i need to jog my memory on this, but maybe 13 or 14 years ago, there were lobbyists pushing against mail order pharmacy, and I remember one of their arguments were that millions of dollars of medicines were being billed for, paid for by Medicare / Medicaid and still sent for patients who had died, in some cases, died years earlier. they also showed pictures of mailbins full of tablets and capsules that had melted in their packages because of the summer heat
Rural vs urban doesn't even really capture the reality in this country. In the before times, I got my finger caught in a hedge trimmer. It was cut to the bone, chipped some bone, really unpleasant. I called a friend with access to veterinary lidocaine, grabbed some of the bird antibiotics I'd stocked up on because they can be had without a prescription, and used steri-strips and superglue to put my finger back together. It's not perfect, there's a bit of a bulge, but the feeling has mostly returned and nobody casually glancing at the finger would notice. By "before times" I mean before Obamacare. Today I'd head straight to the hospital. And fortunately now I can do that, kinda like I did in 2014, just after I first had health insurance. I'd called my doctor's office (because I finally had a doctor I could call) that morning, discussed the pain in my abdomen, and they sent the ambulance. 24 hours later I got home, missing an appendix. Had it happened a year earlier I'd probably decided to tough it out. That would have been a mistake, the appendicitis was fairly rapid onset, I went from normal to severe pain in about 12 hours, and was told that I was maybe 12 more hours from a burst appendix. I'd probably died of sepsis in my bed in a failed attempt to not become homeless. The bill was about $25,000, Obamacare covered all but about $500. Thanks, Obama!
The rural medicine skits are my absolute favorites. I live amongst farmers, and my husband does a fair amount of farming. He knows rural medicine so well. My favorite skit is the one where the farmer comes in on his own. As soon as I heard the farmer didn't finish the fence and came in on his own, I knew it was serious! Farmers are no joke!
My father is a large animal vet in a rural community. He was diagnosed with appendicitis but they couldn't get him in right away for surgery. He asked if he could go work for a few hours until they were ready for him. They said no. 😂
I worked in Rural Maryland for awhile at a VA outpatient clinic. Getting those guys to go to Baltimore for treatment was impossible. All his rural med skits are spot on.
Farmers suffer in good economies and bad, time off the land could be the loss of the farm itself! If only that was the same for the corporate bodies that tend to own all the contracts.... bad or good, they thrive.
It's not just farmers lol. I think because of the family I grew up in, I have never liked drawing attention to myself, and want to take care of everything myself. So. I regularly wait to go to a doctor until it's really too late to do much about whatever it is. 😅
My Dad was a blue collar country man and he was that stubborn guy that you see at the doctors and just know that he was dragged or forced there by someone. He lost over 70lbs and could barely breathe or walk and still didn't want to go. When I found out I had to make the appointment and take him myself. Small cell carcinoma extensive type. Mass measured approx 10cm x 9 cm x 8.5 cm. It was wrapped around his aorta, pushing in on his esophagus, and infiltrated the lungs lymph nodes. He told the doctor it didn't cause him any pain. The stories about these old farmers, ranchers, and down home types are spot on. You have to drag them and the whole way they are talking about the work they could be doing. His oncologist asked what he wanted to do if they could improve things and he told him he wanted to be able to work again.
I love how he captured that lab tech. As someone who works in a lab it's soooo true. If I was handed a random test tube without a barcode I'd be like, "I'm not taking responsibility for that." And the sound comment was spot on. Labs seem eerily quiet when nothing's running but my supervisor walked by with a decible reader the other day because we were complaining about the noise pollution when everything's running. For all his complaints about a work-life balance though, that tech was 100% on his phone when the med student walked up. And he'll definitely go straight back onto at after he leaves XD
I did some college course work in a different sort of lab. The background noise is real. A-weighted dB meters showed cumulative noise during an 8 hour shift (ha ha 8 hours) required us wearing hearing protection, to comply with OSHA standards. I don't want to get into C-weighted dB readings. We had some machines that, at certain times, vibrated my internal organs so strongly it made me panicky. I'd run out of the room and way down the hall whenever they were fired up.
I see myself in the ‘farmer phenomenon’ and I didn’t know it was a thing. I have been suffering with a torn meniscus all summer, slow-rolling toward the final diagnosis because I wanted to get my garden and orchard harvested and stored. I’m a bit sheepish now. I mentioned Dr. G videos to my new orthopedic surgeon and he had a big laugh…he likes Dr G a lot.
I am so grateful to trauma surgeons. 2021 I fell and broke my leg, - compound fracture. I was 76 yrs old so I contemplated my death as I rode in the ambulance. Now an 18 inch titanium rod and 4 pints of blood later, - I am alive, healthy, and humbly grateful to UNC NC Trauma surgeons who saved my life. A generation ago such a break was a death sentence for a Senior Citizen - no exaggeration !!
As a former medical records analyst, I can 100% identify with The Lab! We were in the hospital dungeon, nobody could find us and the patient IS the barcode!
When I was a med student, intern and resident we didn’t have computers, or EPIC. I had to arrive to the hospital around 6 AM and go to the lab and collect all the results manually and then paste them into my patients charts. Much of the scut work we did is now history for the newer generation. This is so spot on, it brings back so many memories.
I have the “I take a controlled substance” and “Epipens and Emgality hate extreme temps in either direction” to avoid all mail order pharmacies. I managed to line up all my other scripts with my Ativan prescription so I only go to the pharmacy once a month.
Dear Bill is a resident, likely first year. He sometimes is helped out by the medical students who often find him exhausted from his labors! The med students will talk to the attendings about the lack of evidence that long hours produce the best doctors! (I know, I went through IM residency where we had 36 hour shifts at the time, that is no longer the case. ) Anyhow, these are still wonderful and I can show them to non medical people because you explain them so well!
The long shifts are a holdover from the early days of US medical schools. The person who set up the residency system was an avid user of Colombian White who didn't understand that most people didn't put in 120+ hour weeks.
This one hits me hard. My fam lives rural / remote, my kid cousin just got burned on the face and hands yesterday, after catching fire in an accident. She was discharged in a day from a rural hospital and has to wait 3 days for a review from a major hospital with a burns clinic in the nearest major city over 1000km away. We can't be mad, cause it really is the case that they do the best they can out there. But also upsetting knowing, she may have more severe facial scaring because of that lack of treatment she will receive. I'm so upset for her right now.
"The patient. Is. The Barcode."😂 This reminds me of a vet I went with my cat a few times. 2 or 3 times, I went and they were telling me about some other cat's records. I kept telling them those were not my cat's records. But it kept happening. 😅
This is why I’m so passionate about providing healthcare to underserved/unserved populations around the world. People shouldn’t die from things we already know how to treat. At my former hospital, annual training included a poster board of shame. They posted the tubes/samples that were incorrectly labeled or procured (PPI redacted) and explained in painful detail how the failure impacted care. Hilarious. Embarrassing. The entire hospital would see it. And everyone on your unit can recognize your handwriting…
I love the rural skits. Strikes that beautiful balance between making fun of the situation while still having immense compassion and understanding for the hardships involved.
You've got to see the one where he treats and then bills his daughter for services she can't afford. Nothing speaks to the evil of healthcare debt better. And well his poor five year old is too adorable!
Farmers are no joke. My dad had his arm casted by the vet, because people doctors were too damn expensive in the early 1950s. A suture is a suture whether your are throwing it into a guy or a cow. I'm sure in some areas, that hasn't changed (much).
@David Hindin, M.D. his grandmother was the village "herbalist" back in Finland during the early 20th century. She treated all sorts of stuff. She'd even set broken noses with homemade plaster. Dad's mom wasn't much different. Outlived 5 GPs and died at 98. Told her butter was bad (love the 1970s). She told them lack of butter gave you dandruff lol. Ate butter, whole milk etc. I miss her lard pie crusts. (seriously angels wept) Dad died 10 years ago. If it wasn't bleeding, hanging wrong or needed a vaccine, we didn't go to the hospital. He never skimped on ophthalmologists, dentists or ENTs, because there's no going back on messed up teeth, eyes or hearing. Wasn't against medical science. Dad didn't "have time" for the slow grind of city medicine. (test test wait wait). He was a hoot.
I am laughing so hard I'm in tears at the cushy office/sipping swiss miss/work-life balance thing. I'm a former ICU/ER nurse, started in the 1990's, loved Micro, but WTF is all this work-life balance shit going around? I don't know how you could hold your composure Dr. David for this video, but thanks for making it! I'm still laughing, I need more laughs so I'm going to rewind and watch it again.
I love your laughter. He is hysterical and didn't expect the reaction from you from what I am used to. I also enjoy your posts of your hobbies especially making the smallest match in a case. Keep up the great posts.
I was just in the ER the other night, but I usually get my care from the local VA outpatient clinic and it is incredible how difficult it is for hospitals and clinics to share medical data with each other. Honestly, kind of ridiculous...
❤ I don’t know how I missed watching this one!! But thank you so much for your time effort and energy. I love your reactions. They truly!!!! Make me laugh and smile you’re awesome thank you I really really wish! I had you for my trauma surgery!! I am Hella funny on anesthesia😊 I hope you’re doing amazing!
Ahh.. memories.. being the one assigned to run periodic venous samples to the lab DURING surgeries to the lab to get blood-gas/crit measurements (cardiovascular surgical research back in the 1980s). I know the routes to this day (including ones that avoided April's office (old admin best avoided)).
I remember receiving a phone call from an insurance representative back in the eighties asking me why our pharmacy was billing for providing the new home glucose monitors but then billing every few weeks for testing strips. What was that about? Why were we billing for strips when they had already paid for the machine?
I've always seen it as a rite of passage during a met call/code blue to get the intern to run the ABG to the labs (for some reason in my hospital they can't go in the pneumatic tubes); or to run to the blood bank and pick up the MTP or to radiology for whatever urgent reason. Every year early in the year, you'll see a panicked intern running in a general direction but looking slightly lost and a kind registrar/RMO would point them to the right place. Sounds inefficient; but it works surprisingly well as a system (I had an ID consultant direct me when I wandered near level 2 with an ABG tube in my hand a petrified look on my sweaty face); but within a month all interns have been rapidly orientated on the key places in the hospital where they'd need to be at any given emergency situation. They've upgraded the pneumatic tubes now so the interns don't have to run around everywhere as much now though!
I am anesthesiology and intensive care doctor in rural hospital in my country. The amount of things we have to work without is longer than the one with things we have :) and also don't have ultrasound :) i still put central lines without ultrasound for example :)
Thank you so much Doc! Really appreciate your time and input. Oh, btw: I love the stuff on your wall behind you, especially the colorful balloon dog, but don't understand the triangle and measuring tape? Are you a carpenter on the side as well? You take care of those precious hands of yours!! See ya on the next one!!
My dad has been a Molecular Technologist on the graveyard shift for about 30 years now. He's pretty much lost his hearing from a combination of the noise in the lab and lack of sleep from non-existent work-life balance.
Poor Resident Bill. In every Dr. Bill sketch (his name is Bill Bill, short for William William), he’s just desperately seeking consults and advice, and being sent around on goose chases or getting chewed out. He always looks like he’s about to cry.
Very definitely it's important to be sure you have the correct patient as far as lab data. My grandmother had an unnecessary mastectomy because her lab results got mixed up with someone else's as she lay on the table while the dr was waiting for the results of her biopsy. This was a LONG time ago, back in the 70s. She got quite a settlement over that one. Sad part of it was that she had a great relationship with that dr......it wasn't his fault but he really didn't recover from that incident. I think he passed away like 6 months later, probably from the stress....
Actually, I had a know a doctor at a rural hospital who had a patient that he knew the diagnosis and knew need urgent specialized surgery at a higher level hospital that had that surgical but had in control. He was fighting with the higher level inside the hospital because he knew the diagnosis but the higher level hospital specialist was saying the patient is fine even though he is visually and clinically unwell right in-front of the rural treating doctor in the hospital. Unfortunately the one patient died to lack of action from the condition the rural treating doctor was arguing to admit to surgery. The rural treating doctor completely cried with the family due to the bureaucracy caused unnecessary death of a patient just because the treating doctor was a rural doctor not an urban doctor.
I'm just a random female, not a veteran, not a farmer, in 2019 I ignored upper abdomen pain, I remember it starting in the night on Christmas Eve (still 2018 at this point). I just pushed on and on, I'd already been having investigations and had an appointment with the doctor and didn't really communicate how severe the pain was. Not quite sure what triggered me going in, but it was early March, I emailed my doctor on a Thursday and he told me he was on call that weekend, so I packed up and went into the ED at 9am on Saturday. I must have looked awful as the triage nurse took me direct to a room, I ended up in hospital for 6 days whilst they ruled out various malignancies and whatnot. Left the hospital with a surgery date a month away, a crap tonne of morphine and returned to have part of my stomach removed and another 6 day stay because my lungs decided they didn't like laparoscopic surgery. It was a bit scary to have something like this randomly happen in my thirties.
@@wholeNwon No, UK. I’ve lived in the US and experienced the insurance issues and stylistic differences between hospitals. I suspect I was ill enough that I might have been briefly admitted, but I suspect I’d have had some tests rather sooner. Unfortunately in the UK outpatient imaging is really clogged up (it’s even worse post Covid), so it’s not uncommon that things that are urgent rather than an emergency get dealt with by inpatient admissions. So I wasn’t getting a CT scan direct from the ER, I actually got that one the first night, but very much in the middle of the night, 1am or something, it was the same scanner as the ER use and sadly when they called me down they also had a possible spinal cord injury patient come in, which I 100% didn’t mind waiting for, but he was alone and scared, so it was really sad to watch, I actually had a nurse (or maybe healthcare assistant) with me as that was the policy for anyone being taken off a ward. We need a massive investment into healthcare and a lot of it needs to go on imaging machines, but also radiologists, I’ve ended up getting some scans privately, the wait is probably still longer than I remember for a basic one in the US, but then there is a delay in getting scans read. I don’t actually work in healthcare so I suspect nurses and doctors have higher priorities, but my doctor sent me for a simply x-ray on 29th August and it’s being done on 5th October - which is utterly ridiculous.
@@anneharrison1849 Obviously I don't know the specific details of your case , and those would be determinative, but guessed that the events were very unlikely to have occurred in the USA.
I spent 4 years working as an overnight tech/nurse/anesthetist/gofer in a research lab at a major hospital. Since it was a PRE-clinical cardiothoracic surgery research lab, that meant our patients were, well, uh, livestock. (Before some rando freaks out about that: if you can figure out how to ensure the bare-bones safety and efficacy of an artificial heart or pediatric LVAD *before* putting it in a human without using cows and sheep, I know a bunch of surgeons that would love to talk to you... Also, I was a licensed vet tech and part of my job was saying no to surgeons who wanted to break the strict animal welfare regulations bc it would be more convenient for their research protocol.) As such, we weren't just in the *basement*. We were in the SUB basement. Where there were very low odds of a patient hearing a sheep holler about the pink elephants or whatever it was seeing on the ceiling after each dose of opioids. The actual LAB lab was also down there. Even the damn morgue was one floor up. The rest of the sub basement seemed to consist solely of dark, creepy hallways connecting the various elevator banks, full of old beds, broken IV pumps, and other shit that might as well have been behind glass that said "break in case of apocalypse". There was at least one anesthesia machine that, according to the last inspection tag on it, had been down there since I was in first grade and still had a fully mechanical BP readout. It was seriously creepy, especially at three in the morning on the way to the elevator that provided easiest access to the cafeteria. So, uh, yeah. Bill's Journey To The Lab seems spot-on.
I totally remember my rotation ar Boston Children's hospital with the tunnels through the basement to bring you to a spot where you could access the labs and other important areas. BTW the blood lab was a down there.
Shivering black bell thumbs up: but because I am a fan of so many channels, I don't get to see each when they populate my notifications 🙄. Yes more videos of all types! 👍
Hi, Dr. Hindin! I am in nursing school and work at a hospital Transfer Center. I love your videos!! Are you comfortable sharing some of the cases you have had in the ER? You're a great storyteller, and I'd love to listen!
I was in Laboratory IT. The wonderfully odd people that worked there was perpetually due to the mish mash of antiquated analyzers. Coulter STK-S. That one was the on Hematology lived and died by. Too bad the last one was manufactured in 1954. And I was working in 1999. No. I am not joking. It had bolt on interfaces to report information back to the IT system. They haven't developed anything better so there is a lively aftermarket parts and reagent pipeline. The one thing to keep in mind when working in the lab is to remember the day the micro lab has scheduled for stool samples. Hematology is also where I saw a lab tech drop a rack of tubes. It was at that point, I immediately went to employee health and signed up for the Hep B vaccine series.
Yea 100% about labeling specimens. I am there histology tech for a small out patient clinic. Any little error no matter how minor or missing info, I can't just assume or fix it myself. I have to go find the original person to fill it out. Then fill out a report about the error, the person who made it, why, and how it was corrected. It might seem silly. But if that patient case ever ends up in a court case, there are to be no doubts that it was in fact the patient's specimen and every thing done with it is documented.
As a veteran, can confirm. You know that pain scale rating chart? Yeah, when you ask a veteran how their pain is that visit, what's the percentage that it's about a 3? Even though you know, for any normal person on that table, would be like an 8 or 9? "How's your pain?" "About a three. Maybe a four." "You have a bone protruding from your forearm." "Oh that? Just give me some Motrin, it'll be fine." Yep. Visit to Sick Call, receive your complimentary 90ct 800mg Ibu. Ran out? "Hey, not feeling well, think I'm going to Sick Call." Yeah. Everyone thinks people go to Sick Call for the free day off (24 hr Quarters). It's really because your Motrin bottle's empty. Also, as someone that currently works IT for a hospital. Once you get to the lab, keep going. That's where we are.
I switched to my insurance mail order pharmacy and they refused to transfer my scripts from my current pharmacy. Then they basically googled my doctors for their contact info and requested new scripts, even though I had refills. They were calling entirely wrong doctors, requesting news scripts when the doctor had just written a script for a year. I went without multiple medications for up to a few weeks. So much work for me and doctors and just so Cigna could save money and make money simultaneously.
Hi there!! Lab scientist here. It’s true, they constantly shove us in undesirable places because they could use the better areas for patient facing care centers. 😅
Meanwhile- in the rest of the world - this problem doesn't exist and people can go to any doctor they want and any pharmacy they want and don't have to worry about the cost. But sure... argue about which uniquely American yet terrible solution is "the best"...
OMG!!!!🤣🤣🤣🤣 THIS SO FUNNY TO ME ON SO MANY LEVELS!!! I help with surgery and do anesthesia lol and my dad is a farmer and pushed his knee replacement off cause it's July it's hay season!!
As a MT, I apologize for our curt stoicism. However, if you don’t get that label on, or something on your specimen doesn’t match in the computer, it’s going in the trash. That’s the most loving we can be I kid, I kid….a little….). 8:00
i need to jog my memory on this, but maybe 13 or 14 years ago, there were lobbyists pushing against mail order pharmacy, and I remember one of their arguments were that millions of dollars of medicines were being billed for, paid for by Medicare / Medicaid and still sent for patients who had died, in some cases, died years earlier. they also showed pictures of mailbins full of tablets and capsules that had melted in their packages because of the summer heat
Wow. So crazy. Funny how much creativity can be brought to bear when there’s huge lobby $$$ flowing
❤ Chubbyemu!
Wow... Got comment from chubbyemu.
You don’t even know how much of a trifecta of a nerdgasm there is here. ❤
I can't not read this in @Chubbyemu ‘s ominous voice.
Rural vs urban doesn't even really capture the reality in this country. In the before times, I got my finger caught in a hedge trimmer. It was cut to the bone, chipped some bone, really unpleasant. I called a friend with access to veterinary lidocaine, grabbed some of the bird antibiotics I'd stocked up on because they can be had without a prescription, and used steri-strips and superglue to put my finger back together. It's not perfect, there's a bit of a bulge, but the feeling has mostly returned and nobody casually glancing at the finger would notice.
By "before times" I mean before Obamacare. Today I'd head straight to the hospital. And fortunately now I can do that, kinda like I did in 2014, just after I first had health insurance. I'd called my doctor's office (because I finally had a doctor I could call) that morning, discussed the pain in my abdomen, and they sent the ambulance. 24 hours later I got home, missing an appendix. Had it happened a year earlier I'd probably decided to tough it out. That would have been a mistake, the appendicitis was fairly rapid onset, I went from normal to severe pain in about 12 hours, and was told that I was maybe 12 more hours from a burst appendix. I'd probably died of sepsis in my bed in a failed attempt to not become homeless. The bill was about $25,000, Obamacare covered all but about $500.
Thanks, Obama!
The rural medicine skits are my absolute favorites. I live amongst farmers, and my husband does a fair amount of farming. He knows rural medicine so well. My favorite skit is the one where the farmer comes in on his own. As soon as I heard the farmer didn't finish the fence and came in on his own, I knew it was serious! Farmers are no joke!
My favorite too! 😂😂
My father is a large animal vet in a rural community. He was diagnosed with appendicitis but they couldn't get him in right away for surgery. He asked if he could go work for a few hours until they were ready for him. They said no. 😂
I worked in Rural Maryland for awhile at a VA outpatient clinic. Getting those guys to go to Baltimore for treatment was impossible. All his rural med skits are spot on.
That’s awesome !
When crops need to be brought in, splint that busted fibula with tree branch and keep on working. (My grandpa did that. Total maniac)
Farmers suffer in good economies and bad, time off the land could be the loss of the farm itself!
If only that was the same for the corporate bodies that tend to own all the contracts.... bad or good, they thrive.
It's not just farmers lol. I think because of the family I grew up in, I have never liked drawing attention to myself, and want to take care of everything myself. So. I regularly wait to go to a doctor until it's really too late to do much about whatever it is. 😅
I live in Laurel and can’t be bothered to drive to the VA in Baltimore unless I’m dying 😂
My Dad was a blue collar country man and he was that stubborn guy that you see at the doctors and just know that he was dragged or forced there by someone. He lost over 70lbs and could barely breathe or walk and still didn't want to go. When I found out I had to make the appointment and take him myself. Small cell carcinoma extensive type. Mass measured approx 10cm x 9 cm x 8.5 cm. It was wrapped around his aorta, pushing in on his esophagus, and infiltrated the lungs lymph nodes. He told the doctor it didn't cause him any pain. The stories about these old farmers, ranchers, and down home types are spot on. You have to drag them and the whole way they are talking about the work they could be doing. His oncologist asked what he wanted to do if they could improve things and he told him he wanted to be able to work again.
The rural medicine ones are my favorites, because that is my family. 🤣😅
That’s so cool. And agree - they’re great
As a pharmacy tech, I love his pharmacy videos. They are pretty spot on. Now, I'm community, not hospital, but yeah...
Hey Jennifer! Yeah - he definitely seems spot on for the inpatient pharmacy folks I've worked with.
This is so true. As a tech this is spot on
I love how he captured that lab tech. As someone who works in a lab it's soooo true. If I was handed a random test tube without a barcode I'd be like, "I'm not taking responsibility for that."
And the sound comment was spot on. Labs seem eerily quiet when nothing's running but my supervisor walked by with a decible reader the other day because we were complaining about the noise pollution when everything's running.
For all his complaints about a work-life balance though, that tech was 100% on his phone when the med student walked up. And he'll definitely go straight back onto at after he leaves XD
I did some college course work in a different sort of lab. The background noise is real. A-weighted dB meters showed cumulative noise during an 8 hour shift (ha ha 8 hours) required us wearing hearing protection, to comply with OSHA standards. I don't want to get into C-weighted dB readings. We had some machines that, at certain times, vibrated my internal organs so strongly it made me panicky. I'd run out of the room and way down the hall whenever they were fired up.
As a hospital phlebotomist, I concur
I see myself in the ‘farmer phenomenon’ and I didn’t know it was a thing. I have been suffering with a torn meniscus all summer, slow-rolling toward the final diagnosis because I wanted to get my garden and orchard harvested and stored. I’m a bit sheepish now. I mentioned Dr. G videos to my new orthopedic surgeon and he had a big laugh…he likes Dr G a lot.
Thank you for taking up my suggestion! My dad is the "island doctor" of a small community in the German North Sea, it's so spot on. Subbed!
Of course - and thank you so much for being a subscriber! And wow - your dad must be such a pillar of his entire community.
I am so grateful to trauma surgeons. 2021 I fell and broke my leg, - compound fracture. I was 76 yrs old so I contemplated my death as I rode in the ambulance. Now an 18 inch titanium rod and 4 pints of blood later, - I am alive, healthy, and humbly grateful to UNC NC Trauma surgeons who saved my life. A generation ago such a break was a death sentence for a Senior Citizen - no exaggeration !!
As a former medical records analyst, I can 100% identify with The Lab! We were in the hospital dungeon, nobody could find us and the patient IS the barcode!
When I was a med student, intern and resident we didn’t have computers, or EPIC. I had to arrive to the hospital around 6 AM and go to the lab and collect all the results manually and then paste them into my patients charts. Much of the scut work we did is now history for the newer generation. This is so spot on, it brings back so many memories.
I have the “I take a controlled substance” and “Epipens and Emgality hate extreme temps in either direction” to avoid all mail order pharmacies.
I managed to line up all my other scripts with my Ativan prescription so I only go to the pharmacy once a month.
Rural medicine is spot on. Women here now have to travel 1 hour + to deliver their babies. And farmers are a tough breed!!
Dear Bill is a resident, likely first year. He sometimes is helped out by the medical students who often find him exhausted from his labors! The med students will talk to the attendings about the lack of evidence that long hours produce the best doctors! (I know, I went through IM residency where we had 36 hour shifts at the time, that is no longer the case. ) Anyhow, these are still wonderful and I can show them to non medical people because you explain them so well!
The long shifts are a holdover from the early days of US medical schools. The person who set up the residency system was an avid user of Colombian White who didn't understand that most people didn't put in 120+ hour weeks.
In light of the recent events, this paradoy is extremely relevant.
I believe Bill is a resident, not a med student. :-)
Ah - makes so much more sense! Thank you!
Several hospitals are also seemingly always being remodeled changing where the labs end up being.🤔
Keep ‘‘em coming! As a non medical person it’s great to understand the additional layer of the jokes. Thanks!
This one hits me hard.
My fam lives rural / remote, my kid cousin just got burned on the face and hands yesterday, after catching fire in an accident. She was discharged in a day from a rural hospital and has to wait 3 days for a review from a major hospital with a burns clinic in the nearest major city over 1000km away.
We can't be mad, cause it really is the case that they do the best they can out there. But also upsetting knowing, she may have more severe facial scaring because of that lack of treatment she will receive. I'm so upset for her right now.
"The patient. Is. The Barcode."😂 This reminds me of a vet I went with my cat a few times. 2 or 3 times, I went and they were telling me about some other cat's records. I kept telling them those were not my cat's records. But it kept happening. 😅
This is why I’m so passionate about providing healthcare to underserved/unserved populations around the world. People shouldn’t die from things we already know how to treat.
At my former hospital, annual training included a poster board of shame. They posted the tubes/samples that were incorrectly labeled or procured (PPI redacted) and explained in painful detail how the failure impacted care. Hilarious. Embarrassing. The entire hospital would see it. And everyone on your unit can recognize your handwriting…
whenever I get labs there's 4 double checks of my identification and confirming that the tubes with blood are mine.
I love the rural skits. Strikes that beautiful balance between making fun of the situation while still having immense compassion and understanding for the hardships involved.
You've got to see the one where he treats and then bills his daughter for services she can't afford. Nothing speaks to the evil of healthcare debt better. And well his poor five year old is too adorable!
Thank you for covering the lab one! Please stop by your lab and show those lab techs some appreciation for the data.
2:53 "can i smell it" HAHA 🤣🤣
I remember when CVS Caremark threatened to stop paying for Costco fills. Told them to fark right off.
Farmers are no joke. My dad had his arm casted by the vet, because people doctors were too damn expensive in the early 1950s.
A suture is a suture whether your are throwing it into a guy or a cow.
I'm sure in some areas, that hasn't changed (much).
Hi Enjay, thanks so much for being a subscriber! Really interesting about your Dad, too - hope his arm healed up ok!
@David Hindin, M.D. his grandmother was the village "herbalist" back in Finland during the early 20th century. She treated all sorts of stuff. She'd even set broken noses with homemade plaster.
Dad's mom wasn't much different. Outlived 5 GPs and died at 98. Told her butter was bad (love the 1970s). She told them lack of butter gave you dandruff lol. Ate butter, whole milk etc. I miss her lard pie crusts. (seriously angels wept)
Dad died 10 years ago. If it wasn't bleeding, hanging wrong or needed a vaccine, we didn't go to the hospital. He never skimped on ophthalmologists, dentists or ENTs, because there's no going back on messed up teeth, eyes or hearing.
Wasn't against medical science. Dad didn't "have time" for the slow grind of city medicine. (test test wait wait). He was a hoot.
I am laughing so hard I'm in tears at the cushy office/sipping swiss miss/work-life balance thing. I'm a former ICU/ER nurse, started in the 1990's, loved Micro, but WTF is all this work-life balance shit going around? I don't know how you could hold your composure Dr. David for this video, but thanks for making it! I'm still laughing, I need more laughs so I'm going to rewind and watch it again.
I love your laughter. He is hysterical and didn't expect the reaction from you from what I am used to. I also enjoy your posts of your hobbies especially making the smallest match in a case. Keep up the great posts.
Hi Judith, thank you so much for your kind words - I'm so happy you like this video and the more creative ones, too!
I love your takes on Dr Glaucomflecken's work.
I was just in the ER the other night, but I usually get my care from the local VA outpatient clinic and it is incredible how difficult it is for hospitals and clinics to share medical data with each other. Honestly, kind of ridiculous...
❤ I don’t know how I missed watching this one!! But thank you so much for your time effort and energy. I love your reactions. They truly!!!! Make me laugh and smile you’re awesome thank you I really really wish! I had you for my trauma surgery!! I am Hella funny on anesthesia😊 I hope you’re doing amazing!
Ahh.. memories.. being the one assigned to run periodic venous samples to the lab DURING surgeries to the lab to get blood-gas/crit measurements (cardiovascular surgical research back in the 1980s). I know the routes to this day (including ones that avoided April's office (old admin best avoided)).
I love Dr. G! Please do more reviews of him. Most of the doctors who review him overlook his humor!
I remember receiving a phone call from an insurance representative back in the eighties asking me why our pharmacy was billing for providing the new home glucose monitors but then billing every few weeks for testing strips. What was that about? Why were we billing for strips when they had already paid for the machine?
I've always seen it as a rite of passage during a met call/code blue to get the intern to run the ABG to the labs (for some reason in my hospital they can't go in the pneumatic tubes); or to run to the blood bank and pick up the MTP or to radiology for whatever urgent reason. Every year early in the year, you'll see a panicked intern running in a general direction but looking slightly lost and a kind registrar/RMO would point them to the right place. Sounds inefficient; but it works surprisingly well as a system (I had an ID consultant direct me when I wandered near level 2 with an ABG tube in my hand a petrified look on my sweaty face); but within a month all interns have been rapidly orientated on the key places in the hospital where they'd need to be at any given emergency situation.
They've upgraded the pneumatic tubes now so the interns don't have to run around everywhere as much now though!
i love the aditional context you give, the only thing i can say is that. I need more.
I am anesthesiology and intensive care doctor in rural hospital in my country. The amount of things we have to work without is longer than the one with things we have :) and also don't have ultrasound :) i still put central lines without ultrasound for example :)
That was so interesting!!! Thank you for sharing your insight into these videos!!!!
Thank you so much Doc! Really appreciate your time and input. Oh, btw: I love the stuff on your wall behind you, especially the colorful balloon dog, but don't understand the triangle and measuring tape? Are you a carpenter on the side as well? You take care of those precious hands of yours!! See ya on the next one!!
My dad has been a Molecular Technologist on the graveyard shift for about 30 years now. He's pretty much lost his hearing from a combination of the noise in the lab and lack of sleep from non-existent work-life balance.
Oooo this got real 🎉
Just a heads up, mail order RX doesn't alway get it right. Customer service is considered Hell - Circle 6, they are working their way to 9.
I love that they almost ALWAYS come on time and are frequently correct. I get so many letters I can't even.
Work for UHC outsourced in my country, it was painful. I really felt i sold my soul.
This aged very well
Poor Resident Bill. In every Dr. Bill sketch (his name is Bill Bill, short for William William), he’s just desperately seeking consults and advice, and being sent around on goose chases or getting chewed out. He always looks like he’s about to cry.
In the hospital some departments fax stuff to each other.
very cutting edge 😂
Very definitely it's important to be sure you have the correct patient as far as lab data. My grandmother had an unnecessary mastectomy because her lab results got mixed up with someone else's as she lay on the table while the dr was waiting for the results of her biopsy. This was a LONG time ago, back in the 70s. She got quite a settlement over that one. Sad part of it was that she had a great relationship with that dr......it wasn't his fault but he really didn't recover from that incident. I think he passed away like 6 months later, probably from the stress....
These reactions are great. What's also fun as a lay person is often having no clue what all the jargon means.
Well done sir!
Your reaction videos light my day
Love your Dr G reaction videos! The extra explanation you include is so interesting.
Actually, I had a know a doctor at a rural hospital who had a patient that he knew the diagnosis and knew need urgent specialized surgery at a higher level hospital that had that surgical but had in control. He was fighting with the higher level inside the hospital because he knew the diagnosis but the higher level hospital specialist was saying the patient is fine even though he is visually and clinically unwell right in-front of the rural treating doctor in the hospital. Unfortunately the one patient died to lack of action from the condition the rural treating doctor was arguing to admit to surgery. The rural treating doctor completely cried with the family due to the bureaucracy caused unnecessary death of a patient just because the treating doctor was a rural doctor not an urban doctor.
Just realised the character in first skit is Jimothy
My rural community is like this 🥲 ranchers are crazy. We have a surgeon he is 80 and is a doc/vet and specializes in horses.
I didn’t realize what a piece of crap UHC really is until my son shared this with me. I’m changing insurance companies.
I'm just a random female, not a veteran, not a farmer, in 2019 I ignored upper abdomen pain, I remember it starting in the night on Christmas Eve (still 2018 at this point). I just pushed on and on, I'd already been having investigations and had an appointment with the doctor and didn't really communicate how severe the pain was. Not quite sure what triggered me going in, but it was early March, I emailed my doctor on a Thursday and he told me he was on call that weekend, so I packed up and went into the ED at 9am on Saturday. I must have looked awful as the triage nurse took me direct to a room, I ended up in hospital for 6 days whilst they ruled out various malignancies and whatnot. Left the hospital with a surgery date a month away, a crap tonne of morphine and returned to have part of my stomach removed and another 6 day stay because my lungs decided they didn't like laparoscopic surgery. It was a bit scary to have something like this randomly happen in my thirties.
In the USA?
@@wholeNwon No, UK. I’ve lived in the US and experienced the insurance issues and stylistic differences between hospitals. I suspect I was ill enough that I might have been briefly admitted, but I suspect I’d have had some tests rather sooner. Unfortunately in the UK outpatient imaging is really clogged up (it’s even worse post Covid), so it’s not uncommon that things that are urgent rather than an emergency get dealt with by inpatient admissions. So I wasn’t getting a CT scan direct from the ER, I actually got that one the first night, but very much in the middle of the night, 1am or something, it was the same scanner as the ER use and sadly when they called me down they also had a possible spinal cord injury patient come in, which I 100% didn’t mind waiting for, but he was alone and scared, so it was really sad to watch, I actually had a nurse (or maybe healthcare assistant) with me as that was the policy for anyone being taken off a ward.
We need a massive investment into healthcare and a lot of it needs to go on imaging machines, but also radiologists, I’ve ended up getting some scans privately, the wait is probably still longer than I remember for a basic one in the US, but then there is a delay in getting scans read. I don’t actually work in healthcare so I suspect nurses and doctors have higher priorities, but my doctor sent me for a simply x-ray on 29th August and it’s being done on 5th October - which is utterly ridiculous.
@@anneharrison1849 Obviously I don't know the specific details of your case , and those would be determinative, but guessed that the events were very unlikely to have occurred in the USA.
Childrens Hospital in Cincinnati had a team to help when FIONA, a premature baby HIPPO was struggling..
Glaucomflecken - you''re a genius
I spent 4 years working as an overnight tech/nurse/anesthetist/gofer in a research lab at a major hospital.
Since it was a PRE-clinical cardiothoracic surgery research lab, that meant our patients were, well, uh, livestock. (Before some rando freaks out about that: if you can figure out how to ensure the bare-bones safety and efficacy of an artificial heart or pediatric LVAD *before* putting it in a human without using cows and sheep, I know a bunch of surgeons that would love to talk to you... Also, I was a licensed vet tech and part of my job was saying no to surgeons who wanted to break the strict animal welfare regulations bc it would be more convenient for their research protocol.)
As such, we weren't just in the *basement*. We were in the SUB basement. Where there were very low odds of a patient hearing a sheep holler about the pink elephants or whatever it was seeing on the ceiling after each dose of opioids.
The actual LAB lab was also down there.
Even the damn morgue was one floor up.
The rest of the sub basement seemed to consist solely of dark, creepy hallways connecting the various elevator banks, full of old beds, broken IV pumps, and other shit that might as well have been behind glass that said "break in case of apocalypse". There was at least one anesthesia machine that, according to the last inspection tag on it, had been down there since I was in first grade and still had a fully mechanical BP readout.
It was seriously creepy, especially at three in the morning on the way to the elevator that provided easiest access to the cafeteria.
So, uh, yeah. Bill's Journey To The Lab seems spot-on.
I totally remember my rotation ar Boston Children's hospital with the tunnels through the basement to bring you to a spot where you could access the labs and other important areas. BTW the blood lab was a down there.
Shivering black bell thumbs up: but because I am a fan of so many channels, I don't get to see each when they populate my notifications 🙄. Yes more videos of all types! 👍
Hi, Dr. Hindin! I am in nursing school and work at a hospital Transfer Center. I love your videos!!
Are you comfortable sharing some of the cases you have had in the ER? You're a great storyteller, and I'd love to listen!
All I have to say is…. Kaiser. Freakin Kaiser!
hahah for legal reasons I will neither confirm nor deny this comment! 😂
I was in Laboratory IT.
The wonderfully odd people that worked there was perpetually due to the mish mash of antiquated analyzers.
Coulter STK-S. That one was the on Hematology lived and died by. Too bad the last one was manufactured in 1954. And I was working in 1999.
No. I am not joking.
It had bolt on interfaces to report information back to the IT system. They haven't developed anything better so there is a lively aftermarket parts and reagent pipeline.
The one thing to keep in mind when working in the lab is to remember the day the micro lab has scheduled for stool samples.
Hematology is also where I saw a lab tech drop a rack of tubes. It was at that point, I immediately went to employee health and signed up for the Hep B vaccine series.
Epic sucks so bad the fact I have to chart the 2 month old I’m seeing doesn’t do recreational drugs makes me insane!
December 8 2024 here. You look strangely familiar….I too am watching videos of physicians making fun of evil health insurance companies.
I like that this is ultimately just you really enjoying watching these short videos. The commentary is also good, but...
Yea 100% about labeling specimens. I am there histology tech for a small out patient clinic. Any little error no matter how minor or missing info, I can't just assume or fix it myself. I have to go find the original person to fill it out. Then fill out a report about the error, the person who made it, why, and how it was corrected. It might seem silly. But if that patient case ever ends up in a court case, there are to be no doubts that it was in fact the patient's specimen and every thing done with it is documented.
So true it is painful......
Jonathan ones are definitely my favourite ones.
The country doctor- that's why I want to go into rural medicine. On the fly problem solving for patients who would otherwise receive no care at all
As a veteran, can confirm. You know that pain scale rating chart? Yeah, when you ask a veteran how their pain is that visit, what's the percentage that it's about a 3? Even though you know, for any normal person on that table, would be like an 8 or 9? "How's your pain?" "About a three. Maybe a four." "You have a bone protruding from your forearm." "Oh that? Just give me some Motrin, it'll be fine."
Yep. Visit to Sick Call, receive your complimentary 90ct 800mg Ibu. Ran out? "Hey, not feeling well, think I'm going to Sick Call." Yeah. Everyone thinks people go to Sick Call for the free day off (24 hr Quarters). It's really because your Motrin bottle's empty.
Also, as someone that currently works IT for a hospital. Once you get to the lab, keep going. That's where we are.
I switched to my insurance mail order pharmacy and they refused to transfer my scripts from my current pharmacy. Then they basically googled my doctors for their contact info and requested new scripts, even though I had refills. They were calling entirely wrong doctors, requesting news scripts when the doctor had just written a script for a year. I went without multiple medications for up to a few weeks. So much work for me and doctors and just so Cigna could save money and make money simultaneously.
I will never be tempted by a pharmacy that isnt legally allowed to ship some of my meds.
Remember that Halsted himself practiced veterinary medicine for neighbors at his summer house.
So true that I wish I was laughing a little harder but.. waaay too true
Hi there!! Lab scientist here. It’s true, they constantly shove us in undesirable places because they could use the better areas for patient facing care centers. 😅
December, 2024?
I've experienced too much hassle with "their pharmacy" and I pay extra to keep my local pharmacy. Worth every extra penny.
Bill is the Resident.. his name is Bill Bill 😂😂
Refreshing to see a video on videos who isn't a jealous troll.
Rural vs city.
Closest hosp in city? 2 miles
My area rural, but going? About 30 min
REAL rural, at least 2hrs.
Love your videos
Learning by doing can be an excruciating process.
My office has paper charts and we fax all the time! Lol!
Former care coordinator here. If you think he is kidding about knocking on your door.... he is not.
100% Accurate, I work for a PBM. 🤣🤣🤣🤣🤣🤣
Got a request for a future video? Lmk below!!
The Ortho Goes to Therapy and New Year’s Resolutions videos!
A detailed video on the facts of what separates a great surgeon from a good one.
This is exactly what it feels like being on Medicare and Medicaid.
Meanwhile- in the rest of the world - this problem doesn't exist and people can go to any doctor they want and any pharmacy they want and don't have to worry about the cost.
But sure... argue about which uniquely American yet terrible solution is "the best"...
Our zoo has human OBGYNs assist with primate labor and delivery
When the Lab was what inspired 80’s dark fantasy.
OMG!!!!🤣🤣🤣🤣 THIS SO FUNNY TO ME ON SO MANY LEVELS!!! I help with surgery and do anesthesia lol and my dad is a farmer and pushed his knee replacement off cause it's July it's hay season!!
As a MT, I apologize for our curt stoicism. However, if you don’t get that label on, or something on your specimen doesn’t match in the computer, it’s going in the trash. That’s the most loving we can be I kid, I kid….a little….). 8:00
So the lab is basically like stepping onto a Forge World, is what I'm hearing.