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- เผยแพร่เมื่อ 26 ก.ค. 2023
- Dr. Glaucomflecken's rural medicine doctor has been one of my favourite characters in the Dr. G cinematic universe for some time... but is it accurate? Let's just say that as a resident doctor working in rural medicine right now, I wish Texaco Mike could bring his MRI out this way. Here's everything you need to know about what its REALLY like working in rural medicine right now.
#drglaucomflecken #medicine #medicalschool
Bio:
Hi everyone, its nice to meet you 🤙 My name Is Gianluca and I'm a second year family medicine resident physician at McMaster University in Ontario, Canada. I'm just trying to document my experiences throughout my medical training and beyond to hopefully help inspire/guide some other students... and make things more fun for myself :) I post a new video once per week.
Feel free to contact me on TH-cam or Instagram if you have any questions.
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(That's all... medical residency and TH-cam keep me busy enough 😅)
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2:24 I am shocked doctors and nurses can't do their own lab work/imaging. Is it really that hard?
It will be interesting to see if AI will fix that issue by reduce the required skill level to perform these tasks
Somewhere in the world, there is a doctor that does those things themselves.
Some days, we’ll see 50-60 patients on a 12 hour shift. We’ll set bones, run codes (CPR), talk to a patient who attempted suicide - and possibly talk to a family if their loved one just passed. There are many hats we wear on a usual shift.
In healthcare, we rely on a multidisciplinary team approach. Nurses, lab techs, phlebotomists - each member is crucial to the team especially since there is only 1 doctor working for the entire hospital on an overnight shift. I can’t imagine being expected to operate an X ray machine, do blood draws, plate urine on culture plates in the hospital lab. I think that anyone who works in healthcare would probably agree with me, but I understand where you’re coming from. It wouldn’t be safe for patients and at the end of the day, that is why we need many different team members. Unfortunately, trying to be a hero and doing everything yourself on a busy night is a great way to miss something and get someone killed which is why I’m glad that the staff I work with are top notch 💪
I hope that gives a bit of an insight into behind the scenes of the ED :)
lab work and imaging is so complex and has so many things going into it that they're their own specialties and disciplines for a very good reason
th-cam.com/video/taSXjTbU9XQ/w-d-xo.html Poof... your blood test problems are solved (for the set of tests they have cartridges for). Surprisingly affordable. Does seem like a rural hospital could spring for one of these to handle ordinary tests during off times. Do a quick check of the heartattack markers (whatever they are) when someone comes in with chest pains. Pop in the blood gases test when the respiratory patient comes in at 9pm. Whatever. Saw this demonstrated by one of the YT anesthesiologists who thought these Abbott toys were the coolest thing since it lets 'em do tests in the OR without having to wait.
As for xrays, I'm guessing every xray machine is different and requires training. Obviously a doc or some or the nursing staff might be able to get said training, but then why are you turning them into radiology techs when you have radiology techs already? Probably cheaper to pay the techs overtime to come in and do it twice a week.
@@nxtgenmd You are an inspiration. Subscribed
My great grandpa was the only 0- donor in three counties in rural Nebraska. The hospital was roughly 30 miles away. They would call when an accident was headed in so he could start that way. He once saved a man from a farm accident that turned out to be his son-in-law. Late in his life, he got a call for two teens in a car accident. His license had been revoked because he was blind, so he creeped the back roads in. The sheriff said, “Virgil? You aren’t supposed to drive!” And he shrugged and said “kids needed blood.” After that, the sheriff or a paramedic picked him up when they needed him. He passed in the mid-90s. Whole family donates blood because of him!
This is an amazing story :) thank you for sharing and thanks to your grandpa and everyone in your family that donates.
Side note: My great father passed at 99. Your story reminds me of him - tough old man with a good heart
No testing?
@@animesavedmylife3648 he saved his SIL in 1966. He passed away in 1996. The Red Cross was testing, but the rural hospital he donated directly to already knew he was O- and did on the spot testing.
They also allowed him to donate more than one pint at a time, then made him stay at the hospital to recover a few hours, sometimes giving him IV fluids.
Your Ggf was a super special man! He was a hero.
Hero
That was NOT Texaco Mike’s first appearance. That was in Ortho trying to get an MRI for his patient and United would only cover walking by an MRI machine behind a Texaco, operated by Texaco Mike.
I acknowledge you as a true Dr. Glaucomflecken lore historian 💪
The racoon cameo was peak rural medicine.
It totally caught me off guard! Totally agree 😂
My primary care doc for about 25 years was a busybody. He and his wife had 3 kids and that wasn't enough so they adopted 3 more over the years. He (not kidding) delivered the evening newspaper 6 days a week to our house, first on his bicycle, then on a little moped. He was on the school board for a few years, then the city commission, mayor of our 40,000 person town, then became a state legislator, all while also being a doctor in his spare time.
Dude literally has no chill
A busy body means a nosy person. He was a busy bee.
You mean his wife had 3 kids and she adopted 3 more. There is no way in hell that the guy was taking care of those kids, lol. She probably adopted more to keep her company because he was never around, lol.
Yeah, I had one of those as a kid too. He was a busybody - the point of him being so involved in everything is it gives him an excuse to check up on everyone and to nag people if they don't go and see him when he thinks they should. Very passionate people who knows they need to actively hunt their patients down with fox traps.
He totally did all those things to avoid being home
When at a small, remote hospital as a medical STUDENT, the only Dr there took the opportunity to take 2 flights to spend the weekend with his interstate girlfriend. He was gone for 10 days ! Lots of great experience and learning there.
Day 1, I was solo doing his fracture/othopedics clinic and learnt an incredibly important lesson. I took a textook to clinic, intending to "sneak" out on some pretence to consult it. With the first patient, I went out to look up how long a Collies fracture needs to be in plaster and felt so bad about that deceit that I took the book back into the consulting room and told the patient I really had no idea how they should be treated, but would make sure to get it right by using the book. The patient really loved that honesty, as did every other patient that morning. Ever since then (1980 !) I have been absolutely honest about not knowing something. People really love honesty, and that you're going to do your best.
As a old retired ER nurse, you have my respect! Those idiot pretend know it alls are dangerous! I wish more nurses would call them out on their BS and really be the “patient’s advocate”!
You are sadly in such a minority! You don't practice in Memphis, TN by any chance, do you?
That is exactly what I loved my old veterinarian for. He would admit, when he was at his wits' end. We then would either decide together, what kind of treatment to try, or I would call a specialist from the next town and my doc wouldn't react insulted.
Thank you for admitting to not knowing something. I've been damaged by so many doctors that couldn't admit they weren't omniscient and ignored issues as a result (almost died from a bacterial infection because the doctor was convinced it was viral and refused to do testing for example.)
It is a real problem among "us". I myself never had a bad experience when admitting not to know something. But i always try to find a solution for my patients (asking/discussion with colleagues, preparing and studying for a 2nd appointment,...)
Greetings from Germany/pediatric pneumology
The first rural ER I helped cover as a RN, the doctor was on call.. the local volunteer EMTs and Firefighters would help us (the two RNs) out until the 86 year old retired twice country doc got to the ER… he didn’t drive at night so his wife would drive him unless she was out on a weekend girls getaway shopping trip or visiting the grandkids somewhere out of town and then, the neighbor would drive him in. Sometimes we had to just run the code by phone and if the patient was resuscitated, we would go ahead and call for a copter.. (the one town reserve police officer would help clear out the parking lot for the LZ).
Every now and then, the University Medical Center would ship a second or third year out to us and it was usually a matter of saying: “it’s ok baby, we’ll get you through this together” (when ‘baby’ was just a term of endearment or Southern term for helpfulness.)
Oh, and yes, the Penicillin or tetracycline from the ‘Feed and Seed’ store has treated many people in that farming community!
The last 24 years of my career in a Level 1 inner major city trauma center was an ok slide once I showed them how you can do a CPR or GSW in the hallway. Childbirth in the hall way became all the treatment cubicles were taken up by ICU overflows.. no problem! Have the house keepers hold up a couple of sheets for privacy.
Keep up the strong work!
Yesss!!!! ❤❤❤
Used Pen-G on myself once as a younger man..... that shit burns going in and will bring tears to your eyes. Finnished the sheep shearing that spring, no infections in the cut.
So essentially, being a rural med doc is a lot like being a paramedic: you work cradle to grave with very limited resources and a whole bunch of creativity and flexibility 😊
I grew up seeing a rural medicine doctor who did everything, including routine surgeries and delivering babies. The clinic had an X-Ray machine, basic lab for bloodwork & routine cultures, and a small pharmacy for basic medications.. The medical culture shock when I moved to a city and having my GP refer me to specialist for anything more than a routine physical, who sent ALL labs out and I'd have to wait days and make another office visit for results, and wrote prescriptions for medications rather than just handing me my meds in a little cardboard box with a handwritten label (early 70s. Doc eventually replaced the boxes with amber vials)...
Quite frustrating. It doesn't feel like they're "doctoring," and takes time to adjust. I'm used to seeing a doctor for more than 30 seconds at a time.
now, this is an old story from a bygone era, but I thought you might find it interesting.
In 1935, up near lake superior, my great grandmother went into labor with her fourth child, my grandmother. The area was so out of the way that in the summer she used a boat to get mail to herself and her neighbors, and in the winters a team of sled dogs. I can't recall who, but someone got her to the nearest road into town: a corduroy road. For those who don't know, a corduroy road is a road made of logs laid perpendicular to the direction of the road. They aren't leveled, they're just... logs. Like a wall of a log cabin laid across the ground. So my great grandmother is in labor, being driven across a road made of bumps. When they finally get into town and to the hospital... its closed. I believe a great uncle or a neighbor was with her, and this person went and frantically searched for the doctor. Because there was only one. They found some nurses and the nurses helped, only to find the doctor absolutely stone drunk.
I can't recall the rest of the story, but my grandmother was delivered safely. Sadly my great grandmother passed away from colon cancer four years later, but the woman was definitely tough as nails.
From a patient standpoint, that was one of the hardest things to get used to when i moved from a TINY Appalachian town in Georgia to Los Angeles. Just like "Wait, hold up, I have to go to ANOTHER BUILDING 3 blocks away to talk to another doctor because this cut is infected? Because you want to test what kind of infection? You're a doctor, why can't you get that here, clean it up and sew it up together? WAIT WAIT and now you're saying I HAVE to go to the Plastics department TO EVEN GET IT SEWN?! (wild animal scratch, semi deep, on hand). Why... What... "
Physician from India here. Doing the lord's work there man. Hats off. Its so difficult to imagine working in a rural community with such limited resources. Most of the specialists here in India want to move to Tier 1 cities. It takes some mojo to move to a rural location to serve the needs of that community
I hope u continue to be happy in the rural village in India 🙂
Some govt health care - tho needing more support is a life line
Blessings upon rural doctors everywhere. Sometimes, an area is simply too remote. If I recall correctly, a man in India in the state of Bihar spent 30 years cutting a road of a handful kilometers through a mountain so that it would only take a short distance to get to medical help, instead of hours to take the usual roads around the mountains, all because his wife passed away just from being unable to get swift access to medical help. He has since passed away, and I hope he rests in peace with his beloved wife. Certainly, I would nominate both him and all equally dedicated rural medical staff to equal high levels of sainthood!
« We are in the middle of nowhere but we still have the Internet »
That’s right there is the very definition of rural medicine
My first hernioraphy was TH-cam guided
Love this! And it’s accurate! I did Locums when my kids were young and was sent out to rural ER’s. When the Locums company first offered me this, they told me I’d be the only doctor there, and I’d be covering all the inpatients as well as the ER. I said ok, as long as I had back up. Nope, it’s just you. I asked - OB? No. Surgery ? No Anesthesia? No, just you. And it was just me, an RN, an LPN, and and Mr. Tom, an elderly man who served as security, maintenance, and everything else. Once a farmer came in with a large piece of metal farm equipment impaled in his leg. Tom took me down to the basement where tools were stored and we picked out something to cut it so I could pull it out the other side. My dad was a radiologist and Id learned how to operate some of the equipment so when needed I’d push the gurney down to radiology, and do what I had to do. Farmer got bit by a huge snake, killed it with a shovel, and brought it with him in a burlap bag. I got on the phone with poison control to help me identify the snake. As I turned it over to examine its ventral scales it apparently had warmed up enough to come back to life and almost bit me. Good thing it didn’t, as we had only one vial of anti venom. I loved rural ER medicine. I’m in a city now, but when my husband announced he wants to buy some land and move off grid - well I’m excited to go back to rural medicine!
You will be deeply appreciated by the locals, too.
This was great! I'm not particularly rural (Hamilton area) but I am a farmer, and so much of what you said here is so true. I think for those of us involved with livestock, it's so unusual to be referred around to different specialists because our vets do everything, and they expect us to be able to do a lot as well. I resent the implication that someone would go home and clean them selves up with rubbing alcohol though! My first aid kit in the barn has betadine, chlorohexidine, sterile gauze, silver sulfadiazine and about 20 more options for potions. Rubbing alcohol is for cleaning the thermometer and getting old marker off the white board!
Agree that we would not use rubbing alcohol as that would hurt and be incongruent with basic treatment we even give the livestock. Now flushing a wound with a water and chlorhexidine mix or iodine mix if it had debris in it is another thing entirely, before deciding if it needs stitches or staples and loading it up with antibiotic cream or gel.
If the Hospital is that far out, sometimes a vet is too and we get good at a lot of livestock care. If no one will see the stitches then chances are I've done them enough to have a pretty good idea of what I'm doing as my vet has been teaching me for over 25 yrs.
As a rural patient, I appreciate the confirmation of the realism from an actual medical worker 😂 it's the mentioning how if it's after 4 you have to chain imaging
My uncle was a GP (general practitioner for you youngens out there) in a small town from 1952-1984 and yes, he did all of those things while brining up 8 kids, sitting on local school boards and member of fraternal organizations. Never had to run against a goat, though!!
I'm an Albertan, and my small town doc was still practicing at 83! He would get called out to deliver breech births, and he was an amazing teacher. He helped me in a lot of ways, including saving my life. He was an amazing clinician because he trained before there were a lot of diagnostic aids. He was a fascinating fellow to listen to. He would often tell me stories about medicine when he was younger.
Yeah up northern Ontario we had an ancient Dr who sounded like Elmer Fudd, after a stroke, but still practiced. During a code, he'd ask a nurse to draw blood mid code. Ok?? He'd call to stop or continue based on blood color ( oxygenation), no oximeter for him!
Love this. I'm not even surprised that so much of the original video is realistic; it has this "it's hilarious / shocking _because_ it's true" vibe.
As for the "target" group of rattle snake bites ... I read, ages ago, a short paragraph in a newspaper on how most injuries during shoveling snow occur in middle aged men. AKA guys who don't work out as much as they did in their twenties but haven't quite realized the implications of that yet.
Yeah. Snow shoveling can be extremely challenging. If you're not in shape and you go out there, it can cause you to have a heart attack. Happens to the guys you mention here.
Sports oriented guys who learned to always give 100% need to learn to pace themselves when they're not in training.
My cousin was bit by a Massasuaga Rattle Snake when he was about ten years old. They were in the Bruce Peninsula hunting in the fall. It was an unusually warm day and he stepped off the trail to have a pee and the snake bit him on the calf. Luckily they were close to the vehicles, they threw him in the truck and drove him to Owen Sound which was a 45 minute drive at whatever insane speed they were going. It was super painful and he is still traumatized by it...but he was okay and made a quick recovery.
Lived in a rural community for years, closest hospital was 30 minutes away and people would joke you only went there if you wanted to die. We learned to take care of everything ourself. My midwife wanted to know if i wanted to transfer to a hospital after my home birth to get stitches and i asked if she could do it herself, because i didn't want to move at all. She shrugged and pulled out her suture thread.
Facts. Growing up in a small town I can't count the amount of people who have just done their own stitches at home. I also got ear infections regularly as a kid and our doctor (45 minutes away) helped my parents order the scope to look in my ear, and taught them how to use it, so they could diagnose ear infections themselves and just call the secretary so he could call in antibiotics to our local pharmacy.
I'm an RN in a small rural hospital in northern MN. All of our docs are also family practice docs in the clinic. The on call doc does the walk in clinic patients, the ERs and rounds on the inpatients for 24 hours, 48 hours for weekends. We only have MRI 1 day per week, and ultrasound during the day on weekdays. Several of us are also on the volunteer BLS ambulance in town as well. We are lucky enough to not need antivenom for anything up here at least.
I live in northern MN myself and that sounds absolutely normal to me. I've had to wait a couple weeks for an MRI because it was already booked solid for the previous week.
Also northern Minnesota here; rural medicine sounds like my dream job.
As a farmer kid that's lived in rural communities most my life, I can confirm that I was taught how to stitch up wounds and set basic breaks by an old Vet since it was hell getting to any hospital or clinic. I still get the occasional call for help until the patient can be coptered out to a bigger hospital usually an hour plus away. 😅 Stitched my own grandma's hand up before.
We live in a rural farming community in Kansas. When I first saw Dr. G's video, I sent it to my husband. His boss owns a farm, fell real bad once, hurt his back and didn't want to go to the hospital. His family made him, which is good, because it was broken. Farmers are effing insane!
A rural family member drove himself to his own vasectomy, had the procedure done under local anesthetic, and drove himself home. He refused to have help, saying "I don't drive with my balls"
I have worked at 2 different rural hospitals and at a city hospital, and I have learned so much more in the rural hospitals. I've done postpartum, acute care, rehab, long-term care, pre and post-op, wound care, and pain clinic in the rural hospitals. I've even done rural home health which is a beast on its own. I absolutely love it.
The scope of rural medicine is why I'm interested in it (if I even get into medicine). I think my rural upbringing is part of the reason I haven't been able to settle into a narrow career after finishing a non-science undergrad and bouncing around for a while. I was wired to be a jack of all trades and problem solve unusual challenges, but I also like taking care of people and hate being behind a desk with little human contact.
Next best thing to being a Vet 😅
Not much human contact in health care. 15 minutes tops to treat people like puzzles with zero time to connect? I mean, it's interaction, and it's with humans, but there's zero soul or humanity in it at all.
@@MaxMckayfulYou are generalising. We are doing what we can in the allotted time. The specialist have many people to see, training and young doctors are able to interact more. However, we aren't allowed to fraternise with patients because someone will always be salty. I'm still studying and I was reported for spending few hours with a dying 18 year old kid whose family was on the way even though I wasn't even assigned to the disgruntled patient's head doctor. My friends and I pitched in to buy a wig for a young woman with alopecia after chemotherapeutic and we were reported (by a very wealthy lady nonetheless). I'm very understanding of the fact that hospital setting is emotionally difficult time but if you too could possibly loose a chance for specialty placement or other opportunities because someone accused you of unprofessional behaviour each time you went out of your way - on your time and on your dime - for a patient, you too would limit your interactions. It's not an excuse to be dismissive or an asshole but we are actively punished for being too friendly and too engaging. I would love to be able to spend more time with patients, especially those lonely and struggling but it's difficult when time is limited and someone will feel stiffled and jealous. And there simply isn't enough time in our schedule so we either feel guilty for not interacting at all beyond minimum or are forced to "play favourites" and get punished for it. We aren't the ones assigning the amount of patients and task each doctor and nurse has. It's not up to us. If we don't fit in alltted time frame, either people will be angry, there will be delays or complete halt of scheduled operations or at best we have to do it on the little free time we have.
I bet you’ll make one hell of a fine doctor someday. Find one or two experienced RNs and you’ll be golden!
And a good vet. They know more than most Drs
Our tiny, rural hospital in West Virginia does have a CT. It is 39 minutes away from me. The nearest acute care hospital is 1 hour and 28 minutes away. When I needed an urgent pulmonology consult (uncontrolled asthma), my local hospital offered me an appointment 1 month away (the pulmonologist visits once a month). I saw one at the acute care hospital. I only had to wait 9 days. I have the utmost respect for doctors who are willing to go into rural medicine. We are so grateful for you!!!
My dad lives in a very small town in Iowa. I work on medical equipment in the DC area with all our hospitals. They have a “hospital” that is smaller than our stand alone ED clinics and has an on call Dr. My father had an issue while visiting and we had to go in to the ED. They were shocked that it was fully staffed and actually busy in the evening.
Also don’t underestimate Texaco Mike running or building a MRI. Some of these farmers are creative.
I’m an NP in rural Texas and I love the people of the community where I serve. It’s frustrating though because resources are limited and the patients often have barely enough money for gas to get to the appointment much less the medications they need. It takes finesse and a lot of heart. 💯 true about the farmer. If they are at the clinic saying their stomach is “hurting a little” you better bet they are having something like a dissecting AAA (yup, it happened right in our clinic). I love rural medicine.
I am a RN. I lived 30 years in a major city and worked at a large Level 1 trauma center. I moved to rural northern Michigan where there are rural medicine doctors. They are absolutely the best. They think outside the box and are great diagnosticians. They use their 5 senses and brains, a skill many urban doctors have never learned.
Dr. Glaumflecken needs to see your video!!! I am sure that he thought he was making a fun of rural medicine and over-exhilarating a bit. And here you are explaining how everything is CORRECT! 😅🤣
Great reaction video! Especially as I can hear how much you love and are excited to help people in challenging situations! Big heart 💗💗💗
Thank you so much @SatumainenOlento :) I really appreciate it. I would absolutely love to have Dr. G react to one of my reactions 😂 It'd be the highlight of my entire TH-cam experience so far. However I suspect that he's well aware of the truth behind his video since he's right about so much.
Have a great week
The state of healthcare due to staffing concerns alone is insane. The idea of ERs being closed is crazy. I work in a semi-rural hospital. I am the singular x-ray/CT tech at night, but at least we have them! We have an MRI trailer that comes 4 days a week. Other than that, yep, pretty much the same. It is a different kind of setting than the Trauma 1 hospital I used to work at, that's for sure.
Lenox Hill ER in NYC was a mad house at 12 noon. It was a zoo. Nurses were short and looked miserable, I felt so bad for them. I can’t imagine what it’s like at night.
Tufts ER in Boston was calm at 1 am. The nurses were great.
We had the misfortune of having to go to the ER.
Yup. We had the mobile MRI trailer come twice a week.
We get the mobile MRI once a month, unless you want to drive 60 miles to the next hospital that has one on site. That usually takes about a month to schedule anyway so might as well wait for the mobile unit. There’s a hospital about 25 miles from mine that I needed to have X-rays at after a bad fall while working and they had to call the X-ray tech in from his New Years Eve party. He showed up in shorts (in -25 weather) and a flannel shirt, having clearly already started celebrating lol. It would’ve been a real fun time if my wrist hadn’t been hurting so badly cause he was in a REALLY good mood haha.
Good video, layman here, but I love the Dr. Glaucomflecken videos. God bless you Doc!!
Thank you so much @Jere616 :) I love Dr. Glaucomflecken's videos and reacting to them too.
Also, I really appreciate the donation - it'll go a long way towards gas money as I'm driving around to the different hospitals and sites up here 💪 God bless you too
@@nxtgenmd Hey Doc, I'm very glad it helps out! Now if you can only get a Jonathan, you'd be really set!!
As someone living in a rural area: At 4:12 re. patients "don't want to go" -- patients may very well simply _not have the money_ to go and see a specialist. When my MIL needs to see one of her specialists (rheumatologist, pulmonologist, allergologist...) it's often hours away and requires a stay overnight in a motel; especially in winter (more than crummy driving conditions, or the bridge is "out" b/c snowstorm). And many people here are farmers, so they might have to find a "farm sitter" who does the milking and feeding etc. during their absence. It's not always that the patient is ornery and/or can't be bothered. 🤷
Actually, the setting could be AL,LA or MS as well as FL. Vast areas of US are underserved. I live in Central IL, had a surgeon try to talk me into him doing colonoscopy as he could fix it if punctured bowel... Since a real gastro was 40 mi away, went to real gastro. As RN worked in nursing home where had to wait til coroner got done in combine to have deceased removed, the NP moonlights as bartender and won't take calls about pts, Local pharmacy has been known to drive to yet another pharmacy to get vital meds needed stat... and come in covered in dust as was tending the grain silo and auger got messed up. Pretty much everyone carries vet wrap in the car as is emergency med equivalent of duct tape. Being late to work because farm equipment is on the move is a valid excuse in spring and fall, esp when sudden good weather.
Yeah. The U.S. is being, and the vast majority of it is rural.
Where I live the closest clinic/doctor is 20 minutes away (drive), and the closest real hospital is 35 minutes.
Not seen any fan boats here in MS, but I always thought he was in the LA bayou
I love my rural ER docs, they just roll with it, with very limited resources.
I try to keep my visits to a minimum but when I’ve been there the range of problems has been impressive.
I live in regional (not even rural) NSW Australia. My nearest hospital is 30km (25 mins away). They sometimes have GPs in emergency. The nearest big hospital is 50km away, but this can be an hour and a half depending on traffic. Not advisable to drive when you have stuff coming out of each end. We do have ambulances, my ambo station is only 5km away, but there are never staff there because they are always out dealing with farmers or car accidents. It's called postcode medicine. Your postcode decides how fast you can get help and what sort of help. My town only has about 5,000 people, no 24hr gps or pharmacies, so if someone is crook or injured, call the cops. They will turn up within a few hours on a quiet night. If they call an ambo, it will respond soon-ish and is free.
I have a story about having a really well known doctor in your rural community! I developed what we think is fibromyalgia a few years ago-- it's one of those frustratingly obscure diagnosis-of-exclusion things. Turns out we have a nationally-regarded rheumatologist right here! He was about a half an hour away.
Thank goodness there are still people like you who are up to the challenge and enjoy it! You will be richly rewarded because you will get to know your patients in far more depth than all the specialists and all the big city hospitals where nobody knows your name.
Having grown up in a rural area, with a doctor parent, and then having worked (not medicine) in a rural area for a couple years myself before deciding I’d become too much of a city person…. I love watching people learn about what rural communities are like, particularly when it comes to the limitations on resources. People who only ever lived in urban/suburban areas sometimes have a blind spot to the idea that the only grocery store might be 20 miles away and any hospital might be over an hour away.
… also, I will admit to first aiding injuries that I would now go to a hospital for (though it helped to have Dr. Parent check my work). Vet wrap is not just for animals!
As someone who has lived in the rural Midwest for my entire life (2+ decades), I’ve never had an MD as my primary care physician after about 4 or 5 years old. My PCP has always been a PA, NP, or some other non-MD provider. I’ve gotten amazing care from my PA and my current PA always works with me to get me the care I need.
In my area, it is a 2 hour drive from my home to the closest academic hospital, and about 1 hr 30 minutes from the closest hospital. MedFlight (helicopter) is essential to keeping patients alive.
Also, my father is a 4th generation farmer. All of Dr. G’s depictions of farmers is accurate.
This is where you reach out and become friends with your local veterinarians… cause those techs can also run lab work, ultrasounds, and may have a little anti-venom. Oh and a huge amounts of meds are the same, abx, pain meds, and IV fluids 😂
I used to live in a rural community. When I needed an MRI, I had to wait two days until the mobile unit was scheduled to drive to my rural hospital, and it was conducted in the parking lot.
His clips ring true for rural medicine around the world. As someone in rural Sweden (who grew up on a farm). In this village we have one small health clinic. It has 1 doctor, 5 nurses and 5 nurse assistants. We are so glad to have him, nearest hospital is 30 minutes away.
I knew you were Canadian almost immediately because of your accent. Greetings from Toronto! Never have a massive gallbladder attack in Simcoe in the middle of the night, by the way.
Oh, and fellow Ontarians -- if the state of rural medicine here disturbs you, STOP VOTING FOR CONSERVATIVES. Thank you.
100% accurate for rural ED medicine in Ontario. Many years ago, when I worked at one of these hospitals as an ED nurse, there might be times that the EDP had left for the night and if any critical patient came into the department we'd have to call them for orders/ask them to come back.
Air boats are a HUGE thing in all US states on the Gulf of Mexico (Florida, Alabama, Mississippi, Louisiana, Texas). Also in Georgia and North & South Carolina on the Atlantic coast. Anywhere with shallow grass flats and swampy areas, including inland lakes too. They are loud, but so much fun!! Love Dr. G rural medicine.
A doctor can also buy an individual portable ultrasound machine to take for rural medicine, pretty handy.
I had an ex that was an ER PA and she did ultrasounds herself at night. Unlike X-ray, you aren’t going to give them (or yourself) cancer by giving it a shot, the worst that will happen is you miss something that someone better trained would have noticed, which is the same as anything in rural meds. And yes, Dr G’s long standing joke about ER doctors only caring about ultrasound is spot on.
Really great commentary on this Dr G video - and it’s so nice to see and hear someone like you who obviously loves his rural medicine gig!
The algorithm brought me here since I love Dr. G ❤
But this video was really special to me as I, a German doctor, did hike the Bruce trail a few years back and I actually knew the places you were talking about. 🎉
I had a very good time with the guys from lions head fire dept. since I've also done some volunteer firefighting and the t-shirt they gave me from their station is still a priced possession of mine 😊
Thanks for your recap Doc. Your enthusiasm for rural medicine is fantastic. Best wishes for a long and successful career....the lives you will touch and care for will be in the 1000s.
A family doctor! Bless you, young man!
My daughter is a second year Med student in Idaho. She and her husband have a passion for rural medicine. She wants to raise the quality of medical care for rural Idaho.
Note she is from LV, NV. Her husband is from WA. He did 3rd and 4th year rotations in rural Idaho. She worked as an MA while applying to med school. Both could see the need to raise the quality of care in rural areas.
Despite being a big city girl, she would live and work in Idaho for the rest of her life if she could. That is her dream and passion. When she sets her mind to something she works like he11 to accomplish it.
I work in a rural hospital. One issue is the refusal of larger more equipped hospitals to take patients that have started to have more complex problems than we can even test for, let alone treat. Combine that with NO specialists, except one cardiologist who has almost no access to anything but an ECHO and EKG.... Those larger hospitals, really don't "get" how limited critical access hospitals are.
Welcome back, loved this reaction video and hearing your insight! 💪🏼
Thanks Josh 🤙
I've loved the rural medicine shorts. I grew up probably not too far where you are (judging by the yellow brick stone house in the back, which common in the area my great grandma grew up in and near where I was raised) and also currently live in Nova Scotia, and it's crazy the things people will see to themselves. While I have been lucky enough not to have any huge issues myself, my grandma cut the pad of her thumb almost all the way off with a mandolin was bleeding everywhere and her response was 'What am I going to the doctor for, they're just going to wrap it, I'll do it myself'. We lived in a city so she did go to the doctor but right now I live in a community where there is no local health care, the nearest 'walk-in' clinics are by appointment only and the lines are often rung off the hook and after the pandemic the majority of the walk in clinics in the city that's close enough to drive to have transitioned to family care only, with the walk ins filling up so fast. I had to go the other day, got to a walk in less than 5 minutes open to see the 'we're fully booked' sign, drove to 6 others to find one that slotted me in for 7 hours later. In a lot of these places it's really no wonder that if you can fix it yourself you do.
My inlaws rented cabins in Minnesota for a reunion and everyone was talking about going to see Duke the mayor nearby. My husband's aunt went to see Duke and a dinner in the town had a sign up apologizing for Duke's inability to make his normallly scheduled rounds that week because his human assistant wasn't feeling well. the older generation at the reunion who grew up in the area said that most years a dog won election and that when cats won, their ability to serve was questioned because they didn't walk predictable routes. As someone who grew up in a rural community in another state, I can see their point that for how often community members seek politicians involvement instead of settling it themselves, a dog's as effective as any elected official. But I do agree with my husband who grew up as a city kid, that it is a bit strange to hear people debating the effectiveness of a dog versus a cat as mayor and not even considering a human.
I once delivered a breech preemie in the ER while moonlighting,mom had preeclampsia. It was a terrible ice storm. We didn’t have any newborn stuff in our hospital. Ambulance out chains on since the helicopter was grounded,I nuked some bags of rice to keep the baby warm and baby went off on a long ride to Oklahoma City to the nearest NICU while I cared for mom.
I started life off as an EMTp in Seattle, then moved Sun Valley, CA. When I started to get close to retirement, I moved to a rual county in Colorado. It took me a solid couple of months to figure out just how true this video is.
Honestly, I agree with the folks saying it’s okay when a Dr. or other medical practitioner admits they don’t know something.
I once had a Dr. look up a med they were prescribing to make sure there were no interactions with my other meds- as a chronically ill person, I’m on quite a few.
It was really reassuring, MUCH more than all the specialists I’ve seen who insisted that because they’ve never been taught about my condition, it must not exist.
Medicine is an ever evolving field- a lot of the work that patient advocacy orgs do is educating medical professionals on how our understanding of the disease has changed since they first learned about it.
Admitting to not knowing something is ALWAYS better than assuming you’re right!
This was a great video, your enthusiasm for your work really shines through. It’s always great to see people excited to be working in medicine, I’m sure your community is happy to have you!
Thx, doctor, for your service to the hardworking residents of rural America!
Wow this was so fun, so educational, and refreshing! Enjoyed it!
Thanks Joanna, glad to hear it :)
I love your videos and u radiate kindness
Thank you :)
I'm in rural USA...had an emergency at 36 weeks pregnant, the tiny rural ER hospital didn't even have a fetal heart doppler...never mind ultrasound access! They did their best to get me stabilized and then it was over an hour ambulance ride to the nearest hospital able to handle OB emergencies
I’m in a (Us) rural community that has experienced a shift of sorts for the last 20+years, where the doctor who was everybody’s doc for decades retired, and now the doctor changes every year. It absolutely sux trying to get a Rx refill on psych meds, because the new doc always wants to see the new patient first, but doesn’t have availability for the next several months
this was great. it reminded me of being a kid in rural nebraska and getting a growth on my neck and the doc just going "hmmm we could send you to Omaha to get it biopsy'd and such, or I could just cut it off right now with this pen knife and we'll see if that makes it better"
and just... going from "yup that's a thing we want off" to "hey you wanna see it?" in about ten minutes remains one of the best healthcare experiences i've had.
That video was pretty much my reaction as well the first time I was placed in a community hospital with less than 20 beds lmao
Favourite patient from that time was a guy who cut his hand with a power tool and basically came in for the sole purpose of "ha look what I did doc, funny huh". Rural folk are built different
Loved this! That's on of my favorite Dr G videos as well! (This one and when a farmer gets hurt.)
I’ve been a rural physician my entire career going on over 40 years now the only doctor in the county. When I talk to specialist needed a transfer I say I have a bible and a stethoscope if I had all the fancy equipment I wouldn’t need you. Would not trade it for anything!!!!
Keep up the great work doctor 💪 all the best
You were talking about imaging hours and I went, hey that sounds like our local hospital and then you said "30 minutes to Owen Sound" welcome to town. We are grateful that we still have an ER. Rural ERs are an incredibly important place in a community.
I worked at a rural hospital. MRI was only 1 day a week and it was a mobile MRI and after 5pm imaging and lab was on call and ultrasound was not available Friday-Sunday. I had to have emergency surgery and the closest hospital to get it done was 150 miles away. Luckily i didn’t have to be transported by ambo as it was only my gallbladder and my husband is a nurse. The doc loaded me up with pain meds and sent us on our way. This is pretty accurate!
Your description of Ontario rural medicine reminds me of working in rural hospitals in Malawi Africa! We had to send the patient to the private hospital for a chest Xray, then get the film and interpret ourselves and there were limited abilities to do lab work but they were great with LP's and delivering babies! Surgical suites had open windows and flies flying around and often ran out of power or water! As an internist I was able to diagnose congestive heart failure in an older man who was a priest with HIV but clearly had chronic noncommunicable disease (In Africa they think of the infectious diseases first, not the NCD's) But somehow they made do. Incredible experience!
It goes back in time to what doctors used to do and be.
Oh amazing I've seen doctors from all the other specialisms react to dr G but you're the first/ only person I've seen from rural medicine!
I've heard about similar stats on rattlesnake bites in Silicon Valley where the patient is male, 20's, and drunk.
I spent half of my twenties in Minnesota and Montana, and this is completely accurate. They bring specialists in from the nearest big city on certain days of the month. I drove myself 25 miles to the nearest town with hospital while going preeclamptic with stroke-level blood pressure and my kidneys failing because I was living in a ghost town of 20 people.
I just love these skits! They bring to mind a lot of real life memories.
I’ve worked as a scribe in rural before (they absolutely loved me because rural hospitals do not get scribes) the machines shutting down is so real. I know of an ER doc who got so fed up with it he did a fellowship with ultrasound machines and learned how to do it himself.
I love your videos and u radiate kindness. Dr. Glaucomlecken AKA the Top G.
Super wholesome content! Will subscribe, I hope we get to hear more about your experiences as a rural doctor.
That racoon cameo was perfect 😂😂
Thank you very much and I’m glad it happened to stop by when it did 😂
glad you're enjoying it up there :) Got my step 2 score back, got a 265!! Better than my nbme's 😄
Dude! You absolutely killed it! Congrats on the score - which way are you leaning for specialties?
@@nxtgenmd for critical care elective I was just using the internet book of critical care which is a great resource for anything you come across. Chapter on sepsis is important. Not sure what I'll do for my general IM SUB-i, step 2 knowledge seems to help in general though. I have two weeks with my PI at princess Margaret now so I'll probably ask for some simple rad onc resource.
@@chrislifts2981 Princess Margaret was my stretch of the woods for years :) great centre, hope you enjoy your time there. Good luck buddy
Congrats on that score!!
Awesome reaction video!! Loved it!! New sub for you, first year resident from Melbourne, Aus❤
Thank you very much! All the best with your residency, I’m sure getting to work in Australia is incredible 🔥
Sounds like southern Nevada Thank you docs! Glad you’re still here🎉
Amazing info!!! I never knew any of this about the basic medical services not available in rural communities.
I’m a huge Dr Glaucomflecken fan and you’re doing a great job!! 😍😃😍
Doc, you are smiling throughout the whole segment - it’s obvious you thoroughly enjoy rural medicine!!
I used to work for a hospital system in Washington state that had an MRI machine on a big rig truck, and someone would drive it to some of the clinics outside Seattle throughout the week in order to provide easier access to imaging for people who lived outside the city. Some of the days, it would go across the Puget Sound on one of the ferries to a clinic on one of the islands. They had the same set up to do CT and DEXA scans.
Love seeing someone adding their perspective to this sort of stuff. I'd been doing medevac up in Yellowknife and it's crazy seeing the sheer scope of what those guys will handle. To say nothing of how many times I've had to give someone an all expenses paid flight to Edmonton at one in the morning.
Ontario rural medicine! Love it! Cheers and thank you from Ottawa. 😁
A friend of mine from England was bitten by a rattler in 2009 or 2010 just north of Parry Sound. He was hospitalized for more than a week, and I remember they used more than 20 vials of anti venom. The Parry Sound hospital herpetologist (yes really) said he must have been bitten by a "particularly venomous sub-species" of the Massassauga rattler. The hospital bill was over $100k, and thankfully they had travel insurance. Rattler bites are horribly painful, I can believe people deliberately try to pick those snakes up, that's insane.
Hairz seems to enjoy the fresh air on this rotation…🤣👍👍 lookin good man😎
My mama! She was a young girl, bothering her brother and he stuck out a leg to trip her, but she slide across the very waxed wooden floor and cleaved her face open on the corner of a heavy chest. My grandmother called ahead and drove to the doctor's house where his wife was washing the dining room table down with potash, they packed her face with ice to stem bleeding and because they had nothing else to numb, lowered the single bulbed lamp and he stitched her back together. My mama's not quite 70 and her scarring is so, so fine, just dimpling on the edge of her nose and brow and again on her upper lip. Can't stress how her young age made a difference for the healing, but he did amazing work!
I recently broke my own right tibial plateau out in the pasture. I hopped 1/4 mile back home and went to the ER the next morning by myself,then drove myself 50 miles each way to the orthopedic clinic to see the surgeon.
I’m a retired rural physician and farmer.
My great, great, great grandpa was one of the few doctors for the men laying down the rail road line in the late 1800s and early 1900’s as they were building the infrastructure across South Dakota and Wyoming. He settled in Cody Wyoming with his family in 1902 and was the town doctor after retiring from the railroad. I can only imagine the stories he would tell us if he was alive.
I grew up in rural australia and it is the same here. We didn't have an ob/gyn in town in over 30 years. Gps and midwives took care of most things but high risk pregnancies or emergancies have to travel an hour and a half to the next biggest town. If you need a specialist you have to wait until they do their regional rotations so you can wait 6-12 months for an appointment. You can travel to larger cities which can be 4-7 hours way. For things like chemo or major surgeries its the same.
Very similar to my experience working in an animal shelter in the south. On the inside we are just trying to do anything we can while making multiple searches and multiple calls, on the outside we are all chill and there is never a worry.
After working way up in Pickle Lake for a while, can verify that remote hospitals have extremely limited staff and resources at the best of time, but they still accomplish an amazing amount with what little they have
I never much objected to a doctor admitting "I don't know much about that". I appreciate it. I'm the informed, intelligent, involved patient and between us maybe we can decide whether it's wise for you to try to fix me or whether I would be happier waiting a week to see a specialist. I don't mind being experimented on a little with something the doc hasn't done in 15 years if it's a minor sorta thing...sure, go ahead and take a stab at it rather than referring me away for almost everything.
But I also understand there are patients out there that absolutely flip out if the doc says "I'm not sure" or if the doc says "I'll order some tests to be sure, but I think it's X, but it could be W or Y or Z or cancer". I once mentioned who my doc was to a friend and she exclaimed "OMG! Worst doctor ever. He won't stop talking and telling me everything that might be wrong with me. Every time I used to go see him I'd come back with all these fears I might have cancer. I don't want to hear it, I just want him to say 'I'll fix you. So I found another doctor'". And my brain kinda exploded a little.
Sure gives a little insight into why some doctors are the way they are. So not just plain arrogance, it's getting pushed into it by some patients being like that, when they attempted to be realistic and humble.
I have had doctors who stepped away to look up medications, I am not fazed. MDs are not experts in every field.
It pains me that doctors have patients like that, because it makes them so much more wary of taking a collaborative approach! I have such a great back and forth relationship with my livestock vet, and I want to work as a part of my own healthcare team in the same way.
@@sct4040 I had a stunningly painful ear infection, once. I asked the doc if there wasn't a topical analgesic for the ear and he pulled the PDR down and started browsing, then after a minute said, "ok, let's try this" and wrote a script for "lidocaine, otic". Pharmacist took one glance and said "no such thing--lemme call the doc" and came back with benzocaine otic. I wasn't upset--primary care doc ain't an ear specialist.
I prefer a "It's not my specialty, but we'll get it figured out" whether the doc treats me or sends me to another doctor. I like it better when they make a joke about my previous incidents like "Why couldn't you have come back in here needing stitches again? I'm really good at those." and I usually joke that I wanted to challenge them this time.