The Illness of Medicine: Dr. Michael Young
Guest : Dr. Michael Young
november 29, 2022
Steven Washuta
Welcome to Trulyfit. Welcome to the children podcast where we interview experts in fitness and health to expand our wisdom and wealth. I'm your host, Steve Washuta, co founder of truly fit and author of fitness business one on one. On today's episode I interview,
Steve Washuta
Dr. Michael Young, I will list all the relevant links in the description. Dr. Jung wrote a book, he wrote multiple books, but the book we'll be discussing today is called the illness of medicine, which is a nonfiction account of all of his experiences and stories throughout the entirety of his life.
Steve Washuta
Basically, from childhood, his father was a physician all the way until retirement have the encounters he's had with the health care system, and the medical system that he finds alarming, and that he wishes there was a way in which we can go about and fix it.
Steve Washuta
And, of course, he gives some suggestions about ways in which we can better the system together as a community, not just health and medical professionals, but also as patients or as general population. It was a great conversation, we talked a lot about surgery, we talked a lot about the state of the medical and health systems that we have now.
Steve Washuta
With no further ado, here is Dr. Michael Young and I Dr. Michael Young, thank you so much for joining the truly fit podcast, why don't you give my listeners in the audience a little background on what you've done in the medical industry and your credentials, and a little bit about the impetus to write your most recent book the illness of medicine? Well, thank
Dr. Michael Young
you, Steve. I hail from the state of Indiana and I went to undergraduate studies there at Indiana University, and then matriculated to rush Medical College in Chicago, where I graduated from and then continued my training in urological surgery.
Dr. Michael Young
Also in the Chicago area. I practiced in the private sector in the field of Urology for 28 years. And I left clinical practice about five years ago, as I became increasingly frustrated by the changes in the medical environment, I wanted to write about it, I wanted to be able to express openly and objectively about it, and not have the constraints of dealing with hospital and corporate administration's at the time I was doing so.
Dr. Michael Young
But along the way, I had an interest in innovation. And I have become faculty at the University of Illinois in Chicago, where I am the Director of the Department of Urology innovation and technology. I teach a course in medical device innovation, to medical students, as well as act as a medical adviser for the innovation center where we develop and design new surgical instruments and medical devices.
Steven Washuta
I'm gonna give a quick summary of your book, I read it, I enjoyed it. And you tell me if I missed anything for the audience. Okay, so from my perspective, the layman, not the not the physician, your your book uses really great anecdotes and stories and examples throughout your entirety of your career.
Steve Washuta
Basically, even before your career, I would say starting because your your father was a physician. So starting from the outset of you growing up and and understanding a little bit about the medical community, all the way until your retirement and it's all the things you saw in the healthcare system and the medical community and industry that you felt had issues.
Steve Washuta
So that can be very targeted things like, hey, the processes and preop are off. And we could make sure that these are logistically work better or could be more things that are sort of umbrella issues like the pharmaceutical industry, and insurance and things of this nature, you kind of work through this, but you don't try to give specific examples on how we can fix all this.
Steve Washuta
It's more about telling the people like me, the patient, that hey, all the problems that you face, we understand and that we are also facing them and that we all have to come together to solve these problems.
Dr. Michael Young
Well, we do but I do. I also feel that at the end of the book, I am suggesting solutions I most of the book is spent describing problems because I don't feel most people are aware of what goes on behind those closed doors or on the other side of the table is that describe it.
Dr. Michael Young
But much of the problem is related to money. It is the flow of money in healthcare and the solutions, I feel are our ability our capability of grabbing back some of that control.
Dr. Michael Young
And I think if we can at least have some say in the direction of that money, we will be able to improve modify The course that our healthcare industry is headed. So it really comes down to, you know, you know, he owns the gold makes the rules. Yeah, we have to gain control
Steven Washuta
of that. Yeah. And your exact quote from the book is the central role of money and medicine must change. And that's a great line. And that is very true. But would you also say that prevention is another key to this meaning that if we can prevent people from having to use the medical industry.
Steve Washuta
To the extent that we have now that works a little bit overwhelmed in the industry, that that could maybe slow the process down so that we don't have physicians having to see 26 to 29 patients a day are?
Dr. Michael Young
Absolutely but we don't sell health in the United States, we sell disease. I don't see too many advertisements on television, about what to do to stay healthy, I am more inclined to see something on television that is selling me a pill. It is selling me a remedy it is selling me a treatment.
Dr. Michael Young
But we know for instance, in in other countries where preventative health is more the agenda, we do see fewer emergency room visits, we do see fewer hospitalizations. Patients, for instance, with their diabetic issues are not going to have the wide flux of highs and lows if there is more of a prophylactic or preventative approach to health care.
Dr. Michael Young
We just don't seem to have that in the US. And obviously, there are many reasons for it. But one of them is our perspective, of remedy of health issues as opposed to preventative health problems.
Steven Washuta
Can you walk my audience through what it all encompasses to go about the process of surgery from the outset of the patient, walking through that door, whether it's at a hospital or a center, to them actually getting into the surgical room to them getting home and all the issues that one may come about that is sort of unexpected in that process?
Dr. Michael Young
Well, it is a long process. And unfortunately for many patients, it is as if they're driving to a location without a map. And I say that because very few patients are actually articulate in the health care process, they are oftentimes presented with a health issue, when they are you know, not prepared for it they it is coming on unexpectedly say an injury or an accident.
Dr. Michael Young
And so, they are navigating a process where they are really dependent upon others to to guide them and direct them and that can be extremely challenging, it can be extremely frustrating, and certainly one that creates a fair amount of of fear and distrust, because they are without control.
Dr. Michael Young
But if you take a person who for instance presents to their physician with a problem, they have a complaint, that physician and his or her affiliated you know mid levels or associates will work up that condition working up meaning a variety of lab tests typically physical exams and imaging studies.
Dr. Michael Young
Many people are used to an x ray, but when you start talking about other advanced imaging such as MRI or CT, they become a little less clear what that entails. And these advanced studies are very expensive. They also require in some cases preparation.
Dr. Michael Young
They may involve a dietary changes or particular imaging on mentors, such as a barium or perhaps intravenous administration of contrast. So planning has to be made for these studies. They're often done in an imaging center or in a hospital environment.
Dr. Michael Young
And so the patient obviously have to navigate those conditions. Once a decision is made, that a individual has the problem, oftentimes, alternatives are discussed.
Dr. Michael Young
Should that patient undergoing medical therapy in terms of a physical injury, say a musculoskeletal injury? due consideration needs to be made to non intervention, perhaps simply managed by physical therapy, which can be extraordinarily effective.
Dr. Michael Young
Alternative forms of therapy I feel should be addressed. There are many conditions they can be treated with non standard treatment. I'm not necessarily advocating them, I'm simply stating that this should be brought out, we have seen marvelous results with acupuncture, or other alternative forms of treatment.
Dr. Michael Young
And then of course, surgery remains, from my perspective, as a surgeon, as the last alternative, even though I am trained as a surgeon, I feel that it is the most invasive and therefore it is the last thing I want to come to as a means to resolve that particular problem.
Steven Washuta
But do you believe most surgeons also feel that way? Or is that unique to you?
Dr. Michael Young
Well, that's a very good question, Steve, you know, to cut is not to cure to cut is to cut. Yeah, and you know, there's an expression in life that if you give a monkey a hammer, he'll treat everything like a nail.
Dr. Michael Young
Yeah. And individuals in their particular field of interest will treat a particular problem accordingly. The medical person will treat it with with medicine. You know, the, the Osteopath or perhaps the chiropractor will be treated by some form of manipulation, and the surgeon will treat it with an incision.
Dr. Michael Young
Are they all right? No. Are they all wrong? No, I think perhaps many surgeons to your point will be more aggressive in that direction, not necessarily out of some nefarious attempt to do more surgery, other than that is the tool that they are trained to use.
Dr. Michael Young
And so yes, a surgeon will more likely operate. Whether or not that is being done. You know, out of self interest, I think is is more likely not the case. It's simply this is the tool they have. But to your original question, should a patient be told that surgery is really the best means to resolve their particular problem.
Dr. Michael Young
And obviously, the patient has to do their own due diligence, they need to understand the risks and benefits and they need to explain to their provider what they do or do not understand. There is nothing more frustrating for a physician than to have a patient who is unaware of what can happen.
Dr. Michael Young
We want an informed patient, I want that patient to go and read up in learn to obtain a second opinion on whatever that particular problem is. Now, I have to add a caveat to that, which is patients often feel that they can go online today they can go on the internet.
Dr. Michael Young
And within a matter of minutes or hours, they can become experts. And No they can't. They can learn the vocabulary, but they don't understand the meaning. I practice neurological surgery and dealt primarily with cancer problems, particularly of the prostate for nearly 30 years and a patient is not going to go online and an hour and come back and try to have a similar conversation with me on the same plane.
Dr. Michael Young
Although they will make they may feel they understand the words they really don't understand the meaning. So it's important that a patient do their best to get educated, trying to become familiar with the problem but don't try to outwit or outdo the physician, they're not the enemy.
Dr. Michael Young
They're simply expressing what you need done and they want you to understand the language. Once the informed discussion has been made, that the patient is is satisfied that they have been explained what they're going to undergo and why arrangements will be made typically by the physician's office through various secretarial staff.
Dr. Michael Young
To make arrangements for that patient. This will often include the need for the patient to be seen by their primary care physician ahead of time for preoperative clearance and evaluation to make sure that the patient is okay for surgery that they have no underlying lung or heart or other metabolic conditions that may put there but undue risk during a surgical intervention.
Dr. Michael Young
They will be informed to obtain perhaps additional X rays that they may not have had before. The other imaging may have been for that particular problem and now they're looking to get a chest X ray EKG and blood work that will be necessary for anesthesia. Once that has been completed, the patient will be given a instructions when and where to show up.
Dr. Michael Young
At the particular hospital or surgical center there'll be there'll be treated at. Oftentimes the patient will have to not have any food or water for at least eight to 12 hours before surgery, depending upon the type of procedure and the type of anesthesia and oftentimes this is referred to as NPO, or nothing per oral.
Dr. Michael Young
Oftentimes, starting at midnight, the night before surgery, the patient will often have to be at the surgical center or the hospital for one and a half to two hours before surgery. They will then be directed towards the either outpatient surgical area or a generalized surgical holding environment.
Dr. Michael Young
They will then be greeted by hospital staff, they will often have to change their clothes into a simple gown. That in itself can make many people feel extremely vulnerable as they are lying in a gurney with nothing more than a a few millimeter thick sheet or cloth gown over them.
Dr. Michael Young
But they're in that environment, they will often then have an intravenous line placed into their hand or arm. More instructions will be discussed with the nursing or hospital personnel. In many cases, at least in private practice, I or another surgeon will come in and greet their patient and often go over the procedure again, this time obviously, in a more modified or abridged version, consent is obtained which is basically giving the hospital and or the surgeon permission to do the surgery.
Dr. Michael Young
The surgery is then performed. The patient is brought into the operating room where they are greeted by the hospital staff. The anesthesiologist who I assume they will have met in that pre op holding area will also be there to induce anesthesia. Once a patient goes to sleep, it's it's interesting to note that time is no longer something that they are cognizant of.
Dr. Michael Young
If you put a patient to sleep for one hour or 20 hours, they don't know the difference because it really is not sleep as we think of sleep. So a procedure is performed, the patient will then awaken in the post anesthesia recovery room.
Dr. Michael Young
Oftentimes at this point, the patient is somewhat disoriented, they may be in discomfort, and we'll need to express that to the caregiver with them. And depending upon the particular procedure, the patient may or may not be discharged and if so they will be given follow up instructions.
Dr. Michael Young
Both post operative care as well as when they need to follow up and notify their physician. And if they're hospitalized, of course, that will be given to them. Depending upon, again the type of anesthesia whether it's general anesthesia or local anesthesia or some combination of the two.
Dr. Michael Young
Patients will typically be prescribed analgesia pain medication, perhaps an antibiotic will be given or other drugs will be given to the patient. And oftentimes Detailed instructions are given to the do's and don'ts.
Dr. Michael Young
One of the things that I think is most important is that patients understand that whether they are young and healthy and strong, independent living alone, it really doesn't matter. They will need someone with them for the next 24 hours, they will need assistance.
Dr. Michael Young
Always assume you will need more help. Because you don't know the intensity of the discomfort or your ability to get around or navigate your home or apartment. Wherever you live.
Dr. Michael Young
So you should have someone with you to assist. You may need someone to help you get to the toilet, getting on and off a toilet, which is something we all do every day and it's routine is not so routine.
Dr. Michael Young
If an arm is in a sling or a leg is in a sling or pardon me is in a cast, lots of things change and so you have to accommodate for that loss of independence postoperatively and of course the rehabilitation after that point is really dependent upon what was done, again was just an abdominal incision versus a extremity that had some form of orthoscopic or orthopedic intervention?
Steven Washuta
Yeah, I love that. You mentioned having someone there by your side, I actually I've been through two surgeries both had their own complications. And after my my first surgery, which was a double greenall, hernia surgery laparoscopically done with DaVinci.
Dr. Michael Young
Yes, you're absolutely right. And often it is the little things. We're all prepared for the big things. But it is the little things, the nuances that we oftentimes take for granted that we need to do.
Dr. Michael Young
And yes, one of the most important aspects. post operatively is of course pain management, the use of analgesics. Certainly we're using less opioids today than we have in the past, which have been notorious for causing gastrointestinal issues, particularly constipation, I would also make the point of need for early and frequent hydration.
Dr. Michael Young
You don't realize how much you need to drink. And as you're lying down the motivation to get up to urinate. It you don't want to do and so you tend not to drink but we are water cooled engines. And we do need hydration. And so certainly having meals prepared ahead of time for a day or two, or at least having easy access to simple meals is so important in that post operative recovery period.
Steve Washuta
Yeah, I'd also like to add one more thing you touched on in your book, there is either no correlation, certainly no causation between how nice a physician is, and how great they are at surgery.
Steve Washuta
So it's a it's on us to do our due diligence. Yes, not only sit down with that surgeon, but it's not just about trusting them, it's probably about looking at the numbers. And looking at the ratios. I had a finger surgery that went awry. And I trusted the surgeon.
Steve Washuta
And after the fact I found out there was about a 50% ratio of his successes or not when it should have been closer to 75%. That was not me. Right? I should have done my due diligence. In that case, I trusted the person rather than looking at the numbers. And I don't think that's common for for the general population to do.
Dr. Michael Young
You're absolutely right. Many, many people Steve will go to a physician because they've been recommended by their primary care physician, very, very few people walked into my office off the street.
Dr. Michael Young
They were referred and you are dependent upon that primary care physicians experiences with that individual. And really, it is not so much personality, but outcome that becomes so important. Now, I've heard of you know, many surgeons who have very challenging or almost icy personalities, you're not going to them to become their friend.
Dr. Michael Young
You're going to them for a technical service, if they are friendly and if you have a relationship that is absolutely wonderful. On the same token, I'm not saying you want to be treated by someone who is you know, just a cold stone.
Dr. Michael Young
There has to be a happy medium where you feel comfortable enough with that individual that you can make inquiries you can call and not feel intimidated by But you also do need to look at their track record and understand. I was the chairman of two medical centers in Chicago. And I can very clearly recall discussing with administration about one or two physicians during my tenure, where they had enormous numbers, which looked terrific.
Dr. Michael Young
But as you mentioned, their complication rate wasn't so good. And so you have to look at the numbers, you have to do your diligence and decide, and compare. One of the problems that I think Facebook patients are faced with today, however, is due to various insurance plans due to networks due to HMOs.
Dr. Michael Young
They may be restricted as to who they can see within their plan. And you may be referred to Dr. X, in wanting to see Dr. Y. But Dr. Y is not in your plan. And that creates a real problem.
Steve Washuta
Yeah. But I think there's a part of us psychologically, this sort of cognitive dissonance for lack of a better term, if you can't go see, you know, surgeon X, you're going to convince yourself surgeon while be fine, because you don't want to tell yourself, I'm going into surgery with someone who might not be capable and qualified.
Steve Washuta
But I do think it is, it's good that we tell ourselves up front, just like all mechanics aren't even an old personal trainers aren't even not all surgeons don't have the same exact skill set and something we may want to pay out of pocket for if if it comes down to that.
Dr. Michael Young
Absolutely. But you know, it's very interesting, Steve, there are there, there are ways in many insurance plans to navigate, you have to be your advocate, because the system will not the system is extremely fragmented, it is much easier to simply direct patients and they will follow the path.
Dr. Michael Young
But if something smells awry, you're not comfortable with who you've been referred to see, you don't like the method with which the referral process is going. Your primary refers you to a particular physician. And they request for instance, your laboratory your medical records. And for some reason, they never seem to get them despite it being sent multiple times, you have to question the efficiency of that office.
Dr. Michael Young
And if there just doesn't smell, right, you need to perhaps let your your primary know and request another physician to be to see you. So don't feel that you are always glued to that person, you were referred, you do have a say. And I do feel that patients do need to speak up when things just don't appear to be consistent with their expectations.
Steve Washuta
That's a great point. And I would just add, you know, being on my side of the aisle, me being the patient and you being the physician, it is a strategic two way communication, because what you don't want to do as the patient is be so pushy, and say, Hey, I research this, this is what I want.
Steve Washuta
And although that doctor disagrees with you, he consents that you're going to fight him every step of the way, he or she, so then they just write you whatever you want, whether it's the prescription, or the the referral to XY and Z person, although they have an experience that was bad with that person, they just know that they're not gonna be able to talk you out of it.
Dr. Michael Young
Yeah, and that is one of the problems we see with direct consumer advertising. You know, I believe it's in 2016, a study was done that showed over 700,000 ads on television that year for drugs. The United States and New Zealand are the only two countries in the world that allow direct consumer advertising of, of, of medical treatment, pharmaceuticals.
Dr. Michael Young
And that puts everybody in a bind because the patient sees the advertisement. And it seems to work. So the patient goes to the doctor's office and is inquiring about that particular drug. And I just have to warn patients that the the ads will tell you what you need.
Dr. Michael Young
They'll tell you why you need it. But what they won't tell you is if you need it, and you have to rely on your physician to be able to make the distinction between the use and need for that particular drug and another treatment. So patients come to the office armed ready, they want this drug.
Dr. Michael Young
They want the little blue pill, right? It may not be the right pill or they want the purple pill that may not be the right pill, but they have it in their mindset already that that's what they what they need. And so be mindful of your physicians experience and expertise and realize that the commercials that you're being presented, they're not directed towards you. They're made in general. And they're designed to sell a drug, not necessarily the appropriate drug for you.
Steve Washuta
As fitness professionals, we have to look over what's called a health history form before we work with our clients, and on that health history form, they obviously have to list their medications, because we need to know if there's any complications that may arise from any of these particular medications when we're when we're exercising.
Steve Washuta
And what I've seen over my years I've been I've over 30,000 hours experience working with people is that it's rare that you see someone on one medication, they're usually on zero, or they're on multiple, right, because you've, you've now made the decision that this medication is going to fix this problem. So the next problem, this medication is going to fix this problem.
Steve Washuta
And then you get down this this bad road where you believe the medication is going to fix all the problems. But this leads into the next question I have, though, because it is difficult, someone like my wife, she's a pediatrician. And people come into her office.
Steve Washuta
Let's go ahead and say they have ADHD or depression, it's much easier for her to deal with this in a pharmacological way than to get them into, let's say, a counselor or psychiatrist, because their people are booked out for six months. So this is a whole industry problem is Am I right?
Dr. Michael Young
It is, we as Americans, though, typically want the quick fix, not necessarily the best fix. While we want the best, but we want it now we want it yesterday. Sure. And the psychological intervention or even physical therapy, these are not quick fixes, they take months, months, six months, a year, two years to improve.
Dr. Michael Young
And that's typically not the mindset of most Americans. To your point, though, about drugs, I would also caution that I have seen, you know, patients come to the office with 10 1214 drugs on their list, I would start thinking about trying to subtract drugs, rather than adding because many of these drugs interact.
Dr. Michael Young
Patients who are taking one thing for one problem may be leading to another. And then rather than prescribing something in his care, that other problem, let's try to get rid of that original medication. And so subtraction is probably just as effective as addition, when it comes to some of these these issues. But again, it all goes back to the fact that the patient needs to be an advocate for themselves.
Dr. Michael Young
They have to be willing, not obnoxiously, but openly question what's being done and ask the question, Why? Why are you doing this? Why are you suggesting that particular treatment not and as a front of the physician or the provider, but really, to make yourself a more informed and therefore probably a better patient?
Steve Washuta
Yeah, that makes it makes a lot of sense. And I know, what my wife sometimes struggles with is that she has to make sure that she lets the parents know that, although she's willing to do X, Y, or Z, that is not what she would do in that circumstance, right? Because ultimately, if these parents are going to push back, it's different when it's one on one.
Steve Washuta
When you're dealing with a parent and a child. That's a whole, that's a whole nother set of issues to deal with. But that this is not my recommendation, I'm willing to try yours. But ultimately, this is not what I would do. And hopefully, they come around at some point and say, Well, this is the expert. This is the person who spent their life studying this stuff, maybe I should, you know, go their route instead of try mine.
Dr. Michael Young
Yes. Agreed. The physician is not God. But they may have a tremendous amount of experience with a particular problem. And you have to heed that that's why you're going to them.
Steve Washuta
So when your book you write, and you cover that, I guess you would call them the the upcoming crop of medical professionals. Sometimes, and I think this is, you know, if you're, I consider myself a dinosaur in my industry only because personal trainers typically don't exist after 45. Right? I'm 37.
Steve Washuta
It's just not a career you do your whole life, because it's hard to make sure that your body is able and capable to do these movements, we usually move into something else. But you know, when we see this young crop coming up, we're able to point out what may be missing what may have changed throughout time, where maybe they're not putting the effort in.
Steve Washuta
Maybe the job itself has changed. The hours have changed, the dynamics have changed. What do you see that it's changed that you would like to potentially fix from the upcoming crop of medical professionals?
Dr. Michael Young
Well, that's a wonderful question. And I think a lot of it is a reflective of our current perspective of health care. Health care has become very roboticized you have a protocol for treating x, y and z. And our training is very much of this type of mentality. Imaging, lab work.
Dr. Michael Young
Oh, and maybe we'll do a physical exam. I'm finding that the younger generation has less experience with putting their hand on a patient, less experience with the need to hold hands, be a human. Now part of that is due to the quota system, the mechanics of how offices and the corporate structure that owns practices today are demanding a much quicker and much more.
Dr. Michael Young
A less friendly evaluation and a more more goal oriented evaluation. The days of going in to see the physician and he or she asking about the family is the rare finding today, you're going in quickly, they're seeing you quickly, oftentimes, that physician is not even looking at you their their back is to you as they are typing into the computer, you know, in the electronic healthcare record, about their exam.
Dr. Michael Young
And so what I think is missing to your question, Steve is the without getting too extreme, but I wish we could see a return to some of the humanity of what healthcare is about, and less of this business aspect of what it has become.
Steve Washuta
I like that answer because you're not blaming it on the person you're saying, because of the insurance, because of the the quota situations because of how the EMR is and how much you have to write up and each individual patient.
Steve Washuta
And because of all of these things, I can't walk into the office, excuse me and walk into the room and say, How are you doing? And you go, Hey, I have depression, I have a sprained ankle. And I think I might have a rash they go, I'll see one of those you come back next week for the right tool, right? So
Dr. Michael Young
Correct. Yes, we just don't have that time. Well, there's many factors involved. But we do know, for instance, that patients, when they know they have an upcoming physician's appointment, will have you know, they'll have prepared a, a list in their head if not written down of questions and problems.
Dr. Michael Young
And we know unfortunately, that in that initial statement by the patient 77% of the time, it's interrupted by the provider. And it's interrupted by the provider 18 seconds into the discussion. So it just shows you that that provider does not have the patience, right, or the time to be able to listen to that which is so important to the patient.
Dr. Michael Young
And I think this is tragic, I think, you know, many providers are compensated now in a, in a in a situation that they don't own their own practices. We know that for instance, 70% of physicians less than 40, are employed by some corporate or hospital structure.
Dr. Michael Young
So they are dictating to them, you have to see X number of patients per hour per day, per week, per month, what have you. Well, that's not going to happen by asking about how is the family. And, again, I think we need to get back to this, I think, I'm not trying to be pollyannish.
Dr. Michael Young
In my perspective, I'm not trying to be, you know, down on the farm perspective of, you know, the good old boys, and how's everybody back home, but you do need some form of dialogue and communication with your physician. And I wish we could see that comeback.
Dr. Michael Young
So that is what I think is a problem today with our roboticized protocols of efficiency, as medicine has become a transactional, of commodity to sustain the business of medicine.
Steve Washuta
And I don't know the numbers. But what I see anecdotally coming from this is now a lot of younger physicians. Now obviously want your take on this are saying, I'm not going to work full time. This is crazy. I can't I can't walk into the office and see 30 patients in a day not have the time to give them and feel like I'm not doing the proper service for each patient.
Steve Washuta
So you know what? I can handle it for 20 hours a week. I'm just going to work 20 hours a week and they're filling people are filling practices with NPs and PAs and they're just they're the most physicians in the let's say you the general pediatrics or the family medicine are not working full time anymore. Do you feel like this is happening? Is this going to be bad for the industry moving forward?
Dr. Michael Young
I think it is. I think that well we know statistically that 30 to 50% of physicians are experiencing burnout, burnout being defined as physical or emotional exhaustion.
Dr. Michael Young
I think if you have a physician who is in his or her office, and they are just being forced to see patient after patient without time to digest to be a human yourself, yes, you're going to become physically and mentally worn out, and therefore you're going to need more time off and retire earlier.
Dr. Michael Young
I don't think this bodes well for the profession I, it is a trend we are seeing. But again, when we have a corporate structure that owns the practice, we're seeing less individual responsibility.
Dr. Michael Young
You know, at three o'clock, I'm done, you have a problem you can call so and so well, that that is, unfortunately not one that raises confidence in the patient, perspective of commitment by that physician, it causes a loss of continuity of understanding of care. If you look at the hospital environment, today is a very good example.
Dr. Michael Young
As more and more corporate structures have taken ownership of practices in hospitals, it became very apparent that it was very cost inefficient for physicians, to go to the office, go to the hospital, make rounds and come back or go to the hospital for an hour or two and make rounds better to have their own paid employee or hospitalist which manages the physicians, patients that are in the hospital, they can therefore stay in the office and turn out more patients more more efficiently in terms of, of not necessarily quality of care, but simply monetary proficiency.
Dr. Michael Young
So you when you're in the hospital, you're going to be seen by this hospitalist this individual who may be very well trained, I have nothing against them as physicians. But the perspective is, you as a patient who have needed your physician or relied upon your position your physician for perhaps months or years, suddenly, you're sick.
Dr. Michael Young
And what you need now more than ever is that healthy or strong relationship with that physician, you need that face you're familiar with. Instead, you're confronted with a stranger who doesn't know you who doesn't know details about you other than the immediate problem.
Dr. Michael Young
And so when you're sick when you're in need, when you've had that heart attack, the person walking in is looking at a clipboard, your patient number 302 for the day, write it again, it's become one of hand off and roboticized treatment that I really don't feel bodes well for the profession.
Dr. Michael Young
And understanding, as I mentioned at the outset, we are all patients, I don't know any physician who is excluded from needing health care. We've all been in a dental chair, we've all had injuries, we've all needed stitches for something, and it's scary.
Dr. Michael Young
And we need that that that face that we're familiar with. And as you stated this working a shorter week, because of burnout, because of all these other financial issues that are been described. I think it becomes an industry more predicated on efficiency than that of healing, which is what we went into it to begin with for
Steve Washuta
You see a lot in schools, whether that is charter schools, or just different types of schools that are coming out where people will go on these adventures tobacco a new way to see what could potentially work right, whether that is an economist mixed with sociologists.
Steve Washuta
And they'll they'll start these new ventures and say, You know what, maybe we can perfect the schooling process a little bit better. Let's go about it this way and see what we can do. Do you think that'll ever happen in the medical industry? Has that happened to somebody said, you know, what we're gonna we're gonna start from from, from the ground level, we're gonna start from scratch and sort of redevelop the system.
Dr. Michael Young
Well, I think it's a hopeful goal, Steve, I, I feel that if we're going to get there, it's going to be a generational change. We're talking 2030 years the curriculums of the medical school. Again, as I as I am now faculty at the University of Illinois, and very much engaged with the students.
Dr. Michael Young
I have seen and witnessed a change. We're putting the students through a rigorous academic environment. I hope we can find a means to include training, expose Was your to humaneness if that is such a word, as opposed to simply technical, detailed information about a physiological process gone awry.
Dr. Michael Young
At the end of the day, we're taking care of people. And if you can treat a person's emotions, if you can treat their anxiety if you can give them confidence, I think you're going to improve their physical well being in a much more effective manner.
Steve Washuta
Dr. Young, this has been great information. Where can my audience find more about you personally, more about your book, the illness of medicine, I know you've wrote a second book anywhere they can find your books and anything about you personally.
Dr. Michael Young
Well, thank you for asking the illness of medicine or was a nonfictional description of experiences in clinical practice. It can be found on my website, which is Michael J. Young md.com.
Dr. Michael Young
And from that website, one can find a link to either Amazon or to my publisher, GM books. Or of course, one could go to Amazon or any number of the e book opportunities. In Chicago where I reside, unfortunately, I think there are just a handful of bookstores.
Dr. Michael Young
It's very hard to to go to a bookstore today. They're they're rare. And just dealing with the cumbersome pneus of parking and paying and so I find many people are buying books online. And so obviously Amazon is a is an easy venue to do that or simply through my my website.
Steve Washuta
And I just want to add, we did not go over everything in the book. There are still a ton we didn't talk about here, so it's well worth getting it. And the read. My guest today has been Dr. Michael Young, thank you so much for joining the tool for the podcast.
Dr. Michael Young
Thank you so much, Steve.
Steve Washuta
Great, thanks for joining us on The Trulyfit podcast. Please subscribe rate and review on your listening platform. And feel free to email us we'd love to hear from social@trulyfit.app. Thanks again.
Dr. Michael Young
Website : https://michaeljyoungmd.com/