questions for the end that's right um you know i i think it's i've had a it's been so much fun really getting into and trying to make a difference in like the health care system like advocacy why does it sound like your eulogy right now you're supposed to talk about the future you're like it's been so much fun. Oh, oh, oh, yeah. I'm done now. I'm seeing everybody. You're not going to hear for me ever get, no. Oh, okay. So like going forward, I'm not a very future oriented thinking person. Yeah, you are. I don't, I don't, kind of. I want to get excited. We, we talk about the doom and gloom of pseudomonas in the eye. I'm working on a book. Oh, yeah, yep.

This will be a kind of like a Glock and Fleckens guy. So it's going to live here. Yeah, we're right here for it for everyone. Um, kind of like a Glock and and Fleckin's guide to medicine. So it's going to be more humorous, you know, bringing the characters and just kind of levity. And I think it'll be a great book for, you know, anybody who's... Okay. That's exciting.

So that's a good tease. That's fun. Working on, you know, my wife and I have a live show that we do called Wife and Death, where we talk about our story. And I give credit to her. She came up with the name. and I want to do another show. I'm currently writing it

just about the healthcare system, which sounds hilarious, but I try my best to make it funny. I'm pretty sure it's really good. I love performing. You know, that stand-up comedy kind of background has never really left me. So I love speaking and, you know,

getting on stage and doing some fun stuff like that. And where can people follow the journey? Oh, I mean, everything I do, my website, Glock and Flecken.com. Which is easy to spell. Yeah, yeah. Very simple. Just spell, just like it sounds. You know, it's easy.

Yeah, you can find everything there. Our podcast, obviously, knock, knock. Hi. I've been a guest on. Yes, you have. Yeah, you're one of our first guests. We've got to have you back on too. Yeah. What's going to be our conversation, V2?

We're going to have a live boxing match. Oh, between me and? Oh, I don't know. Not me. Me? No, yeah. I'll just, I'll just moderate it. How about that?

I don't know. But knock, knock high with the Glock and Fleckens. And yeah, that's about it. Awesome. Well, I hope you had fun. Yeah, this was great. Thank you. On the checkup.

Getting the full body exam. That's right. If you enjoyed this episode, you might enjoy my conversation with Molly Burke, who we just discussed with Will. Molly is a blind YouTuber who says that she does not want to cure her blindness. It was a fascinating conversation. So make sure to scroll on back and find it. And if you enjoyed this one, please don't hesitate to give us a five-star review.

Perhaps leave a comment, as it's the best way to help us find new listeners and viewers. And as always, stay happy and healthy.