Knock Knock, Hi! with the Glaucomfleckens

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 year (not the 22,000 the feds expected), doctors are winning about 85% of the time,...

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 thing a person sees before death, which murderers took seriously enough to...

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 it, and what finally helped me through it last time. Also, Dr. Oz is pushing to el...

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 his left hand literally tied to his chair for writing right-handed, had a philoso...

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 now, and the only people who actually lose are patients, premiums keep going up...

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 genuinely useful tools for dealing with it. We also got a proper medical explanation for...

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 it kills non-competes and non-disparagement clauses so hospital-employed doctors...

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 logistics, the physical toll of taking overnight call as you get older, the finan...

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 14 hours down to 12, and loosening call frequency from every third night to ever...

This week Kristin and I are talking business; specifically, how doctors go from having a great idea to actually building a company around it. We're joined by Dr. David Lortscher, a board-certified dermatologist, co-founder of Curology, and author of Why Doctors Win: The Doctor's Guide to Creating or Joining a High-Impact Startup. David breaks down why so many of the most successful healthcare comp...

This week I'm tackling two things that have been on my mind. First, I saw a piece of content from another physician creator explaining why they left private practice, and the framing bothered me: the idea that private practice is inherently about squeezing as much money out of patients as possible. I get where that creator is coming from, but I think that's simply a culture problem at that&nb...

This week I'm sitting down with Dr. Fran Heydanek, OBGYN, mom, and one of the biggest medical content creators out there fighting misinformation. We start with the wildly common experience of getting scammed by fake podcast invites (yes, it's happened to both of us), then get into her actual path to medicine: integrated arts classes, a rejected dentistry detour, a brief love affair with pathology,...

Welcome back to Knock Knock Eye, my one-stop shop for all things eyeball related. This week I'm taking a quick break from corporate practice of medicine talk (just this once, I promise) to dig into a mailbag question from a listener named Gina, who fainted during a routine gonioscopy exam. We get into what a vasovagal reaction is, why the eye seems to be such a common trigger for fainting, and wha...

This week we go down a bit of an emotional rabbit hole, starting with a Mad Men clip about nostalgia. This leads to us reading some genuinely fascinating research on nostalgia; why it exists, what it does to our brains, and why it might actually be an evolutionary survival mechanism. We talk about looking back at old photos of our kids, why parenthood memories tend to get rosier over time, and whe...

So last episode I made the case that medical student research should be banned, and I clearly touched a nerve. I got flooded with angry messages arguing against me, and honestly, I expected some backlash since it was a genuinely spicy take. But I want to be clear, I was being facetious, obviously nobody's going to actually ban med student research. What I actually want to unpack this episode is wh...

This week we start by discussing our daughter's summer geometry crash course, and I forgot how much I hate proofs. I also tell the story of getting stuck at the Salt Lake airport with the Portland Thorns professional soccer team, which hit me with a wave of nostalgia for my old Ultimate Frisbee team days, followed by Kristin's late-night ladder saga trying to fix a chirping smoke detector on our v...

I just wrapped my second call week of the year, and honestly, getting older has made overnight pages so much harder than they used to be. At 30 I could wake up from a dead sleep and immediately have a coherent medical conversation, and now, ten years later, I basically have to be walked through who I am and what hospital I'm even at before I can function. I also tell the story of getting completel...

This week Kristin and I get into "Ozempic face," which has been all over social media, and I break down what's actually happening medically when people lose facial fat quickly on GLP-1 medications. Kristin gets grossed out the moment I bring up orbital fat, so we go down a whole rabbit hole about fat pads, blepharoplasty, and why your eyes need that squishy cushion behind them. I also share someth...

I've got a love-hate relationship with research, and this week I finally get into why. I'll read a study, I'll watch a talk, I genuinely enjoy learning about it, but performing research myself has never been my thing, and I get into the whole story of how I ended up doing it in med school anyway purely to check a box. Then I break down the newest NRMP match data, and the numbers are insane. We're...

This week Kristin and I start off with something I've been wanting to work on for a while, my medical Spanish, because we're opening up a new location and I want to actually be able to communicate with my Spanish-speaking patients. Kristin was a Spanish major, so she helps me practice phrases sent in by a Spanish-speaking listener named Gabe, and let's just say it does not go great.  Then I g...

I wanted to start this one off talking about Sydney Towle, a 26 year old TikToker who documented her stage four cholangiocarcinoma diagnosis with so much humor and honesty that it genuinely impacted me, even though I never knew her in real life. Her passing hit hard, and it brought back a lot of what I went through with my own testicular cancer diagnoses at 26 and again at 31. I talk about how iso...

This week Kristin and I sit down with Matthew Zachary and Jen Singer, two cancer survivors who between them have basically seen every corner of the American healthcare system and lived to write a book about it. Matt founded Stupid Cancer, the organization that essentially created the young adult cancer advocacy space out of nothing back in 2007, and I can personally attest to how much that work ha...

I've got something serious to get off my chest this week. It's about how Kristin gets treated in the comments section of our own YouTube clips. A recent clip from our episode with Rana Awdish set me off; Kristin talked about the "God complex" in medicine and what happens when patients don't fit neatly into the box the system has for them. The response from some corners of the internet was exactly...

We start with Kristin's ever-escalating sleep setup, my childhood bedtime prayer that explicitly included the possibility of dying in my sleep every night from ages zero to eighteen, and the fact that I then did actually die in my sleep, which, in retrospect, really should have been a tell. The midlife crisis hobby conversation covers mountain biking, beekeeping, Bob Ross-style painting, and actin...

Dr. Oz's proposed 2027 CMS rules dropped, and I've been waiting all week to get into them. The push toward value-based care and Accountable Care Organizations continues, but the headline for anyone in private practice is the multiple procedure cut: if you bill an E&M code and a procedure on the same day, Medicare now pays 100% for the more expensive service and only 50% for the other, regardless o...