Knock Knock, Hi! with the Glaucomfleckens

I failed my very first standardized patient encounter in medical school because I saw a 49-year-old woman with abdominal pain and did not order a pregnancy test — immediate fail, well-earned shame, lesson learned — and it turns out that story is actually a pretty good entry point to this episode about what…

Halloween is around the corner, so here is a little housekeeping. I open with the saga of my HOA fining me for window units during a 117°F Portland heat wave, including the time I taped a photo of Brad Pitt to one to make it “more beautiful.” Then our family’s Star Wars Halloween plan: I was going to hide inside an…

Dr. Rachel Zoffness is a pain psychologist and assistant clinical professor at UCSF and Stanford, and she came on to do something I desperately needed, explain what I actually did not learn in medical school about pain, which turns out to be most of it. The thing I absorbed is apparently what 96% of medical schools…

This week I get into the No Surprises Act, starting with my own $20,000 out-of-network bill after my cardiac arrest and the nine-month fight to resolve it. The law was supposed to prevent exactly that, and from the patient side it works. But the arbitration system behind it is now processing millions of claims per…

Dr. Lindsey Fitzharris is back and she brought her best book yet. Sleuth Hound: The Case of the Real Sherlock Holmes, out October 20th, which tells the story of Joseph Bell, the Edinburgh surgeon who was the actual inspiration for Sherlock Holmes. We cover optography (the Victorian belief that eyeballs record the last…

The weight of the healthcare system has been sitting heavy. Our practice officially dropped UnitedHealthcare after they offered a 0.8% rate increase, and I’m feeling genuine empathy fatigue for the first time since I came back to clinic after my cardiac arrest. I talk about what that feeling actually is, how to spot…

We did back-to-school night for our ninth grader and I came away wanting to re-enroll myself. The CS teacher (28 years in the classroom) convinced me that what computer programming really teaches is attention to detail, one misplaced space breaks the whole thing, and the Spanish teacher, who grew up under Franco with…

The Blue Cross Blue Shield Association put out a truly hilarious study complaining that AI tools drove nearly $1 billion in extra costs for their insurers over two years, blaming hospitals and doctors for using AI to code more accurately. This from the industry that pioneered using AI to deny claims. It's an arms race…

This week Kristin and I sat down with Dr. Sasha Hamdani, a board-certified psychiatrist, ADHD expert, and author of the new book Too Sensitive: Rejection, Resilience, and the Science of Feeling Deeply. Sasha breaks down the actual neuroscience behind why some of us feel emotions so intensely, and gave us some…

I'm back in the corporate practice of medicine content cycle, this time on the Stop Corporate Takeovers of Physicians Act, a new federal bill modeled on Oregon's landmark CPOM law. It closes the MSO / PC ""friendly physician"" loophole that corporations like Apollo MD use to get around existing laws in 34 states, and…

This episode kicks off with a listener email from someone facing a conundrum: she finds out about getting tenure within a few weeks of turning 40, all while wondering if she should ditch academia and go to medical school instead. Kristin and I dig into what it would actually take to start med school at 40: the family…

Coming to you from a hotel patio in Lebanon, New Hampshire, this week I dig into the ACGME's newly released revisions to resident work-hour restrictions. We walk through what's actually being proposed: eliminating the mandatory 8-hour rest period between ordinary shifts, cutting required rest after a 24-hour call from…