Interview with Drs. May and Tim Hindmarsh
This week, Drs. Tim and May Hindmarsh describe the genesis of BS Free MD Podcast. They also share some of the challenges they have faced together as a two-physician couple.
This is the second time we’ve presented an interview with two guests. In both cases, it was a physician “power-couple.” Besides producing a podcast, today's guests have both worked primarily in clinical positions.
Dr. Tim Hindmarsh has tried several nonclinical jobs. However, he has now found an enjoyable and fulfilling career in urgent care. Meanwhile, Dr. May Hindmarsh has been exploring nonclinical options more aggressively.
Our Sponsor
We're proud to have the University of Tennessee Physician Executive MBA Program, offered by the Haslam College of Business, as the sponsor of this podcast.
The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, the program only takes one year to complete.
By joining the UT Physician Executive MBA, you will develop the business and management skills you need to find a career that you love. To find out more, contact Dr. Kate Atchley’s office at (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.
Committed Family Physicians
Tim and May are both board-certified family physicians. And they have worked in family practice, inpatient care, urgent care, and other settings.
They have a thriving marriage. And they have provided marriage counseling and led medical missions. Originally from Canada, they now live in the rural Pacific Northwest.
May opened up about her struggles. And Tim provided insights and advice for finding clinical work that’s fulfilling and fun. They both share their perspectives on clinical medicine, nontraditional jobs, and their favorite podcast episodes.
BS Free MD Podcast
Tim and May host BS Free MD Podcast together. We learn how that came to pass.
The podcast addresses many topics, including marriage in medicine, work/life balance, “F” words (faith, family, finances, and fun), and current controversies such as the response to COVID.
And they present two special series. In “DOCTALES WITH COCKTAILS” they “raise a glass, unwind and toast funny tales, laugh at past antics, and dish outrageous memories over our favorite libations.”
And when presenting “THE PHYSICIAN AS PATIENT” they feature “a guest physician and their story on the other end of the stethoscope.”
Summary
Tim and May have a wonderful story to tell. They work together in all aspects of their life. They have successfully overcome the challenges of a two-physician family. And they have created a fascinating podcast addressing many interesting and important topics. This episode is a bit longer than usual, but you will enjoy it.
NOTE: Look below for a transcript of today's episode.
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Transcription PNC Podcast Episode 226
Get No-Nonsense Medical Information at the Awesome BS Free MD Podcast
John: I met May and Tim through the Doctor Podcast Network. And we have both been meaning to get together for almost a year. They produced the BS Free MD podcast.
I've done a thorough analysis of their shows, and I can confirm that it's at least 90% BS-free. Now there was a time back last April, you might want to check that out, when they kind of went off the rails there, but anyway, Doctors May and Tim Hindmarsh, welcome to the PNC podcast.
May: Hello. Thanks for having us. We're super honored and excited to be here.
Tim: Absolutely.
John: Well, it's good to have you here. We've been meaning to do this for a while and I don't know, we get busy and then we forget. I've got some mild dementia so that doesn't help. But anyway, like we do with all of our guests, I think I'd like to hear each of you tell me a little bit about your background education and up to what you're doing now.
Tim: All right. Well, we were both educated in Canada. I was actually educated in my hometown.
May: Born and raised.
Tim: Which was Saskatchewan. And that's actually pronounced correctly because it gets pronounced all sorts of different ways. I went to the University of Saskatchewan. May was from Northern Manitoba. We met in medical school. We actually got married three days after we graduated, and then went on a three-week honeymoon. And then we went into residency straight after that, which was not a honeymoon by any stretch.
May: Yeah, if you want to challenge your marriage and see if it's up to the test, just jump right into residency after getting married.
John: Let me interject there for a minute. I got married in my second month of medical school. Needless to say, it didn't last.
May: Oh, I'm so sorry. So you understand.
John: Maybe, but it's rough.
May: No kidding. Well, just some extra info. My sister who's seven years younger than me moved in with us, six months into our internship year. Basically, we joke about it now. She's really cool about it but was an undiagnosed bipolar patient. She basically was like Garfield in our home. Except for at night when she would go out like a cat. It was really bad. And you talk about a lot of stress in a marriage. But anyway, we did our internship and residency in Edmonton, Alberta, Canada. And then as we were talking earlier, we actually got recruited to move to the US because things were changing in the states with healthcare. And did HMOs come into play?
Tim: Well, it was managed care, and we were family doctors.
May: And the landscape was changing in Canada because the government put some restrictions on physicians back then where you couldn't move or work anywhere, except for wherever you did your training, which meant you would not get paid. What happened was there was a big exodus to the US back then in the 90s.
We got heavily recruited and decided we were going to come down to Oregon is where we chose. But while we were waiting, we actually did urgent care back in the day before urgent care really was known. It was called minor emergency care. We did that for a few months while waiting and then we zoomed down to the US.
Tim: Yeah. 98% of deciding where to live was based on recreation.
John: Oh, that's good. That's good to follow.
Tim: Literally I spent summers in the Gorges windsurfing and I was like, I want to be close to that place. I used to live in Whistler, so I skied tons. I need to be two hours from all of these different places. I want to practice rural medicine. And May was like, "Yeah, get me a house in the woods and I'm happy". So that's kind of how it ended up.
May: Yeah. We basically lived here in Oregon in the Pacific Northwest since then in the exact same house, against what some financial planners would say. We actually have been in the exact same home since 94, our dream house. We raised our kids. We're now empty nesters and have had a varied career.
I practiced mostly part-time family practice and then transitioned into urgent care. Tim has had a wildly diverse career from family practice to OB. And we both did hospital medicine too. Back in the day, we'd take care of on-call and patients in the hospital ICU. We did all that. But he's had a lot of non-clinical career experience over the years. He's been on every committee. If there's a committee, he's been on it.
Tim: I had a Saturday where I drove to the hospital and on the way, I stopped at the funeral home and did a medical examiner death investigation on two kids that were high, getting chased by the police and drove into a tree. I went into the hospital, admitted my maternity patient, who was one of my best friends' wives, saw two or three other patients and then went into the ICU and held the hand of a guy that was later to pass away that evening. So that was back when rural medicine was...
May: Yeah, that was fun. We got to do all the ORs man. We did the training. We did autopsies on patients.
Tim: Well, you did in training. Not in the United States. They were Canadian autopsies. "He looks pretty dead, eh? Oh, he has been outside. He is really stiff".
John: I don't know. Sounds like family medicine there. You really had rural family medicine.
May: Yeah. And true call. I don't miss those days. I do miss taking care of patients in hospital, but now we've over the years transitioned into urgent care. Me first, and then Tim. And fast forward to some big career changes in the last few years. Now we're doing a podcast which will be our 48th episode. And it's been pretty successful, pretty fun. It's been like a dream in the making because we talked about it for the past couple of years. I'm like, why don't we do a podcast? And then it didn't really happen until a few things. It's interesting how things fall into place. As I was saying before yours was the very first podcast I ever listened to, John.
John: I'm honored.
May: I was in a bad way in 2019 with our careers. I was basically ready to pull the plug big time. And so, I was looking for some nonclinical career alternatives and was binging on your show. As I was saying, I was out in the garden. It was just one after the other, after the other. And then, I loved the ideas in this show. And then we got hooked up with our financial planner through your show because he was on. And then long story short, when the Doctor Podcast Network was created by Ryan Inman, then he basically invited us to be part of that. And that's sort of the summary of how we got to where we're at with the podcast.
John: Excellent. We're going to talk a lot about the podcast, but I do have to pause for a minute and talk about your work currently clinically. This podcast obviously is aimed at those that are doing nonclinical, but the thing is the only reason it's aimed at those people is that it's a solution to the problem is they hate what they're doing, most of the time or they're disabled or they don't like medicine anymore for some reason.
I'd love for more people to stay in medicine. Obviously, I need someone to take care of me and my family and all that. Where does that stand with you? If you're both doing it, I know maybe, May, you're not doing it quite as much. Tim, we'll maybe start with you. What is it that's keeping you in clinical medicine? And what did you change? Because I assume there was a point where maybe it wasn't as fun as this moment. What about it is fun? What keeps you in it?
Tim: Well, I think it's really straightforward. It's weird. The frog being boiled in water analogy is reused ad nauseam because it's largely true. And I kind of hit the wall in family practice. Especially when I was sitting on lots of committees and doing utilization management and I really understood the new regulations in the ACA and metrics and MIPS and macro and so forth, I really felt like the light at the end of the tunnel was the oncoming train. And I knew that if I didn't get out of medicine and do something different or do medicine in a different way, there was no way I was going to tolerate it. The metric ticking just made me insane. Because I felt that it was morally wrong. It was morally wrong to do things for a patient because it really only benefits me and my healthcare system and not the patient. And that was an absolute nonstarter.
May: Yeah. That drove me crazy. I got out in 2010 from family practice because even then it was coming into where we were working and I'm like, "I can't do this".
Tim: Right. And then I moved over to urgent care. May followed me into that and really enjoyed it, but then the burdens of just the corporate structure in medicine started to become way more than I wanted to deal with. We left a practice business we'd been involved with for 25 years about a billion-dollar a year multi-specialty multi-hospital system. Kind of a medium-ish sized. I found, again, a medium-sized physician group, which was great. I worked there for a couple of years, then they got bought out by the single biggest for-profit healthcare entity in the world and we're like, "Okay, we're done. We're not going to do this".
Again, the frog is being boiled in water. You start to blame medicine. Is it the patients? Is it me? Have I done the career too long? Or is it the way I'm doing it? And so, now what we're doing, which I think is one of the three or four alternatives' people have if you're getting fed up, especially in the corporate structure of medicine, is that we joined one of our former residents and started a private clinic.
And really what's honest to goodness, what's keeping me going, it's exactly the same thing that really had me leave primary care, which is sort of this moral ethic of what are we supposed to do as doctors. And so, we're in a private clinic and we're in one of the only places, I don't understand this, but we will see sick COVID patients.
In three months, we have become the go-to place for sick COVID patients. We don't prescribe ivermectin. We have none of this kind of fringy stuff, we've stayed right on the train tracks. We've somehow managed to secure some of the most robust supplies of monoclonal antibodies in the entire state. We're aggressive with treating people. We treat people with steroids. We treat them with aspirin. We stay exactly with what we think the emerging data is telling us. And it has been amazingly successful and personally has been amazingly gratifying because you feel like you're actually part of the solution rather than "Yeah, just stay home until you're blue and then call the ambulance and get put on a ventilator and hope to God you don't die". And so, for me, again, what's driving me both from personal satisfaction and a career part is the moral aspect.
May: And I think it comes full circle. We've been doing this for almost 30 years. Back in the day, it seemed weird, because I don't feel like we're that old, but back then you'd have control in your little clinic, even though you could be part of a big group. You are kind of left alone to say how you wanted to run your practice and do things. And there was no insurance company kind of keeping an eye on every little thing you did. And now we're in a situation with our own, this private little group, where we get to decide how we want to take care. There's insurance, but yet you still have enough autonomy right now, especially doing urgent care, that you don't have to do the MIPS and macro, you can decide how you want the office to run. There's the plus and minus of hiring your own people. But you have so much more say than being a cog in the wheel as I always said, like the Walmart checker, I just show up to see patients. I have no say, I go home.
Tim: And that's the thing, right? Part of it is a respect issue. I've been on tons of different committees, parent board of the corporation I worked for previously, et cetera, et cetera. And it's like, "Okay, so you don't want to listen to what I have to say?" Not to toot my own horn or whatever, but right, wrong or indifferent, I'm exactly who you should be canvassing for information. I've got tons of clinical experience. I've got tons of leadership experience. The recognition you get is it's your turn to be the McDonald's employee of the month. And I'm like, "Eh, no, thanks. I can do this on my own much better than I can with somebody else".
John: In the group that you're in now or part of, or owner of, what have you. You feel like you're totally engaged and you have a say in everything that goes on, nothing's going to be just done to you at this point, other than let's say the occasional insurance company.
Tim: Well, exactly. Obviously, you got to obey the law.
John: Avoid the lawsuit.
Tim: Right. You practice good medicine, you obey the law, you treat people with dignity, and of course, there's going to be insurance BS, but there's insurance BS everywhere. I mean, that's just life.
John: That sounds good.
May: Listening to podcasts, and people that have started their own cash-only business or concierge practices. It's no wonder that people are embracing that and it's starting to take off again because it's really allowing physicians to practice on their terms. You got to have the business sense, but that could be figured out, but they just do it all the time. Why can't physicians, right? I mean, how many dentist groups do you know? That's why I think these small concierge practices and people getting innovative and cash only groups, direct patient care. I do have COVID. My COVID brain is not working so great.
Tim: When you work in a COVID clinic, you get COVID.
John: Yeah, yeah. For sure.
May: That's why I think these new types of practices are coming full circle again, and people are liking it because it's like, "Yes, I got my autonomy back under my terms". And I respect the bigger organizations and the fact that yes, you have to have those in these academia-type settings. And for some people, they like that, it works for them. But I think long haul, probably not.
Tim: But the fact is, two things can be true at the same time, right?
May: Yes.
Tim: Like if you look at the pharmaceutical industry, people say "I hate big pharma. Big pharma's evil". And I'm like, okay, well, when Bayer was part of the consortium that built Zyklon B in World War II to gas people, that's pretty evil. That's objectively evil. When they developed aspirin, not so much. Take for instance the pandemic. If you're going to roll out monoclonal antibodies, if you're going to roll out vaccines, if you're going to roll out antivirals, little pharma isn't going to do that. You need these gigantic infrastructures to do that. You need big hospital systems with super elegant pet scans and MRIs and things to do really specialized stuff. So, you can have direct primary care where you pay a membership, you see your doctor, you have great access and you can have big gigantic things. They're immoral. Some of them are good, some of them are bad. And you got to see what works for you.
John: May, based on the little conversation before we start the podcast, you're feeling a little slightly different, I think, than Tim in terms of where you are in that spectrum and what's driving that and what are you thinking about doing long term?
May: Yeah. My feelings with the whole thing are a little different from the fact that I always said, I don't know why you get these things in your head but when I got to 50, I was going to be done medicine. I don't know where that came from.
Tim: Whoops yeah.
May: Whoops is right. It's called kids in college with big bills and bad planning. It's weird. I always had this. I call it bipolar relationship with medicine. Some days I'd miss it so bad when I was at home with the kids or doing other things and then I'd be there and I'd be like, "Eh, okay, I'm kind of burnt out. I'm kind of done with this". What really hit me was probably the mid to 20-teens. Like I said we went through a big thing at work in 2019. We'd been there 25 years.
I started listening to your podcast. I'm like I got to do something different. And Tim's like, "Well, you're a great doc. People love you. Maybe it's just the situation. Why don't we try it under different terms?" Which we did. We move to that smaller group. It was physician-owned and run. I'm like, "Yes, I'd like this idea. This is better. We should have more say". And that started off great. I was starting to love medicine again and I'm like, "Okay, this is good" until a year and a half into it, I was the same kind of thing. Red flags started coming up for me. I could do the job well, but I was just unpassionate about ticking all the boxes. And then we got bought out by the massive...
Tim: $387 billion a year.
May: Yeah. You go figure it out who bought us out. And then, it was awful. To the point where you just have no say again and I would literally be on the road driving home because we had a commute. It was like 45 minutes, with the feeling like I just wanted to drive into the back of this semi. I hated it so much. And that's a horrible, horrible feeling to have. And yet we'd set ourselves up with these goals and things with our kids, getting them through college and financial plan. And not that I couldn't just pull the plug, but I had a contract and I couldn't just hop out.
So, it's an awful feeling because you're like, I can do this job and make really good money. It's easy to make this money at this point in my career because you can just show up and it's not almost remote, but when you've done it for 30 years and you're good at it, and you recognize your boundaries and you set yourself up, well, it's not hard to make really good money as a physician doing this. And so, to just go, "Eh, I'm going to just quit. I'll go work at Starbucks because I'll be happier. I'll go sell clothes at the retail store. I might have no stress, but I mean, who wants to make no money?" You know what I mean? And so, it's a horrible place to be. You're like, "Well, what am I going to do?"
And then along came this opportunity with our friend and previous resident and I was like, "Okay, maybe. This is a whole new thing. Maybe I'll learn to love medicine again". This really just started in July and I've been helping out, but I'm quickly finding that. And I love being able to help patients and it's a community of people where we've been for the last 25 plus years and we're well respected and I love these people, but my heart is just not in the medicine anymore.
I'm really right at a point right now where I'm going to be diving back into your show and your app and everything and trying to just figure out, "What is it that May needs to do for this next phase of her life?" Because I'm at the point, this real tipping point right now, where I can't do this anymore, the clinical part.
John: Well, thank you for sharing that. I've always felt, or at least I've learned lately that there's a lot of mental stress in practicing medicine, even if we see it as routine oftentimes. But the reality is if you really think about other jobs where people spend 8, 10, 12 hours making really serious decisions day after day after day. We don't realize how that it's just not normal. And you can be stoic and you can be resilient and whatever but I think most physicians are ready to retire after 20, 25 years. It's just too much. And just because we're worn out.
May: Yeah. My whole story would be for another podcast itself. And it's not unique because I've heard other people talk about their career paths and how they ended up in medicine and pressures and was it something they wanted to do or not. And then you kind of learned to make it your own and take responsibility.
But the gist of it now for me is "Where am I going with this?". It's trying to just recognize that I've also had a lot of physical handicaps along the way. I have severe migraine disease, which have made it through some autoimmune issues as well. And I've had mentors and physician teachers along the way, who are like "Go, get out. You can't do this job because of your health issues". And I managed to be tough and make it work. But the hard part is this pride factor. Partly it's like, "Well, I'm a doctor. That's how I identify. What am I going to do? Can I just go work at a wine shop?"
Tim: You live in Oregon. It will be a weed shop.
May: There's the pride factor. You're in a small community. It's like, no, I quit. Figuring out what you want to do, it's scary. And so, just jumping into the nonclinical career realm and looking, it is a scary thing to own all that.
Tim: Well, if I can wax philosophical because I was listening to this and you're bearing your soul to a large degree, which I think is really powerful. We were at a golf fundraiser for an event and the guy there was, Darren Clarke, who's a professional golfer. He won the Open Championship seven years ago. And he said the difference between recreational golfers and professional golfers is recreational golfers play from the tee to the green. Professional golfers play from the green to the tee.
In other words, they're seeing where they want to end up for their putt and that is how they base every single shot all the way back to the tee box. And it reminds me, professional life people, people that do really well at life, play from the green to the tee, not the tea to the green. And so, you know that if you're blessed with old age, you should probably save some money. You know that you're going to have to do a job to get that. And you want it to be somewhat satisfying. And so, it's really interesting because when you listen to those surveys where they've talked to people that are terminally ill "What are your greatest regrets?" Overall, the greatest regret is that you did not live your life based on your terms. You lived it based on the terms that other people placed on top of you. And doctors are really, really good at living based on other people's terms.
And so, I would challenge the listeners. If you're at this place where May was, it reminds me of the song by Rush and the course is "We will pay the price, but will we count the cost"? When you're at a place in your career where you're like "Should I drive the back of the semi?" That's a real thing. Physician suicide is a real thing, but it's not that elevated in men. It's wildly elevated in female doctors. It's a complete aberration in all suicide statistics because women generally are smart enough not to kill themselves. And so, you can make money, you can do this for a long time. Making money actually is fairly easy because the more experience you have, the easier the job is. But if it costs you your soul, what have you gained?
John: Yeah, exactly. Well, more to come on that May. We'll have to have you come back here down the road and see what's transpired. Again, thanks for sharing that. Now I want to shift gears to the podcast. Just from listening to the podcast, there's a lot of these things we were talking about today, intertwine in that and the guests you have. There are very interesting topics. I was looking back through some of them and I was reminded that in addition to doing a lot of interviews, and you have some sort of extras, like the "Doctales with Cocktails" and the "The Doctor As Patient". So just give us the whole low down on the podcast and how those different aspects evolved and where things are today.
Tim: Well, it's called BS Free MD for a reason. I was getting fed up with BS in medicine since I almost started.
May: Yeah, and as we say, it's actually as part of the tag in our show at the end, I believe, but even on our website, as you can imagine us being married together, talking. I mean, shop talk at home is just the way of the norm.
Tim: And drove our children insane.
May: Literally. But we always are having conversations and Tim is always exploring all these things in medicine. Why are we doing this and him being so experienced in all the committees, the background in business, et cetera, would be just questioning so much, not just the clinical stuff that we do, but the nonclinical. And we're always having these conversations. Finally, just for lack of me needing a different audience for him, I'm like, "Why aren't we just doing this?" Our friends always laugh at the conversations we have together, the way we play off each other. But I'm like, "Why aren't we doing this as a podcast where people can hear this?" Because we're just sitting here talking about it over and over and over.
Tim: Well, we would debate. The thing is May and I disagree often on medical stuff. And that's important. The healthy debate is really critical and she always plays devil's advocate. The BS free part is really, we're going to be on, we're honestly sharing our hearts and we're sharing information about healthcare, where we see something that doesn't really make sense. We're not saying we have the answer by any means, but we'll try to help tease that out. And so, we've had some really interesting interviews.
May: The whole gist of the show is that we wanted it to be about topics that are pertinent and that are current. Because we encourage not just clinicians to listen but nonmedical patients to listen as well so that they can understand what's going on. And we try to phrase everything in a way so that you can be a clinician or not so that you understand the conversation because this is the kind of thing we do in front of patients. And also, we're fun people. We have an E rating. We like to tell stories about where we've been and that was the genesis for the "Doctales with Cocktails". It's to share stories of our career on the way, obviously maintaining HIPAA, not giving anything away about patients, but some fun things that we've done and seen, and or the colleagues have experienced.
We actually started to get to know some interesting physicians and I'm like, "Wow, physicians, and their patients too, they've had some crazy things happen to them". And I'm like, "What a better story to tell than the doctor is patient and what their experience was because I've been a patient unfortunately too many times". And it is very different on the other side of the exam table when you're under the knife or having something go on. It changes how you deal with your patients and look at them with that. We've incorporated that and are always looking for more stories to tell as far as the doctor's patient series.
Tim: Yeah. There are a couple of things I'm really particularly proud of. One is we went through the opioid crisis from several different angles. The first off calling BS on our profession because we really started it. It was really terrible research and groupthink that started prescribing a long opioid for chronic pain, which I think was obviously a total disaster. And then, of course, drug companies saw an avenue, and the piling on continued, even with regulators. Pain is the fifth vital sign, which made my head spin around and puke green stuff like Linda Blair because that is completely idiotic. How can something subjective be a vital sign?
We went through that and then we interviewed a guy named Ben Westhoff. He wrote a book called "Fentanyl, Inc" where he as an investigative journalist posed as a drug dealer and infiltrated China's fentanyl labs, which was fascinating to see at least. And then we brought it full circle in there and we interviewed some friends of ours who lost a child to an accidental fentanyl overdose. Oh. And that was... Get a box at Kleenex for that.
May: Very powerful.
Tim: Very powerful. And they were so gracious and open. It actually gives me kind of chills even thinking about it now. And then we go all the way from there to interviewing Steve Torrence who's the four-time world champion, top field dragster champion who's had some health challenges, and managed to do this super intense job and get through some health crises. And then of course the COVID stuff we've done with Peter McCullough and Harvey Risch and kind of are challenging some of the groupthink that we think is going on in COVID as well. Which really helps spur at least my passion for early treatment. This is not a curable illness necessarily, but it's definitely treatable. And doctors need to not be scared to see sick people.
John: Now I take it that, and I notice this because I'm podcasting, things change over time and we think we're going in it in one direction. But I think you've sort of described a little bit, but what do you see going over the next 6 to 12 months more of what you've been doing recently? Are you looking to expand with different types of guests?
May: Well, we're going to continue what we have been doing. We do have a little dream planned that we don't want to totally give away.
Tim: No one steals your dreams because your dreams are way too hard for someone else to do. We'll talk about it. We'll share it.
May: Actually, Tim loves history and I love watching some of these shows on TV and dirty jobs and things where they have history of what's going on around the world. And I'm like, "What about what's going on in medicine or the history of medicine across America?" We love to travel and I'm like, "What if we could start doing some podcasts on medicine across America and key places in the US, North America even, where things have been discovered, have been game changers and would be kind of fun to take the audience there and discover part of America.
Tim: We do that on video and drive one of our old cars.
May: We would like to actually consider doing that as a video series and traveling around. And so, expanding the podcast, but also doing some video.
Tim: Kind of Smokey and the Bandit meets Marcus Welby and Ted Nugent.
May: Oh my gosh.
John: Well, now that it's out into the world, now we're going to hold you to it. You're going to have to do it now.
May: The famous videographers that want to put us or help us out other than us holding up our selfie cam.
Tim: Because that we don't know anything about.
May: Yeah. But that is kind of where we see it going. That's what we'd like to do anyway.
John: Now you've also mentioned some of these really interesting guests. Have some of those people changed the way you look at things? Did you have any "aha" moments from some of those guests that you would want to share with us? I found the whole union thing very interesting. Just personally it's like, yeah, we need to do something like that. At least in those areas that need it. But there are probably dozens of other things that you've probably experienced during this year.
Tim: There's a couple. The one that comes to mind is the most intensely kind of "Oh boy" was Harvey Risch, who's the Yale epidemiologist. And it wasn't so much what he said about COVID or whatever, but it was really the fact of how his entire life has been reading studies, producing studies, doing research, and then educating the next generation of physicians on how to critically appraise data and produce good data. And essentially, he just turned a spotlight on how much absolute garbage science there is.
John: It's like fake news, right? Garbage science.
Tim: And how so much is just nonsense and to get really good data and to not be able to poke holes in it and to look at how studies are done, how the math is done to determine that, et cetera, et cetera. That one really changed my entire outlook on a lot of what we get. This is a little bit cynical, but I think it's actually true. So many physicians are just kind of what the drug rep says is what we do, because it's easy because we like shiny new things. Let's be honest, drug companies wouldn't spend hundreds of billions of dollars on advertising if it didn't work.
John: Absolutely.
May: For me, we did a two-part series with Dr. Peter Breggin, who I thought I knew nothing about until his wife who co-writes with them, reached out to us through one of the COVID groups were part of and wanted us to talk about his book "We Are the Prey", and what's going on with COVID. And I'm like, this could get a little bit kind of crazy.
Tim: We thought it would be like a major tinfoil hat session.
May: Yeah. And then when I started doing some background and looking into who he was, I'm like, "Oh my gosh, I've heard of his books. I remember Prozac Nation and all the things that he's written". And I remember he was back on Oprah. And then when I realized he was the key psychiatrist in putting it into lobotomies, I was blown away. We wanted to do a lot of focus with him on mental health in America and the ending of the lobotomy phase of things. He's a sweetheart and he's very much against just throwing SSRIs at patients or throwing any psychotropics. At first, I was like I don't know if I agree with this, but it makes me feel like, maybe this is the next wave of not like the opioid crisis, but as doctors, we know that mental health isn't getting enough attention in America and it's too easy to just throw pills at patients and it makes me think, yeah, maybe that will be the next thing of the future. If we ever get enough funding and focus on mental health, that we've just tossed pills at everybody that comes in "Here, take your Prozac. Here's your Zoloft. Go away". And it was really eye-opening from that.
Tim: Especially when you have somebody who's still seeing patients and it is sharper than you and me personally. And he is 85 years old. That speaks volumes. But the other thing about it that's really interesting is don't forget common sense. I did a talk at a CME luncheon one day a couple years ago. And I talked about how so much of what we do in medicine is not really medicine. It's not necessarily data-driven, we do it to bill. What's really worked great in healthcare, the greatest thing ever to happen in the history of public health is sewer systems and clean water clearly. Then followed very closely by childhood vaccines for lethal illnesses and then maybe antibiotics. And then after that, everything else is almost window dressing, but we charge a lot for it. And it was great because I talked to one of the psychiatrists there, who I was friends with, and he was a really honest guy. And he had like 30, 35 years of experience. And he goes, "Yeah, you're right. If all these psych meds we gave to people really worked, why am I seeing the same people every week?"
May: Yeah. You asked where we're going in the future and we're reading some really interesting books right now. And I guess we aren't usually afraid to sort of step into a bit more controversial realm in medicine, but try to be respectful of both parties. And I think in the future, there are a few topics we would like to delve into in what we're doing in healthcare, especially in the gender realm, which we might like to push.
Tim: Well, with children specifically. We'll see if we can secure those interviews. One interview that's coming up that we are super-duper excited about is with one of the world's foremost experts on the gut microbiome and stool transplant, and that will have the engaging title of each and live.
May: Yeah.
John: No asterisks or any other...
Tim: Maybe.
May: Okay. Maybe a little proof emoji at the end of it.
John: We're getting down to where we might have to leave soon, but I wanted to mention a couple of things before we get to that point or saying goodbye. And that is that BS free MD, obviously that's the podcast and the website's the same, just bsfreemd.com. And then you're on Facebook and you're on Instagram. Anything I'm missing?
May: No, that's it. Yeah. Occasionally we'll do live streams. That's how we got started before the podcast. It was a Facebook livestream and we will go on there, answer questions, engage with our audience.
John: That's cool. They should go to the Facebook group and engage in that and then catch whatever live streams when they come up. And do you give little advanced notice about what the upcoming podcasts are going to be and that kind of thing?
May: We try to, sometimes it's the same day, but we usually absolutely do put a little event ahead of time. So, someone can get the ticker clock counting down till the day.
John: All right. We'll put links, of course, in the show notes. Now the last thing I usually do is, given everything we've talked about, can you each give your advice or just words of encouragement for listeners who are frustrated with their practice or burnt out or any of the above? And going through some of the things maybe you're going through, May, what advice would you have for them?
May: Well, I think Tim should give his little fast tennis court dog poop analogy. My point is that you invest a lot into medicine, money nowadays, money, as well as time. And our whole 20s disappeared as far as training. And so, I get a little sad sometimes when I get in some of these Facebook groups, and I see people who are so disgruntled and giving up when they've just completed residency, they're burnt out already or two or three years into practice.
And part of me says, "Eh, did you really know what you were in for?" And maybe I want to blame the residency for maybe not training people appropriately. But giving up a little early, I would say try something else. Because we need great doctors, we need doctors to continue to practice. And sometimes it's not the right fit, it's not the right place. And I have done that numerous times from changing from family practice to urgent care because it's more of what we were really trained to do to different settings, filling in, doing some locums locally, but different group styles from big giant Corp to totally small physician ones. So don't necessarily think it's you, explore other options before you decide to really pull the plug because you can find joy in medicine possibly. It doesn't mean you will, but I don't want to see good doctors give up too soon. That would be my advice.
And another thing it would be what Tim has done that I didn't do is start feeling out some nonclinical options while you're still there to see if it's a fit, whether it's some committees, to see if you're really interested in that. Because for me, that type of thing, the corporate committee was never my thing.
Tim: And sometimes you'll realize it's not your thing. And it was good you tried it out so that you don't get burned out and then go into something that you hate even more.
May: Anything you want to say?
Tim: Well, if you want the dog poop tennis court very quickly?
John: Yes.
Tim: Imagine that you have this beautiful park, and in it is this wonderful private tennis court, and you're a tennis player. You've grown up playing tennis your whole life and you love tennis. Well, what happens is: as the housing development around the park changes, there are all these people that decide that they all have to have dogs and they make it into a dog park. And then they say, well, we'll just pay for all the dues for the tennis court. We'll take care of the tennis court. But what they do is they use the tennis as essentially the big dog bathroom.
And so, you're still out there trying to play tennis. And as time goes by, you don't really notice it at first, but after a while, you're like, "Man I'm slipping in a lot of dog poop when I'm playing tennis". And then you're hitting the ball and it's like splashing like a fresh Labrador. And you're like, "This is terrible. I hate tennis". And in reality, you don't hate tennis. You hate the way you're playing tennis because you're playing tennis on dog poop. And I think a tremendous amount of what happens in medicine is people like "I'm burnt out on medicine". No, you can't be. You can't be burnt out on anything in five years. I'm sorry. You did a residency. You got into medical school. I call absolute BS on that. But you can absolutely be burned out on all the dog poop they put on you.
I think it's really important to differentiate "Do I just need to do this in a different court or did I pick the wrong career?" Because people clearly pick the wrong career but when you see the number of residents coming out that are burned out so quickly, I think it's the venue you're playing in and not the game you're playing because medicine is super rewarding. It's amazing. But nothing is more frustrating when you take your time, hundreds of thousands of dollars, and your passion for helping people, and have it blocked by somebody with a 10th of your training. Nothing. It makes the dog poop look like nothing. And so, there are other ways to do this. We're going to be doing other episodes as far as nonclinical careers, different ways of practicing medicine, and really, listen to the union one. I've never really been a union guy. I've always prided myself in being kind of more to the right of center. But this one was absolutely eyes wide open.
John: Yeah. That was excellent. And your guest really said, okay, this is what has to be going on for a union to be considered. You put it really so clearly. It's not like, "Well, we're just unhappy so we're going to form a union". No, that's not how it works. Very good. All right. Well, I want to thank you both for being here today. This has been fantastic. I've had a really good time and we'll have to do this again sometime.
May: Yes. When we're famous people on the history channel then you can ask us how that's going on? That's our dream and we're having fun doing the podcast. And it's been an honor and pleasure to be here and chat with you today.
John: It's been my pleasure. We'll see you soon. Take care.
May: Bye.
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Transcription PNC Podcast Episode 226
Get No-Nonsense Medical Information at the Awesome BS Free MD Podcast
John: I met May and Tim through the Doctor Podcast Network. And we have both been meaning to get together for almost a year. They produced the BS Free MD podcast.
I've done a thorough analysis of their shows, and I can confirm that it's at least 90% BS-free. Now there was a time back last April, you might want to check that out, when they kind of went off the rails there, but anyway, Doctors May and Tim Hindmarsh, welcome to the PNC podcast.
May: Hello. Thanks for having us. We're super honored and excited to be here.
Tim: Absolutely.
John: Well, it's good to have you here. We've been meaning to do this for a while and I don't know, we get busy and then we forget. I've got some mild dementia so that doesn't help. But anyway, like we do with all of our guests, I think I'd like to hear each of you tell me a little bit about your background education and up to what you're doing now.
Tim: All right. Well, we were both educated in Canada. I was actually educated in my hometown.
May: Born and raised.
Tim: Which was Saskatchewan. And that's actually pronounced correctly because it gets pronounced all sorts of different ways. I went to the University of Saskatchewan. May was from Northern Manitoba. We met in medical school. We actually got married three days after we graduated, and then went on a three-week honeymoon. And then we went into residency straight after that, which was not a honeymoon by any stretch.
May: Yeah, if you want to challenge your marriage and see if it's up to the test, just jump right into residency after getting married.
John: Let me interject there for a minute. I got married in my second month of medical school. Needless to say, it didn't last.
May: Oh, I'm so sorry. So you understand.
John: Maybe, but it's rough.
May: No kidding. Well, just some extra info. My sister who's seven years younger than me moved in with us, six months into our internship year. Basically, we joke about it now. She's really cool about it but was an undiagnosed bipolar patient. She basically was like Garfield in our home. Except for at night when she would go out like a cat. It was really bad. And you talk about a lot of stress in a marriage. But anyway, we did our internship and residency in Edmonton, Alberta, Canada. And then as we were talking earlier, we actually got recruited to move to the US because things were changing in the states with healthcare. And did HMOs come into play?
Tim: Well, it was managed care, and we were family doctors.
May: And the landscape was changing in Canada because the government put some restrictions on physicians back then where you couldn't move or work anywhere, except for wherever you did your training, which meant you would not get paid. What happened was there was a big exodus to the US back then in the 90s.
We got heavily recruited and decided we were going to come down to Oregon is where we chose. But while we were waiting, we actually did urgent care back in the day before urgent care really was known. It was called minor emergency care. We did that for a few months while waiting and then we zoomed down to the US.
Tim: Yeah. 98% of deciding where to live was based on recreation.
John: Oh, that's good. That's good to follow.
Tim: Literally I spent summers in the Gorges windsurfing and I was like, I want to be close to that place. I used to live in Whistler, so I skied tons. I need to be two hours from all of these different places. I want to practice rural medicine. And May was like, "Yeah, get me a house in the woods and I'm happy". So that's kind of how it ended up.
May: Yeah. We basically lived here in Oregon in the Pacific Northwest since then in the exact same house, against what some financial planners would say. We actually have been in the exact same home since 94, our dream house. We raised our kids. We're now empty nesters and have had a varied career.
I practiced mostly part-time family practice and then transitioned into urgent care. Tim has had a wildly diverse career from family practice to OB. And we both did hospital medicine too. Back in the day, we'd take care of on-call and patients in the hospital ICU. We did all that. But he's had a lot of non-clinical career experience over the years. He's been on every committee. If there's a committee, he's been on it.
Tim: I had a Saturday where I drove to the hospital and on the way, I stopped at the funeral home and did a medical examiner death investigation on two kids that were high, getting chased by the police and drove into a tree. I went into the hospital, admitted my maternity patient, who was one of my best friends' wives, saw two or three other patients and then went into the ICU and held the hand of a guy that was later to pass away that evening. So that was back when rural medicine was...
May: Yeah, that was fun. We got to do all the ORs man. We did the training. We did autopsies on patients.
Tim: Well, you did in training. Not in the United States. They were Canadian autopsies. "He looks pretty dead, eh? Oh, he has been outside. He is really stiff".
John: I don't know. Sounds like family medicine there. You really had rural family medicine.
May: Yeah. And true call. I don't miss those days. I do miss taking care of patients in hospital, but now we've over the years transitioned into urgent care. Me first, and then Tim. And fast forward to some big career changes in the last few years. Now we're doing a podcast which will be our 48th episode. And it's been pretty successful, pretty fun. It's been like a dream in the making because we talked about it for the past couple of years. I'm like, why don't we do a podcast? And then it didn't really happen until a few things. It's interesting how things fall into place. As I was saying before yours was the very first podcast I ever listened to, John.
John: I'm honored.
May: I was in a bad way in 2019 with our careers. I was basically ready to pull the plug big time. And so, I was looking for some nonclinical career alternatives and was binging on your show. As I was saying, I was out in the garden. It was just one after the other, after the other. And then, I loved the ideas in this show. And then we got hooked up with our financial planner through your show because he was on. And then long story short, when the Doctor Podcast Network was created by Ryan Inman, then he basically invited us to be part of that. And that's sort of the summary of how we got to where we're at with the podcast.
John: Excellent. We're going to talk a lot about the podcast, but I do have to pause for a minute and talk about your work currently clinically. This podcast obviously is aimed at those that are doing nonclinical, but the thing is the only reason it's aimed at those people is that it's a solution to the problem is they hate what they're doing, most of the time or they're disabled or they don't like medicine anymore for some reason.
I'd love for more people to stay in medicine. Obviously, I need someone to take care of me and my family and all that. Where does that stand with you? If you're both doing it, I know maybe, May, you're not doing it quite as much. Tim, we'll maybe start with you. What is it that's keeping you in clinical medicine? And what did you change? Because I assume there was a point where maybe it wasn't as fun as this moment. What about it is fun? What keeps you in it?
Tim: Well, I think it's really straightforward. It's weird. The frog being boiled in water analogy is reused ad nauseam because it's largely true. And I kind of hit the wall in family practice. Especially when I was sitting on lots of committees and doing utilization management and I really understood the new regulations in the ACA and metrics and MIPS and macro and so forth, I really felt like the light at the end of the tunnel was the oncoming train. And I knew that if I didn't get out of medicine and do something different or do medicine in a different way, there was no way I was going to tolerate it. The metric ticking just made me insane. Because I felt that it was morally wrong. It was morally wrong to do things for a patient because it really only benefits me and my healthcare system and not the patient. And that was an absolute nonstarter.
May: Yeah. That drove me crazy. I got out in 2010 from family practice because even then it was coming into where we were working and I'm like, "I can't do this".
Tim: Right. And then I moved over to urgent care. May followed me into that and really enjoyed it, but then the burdens of just the corporate structure in medicine started to become way more than I wanted to deal with. We left a practice business we'd been involved with for 25 years about a billion-dollar a year multi-specialty multi-hospital system. Kind of a medium-ish sized. I found, again, a medium-sized physician group, which was great. I worked there for a couple of years, then they got bought out by the single biggest for-profit healthcare entity in the world and we're like, "Okay, we're done. We're not going to do this".
Again, the frog is being boiled in water. You start to blame medicine. Is it the patients? Is it me? Have I done the career too long? Or is it the way I'm doing it? And so, now what we're doing, which I think is one of the three or four alternatives' people have if you're getting fed up, especially in the corporate structure of medicine, is that we joined one of our former residents and started a private clinic.
And really what's honest to goodness, what's keeping me going, it's exactly the same thing that really had me leave primary care, which is sort of this moral ethic of what are we supposed to do as doctors. And so, we're in a private clinic and we're in one of the only places, I don't understand this, but we will see sick COVID patients.
In three months, we have become the go-to place for sick COVID patients. We don't prescribe ivermectin. We have none of this kind of fringy stuff, we've stayed right on the train tracks. We've somehow managed to secure some of the most robust supplies of monoclonal antibodies in the entire state. We're aggressive with treating people. We treat people with steroids. We treat them with aspirin. We stay exactly with what we think the emerging data is telling us. And it has been amazingly successful and personally has been amazingly gratifying because you feel like you're actually part of the solution rather than "Yeah, just stay home until you're blue and then call the ambulance and get put on a ventilator and hope to God you don't die". And so, for me, again, what's driving me both from personal satisfaction and a career part is the moral aspect.
May: And I think it comes full circle. We've been doing this for almost 30 years. Back in the day, it seemed weird, because I don't feel like we're that old, but back then you'd have control in your little clinic, even though you could be part of a big group. You are kind of left alone to say how you wanted to run your practice and do things. And there was no insurance company kind of keeping an eye on every little thing you did. And now we're in a situation with our own, this private little group, where we get to decide how we want to take care. There's insurance, but yet you still have enough autonomy right now, especially doing urgent care, that you don't have to do the MIPS and macro, you can decide how you want the office to run. There's the plus and minus of hiring your own people. But you have so much more say than being a cog in the wheel as I always said, like the Walmart checker, I just show up to see patients. I have no say, I go home.
Tim: And that's the thing, right? Part of it is a respect issue. I've been on tons of different committees, parent board of the corporation I worked for previously, et cetera, et cetera. And it's like, "Okay, so you don't want to listen to what I have to say?" Not to toot my own horn or whatever, but right, wrong or indifferent, I'm exactly who you should be canvassing for information. I've got tons of clinical experience. I've got tons of leadership experience. The recognition you get is it's your turn to be the McDonald's employee of the month. And I'm like, "Eh, no, thanks. I can do this on my own much better than I can with somebody else".
John: In the group that you're in now or part of, or owner of, what have you. You feel like you're totally engaged and you have a say in everything that goes on, nothing's going to be just done to you at this point, other than let's say the occasional insurance company.
Tim: Well, exactly. Obviously, you got to obey the law.
John: Avoid the lawsuit.
Tim: Right. You practice good medicine, you obey the law, you treat people with dignity, and of course, there's going to be insurance BS, but there's insurance BS everywhere. I mean, that's just life.
John: That sounds good.
May: Listening to podcasts, and people that have started their own cash-only business or concierge practices. It's no wonder that people are embracing that and it's starting to take off again because it's really allowing physicians to practice on their terms. You got to have the business sense, but that could be figured out, but they just do it all the time. Why can't physicians, right? I mean, how many dentist groups do you know? That's why I think these small concierge practices and people getting innovative and cash only groups, direct patient care. I do have COVID. My COVID brain is not working so great.
Tim: When you work in a COVID clinic, you get COVID.
John: Yeah, yeah. For sure.
May: That's why I think these new types of practices are coming full circle again, and people are liking it because it's like, "Yes, I got my autonomy back under my terms". And I respect the bigger organizations and the fact that yes, you have to have those in these academia-type settings. And for some people, they like that, it works for them. But I think long haul, probably not.
Tim: But the fact is, two things can be true at the same time, right?
May: Yes.
Tim: Like if you look at the pharmaceutical industry, people say "I hate big pharma. Big pharma's evil". And I'm like, okay, well, when Bayer was part of the consortium that built Zyklon B in World War II to gas people, that's pretty evil. That's objectively evil. When they developed aspirin, not so much. Take for instance the pandemic. If you're going to roll out monoclonal antibodies, if you're going to roll out vaccines, if you're going to roll out antivirals, little pharma isn't going to do that. You need these gigantic infrastructures to do that. You need big hospital systems with super elegant pet scans and MRIs and things to do really specialized stuff. So, you can have direct primary care where you pay a membership, you see your doctor, you have great access and you can have big gigantic things. They're immoral. Some of them are good, some of them are bad. And you got to see what works for you.
John: May, based on the little conversation before we start the podcast, you're feeling a little slightly different, I think, than Tim in terms of where you are in that spectrum and what's driving that and what are you thinking about doing long term?
May: Yeah. My feelings with the whole thing are a little different from the fact that I always said, I don't know why you get these things in your head but when I got to 50, I was going to be done medicine. I don't know where that came from.
Tim: Whoops yeah.
May: Whoops is right. It's called kids in college with big bills and bad planning. It's weird. I always had this. I call it bipolar relationship with medicine. Some days I'd miss it so bad when I was at home with the kids or doing other things and then I'd be there and I'd be like, "Eh, okay, I'm kind of burnt out. I'm kind of done with this". What really hit me was probably the mid to 20-teens. Like I said we went through a big thing at work in 2019. We'd been there 25 years.
I started listening to your podcast. I'm like I got to do something different. And Tim's like, "Well, you're a great doc. People love you. Maybe it's just the situation. Why don't we try it under different terms?" Which we did. We move to that smaller group. It was physician-owned and run. I'm like, "Yes, I'd like this idea. This is better. We should have more say". And that started off great. I was starting to love medicine again and I'm like, "Okay, this is good" until a year and a half into it, I was the same kind of thing. Red flags started coming up for me. I could do the job well, but I was just unpassionate about ticking all the boxes. And then we got bought out by the massive...
Tim: $387 billion a year.
May: Yeah. You go figure it out who bought us out. And then, it was awful. To the point where you just have no say again and I would literally be on the road driving home because we had a commute. It was like 45 minutes, with the feeling like I just wanted to drive into the back of this semi. I hated it so much. And that's a horrible, horrible feeling to have. And yet we'd set ourselves up with these goals and things with our kids, getting them through college and financial plan. And not that I couldn't just pull the plug, but I had a contract and I couldn't just hop out.
So, it's an awful feeling because you're like, I can do this job and make really good money. It's easy to make this money at this point in my career because you can just show up and it's not almost remote, but when you've done it for 30 years and you're good at it, and you recognize your boundaries and you set yourself up, well, it's not hard to make really good money as a physician doing this. And so, to just go, "Eh, I'm going to just quit. I'll go work at Starbucks because I'll be happier. I'll go sell clothes at the retail store. I might have no stress, but I mean, who wants to make no money?" You know what I mean? And so, it's a horrible place to be. You're like, "Well, what am I going to do?"
And then along came this opportunity with our friend and previous resident and I was like, "Okay, maybe. This is a whole new thing. Maybe I'll learn to love medicine again". This really just started in July and I've been helping out, but I'm quickly finding that. And I love being able to help patients and it's a community of people where we've been for the last 25 plus years and we're well respected and I love these people, but my heart is just not in the medicine anymore.
I'm really right at a point right now where I'm going to be diving back into your show and your app and everything and trying to just figure out, "What is it that May needs to do for this next phase of her life?" Because I'm at the point, this real tipping point right now, where I can't do this anymore, the clinical part.
John: Well, thank you for sharing that. I've always felt, or at least I've learned lately that there's a lot of mental stress in practicing medicine, even if we see it as routine oftentimes. But the reality is if you really think about other jobs where people spend 8, 10, 12 hours making really serious decisions day after day after day. We don't realize how that it's just not normal. And you can be stoic and you can be resilient and whatever but I think most physicians are ready to retire after 20, 25 years. It's just too much. And just because we're worn out.
May: Yeah. My whole story would be for another podcast itself. And it's not unique because I've heard other people talk about their career paths and how they ended up in medicine and pressures and was it something they wanted to do or not. And then you kind of learned to make it your own and take responsibility.
But the gist of it now for me is "Where am I going with this?". It's trying to just recognize that I've also had a lot of physical handicaps along the way. I have severe migraine disease, which have made it through some autoimmune issues as well. And I've had mentors and physician teachers along the way, who are like "Go, get out. You can't do this job because of your health issues". And I managed to be tough and make it work. But the hard part is this pride factor. Partly it's like, "Well, I'm a doctor. That's how I identify. What am I going to do? Can I just go work at a wine shop?"
Tim: You live in Oregon. It will be a weed shop.
May: There's the pride factor. You're in a small community. It's like, no, I quit. Figuring out what you want to do, it's scary. And so, just jumping into the nonclinical career realm and looking, it is a scary thing to own all that.
Tim: Well, if I can wax philosophical because I was listening to this and you're bearing your soul to a large degree, which I think is really powerful. We were at a golf fundraiser for an event and the guy there was, Darren Clarke, who's a professional golfer. He won the Open Championship seven years ago. And he said the difference between recreational golfers and professional golfers is recreational golfers play from the tee to the green. Professional golfers play from the green to the tee.
In other words, they're seeing where they want to end up for their putt and that is how they base every single shot all the way back to the tee box. And it reminds me, professional life people, people that do really well at life, play from the green to the tee, not the tea to the green. And so, you know that if you're blessed with old age, you should probably save some money. You know that you're going to have to do a job to get that. And you want it to be somewhat satisfying. And so, it's really interesting because when you listen to those surveys where they've talked to people that are terminally ill "What are your greatest regrets?" Overall, the greatest regret is that you did not live your life based on your terms. You lived it based on the terms that other people placed on top of you. And doctors are really, really good at living based on other people's terms.
And so, I would challenge the listeners. If you're at this place where May was, it reminds me of the song by Rush and the course is "We will pay the price, but will we count the cost"? When you're at a place in your career where you're like "Should I drive the back of the semi?" That's a real thing. Physician suicide is a real thing, but it's not that elevated in men. It's wildly elevated in female doctors. It's a complete aberration in all suicide statistics because women generally are smart enough not to kill themselves. And so, you can make money, you can do this for a long time. Making money actually is fairly easy because the more experience you have, the easier the job is. But if it costs you your soul, what have you gained?
John: Yeah, exactly. Well, more to come on that May. We'll have to have you come back here down the road and see what's transpired. Again, thanks for sharing that. Now I want to shift gears to the podcast. Just from listening to the podcast, there's a lot of these things we were talking about today, intertwine in that and the guests you have. There are very interesting topics. I was looking back through some of them and I was reminded that in addition to doing a lot of interviews, and you have some sort of extras, like the "Doctales with Cocktails" and the "The Doctor As Patient". So just give us the whole low down on the podcast and how those different aspects evolved and where things are today.
Tim: Well, it's called BS Free MD for a reason. I was getting fed up with BS in medicine since I almost started.
May: Yeah, and as we say, it's actually as part of the tag in our show at the end, I believe, but even on our website, as you can imagine us being married together, talking. I mean, shop talk at home is just the way of the norm.
Tim: And drove our children insane.
May: Literally. But we always are having conversations and Tim is always exploring all these things in medicine. Why are we doing this and him being so experienced in all the committees, the background in business, et cetera, would be just questioning so much, not just the clinical stuff that we do, but the nonclinical. And we're always having these conversations. Finally, just for lack of me needing a different audience for him, I'm like, "Why aren't we just doing this?" Our friends always laugh at the conversations we have together, the way we play off each other. But I'm like, "Why aren't we doing this as a podcast where people can hear this?" Because we're just sitting here talking about it over and over and over.
Tim: Well, we would debate. The thing is May and I disagree often on medical stuff. And that's important. The healthy debate is really critical and she always plays devil's advocate. The BS free part is really, we're going to be on, we're honestly sharing our hearts and we're sharing information about healthcare, where we see something that doesn't really make sense. We're not saying we have the answer by any means, but we'll try to help tease that out. And so, we've had some really interesting interviews.
May: The whole gist of the show is that we wanted it to be about topics that are pertinent and that are current. Because we encourage not just clinicians to listen but nonmedical patients to listen as well so that they can understand what's going on. And we try to phrase everything in a way so that you can be a clinician or not so that you understand the conversation because this is the kind of thing we do in front of patients. And also, we're fun people. We have an E rating. We like to tell stories about where we've been and that was the genesis for the "Doctales with Cocktails". It's to share stories of our career on the way, obviously maintaining HIPAA, not giving anything away about patients, but some fun things that we've done and seen, and or the colleagues have experienced.
We actually started to get to know some interesting physicians and I'm like, "Wow, physicians, and their patients too, they've had some crazy things happen to them". And I'm like, "What a better story to tell than the doctor is patient and what their experience was because I've been a patient unfortunately too many times". And it is very different on the other side of the exam table when you're under the knife or having something go on. It changes how you deal with your patients and look at them with that. We've incorporated that and are always looking for more stories to tell as far as the doctor's patient series.
Tim: Yeah. There are a couple of things I'm really particularly proud of. One is we went through the opioid crisis from several different angles. The first off calling BS on our profession because we really started it. It was really terrible research and groupthink that started prescribing a long opioid for chronic pain, which I think was obviously a total disaster. And then, of course, drug companies saw an avenue, and the piling on continued, even with regulators. Pain is the fifth vital sign, which made my head spin around and puke green stuff like Linda Blair because that is completely idiotic. How can something subjective be a vital sign?
We went through that and then we interviewed a guy named Ben Westhoff. He wrote a book called "Fentanyl, Inc" where he as an investigative journalist posed as a drug dealer and infiltrated China's fentanyl labs, which was fascinating to see at least. And then we brought it full circle in there and we interviewed some friends of ours who lost a child to an accidental fentanyl overdose. Oh. And that was... Get a box at Kleenex for that.
May: Very powerful.
Tim: Very powerful. And they were so gracious and open. It actually gives me kind of chills even thinking about it now. And then we go all the way from there to interviewing Steve Torrence who's the four-time world champion, top field dragster champion who's had some health challenges, and managed to do this super intense job and get through some health crises. And then of course the COVID stuff we've done with Peter McCullough and Harvey Risch and kind of are challenging some of the groupthink that we think is going on in COVID as well. Which really helps spur at least my passion for early treatment. This is not a curable illness necessarily, but it's definitely treatable. And doctors need to not be scared to see sick people.
John: Now I take it that, and I notice this because I'm podcasting, things change over time and we think we're going in it in one direction. But I think you've sort of described a little bit, but what do you see going over the next 6 to 12 months more of what you've been doing recently? Are you looking to expand with different types of guests?
May: Well, we're going to continue what we have been doing. We do have a little dream planned that we don't want to totally give away.
Tim: No one steals your dreams because your dreams are way too hard for someone else to do. We'll talk about it. We'll share it.
May: Actually, Tim loves history and I love watching some of these shows on TV and dirty jobs and things where they have history of what's going on around the world. And I'm like, "What about what's going on in medicine or the history of medicine across America?" We love to travel and I'm like, "What if we could start doing some podcasts on medicine across America and key places in the US, North America even, where things have been discovered, have been game changers and would be kind of fun to take the audience there and discover part of America.
Tim: We do that on video and drive one of our old cars.
May: We would like to actually consider doing that as a video series and traveling around. And so, expanding the podcast, but also doing some video.
Tim: Kind of Smokey and the Bandit meets Marcus Welby and Ted Nugent.
May: Oh my gosh.
John: Well, now that it's out into the world, now we're going to hold you to it. You're going to have to do it now.
May: The famous videographers that want to put us or help us out other than us holding up our selfie cam.
Tim: Because that we don't know anything about.
May: Yeah. But that is kind of where we see it going. That's what we'd like to do anyway.
John: Now you've also mentioned some of these really interesting guests. Have some of those people changed the way you look at things? Did you have any "aha" moments from some of those guests that you would want to share with us? I found the whole union thing very interesting. Just personally it's like, yeah, we need to do something like that. At least in those areas that need it. But there are probably dozens of other things that you've probably experienced during this year.
Tim: There's a couple. The one that comes to mind is the most intensely kind of "Oh boy" was Harvey Risch, who's the Yale epidemiologist. And it wasn't so much what he said about COVID or whatever, but it was really the fact of how his entire life has been reading studies, producing studies, doing research, and then educating the next generation of physicians on how to critically appraise data and produce good data. And essentially, he just turned a spotlight on how much absolute garbage science there is.
John: It's like fake news, right? Garbage science.
Tim: And how so much is just nonsense and to get really good data and to not be able to poke holes in it and to look at how studies are done, how the math is done to determine that, et cetera, et cetera. That one really changed my entire outlook on a lot of what we get. This is a little bit cynical, but I think it's actually true. So many physicians are just kind of what the drug rep says is what we do, because it's easy because we like shiny new things. Let's be honest, drug companies wouldn't spend hundreds of billions of dollars on advertising if it didn't work.
John: Absolutely.
May: For me, we did a two-part series with Dr. Peter Breggin, who I thought I knew nothing about until his wife who co-writes with them, reached out to us through one of the COVID groups were part of and wanted us to talk about his book "We Are the Prey", and what's going on with COVID. And I'm like, this could get a little bit kind of crazy.
Tim: We thought it would be like a major tinfoil hat session.
May: Yeah. And then when I started doing some background and looking into who he was, I'm like, "Oh my gosh, I've heard of his books. I remember Prozac Nation and all the things that he's written". And I remember he was back on Oprah. And then when I realized he was the key psychiatrist in putting it into lobotomies, I was blown away. We wanted to do a lot of focus with him on mental health in America and the ending of the lobotomy phase of things. He's a sweetheart and he's very much against just throwing SSRIs at patients or throwing any psychotropics. At first, I was like I don't know if I agree with this, but it makes me feel like, maybe this is the next wave of not like the opioid crisis, but as doctors, we know that mental health isn't getting enough attention in America and it's too easy to just throw pills at patients and it makes me think, yeah, maybe that will be the next thing of the future. If we ever get enough funding and focus on mental health, that we've just tossed pills at everybody that comes in "Here, take your Prozac. Here's your Zoloft. Go away". And it was really eye-opening from that.
Tim: Especially when you have somebody who's still seeing patients and it is sharper than you and me personally. And he is 85 years old. That speaks volumes. But the other thing about it that's really interesting is don't forget common sense. I did a talk at a CME luncheon one day a couple years ago. And I talked about how so much of what we do in medicine is not really medicine. It's not necessarily data-driven, we do it to bill. What's really worked great in healthcare, the greatest thing ever to happen in the history of public health is sewer systems and clean water clearly. Then followed very closely by childhood vaccines for lethal illnesses and then maybe antibiotics. And then after that, everything else is almost window dressing, but we charge a lot for it. And it was great because I talked to one of the psychiatrists there, who I was friends with, and he was a really honest guy. And he had like 30, 35 years of experience. And he goes, "Yeah, you're right. If all these psych meds we gave to people really worked, why am I seeing the same people every week?"
May: Yeah. You asked where we're going in the future and we're reading some really interesting books right now. And I guess we aren't usually afraid to sort of step into a bit more controversial realm in medicine, but try to be respectful of both parties. And I think in the future, there are a few topics we would like to delve into in what we're doing in healthcare, especially in the gender realm, which we might like to push.
Tim: Well, with children specifically. We'll see if we can secure those interviews. One interview that's coming up that we are super-duper excited about is with one of the world's foremost experts on the gut microbiome and stool transplant, and that will have the engaging title of each and live.
May: Yeah.
John: No asterisks or any other...
Tim: Maybe.
May: Okay. Maybe a little proof emoji at the end of it.
John: We're getting down to where we might have to leave soon, but I wanted to mention a couple of things before we get to that point or saying goodbye. And that is that BS free MD, obviously that's the podcast and the website's the same, just bsfreemd.com. And then you're on Facebook and you're on Instagram. Anything I'm missing?
May: No, that's it. Yeah. Occasionally we'll do live streams. That's how we got started before the podcast. It was a Facebook livestream and we will go on there, answer questions, engage with our audience.
John: That's cool. They should go to the Facebook group and engage in that and then catch whatever live streams when they come up. And do you give little advanced notice about what the upcoming podcasts are going to be and that kind of thing?
May: We try to, sometimes it's the same day, but we usually absolutely do put a little event ahead of time. So, someone can get the ticker clock counting down till the day.
John: All right. We'll put links, of course, in the show notes. Now the last thing I usually do is, given everything we've talked about, can you each give your advice or just words of encouragement for listeners who are frustrated with their practice or burnt out or any of the above? And going through some of the things maybe you're going through, May, what advice would you have for them?
May: Well, I think Tim should give his little fast tennis court dog poop analogy. My point is that you invest a lot into medicine, money nowadays, money, as well as time. And our whole 20s disappeared as far as training. And so, I get a little sad sometimes when I get in some of these Facebook groups, and I see people who are so disgruntled and giving up when they've just completed residency, they're burnt out already or two or three years into practice.
And part of me says, "Eh, did you really know what you were in for?" And maybe I want to blame the residency for maybe not training people appropriately. But giving up a little early, I would say try something else. Because we need great doctors, we need doctors to continue to practice. And sometimes it's not the right fit, it's not the right place. And I have done that numerous times from changing from family practice to urgent care because it's more of what we were really trained to do to different settings, filling in, doing some locums locally, but different group styles from big giant Corp to totally small physician ones. So don't necessarily think it's you, explore other options before you decide to really pull the plug because you can find joy in medicine possibly. It doesn't mean you will, but I don't want to see good doctors give up too soon. That would be my advice.
And another thing it would be what Tim has done that I didn't do is start feeling out some nonclinical options while you're still there to see if it's a fit, whether it's some committees, to see if you're really interested in that. Because for me, that type of thing, the corporate committee was never my thing.
Tim: And sometimes you'll realize it's not your thing. And it was good you tried it out so that you don't get burned out and then go into something that you hate even more.
May: Anything you want to say?
Tim: Well, if you want the dog poop tennis court very quickly?
John: Yes.
Tim: Imagine that you have this beautiful park, and in it is this wonderful private tennis court, and you're a tennis player. You've grown up playing tennis your whole life and you love tennis. Well, what happens is: as the housing development around the park changes, there are all these people that decide that they all have to have dogs and they make it into a dog park. And then they say, well, we'll just pay for all the dues for the tennis court. We'll take care of the tennis court. But what they do is they use the tennis as essentially the big dog bathroom.
And so, you're still out there trying to play tennis. And as time goes by, you don't really notice it at first, but after a while, you're like, "Man I'm slipping in a lot of dog poop when I'm playing tennis". And then you're hitting the ball and it's like splashing like a fresh Labrador. And you're like, "This is terrible. I hate tennis". And in reality, you don't hate tennis. You hate the way you're playing tennis because you're playing tennis on dog poop. And I think a tremendous amount of what happens in medicine is people like "I'm burnt out on medicine". No, you can't be. You can't be burnt out on anything in five years. I'm sorry. You did a residency. You got into medical school. I call absolute BS on that. But you can absolutely be burned out on all the dog poop they put on you.
I think it's really important to differentiate "Do I just need to do this in a different court or did I pick the wrong career?" Because people clearly pick the wrong career but when you see the number of residents coming out that are burned out so quickly, I think it's the venue you're playing in and not the game you're playing because medicine is super rewarding. It's amazing. But nothing is more frustrating when you take your time, hundreds of thousands of dollars, and your passion for helping people, and have it blocked by somebody with a 10th of your training. Nothing. It makes the dog poop look like nothing. And so, there are other ways to do this. We're going to be doing other episodes as far as nonclinical careers, different ways of practicing medicine, and really, listen to the union one. I've never really been a union guy. I've always prided myself in being kind of more to the right of center. But this one was absolutely eyes wide open.
John: Yeah. That was excellent. And your guest really said, okay, this is what has to be going on for a union to be considered. You put it really so clearly. It's not like, "Well, we're just unhappy so we're going to form a union". No, that's not how it works. Very good. All right. Well, I want to thank you both for being here today. This has been fantastic. I've had a really good time and we'll have to do this again sometime.
May: Yes. When we're famous people on the history channel then you can ask us how that's going on? That's our dream and we're having fun doing the podcast. And it's been an honor and pleasure to be here and chat with you today.
John: It's been my pleasure. We'll see you soon. Take care.
May: Bye.
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