Speaker 1: Hello, this is the Itchy and Bitchy Podcast because being
Speaker 1: itchy is bitchy and our medical system sucks. I'm doctor
Speaker 1: Keith Nolica, a vetnary, allergist and dermatologist.
Speaker 2: And I'm Stephen Miller, a doctor of nursing practice and
Speaker 2: a que care nurse practitioner.
Speaker 1: Send us your questions at ask at itch not dot com.
Speaker 1: We love you, but we're not your doctors. The information
Speaker 1: we discuss is not direct medical advice. Please talk to
Speaker 1: your provider who is the expert on your care. The
Speaker 1: Itchy and BITCHI podcast is sponsored by Doc Itchy Medical
Speaker 1: Pets supplements designed to optimize your pet's health with the
Speaker 1: latest veterinary medical research. Visit docchi dot com or find
Speaker 1: us on Amazon. Don't forget to send us your questions
Speaker 1: to ask at dot com. Welcome back as always. I
Speaker 1: hope you're safe and well. How are you care, Captain?
Speaker 1: Are you feeling safe and well? I am good, okay,
Speaker 1: So welcome to myself, doctor Milica and doctor Miller, and
Speaker 1: we are happy to be taking the reins from Karen
Speaker 1: nicol who's done a wonderful job, been a dear friend
Speaker 1: with us, and I know personally taught me quite a
Speaker 1: bit about optimizing medical care in humans, which I've tried
Speaker 1: to apply to animals.
Speaker 2: What do you think, doctor, Yeah, I mean I have
Speaker 2: had twenty six years of experience as a que care
Speaker 2: nurse practitioner and doctor of nursing practice in cardiology, and
Speaker 2: so a lot of experience with patients and healthcare system,
Speaker 2: both on the inpatient and the outpatient side, Lots and
Speaker 2: lots and lots of experience and observation.
Speaker 1: All right. And I've had thirty years of experience postgraduate
Speaker 1: school from veterinary school, teaching in four different universities, and
Speaker 1: clinical practice lecturing all over the world textbooks. So we're
Speaker 1: both tend to be a little bit ocd. I'll have
Speaker 1: some slight insomnia, so we're up late doing all sorts
Speaker 1: of activities, and we're also very curious. We also part
Speaker 1: of the premise of this is itchy and bitchy Dakichi,
Speaker 1: and I've been Docicchi since I was assistant professor at
Speaker 1: the University of Georgia and one of the assistants there
Speaker 1: named me that, so this kind of fits. Well, thank you.
Speaker 2: I'm right add that I am not bitchy.
Speaker 1: So you're not Doc bitchy, okay, but we are bitchy
Speaker 1: about the system. So that's what the today's topic is.
Speaker 1: The system sucks. And so one of the reasons we
Speaker 1: were very interested in helping Karen transition this and not
Speaker 1: just having her stop giving the wonderful information that she
Speaker 1: provides to all of the listeners is that the system
Speaker 1: really is broken and it really does suck. And so
Speaker 1: we have a lot of experience, five children, a lot
Speaker 1: of medical experience, highly educated with treatments and pathomechanisms, and
Speaker 1: it's just a crappy system. So we're going to talk
Speaker 1: about why the system sucks today and get all of
Speaker 1: our venting out and so from here on hopefully we
Speaker 1: can talk more about treatments and biomechanisms and why things
Speaker 1: happen the way they do and what you can do
Speaker 1: about it. But this is the bitchy episode. Are you ready, Doc? Yeah? Okay,
Speaker 1: So here we go. So the first thing I just
Speaker 1: think is absolutely horrible is that the system is unbelievably abusive.
Speaker 1: Our system in America is broken. If you look at
Speaker 1: other first world countries that are not perfect, but the
Speaker 1: overall experience and the quality of care for the cost
Speaker 1: us is a much better value added package. Currently, in
Speaker 1: our current system with insurance companies corporate hospital care, the
Speaker 1: only people that are really making significant profit profits are
Speaker 1: the CEOs, the CFOs, the c suite leaders of the corporations,
Speaker 1: and then maybe the investors that own the stock in
Speaker 1: the companies. Everyone else, the providers, the doctors, the nurses,
Speaker 1: the patients, the families, the staff members are all being
Speaker 1: abused by the system. It's just a horrible system. Like
Speaker 1: I said, you know, we have five kids. I'm almost
Speaker 1: fifty nine years old, so I've had a variety of
Speaker 1: health issues. I do have chronic migraines that have worsened
Speaker 1: in the years, and trying to navigate as a trained
Speaker 1: medical individual, trying to navigate the insurance system, the provider
Speaker 1: system to get medications for a chronic disease like migraines,
Speaker 1: It's just been horrible and abusive, and I've even thought
Speaker 1: about giving up several times. It's just crazy. And then
Speaker 1: I watch people like Steven Miller, doctor Miller here, you know,
Speaker 1: trying to do cardiology in a clinical setting, and the
Speaker 1: providers are being abused just as much as the patients
Speaker 1: are being abused. And it very often comes down to
Speaker 1: the insurance companies deciding what treatments they will or won't
Speaker 1: allow based on revenue and cost structure, and has nothing
Speaker 1: to do with the patient or the provider in the
Speaker 1: exam room. It's just a crazy system.
Speaker 2: I would also argue too, that the healthcare systems within
Speaker 2: hospital systems are getting abused at some level, and that's
Speaker 2: because we in the US don't have a minimum standard
Speaker 2: of care that we can agree upon between our illustrious politicians,
Speaker 2: and so we haven't established what the minimum of care is,
Speaker 2: and therefore the hospital systems are put in the diff
Speaker 2: place of providing care to all, you know, especially through
Speaker 2: the emergency departments in this and that, and so there
Speaker 2: are some subtleties of that that I would argue on
Speaker 2: the side of the system, even though I'm in the
Speaker 2: system and there are many days when I'm just utterly
Speaker 2: exhausted with the current system. So yes, the providers, the
Speaker 2: doctors and nurse practitioners and nurses are getting, you know,
Speaker 2: worked very hard and some many times under challenging circumstances
Speaker 2: to try to provide the best of care for people.
Speaker 2: So that can be challenging when you're held to standards
Speaker 2: of production when it's a for profit system.
Speaker 1: Yeah, So I think one of the tendencies with my
Speaker 1: family and talking to friends and just kind of listening
Speaker 1: to the general public is to blame the provider because
Speaker 1: they're sort of of.
Speaker 2: The doctor the face of the right.
Speaker 1: So you know, the doctor won't let me do this,
Speaker 1: or the doctor does this, or the doctor does that.
Speaker 1: But I've watched doctor Miller here and he often will
Speaker 1: will go into start hospital rounds, aren't cardiology patients seven am?
Speaker 1: And then sometimes you know, be done with the day
Speaker 1: at five o'clock, but have to finish up clinics for
Speaker 1: another hour, hour and a half. And then how much
Speaker 1: time do you spend on your own time at home
Speaker 1: doing lab follow up or call?
Speaker 2: So I come home and I work many nights three
Speaker 2: hours sitting on the couch with my computer rolling through
Speaker 2: with the current electronic medical record, phone calls and messages
Speaker 2: and buckets. We call them buckets. And the buckets are
Speaker 2: like laboratory buckets and testing buckets and messages and this
Speaker 2: and that.
Speaker 1: So so you know, a lot of current work trends.
Speaker 1: One is that people can opt in for a four
Speaker 1: day week and they can do ten hour shifts or
Speaker 1: twelve hour shifts, which seem like a really really long time.
Speaker 1: Very often, I think you put in easily fifteen hours
Speaker 1: a day. Would you every day every day? And then
Speaker 1: when you're on call, you're on call every other month ish.
Speaker 1: And when you're on call, how many days in a
Speaker 1: row will you have done clinics and hospital rounds And
Speaker 1: what's the maximum like duration that you're every single day?
Speaker 1: Bam bam bam bad.
Speaker 2: So I call that a twelve day week, and so
Speaker 2: that's basically Monday through Friday clinic and then being on
Speaker 2: coverage for the weekend. And so, you know, you get
Speaker 2: pressed because of the burden of the work. You feel
Speaker 2: challenged to take your time off because there are so
Speaker 2: many people trying to get in to be seen and
Speaker 2: no spots to put them in. And it's become particularly
Speaker 2: were since COVID. So there was this post COVID analysis
Speaker 2: where we found that people sat on their care and
Speaker 2: then there's been this title wave that's come after COVID,
Speaker 2: and now clinics are strained and stressed because there aren't
Speaker 2: enough spaces to see all the patients. Number one, number two.
Speaker 2: There's this huge amount of retirement that's occurring among senior providers,
Speaker 2: nurses and doctors, and all of that plays into the
Speaker 2: fact that resources are a limited resource, and so you
Speaker 2: start to get squeezed. And then as the AI and
Speaker 2: you know, online information has become more available, people have
Speaker 2: become more demanding because they feel like they need now
Speaker 2: they've got all this in information on you know, the web,
Speaker 2: and so they message you at night with these very
Speaker 2: detailed messages that are really not appropriate for just a
Speaker 2: quick message through the EMR. And so most of those
Speaker 2: things really need an office visit to sit down and
Speaker 2: have a proper conversation and evaluation of their case.
Speaker 1: Yeah. So you know, just imagine working fifteen hour days
Speaker 1: for twelve days in a row, and then next time
Speaker 1: you think that the provider is causing the problem, just
Speaker 1: you know, kind of ponder that for a minute. Okay,
Speaker 1: we're going to take a break and then we'll come
Speaker 1: back and we'll continue our little bitchy session here. All right,
Speaker 1: we're back, and this is the bitchy part of the
Speaker 1: Itchy and Bitchy Podcast. So Stephen, what's on your list?
Speaker 2: Yeah? I think one thing I hear as a big
Speaker 2: frustration from a lot of page is the lack of
Speaker 2: integration of EMRs in our current system, and it's become
Speaker 2: a big issue because it's led to in efficiencies in
Speaker 2: communication between providers, inefficiencies and the sharing of the laboratory results,
Speaker 2: which then leads to higher cost of care because everybody
Speaker 2: needs their labs.
Speaker 1: And we actually do have a so EMR. We're talking
Speaker 1: electronic medical records.
Speaker 2: Or which are electronic health record. There are a couple
Speaker 2: of ways to refurther.
Speaker 1: So one of the big attempted developments was that if
Speaker 1: we had everything computerized, then all of the clinics, all
Speaker 1: of the hospitals, Medicare, Medicaid, could share the information and
Speaker 1: no matter where you went, your information would follow you.
Speaker 1: For optimal health care, that was the goal.
Speaker 2: And in the current health care system we are all
Speaker 2: sort of forced into utilization of electronic health records or
Speaker 2: electronic medical records, and that's all been very closely regulated
Speaker 2: through the US Department of Health and Human Services, which
Speaker 2: is really the central authority for health data interoperability, and
Speaker 2: so there are national standards that are set for those things,
Speaker 2: and so we're held to that standard and they oversee
Speaker 2: information exchange. There actually is an Office of Integration that
Speaker 2: is there, but they've been there for years and we're
Speaker 2: still not integrated, so that it's very, very very slow.
Speaker 1: So what are people frustrated about or what's your frustrated
Speaker 1: in the.
Speaker 2: Fact that they may go in the hospital and that's
Speaker 2: one medical record and show up in the office and
Speaker 2: I'm on another medical record and I can't get the
Speaker 2: hospital record that they had a different system, or they
Speaker 2: saw their primary care who was on one medical record
Speaker 2: and I'm on another medical record, or we might even
Speaker 2: be in the same medical record, and we have a
Speaker 2: situation where the data tables don't cross communicate, and so
Speaker 2: it's really layered and complex, but also has led to
Speaker 2: a lot of frustration, duplication and healthcare and just lack
Speaker 2: of collaboration.
Speaker 1: Yeah, and this is also why for the last ten
Speaker 1: years five years especially, would go see a provider, they
Speaker 1: spend a lot of time typing into a computer or
Speaker 1: electronic device because they're entering information into the electronic record.
Speaker 1: And I think at least we use an EMR in
Speaker 1: the veterinary side as well, and ours is much more
Speaker 1: efficient and the human side because it's not regulated, so
Speaker 1: it just does what we need it to do. But
Speaker 1: it really can be a barrier to communication and relationship building,
Speaker 1: and then especially if it's not providing the efficiencies that
Speaker 1: it was really intended and designed to do, I can
Speaker 1: see how that would be really frustrating. Yeah.
Speaker 2: Yeah, it's very frustrating when people go, for example, to
Speaker 2: their prime here and they get lipids done two months ago,
Speaker 2: and then they're coming to my office and I'm held
Speaker 2: accountable for the lipids since I'm cardiology, and so then
Speaker 2: I don't have the lipids, and so then we either
Speaker 2: have to track it down, track it down, have a
Speaker 2: nurse that call and get those results, which then puts
Speaker 2: a burden on our clinic, and then delay in care
Speaker 2: because I don't have them at that visit, and then
Speaker 2: I have to once I get them, I'm on the
Speaker 2: couch at night reviewing records and having to comment on
Speaker 2: their LDL. So it's just led to a lot of
Speaker 2: inefficiency in the system and massive frustration for patients.
Speaker 1: Yeah, and if it was optimized, I think it could
Speaker 1: be much much better. And now the trend is and
Speaker 1: she may have a different opinion, but the last time
Speaker 1: I went in for my migraine headaches, the neurologist, I
Speaker 1: think it was actually a nurse practitioner, really really great guy,
Speaker 1: so thank you very much. But he used his phone
Speaker 1: and an AI app to record our conversation and then
Speaker 1: it would enter it into the electronic health record or
Speaker 1: medical record, and he didn't spend any time typing on
Speaker 1: the computer. And I found that experience really actually quite
Speaker 1: much more pleasant than just typing. But I think you've
Speaker 1: had problems with the AI bots and the accuracy with those,
Speaker 1: or what's your what's your issue with.
Speaker 2: The well So there's multiple issues, and so I certainly
Speaker 2: would disagree with you on the use of AI bots
Speaker 2: recording patient provider interactions and integrating conversations, and it's some
Speaker 2: of the issues are that it records a conversation and
Speaker 2: then every visit between every patient sounds basically exactly the same,
Speaker 2: and so there is a lack of individuality of the node,
Speaker 2: or at least it seems that way. The bots are inefficient.
Speaker 2: Sometimes they'll be down. Many times. You may like parts
Speaker 2: of what the bot says, maybe in the history of
Speaker 2: present illness, but you don't like what it does with
Speaker 2: the physical exam, so you have it do that in
Speaker 2: the exam room and then you have to go out
Speaker 2: of the exam room and spend time regenerating whatever part
Speaker 2: of the note. And if you're a good typer, and
Speaker 2: I think I'm a good typer, my air rates probably high.
Speaker 2: But you can do a bulleted note that's much more
Speaker 2: efficient and quick and integrated, and you don't have to
Speaker 2: go out of the exam room and spend another ten
Speaker 2: minutes undoing whatever the body did. And so it's the
Speaker 2: same thing that technology can be really really great, but
Speaker 2: it's not always the miracle answer that we hope it is. Well,
Speaker 2: and another frustration of the system is that all of
Speaker 2: these things are new, right, and so now theer you know,
Speaker 2: all these these bots are getting launched prematurely before they're optimized,
Speaker 2: and they're launched into these clinics, and so then you
Speaker 2: have the the reps for these bot companies who are
Speaker 2: coming to the providers wanting to learn from them how
Speaker 2: to make the bot better. So the providers are already
Speaker 2: stressed with their burden of workload and taking care of patients,
Speaker 2: but now we're spending our time educating the bot companies
Speaker 2: on how to make their bot better.
Speaker 1: And again this is kind of my point that the
Speaker 1: providers are truly getting abused in this situation too. So
Speaker 1: AI bots sound like a great idea. You know, if
Speaker 1: I were a CEO and organizational COEO, you know, it's like,
Speaker 1: oh my gosh, that would you know, make things so
Speaker 1: much more efficient and I could save twenty percent and
Speaker 1: all of these great statistics, and so I could push
Speaker 1: it downstream and have the providers required to use it.
Speaker 1: And suddenly, now that's you know, one more giant thing
Speaker 1: that's piled on.
Speaker 2: And this is across the board, you know, with now
Speaker 2: that we have remote monitoring with certain devices like pacemakers, defibrillators,
Speaker 2: this and that, and those companies have these systems that
Speaker 2: out there, and we try to use these across the
Speaker 2: board so that we can more efficiently take care patients.
Speaker 2: But then again here you have these companies coming to
Speaker 2: the provider in between visits or setting up meetings to
Speaker 2: have you come and teach them how to make their
Speaker 2: system better. And so the providers are getting so squeezed
Speaker 2: right now with technology improvement and should be yeah improvement, yeah, improvement,
Speaker 2: whereas you know, what we want and are good at
Speaker 2: is spending time with our patients and providing care on
Speaker 2: an individualized basis.
Speaker 1: So technology is a pet peeve a broken system. Okay,
Speaker 1: we're going to take another break and we'll be right back.
Speaker 1: All right, we're back. And one of my next issues
Speaker 1: that I have with the medical system relates to something
Speaker 1: that we were talking about before, and that's social media
Speaker 1: and doctor TikTok. Social media is not a doctor. It
Speaker 1: is not a provider. Chat and Claude and Xai are
Speaker 1: getting better and they're better than just doing a Google search.
Speaker 1: But one of the things that drives me absolutely crazy
Speaker 1: in my clinic, my own veterinary clinic, is that people
Speaker 1: will find something on social media, call it doctor TikTok,
Speaker 1: and they'll absolutely go down this rabbit hole. And some
Speaker 1: of the things are bizarre that you know, they're willing
Speaker 1: to give their dog or take something that's incredibly toxic
Speaker 1: instead of something that's much much safer that might be
Speaker 1: prescribed or an FDA approved drug, but since it's part
Speaker 1: of the government or some perceived formal system, they just
Speaker 1: have issues with it. So but they're replacing something that's
Speaker 1: much much safer and effective with something that's way more toxic.
Speaker 1: The other thing that I think is just crazy crazy
Speaker 1: to me is that if there's no biological mechanism for
Speaker 1: some of these things, and they're just downright dumb. They
Speaker 1: don't even make sense for someone that graduated middle school.
Speaker 1: So one of the things I came across recently is
Speaker 1: that if you take hydrogen peroxide, it'll increase your penile size,
Speaker 1: so it'll make your penis bigger. Well, we give hydrogen
Speaker 1: peroxide to dogs that ate garbage or toxic substances to
Speaker 1: make them vomit. So you can give, you know, a
Speaker 1: golden retriever a tablespoon of hydrogen peroxide and ten minutes
Speaker 1: later there's a big pile of vomit on the floor.
Speaker 1: So whoever came up with that, it was a big
Speaker 1: joke on whoever decided that they wanted to try it out,
Speaker 1: because that's not going to work out.
Speaker 2: Well again, I mean, I think the driving force for
Speaker 2: doing this podcast, at least on my part, was to
Speaker 2: be able to educate people about proper evidence that's out there,
Speaker 2: helping people know how to tease through evidence. So educating
Speaker 2: people about studies and how studies are done and what
Speaker 2: population size means. And you can find evidence for anything,
Speaker 2: but it's.
Speaker 1: Well evidence again in air quotes that one person said
Speaker 1: one thing or in veninary medicine. We have a big
Speaker 1: problem that six dogs did something, and six dogs is
Speaker 1: not statistically reliable, you know, So one quote, one patient,
Speaker 1: one experience does not mean that's the truth.
Speaker 2: Right, and so a study of one is not a
Speaker 2: valid study. It's a case study or a case representation,
Speaker 2: a case report.
Speaker 1: And which could be useful.
Speaker 2: It could be useful at the beginning leading to evaluation
Speaker 2: of something downstream. But again the issue comes in that
Speaker 2: people just don't know what to do with all of
Speaker 2: the evidence that's at their fingertip on their cell phone,
Speaker 2: which and they don't know how to integrate that into
Speaker 2: their care. And so when you have people that spend
Speaker 2: years of their life in their doctorate work or whatever
Speaker 2: learning about studies and adjudication of studies, and you're expecting
Speaker 2: someone who may or may not have those skill sets
Speaker 2: to interpret, then that's a.
Speaker 1: Lot Which brings me to one of your points that
Speaker 1: you mentioned and earlier, is that now both you and
Speaker 1: I in ventary medicine human messin are having to explain
Speaker 1: a lot more facts where before before we had Google especially,
Speaker 1: but now chats and TikTok. I really do think TikTok
Speaker 1: is a big issue. Why pick on TikTok, But we're
Speaker 1: having to explain things where before people patients are collients
Speaker 1: would just assume that we were the experts and trust
Speaker 1: our judgment, trust us, and we'd say, you know, this
Speaker 1: is the therapy or the diagnostics we need to do,
Speaker 1: and it was a very efficient process. And now because
Speaker 1: they did their research air quotes again, then we have
Speaker 1: to explain the biomechanisms and why we're suggesting and what
Speaker 1: the diagnostics are. And it's almost this mini course in
Speaker 1: whatever the diagnosis and disease processes, which takes up another
Speaker 1: huge amount of time, and.
Speaker 2: You're given fifteen minutes to see a patient or less
Speaker 2: because now you have medical system, so you're given fifteen
Speaker 2: minutes and sometimes you might even get double booked a
Speaker 2: fifteen minute slot. And so then you've got someone who
Speaker 2: wants to dive into the finer details of cortisol metabolism
Speaker 2: and you're trying to balance that with getting to how
Speaker 2: do we get you taken care of and stabilized and
Speaker 2: empowered to be in a good place health wise, and
Speaker 2: so it's it is challenging.
Speaker 1: It's just it's just drives me crazy.
Speaker 2: The exam room is not meant to be a college course.
Speaker 2: It's meant to seek the advice of an expert within
Speaker 2: their given field on a treatment plan for you and
Speaker 2: what your current health situation is and where you go
Speaker 2: from there, and just.
Speaker 1: Pay attention for just blatantly dumb ideas like hydrogen peroxide
Speaker 1: to make your penis bigger. Okay, we're going to take
Speaker 1: a break and we'll be right back. All right, We're
Speaker 1: back where their final pet peeve, So, Steven, what you got?
Speaker 2: Yeah? So, I think that another frustration for many patients
Speaker 2: is the current payer system or insurance companies driving health care,
Speaker 2: healthcare insurance driving care and so like for example, when
Speaker 2: you got your migraine headache, that was a nightmare, yes so.
Speaker 2: And a lot of patients who have made their way
Speaker 2: through multiple, multiple, multiple multiple treatments hit this quote nightmare
Speaker 2: where a medication is recommended by their provider and then
Speaker 2: the insurance company or payer then puts them through the
Speaker 2: prior authorization process, and then you get denials, and then
Speaker 2: you get appeals, and then the provider on the back
Speaker 2: end of that is having in addition to all the
Speaker 2: many other things that we take care of, we're now
Speaker 2: late in the evening or in the middle of clinic
Speaker 2: trying to work in an on phone conversation with a
Speaker 2: peer to peer evaluation. And this has become ultimately frustrating
Speaker 2: for people. It's led to some block and access to
Speaker 2: care for people in ability to get met needed medications.
Speaker 2: And it's a frustration of our system. It's tied to
Speaker 2: for profit healthcare companies making their bottom line, but then
Speaker 2: also the cost of the pharmaceuticals that are out there,
Speaker 2: cost of care, and so but it is a frustration
Speaker 2: for patients and providers.
Speaker 1: So I've had at least three appointments for my migraine
Speaker 1: simply because the medications were not a by the insurance company,
Speaker 1: and for my migrants, which is a chronic disease. And
Speaker 1: I do understand this being medically trained that you know
Speaker 1: there are a lot of therapies and their different levels
Speaker 1: that you need to go through to make sure that
Speaker 1: something's safer, simpler, cheaper, is not going to be as
Speaker 1: effective or very effective rather than a twelve hundred dollars
Speaker 1: a month medication. But truly my medical list, I've had
Speaker 1: migraines since I was in college. I've been on thirty
Speaker 1: different medications over forty years, and I have that all
Speaker 1: documented and listed, and so for the insurance company to
Speaker 1: still at this point in time be arguing about did
Speaker 1: I do you know one drug versus another drug? And
Speaker 1: my whole thirty different medications have been very well documented
Speaker 1: with time correspondence, and it's just crazy and it's not
Speaker 1: even the provider has no control over this right.
Speaker 2: And then during our right now, with healthcare shifting so much,
Speaker 2: you're in insurance may change and then your provider has
Speaker 2: to change. So then you go see a new provider
Speaker 2: because now your old provider is not covered by your
Speaker 2: current plan, and your new provider doesn't have all that
Speaker 2: history in their not because they haven't seen you for
Speaker 2: a long all these.
Speaker 1: Year, which it goes back and.
Speaker 2: Then it just becomes this horrible circle of frustration for patients.
Speaker 2: And I would just encourage people to know it's frustrating
Speaker 2: and it's frustrating for providers, and we are all trying
Speaker 2: to figure this out and get patients what they need
Speaker 2: as quickly as we can get it for them.
Speaker 1: You know, talk to your politicians. The system's broken somehow,
Speaker 1: you know. The people that we interact with, the nurses,
Speaker 1: the providers, the doctors, even the insurance representative on the phone.
Speaker 1: They're not in control of any of this at all,
Speaker 1: and so don't take your frustrations out on those people.
Speaker 1: It really is a systematic propum and it really is
Speaker 1: just it's crazy. So all right, any final comments.
Speaker 2: Yeah, So, I mean, I think that having said all
Speaker 2: these things, certainly we want to the system is broken,
Speaker 2: and the system does suck. There are many things about
Speaker 2: the system that are amazing. There are amazing providers out
Speaker 2: there who have spent their entire lives committed to doing
Speaker 2: what they do and to put themselves through all of
Speaker 2: these changes in healthcare is a testament to their skillfulness
Speaker 2: and their persistence and passion for taking care of people.
Speaker 2: And so I just hope that you all are able
Speaker 2: to find a provider who's willing and able to advocate
Speaker 2: for you in the constantly evolving and changing times in healthcare.
Speaker 1: All right, Well, with that, thank you for listening, and
Speaker 1: please please stay safe, stay well. Send us to your questions.
Speaker 1: We'd love to have feedback and have questions. We'll try
Speaker 1: to have every couple of months in a whole episode,
Speaker 1: just answering the questions that we receive. And you can
Speaker 1: send those questions to ask at itchnot dot com and
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Speaker 1: Thank you for joining us. This is the Itchy and
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