Knock Knock, Hi! with the Glaucomfleckens

Today's main event: how a physician-owned practice negotiates with UnitedHealthcare. UHC is notorious for raising premiums 20 to 30% while offering physician reimbursement bumps of about 1%. I walk through exactly how we push back at Eye Health Northwest, phone messages that spell out the math, letters to patients, and yes, taking the contract to the brink when we have to. This works because we're...

This week we're joined by Kendra Cunningham and Kayla Messana, sisters and co-hosts of the podcast Flatlined and Fine, and their stories are almost impossible to believe. Kayla was 31, healthy, three kids, husband just back from deployment, when she woke him up with agonal breathing in the middle of the night. He dragged her to the floor, did CPR for 10 minutes, and she was shocked twice by an AED...

I'm on call July 4th for the first time in what feels like forever, and I have fully lost perspective on what call should feel like. 2018 me, fresh out of an Iowa trauma center, would be horrified at how nervous private practice me has gotten about it. I'll report back after the holiday. Today's main event is World Cup eye injuries. Every professional sport needs an ophthalmologist on the sideline...

I've been watching the Sheriff of Sodium break down medical education data on social media for years, so I'm thrilled to finally have Dr. Bryan Carmody on the show to help me understand what's actually happening to the system that turns medical students into doctors. We start with the basics What the Match is, why it was created in the 1950s to solve a headhunting problem that was stressing everyo...

A few things on the agenda today. First, RFK Jr. and the MAHA crew want medical schools to dedicate around 40 hours, roughly 20% of preclinical training, to nutrition education. I have some thoughts. We already have dietitians, med school is already a fire hydrant, and the Krebs cycle had it coming, but this isn't the way. Then a Mark Cuban appreciation segment, because he's out there on X draggin...

This week we sit down with Dr. Chris Allen, board-certified sleep medicine physician, board-certified pediatric neurologist, and a man who has been on CPAP therapy for 22 years. We cover how a sleep study actually works, the real misconceptions around sleep apnea, why CPAP isn't the only treatment option, and what the difference is between a home sleep test and a full in-lab polysomnogram. Oh, and...

I just watched The Backrooms and now I can't stop thinking about hospital liminal spaces. The basement. The pathology lab. The OR at 2 AM when you're going in for an open globe. We start there. Then a great Spotify question pulls me into ophthalmology boards, what the written test is like, the oral exam I took inside an examiner's actual hotel room (with their luggage in the corner) during a hotel...

Dr. Heather Gatcombe, a clinical radiation oncologist at Emory, who immediately humbles me by explaining that her job involves a lot more than drawing circles on a screen, it involves medical physics boards, cancer biology exams, and oral evaluations with the world's leading subspecialty experts. I'm putting radiation oncology in my "insanely smart doctors" tier, effective immediately. But Heather...

We're dropping this bonus episode because something genuinely historic happened in oncology and we couldn't wait until our regular schedule to talk about it. Dr. Mark Lewis, GI medical oncologist, pancreatic cancer survivor, and one of our absolute favorite guests. He just got back from ASCO, the Super Bowl of oncology, where a new drug called daraxonrasib received one of only about six standing o...

I’m back from a whirlwind speaking tour where I realized my entire social media presence might just be a long-con ruse to get a captive audience of 1,000 electrophysiologists to look at my genetic testing report. I officially "locked the doors" at the Heart Rhythm Society in Chicago until someone could tell me if my phospholamban mutation actually means anything. Spoiler alert: I met the guy who l...

Victor Wembanyama, the 7'5" alien playing for the Spurs, apparently refuses to look at blue light after 9pm, which allows me to get into my love-hate relationship with blue light glasses, the misinformation campaign that has them treating everything from dry eye to macular degeneration, and the one claim that actually holds up: sleep and circadian rhythm. Then a great Patreon question drops me int...

I’m stepping away from the slit lamp this week to talk about a different kind of eye emergency. The ones happening on the front lines of protests across the country. I’ve been seeing way too many videos of people losing their vision to "non-lethal" force, so I invited Adam Rose, the Deputy Director of Advocacy for the Freedom of the Press Foundation, to help us navigate this. Adam has 20 years of...

I'm not in a great mood and I'll tell you why. A mini fridge in our family room sprang a slow leak, and before I knew it I was $5,000 deep in a restoration black box with no idea whether any of those numbers were real. Which, of course, got me thinking about healthcare cost transparency, because everything eventually does. From there I get into Oregon's SB 951, the strongest corporate practice of...

We’re diving into a heavy topic that’s been making the rounds on medical TikTok, the soul-crushing feeling of "wasting your twenties" in medical training while your non-medical friends are out buying houses and going to clubs instead of living in squalor with five roommates. Kristin and I look back at our own unusual twenties, including the "Sock on the Pager" move which Kristin officially is clai...

Today is a day for celebration and a little bit of "I told you so." We finally have a resolution in the saga of the Eugene Emergency Physicians (EEP). Just as final arguments were about to begin, PeaceHealth completely rescinded its contract with Apollo MD and restored it to the local doctors who have served the community for 35 years. I’m breaking down the federal judge’s scathing remarks, includ...

I’m opening up this week with a bit of a public service announcement: please stop pointing stuck containers at your face. We’re diving into a bizarre and honestly terrifying recall of 8 million Thermos bottles that have been essentially turning into high-pressure gas bombs in people’s kitchens, causing some devastating eye injuries. I try to explain "blunt force blindness" to Kristin, who, like ma...

Put down the "Standard of Care" manual for a second, this week I’m talking to you like a med student watching a corporate train wreck in slow motion as we break down the "rigged" request for proposals (RFP) process. I’ll show you how a local group with 35 years of perfect staffing was given a "0.1" score for call coverage just so a corporate giant could swoop in. We’ll also discuss a federal judge...

We dragged the kids across the country for a mix of family time and a high-stakes meeting at the Capitol with Senator Elizabeth Warren. I’ll admit, I was a nervous wreck trying to record a skit in a Senate hallway in under five minutes, but the Senator had her lines down and even brought a bit of upbeat energy to my usual comatose resting face. We’re pushing the "Breakup Big Medicine Act" because...

Put down the hospital cafeteria coffee because today I am diving into a "barbaric" problem in American hospitals that I can't believe I haven't addressed yet: ED Boarding. I’m talking to you like a med student in the trenches to explain why patients are stacking up in hallways for days and why it’s not because we’ve run out of beds, but because the incentives of hospital administration and insuran...

I’m feeling a bit reflective this week as we head into Mother’s Day, a holiday that used to be a real bummer for us. It turns out that having a cardiac arrest the day after Mother's Day imprints some pretty weird sensory triggers, like the specific way a tree buds or the smell of spring air. Joining Kristin and I to talk about motherhood, medicine, and the messy "long view" of family life is Dr. R...

I’m feeling a little run down today—it’s peak "conference season," and I’ve been bouncing between recording studios and speaking gigs. But I couldn’t wait to give you an update on the situation in Eugene. We’ve moved past simple contract disputes and into "administrative meddling," with leaked emails showing a hospital CEO attempting to influence clinical decisions in real time without a license t...

This we're joined by one of the few people whose medical comedy I actually enjoy: Dr. Paul Tran. Dr. Tran is a pediatric gastroenterologist who has mastered the art of playing a perpetually anxious med student on TikTok, but in real life, he’s an attending who actually cares about things like "ethics" and "professionalism". We get into the "fodder ability" of different specialties, basically my in...

I just got back from Puerto Rico, where I attended my very first gynecology oncology conference. It turns out that even though we're at opposite ends of the body, ophthalmologists and gynecologists actually share a lot, mostly a love for speculums and organs that dilate. I’m also diving into the terrifying news of a Florida surgeon recently indicted on manslaughter charges after removing a patient...

This week, we tackle the emotional roller coaster of Match Day and the precarious "new frontier" of medical professionalism on social media. Kristin and I reflect on my Match experience, including the moment Kristin cried after finding out we were moving to Iowa, and offer a heartfelt word of encouragement for students navigating the heartbreak of not matching. We discuss why "it can always get wo...

Put down the study guides for a second because I’m taking you back 20 years to my own medical school application, back when the MCAT was still paper and pencil. I’m breaking down my 4.0 GPA, my "31S" test score, and why I spent my interviews pretending to be passionate about the phylogenetics of North American fruit bats just to check a box. We’re also diving into the high-stakes Department of Jus...