Hospital Budgets with Chief Medical Officer Dr. Chris Longhurst | Knock Knock, Hi! with the Glaucs

[@lizmalsam7528]

This was a great podcast! My Dad was a general surgeon in a small town in Wisconsin ~ the only surgeon. He was on call 24/7 except for 2 weeks a year when he took us camping. I remember him going to all our school functions & being called out every single time. I was raised with the concept of giving Dad a break because he was helping others. If he didn’t feel he could do the surgery, the patient had to be transported to Minneapolis/St. Paul. He’s a legend in my book! He also told me he wanted to be a doc because he could exceed the speed limit to house calls. 😂😂😂

[@jupiter0jupiter]

That's an amazing story! thanks for sharing. I'd like to ask what you meant by being called out at school functions? like, people complaining because your dad wouldn't do their surgery?

[@lizmalsam7528]

@@jupiter0jupiter ~ the hospital would literally come find him for emergency surgery. No pagers in those days! He would never turn away a patient in crisis.

[@aidanhancock2117]

​@@lizmalsam7528 i guy i know was in a similar situation, but not exactly. His dad is some sort of specialist surgeon in semi rural England. If his dad was at a event, there was a fair chance he'd leave halfway. Apologised to his son every time, and eventually the son explained the reason he never got upset is because he knew if his dad didn't cover the operation, the patient had to be transported to a hospital near london, Cambridge i think, a good hour to two hour drive, not really viable, or a half hour or so flight, and alot of his patients were really unstable if they were in need of his specialisation. He accepted if his dad left it was because there was a good chance if he didn't someone could die. In his words "pretty good excuse." Was immensely proud of his dad. Theres some costs to being a medical professional people dont realise. They're genuinely heroes. The guys dad wasn't like estranged or anything from his son, they still found time for each other. But i think it hurt the dad he couldn't be there. The school always recorded events for him though.

[@cassaundracasey1030]

My Mom put everyone to sleep, in three counties. Three rural hospitals would page her, around the clock, 24/7. My Dad, a Hospital Administrator, wired our family crew cab, so when we were waterskiing on the lake and her pager went off, the lights and horn on the truck, which was parked at the boat ramp, would flash and blare. A lot of people recognized us when we were in town, and would (proudly) proclaim that my Mom had put their Mom’s neighbor’s cousin to sleep so the doctor could save their life. It was really crazy, but also very lucrative for our family. Wild rural doctor stories are whst we grew up on, since she had to deal with EVERYTHING that came through the ER or OR doors!! ❤

[@jacobjohnson8686]

Wow... patients had to be transported to another _state_ if he couldn't do it? That's a lot of responsibility, haha! (And what if their insurance didn't cover out-of-state care?)

[@margaretandandrewroth9229]

When your wife said “what you really need is a nurse” 22:51 I literally CACKLED. I’m legit listening to this before my night shift in stepdown as a nurse ❤😂

[@angrydalek]

So I had my wisdom teeth removed today, I asked my Oral Surgeon if he heard of you. He had and not only does he find you hilarious, but he says your depiction of some of the medical people is spot on. He didn’t realize you had Dental videos and now has to look them up. It was a nice bit of conversation I wouldn’t of had otherwise.

[@just_some_commenter]

I think I can fit 2-ply into the budget. Here's how 1. Add one more clause to that contract every patient is forced to sign before receiving care: "I agree to pay for any and all restroom products used by myself, all my guests and visitors, and any staff or contractors involved in my care." 2. Bill $1.50 per square of toilet paper used. Actually, that's the generic rate; it's $2.50 for brand name. 3. Upon request, and if the patient provides proof that they can't afford to pay full price for toilet paper, reduce the bill to $0.50 per square. This act of selfless charity lets you check off the "forgive medical debt" and "provide 2-ply toilet paper" checkboxes in one fell swoop! You're welcome! Do keep me in mind if a C-suite position becomes vacant. I'm ready to start immediately, willing to relocate to San Diego, and flexible (at least in the upward direction) on pay, but I do expect a personal Jonathan -- or at least a Jared -- as part of my benefits package.

[@phoenixfire8978]

As a kid, I remember a time when a team of parents was thrown together because one of the kids teams didn’t show up. Instead of the kids missing out on a game. My mom was on the team. What I remember most vividly was the town chiropractor AND doctor were both in attendance. They spent the game calling out to the parents about who they’d be seeing first thing Monday morning when their offices opened again.

[@daaara]

"Before we get into that... Something in my life has returned..." *thinking* "oh no, not his third ball" "...and that is physical activity! ☺"

[@janinawaz4596]

A third gonad, provided it's healthy, might be helpful.

[@StefinSeattle1]

I had that same reaction of, “Oh, no!” But I did the math 🤔 and saw that they weren’t upset so I relaxed…marginally.

[@danevon91]

Hey Dr Glaucomflecken! I’m a fairly new RN in California. CA is the only state in the US with legally mandated nurse to patient ratios actually, largely due to our unions. It would be an excellent idea to have a federally mandated ratio country-wide as mandated ratios have been shown (in studies) to save patient’s lives! Whether this will ever happen is uncertain though bc mandated ratios are much more costly to corporations, but I’m sure they can find room in the budget for it 😊

[@petersmit1649]

Yes and no. if its 4 patients with decent acuity levels then yes 4-5 should be the limit. But if you get an emergency situation where you have to take an influx and theres no space available in other hospitals you should take the 5th 6th patient instead of dump them

[@petersmit1649]

I should also add it raises the cost of labor very high so that it could bankrupt hospitals.

[@jimjimmy3131]

Meanwhile Netherlands 🇳🇱 , having 16 patients at a time :) AHAHHAHAHHAH JESUS , THIS JOB IS SO FUCKING SHITTY.

[@margaretandandrewroth9229]

Hopefully illinois is going to be the second!!!! They’re working on legislation now!!!

[@patrick815]

Wills generation played soccer growing up, which makes the U.S. similar to other nations now. Wills parents didn't play soccer and so this is awesome movement for our country

[@GloriaCraven0213]

THANK YOU for this, for illuminating us with your brilliant perspectives, personalities, topics, guests. I adore your relatable, humane, profound yet casual presentations. LOVE YOUR SHOWS THANK YOU SO MUCH!

[@janinawaz4596]

Longhurst smelled his fingers LOL (51:18) What a fascinating interview, I wanted to know more about administration and what HIS one wish might be. Please consider interviewing Dr Rachel Exotic Pet Vet, or any vet. Maybe a large animal vet.

[@Miss_Dis]

Jelly Bean Tigers! Love it! Also I love the Bed by Eight name 🥰 also Dr G, aren't you afraid that you will need to practice body medicine on your teammates?

[@sciencebunny]

Kiddie-ologist makes a lot of sense and is so much more approachable to tiny patients ❤

[@hydrangeadays]

Thank you all for this informative interview!

[@towelman1]

As a Pediatrician I am disappointed that the intersection of a Pediatrician and an Ophthalmologist discussing equipment acquisition did not include a discussion about an automated vision screener for the outpatient pediatric office :(

[@Burning_Dwarf]

My dad used to be high level indoor football player (ugh ok, soccer). Volunteer games in the other leagues were always fun.

[@furl_w]

There really is a systemic financial issue here particularly with insurers as the middle-man. There needs to be regulation about how much blood insurers can extract from patients and hospitals but that won't happen in our current political environment, so it's inevitable that failures will happen. It's so predictable and yet people aren't going to do anything about it until the worst possible scenario results from it.

[@KxNOxUTA]

Actually, I successfully re-animated my drowned baby aquatic turtle, which I found limp at the bottom of the tank upon coming back from high school. After days of it getting up there just fine. I took the poor animal into my hands! Their shells are still soft when young. It had probably failed to climb onto the basking spot, since I had rescued it from a store already sickly and with some deformation going on. The later had probably made the climb extra challenging (poor baby). It's head and limbs were just limply dangling from it's body. I gently squeezed it's soft-ish shell, chest compression style, between two of my fingers. I took it's tiny head between my lips and blew carefully. I had no hope. It was a panic type reaction on my side. But then suddenly she moved (and panic pooped)! 😭😭😭😭 I was at my (ex) bf's place across the border! I didn't speak the language. He was at work. I managed to ask the neighbour for help who brought me to the vet an hour later (cause the vet was on lunch break. Can't believe there WAS a vet in that small town). They just gave the tiny animal an antibiotic, since tank water got into it's respiratory system. That might have lead to inflammations otherwise. My sweet turtle and her sister are both big ladies now. They're thriving. My DIY physiotherapy for the animal has countered some of the deformations. She's a tad slow (her reactions to stuff are delayed!) but she's otherwise very happy and curious. Loves to do her turtle ballet poses in the basking area, with her feet elegantly stretched into all directions, for maximum basking. So, not a human medical story, but one where having learned human first aid, actually worked in rescuing my beloved pet.

[@scrumptious9673]

What a great guest!

[@circleroundthesun1]

Are you in Boston? If not, I just saw your doppelganger at Brigham and Women's when I came in with a fractured rib (after sitting in the waiting room for like 9hours) at 4am. Such A NICE man... Either way. Thanks! ER waiting room

[@JM-ig4ed]

From an admin position - what is up with telling families of patients they can bring the patient home - with NOT WARNING - or ability to facilitate a move home. Wish you could talk about that.

[@SandfordSmythe]

There is a professional obligation here.

[@cynthiaejiogu8442]

Impressive! The frisbee ! I live in Northern California and my mom and sister went to Sonoma State they had Frisbee there from the 1970-80’s

[@ShmuelYonah]

Nurse dad here. Am I useful in some medical scenarios outside of work? Sure, I guess. But am I able to successfully diagnose and treat my kids? Everything is a virus.

[@duo315]

17:47 I take call in my nursing job and am a heavy sleeper. If my cell phone rings, i have it set up so the lights turn on and my extremely loud cordless home phones (only bought them for this purpose) are set to ring

[@MC_Mega-Jessup]

As a nursing student in California - I would say even 4 med-surg patients per nurse can be an overwhelming task (good ol' polypharmacy), especially when you tack on all the unnecessary meetings and stuff that hospitals like to do. It's honestly appalling that California is the only one with a statewide mandated ratio. Now clearly people aren't dropping dead left and right, so the poor nurses are making it work, but I bet you it's at a significant cost of care quality and nurse burnout. I would never accept a position asking me to care for 14 patients (a real number I've read) - I would definitely burn out in less than a year and go to bed every night thinking about all the patient care I couldn't get to.

[@mattshaw6259]

You would hate nursing in Ny

[@gushodges8320]

Loving this podcast! Great job!❤

[@karebu2]

Admin bro…

[@torianantonio9561]

You should get the ER doctor to come on I think thats his youtube name

[@hopeful4243]

Yooo Doc Glauc started a podcast let's go! Would be cool if they get Dr K here.

[@Gazzy.]

I just got diagnosed with corneal ectasia, I guess I was born with it, I haven't had LASIK and was actually going in for a consult. is corneal ectasia really that bad?

[@Ruqaiyya1555]

Hello from Texas!

[@bubblesbubble5264]

If the patient is " low" Acuity , then they can be sent to a sub-acute rehab place . They're in the hospital for a reason, to be monitored . Trying to suggest 4 patients per one nurse might be too few patients, ask if you would want your parent or whoever you love to be in a hospital on a floor , being assigned to a nurse that has too many patients . Outcomes are worse when there are too many patients assigned to one nurse. Plenty of studies done on this. This is not a paper towel roll business where people won't die or get sick from slow production of paper towels. This isn't some kind of retail job or cupcake business where people won't get impacted in ways that really matter . It is a hospital. Do not knock safe staffing ratios , if you would not dare send your relative to a place with unsafe nurse: patient ratios. You would be using your cash to send your relative and pay for the " Concierge" level floor a lot of major hospitals have , it is where they get specialized attention , the nurses only have one or two other patients . I do not believe the suggestion here in the podcast that the hospital has trouble finding nurses to hire . While nursing schools are pumping out a ton of them. Go train them. Put them on orientation. You'll have plenty of fine nurses. Hire the thousands you have that are experienced nurses , applying to all the job postings . The answer smelled of insincerity.

[@Ms.Opinionated]

Don't Nurses and Techs deserve 2-ply too?!!!!

[@josephelias9081]

Holy mandibular symmetry.

[@ADKEMT]

Adults are just children burdened with responsibility.

[@ARedFeather]

Where do i get a unicorn headband!?

[@fatgezimbela7272]

Interview me! Im a medical student with a family! Can talk about doing that.

[@cynthiaejiogu8442]

First up! Hi Dr from Sacramento! Telephone advice RN with Kaiser

[@mollycule2792]

I’m disappointed you weren’t playing pickleball

[@snackie1359]

Hello!!

[@pattinorton1085]

So funny!

[@dougyaroch3380]

Students, could get credit for watching children

[@hobodarkness7696]

Helloooooo

[@Ciborium]

Please do an episode about how great the Canadian health care system is and how MAID (doctor-prescribed suicide) is a valid treatment option for all illnesses and should be incorporated into the American health care system. I think you would agree with me that MAID is an inexpensive and effective treatment for PTSD and a variety of psychological and chronic health issues.

[@SandfordSmythe]

Off the edge here.

[@Ciborium]

If doctors would only prescribe Canadian-style MAID more often, hospital budgets would be overflowing with revenue due to a sharp decrease in expenses.