obviously it blew up we got your attention and then you know I think it didn't help us out I think it just fed everyone who likes the drama that's Dr ad hope who works as an emergency room Doc in the UK but you may know him from his popular YouTube channel Dr hope sick notes he makes reaction videos to Medical dramas like Gray's Anatomy or medical scenes from Marvel movies or medical memes and if you think that sounds an awful lot like some of my videos you'd be right and that's kind of the point you see despite the fact that Dr hope and I are intellectual and educated doctors in our 30s we're still YouTubers which means we've got beef I start getting like comments on my channel like you just want to be Dr Mike you're Ripple off Doctor Mike and I was like no and I kind of got a bit like you're probably like more annoyed than I should but who really stole the concept from who can somebody even own a concept on YouTube a lot of questions needed to be answered and we're mature adults so I wanted to clear the air the best way I know how no not a boxing match but a good old-fashioned based face debate we sat down and got to tell our sides of the story from where the drama started to how it nearly sabotaged my business it's how we found ourselves two doctors from opposite ends of the Earth confronting each other right here in New York City take me through your head mid-2017 this happened okay or 2018 2018. 2018. what was going through your mind when you saw my videos and just to set up this situation for people it's about reacting to Medical drama shows uh I put out my first one in mid-2018 of reacting to Gray's Anatomy but Dr hope did his before so you you've done a few episodes now you see I did mine yeah what's happening in your mind yeah so so basically I started a YouTube channel I guess um a year a year or two after you yeah and my channel was pretty rubbish okay so I was doing what I thought you would like if you said to someone back then you're gonna make medical videos on YouTube what they look like that is literally I was talking about like this is a gallbladder this is a heart attack and the videos have got quite a lot of views now but at the time I looked like a rabbit in the headlines like it was almost like infomercial style hi what's that simple this guy it was like that um and I thought and they're not working no one was watching the videos so I was like well how can I do something that's a bit more a bit more fun um yeah and I thought what did I watch when I was before medicine so I came into medicine late and I used to love uh house and my my friends even at the time when I applied to med school were like you only want to go to med school because you love house and I've obviously that hurt me because it was very true you know so you have to I have to call it what it was and so yeah I thought you know what I love how so let's break down like this journey in it so that's what I did and at the time there were some react channels out there but they doctor reacted up but they were like the clip shows yeah and I thought we could make a more like wired magazines yeah right and Dr Ken had I don't know who that is okay cool but there are a couple other videos out there so I do you know who Dr Ken is oh yeah yeah oh okay okay sorry I didn't know that's the doctor kid or something cool and so I decided to yeah I thought I'd make like a long form you know what we all know is the kind of professional reacts Dr reacting yeah so put them out and then it they sort of went like crazy big like for me at the time it was like 10 000 views 20 000 views and I was like loving it and I was like this this is amazing this is so easy and then obviously um sort of I think at the time my channel was getting more views than yours so I was like look at this this is how you do it man yeah and then uh because I was a fan you know I watched the videos before I really enjoyed them um so I was like yeah this this guy's got it going on knows how to do stuff um and then yeah I saw you were doing that stuff and I was like oh okay cool and then I thought maybe there'd be like a little link little shout out or something you mean when you saw those videos yeah when your videos came out I was like oh that's kind of similar to what I'm doing then there was like a few more came out but your videos when my got ten thousand were getting hundred thousand and then a Millions then whatever and then um yeah and then I sort of thought Okay cool so you know give a little sent you an email said yeah we do a similar thing do you want to do like a collaboration or whatever I think I sent a couple of emails and then on like an Instagram message and then and then around about that time when your videos are getting crazy I started getting like comments on my channel like you just want to be Dr Mike you're Ripple off Doctor Mike and I was like no and I kind of got a bit like you're probably like more annoyed than I should do yeah that's normal though right I was like you know someone's doing similar stuff and I was like oh I felt like I maybe it'd be nice to have like a little link to it or maybe just like hey this guy's cool and I felt like I was justified in that purely because I think people come up for like you know legal eagle and he would be I think his first videos gave you like oh check out Dr Mike I've done this I'm doing this professional reacts because he he did it and I thought even if and I believe this to be true we came up with the idea at the same time you know I don't believe you sort of looked and were like but I thought even if I felt like it was still nice to have a bit of a like a shout out um and also where Leela I know that to be true because several times I thought oh this is a good idea for video I'll type it in and it's you know that that has been proved to exist so um yeah and then I think what I regret doing is yeah and I'm sorry about this actually I think I did like a video that to try and end it this was but it just started it it was and looking back it's so immature and to like I kind of did a video because I wanted to do all these people that write comments on my channel I wanted to just post something and I got bored like writing a post I was like I'm on YouTube I'm just gonna write a video about it and do a video about it and then I can just leave that link in and talk about the whole thing talk about what I thought happened and you know what it was I just not a good idea to do okay because it's it's I think it's very confrontational so I think whenever you want to change someone's mind you've got to like walk alongside them not not bad heads with them and I thought it was looking back very cringe but um but yeah so that that was one thing I I you know I I didn't think I handled in the right way and then obviously it blew up we got your attention and then you know I think it didn't help us out I think it just fed everyone who likes the drama and also it didn't make me feel good either like you know I talked about before you know sponsorship stuff when it goes wrong it just put so much pressure on that week at work was horrible you know and we've all had controversies in our lives like but we're not used to having that play out in the worlds yeah I mean we used to be having just beasts made with our friends and things you know a few people not being having us on stage with you know hundreds thousands millions of people that does not make people feel good yeah um so anyway I think we kind of just left things were and then obviously um we've connected over it you've sent me some really nice messages in the pandemic so classy guy like that thank you and uh yeah and I I think we just yeah that's how that's my tail player well it's interesting hearing it from your point of view because from my point of view you probably have no idea how like I'm curious how do you think it landed for me or like where do you think my head was at because I think it's going to be in a very different place than you think it was okay um for me when we were doing the channel for the first year when we were doing the channel we got fired by our MCN because they viewed us not successful um of making content they were giving us a monthly budget and they said we're done paying you because you're not successful we don't think your channel is going to go anywhere and we were actually filming in the YouTube spaces at the time where they allowed us to film for free if you had over a hundred thousand subscribers and we had a med student with us uh his name is Donald Pettit he's an ER doctor actually now um and he's a really good doctor shout out Donald Pettit and he goes you should react to watch one of these shows and I'm like dude I hate those shows they make me so angry he goes exactly that's why you got to do it so at the end of that video we said okay if you get this video a text and we're like I'll do it even though I refused Dan was bugging me about doing it for a long time even before that because he said there's comments about it but I'm like dude that's so boring who's going to want to see and I actually downplayed the concept so finally we did it and even when I did it I'm like Dan is this going to be even good I don't think this is ideal he's like no I'll edit it'll be good we put it out it blows up it doesn't go trending but it starts gaining views like exponentially that I've never seen before then we put out right away he's like oh we got to follow this up with a good doctor so we do good doctor now good doctor trends like number one on YouTube and when that happens you start getting the sponsorship attention media attention like no other and again I'm a regular doctor I don't know what to expect or how to deal with this massive influx of emails and I'm getting people reaching out from real life of people who've known me wishing me congrats people who hate me people like you were getting haters about the Virgin thing people who wanted sponsorships people who said I owe them something uh for using the show and that I'm stealing from the show so there was so many such an influx of emails that I was like I just gotta push through and keep doing it and I don't know who's being genuine in this group and who's not so I'm gonna ignore it and I remember like even we gained so many subscribers in that week I tweeted something and you made like a joke that oh uh you know I wish you did it first though or something and I'm like God why is this doctor attacking me when we're both doing the same thing so I felt attacked when I shouldn't have felt attacked it was a genuine thought you were having and Dan and I were in Florida in Kissimmee Florida doing a sponsorship deal when you published your video and I literally lost like my emotional handle in the meeting of this brand deal that I'm with and Dan's like Mike you got to focus on like you're having lunch with Executives you need to focus I'm like no and I'm showing the executives the comments because the amount of negativity that came in after that video was so big and I was like how do I fix this what do I do I'm so mad I don't feel like I cheated I'm so sorry man no no no no I just you let this is a thing you never know where people are when you know when you have these things you're doing it from your point of view you're like look I did this and look at this success and at the same time I'm like I understand what he's saying I wish he went about it differently and I didn't know like that I I felt like because you made the video had I reached out and messaged you privately and been like look totally sorry but this was not this thing I thought you might even make a video about me DM me yeah right because I don't know you as a person I don't know what your motives are so but at the same time I'm like I want to make it right like I'm like had had we known each other or had some kind of communication I was like I would bring him on the channel I would support because I always want doctors to come on yeah yeah like that's always been my mission and because the success was never planned I thought I was gonna do the same thing as you like the gallbladder thing you're right yeah it's a gallbladder thing I love that um so it was sad that it devolved to that and now even when like I'll make appearances on other people's channels they'll reference this beef yeah like this is still an ongoing thing that's why I'm excited we get to talk about it yeah yeah yeah cool so that was uh that was where my head was yeah I think um yeah I I I think you're right in terms of the way I handled it because I stupidly thought doing a video would end it like was almost like Dr Mike doesn't want to chat about it so this is this is the Line in the Sand let's get on with it yeah but that's not the way the internet works no no I just I just fed the trolls and it well you know well not necessarily the trolls just it it was just an un negative energy putting that out and people love negative energy yeah well our YouTube beef appears to be squashed there's still plenty of professional beef between us I'm a board certified doctor practicing in the U.S Ed is a board-certified physician practicing under the NHS of the United Kingdom these are two vastly different Healthcare systems and rather than debate which country's Healthcare System was better I asked the opposite which one was worse what I'll point out about our system is that I think it's slightly misrepresented as being a purely capitalistic commercial Healthcare System and it's not it's actually a hybrid system in that there's a handful of people who are or a percentage of people who are insured by their employer they have employer-based health insurance like for example all my employees and myself are covered by my company pays their health insurance then there's a group of people who are like say over the age of 65 have a disability they're covered by government covered insurance that's paid for by the government by the taxpayers if you fall into a bracket of poverty you're also covered and you get coverage from the government and then there's people who pay out of pocket on their own who just like have their own business or something and they pay out of pocket and then there's people who are uninsured so it's a very messy system and because it's so hybridized there's a lot of ways that people fall through the cracks and horror stories are a result so you have people who are like I just got fired from this job I'm about to take this job so I'm not covered I got in a car accident and now I have these bills and I'm being bankrupt so that's why our system sucks and so in that scenario does the previous employer not pick it up there's a lot of weird rules yeah and each one will be back I'm covering you only until this period this kicks in after you work for this period it's very messy and it makes it even Messier for us doctors because when I treat a patient I have no idea what insurance they have what coverage they have what recommendation I'm giving them how much it costs so it's impossible for me to be aware of what their financial Journey with the system is going to be except if they're fully uncovered then I know it sucks and I know what little things I can help them out with coupons so you actually have that actually forms part of your management plan correct mate that is so insane I'll have a patient come in this just happened the other day I prescribed them an antibiotic clindamycin and or doxycycline I forgot which one it was and I I send it out I have to be aware if their insurance covers it if they're uninsured I have to find them a coupon online to make sure they can pay for it and ask them ahead of time can you afford this medicine if not I have to find a different one that is the same anti-microbial thing and then the pharmacy will call me and say hey uh the medicine's rejected uh by the pharmacy and I'm like why they're like you have to do a prior authorization I have to call and argue why this is a cheap medicine doxycycline it's available everywhere they're like oh it's because you ordered capsules they only cover tablets I'm like you can't switch it they're like no we as a pharmacist can't switch it I don't even know the difference between tablets and tablets and capsules do you I don't know I don't know I don't know either uh yeah give tablets well it's cheaper yeah that's probably yeah it's cheaper yeah oh my word but I just kind of that all that extra paperwork yeah and that time and that money in that whole process it stops us from being doctors right that's crazy and how many in in a sort of how long do you get for a consultation as a family medicine doctor if they're a new patient and they're coming in for a quote-unquote establishing physical visit it's 30 minutes okay what about if they're coming 15 minutes yeah right okay so it's basically the same in the UK I think they have 10 minutes but the BMA want to have 15 minutes okay so the the 10 minutes is impossible right I mean some can take elderly people five minutes take off a jacket exactly you know and that's you know or get on the couch how do you talk about someone's mental health in 10 minutes yeah yeah yeah but I think things just run late and people GPS end using like it's horrendous to be okay so I've kind of summarized the U.S system summarize the NH yeah so we have the National Health Service we're very proud of the National Health Service it's publicly funded people always say it's free yeah the money just comes from somewhere else so it gets paid free taxes and yeah it's done everything is done on priority essentially but there is a private Health Care system too um so people that can afford it and and companies oh so there is a private Hut yeah okay so people they're private hospitals and typically um Specialists will work a day a couple days a week and some people will be full time in the private practice you know orthopedic surgeons you know the fancy ones right and yeah so people typically use that when they've got a lot of money or they just are fed up waiting because the waiting list can be weeks to months for for many different procedures so give me an example if I let's say I'm in the NHS I'm a taxpayer uh I have headaches that wake me up from sleep they get worse with sexual activity um there are new headaches they're 10 out of 10 whatever I'm trying to give red flags for headaches and I come in my GPA and he says you need to see a neurologist yeah does that take a long time yeah so we have things called two-week weights okay so these are whenever certain red flags you know pop up then we can get so an urgent visit is two weeks yeah yeah if a patient has to wait two weeks in my office now they're yelling at me yeah yeah and that's not an urgent that's elected but often the GP will send them to a e you know if they feel like this you know a bleed or obviously you know they'll come straight to a e and we'll see them in the emergency department but yeah the typical weight for cancer you know if people have got bowel symptoms that uh think it's cancer it's a it's a two-week wait okay is that is that longer there um so like for example I'm trying to think of a patient that I had that I needed to get seen early um like for example if I have a patient with um some kind of really bad esophagitis or gastritis from like a potential ulcer I want them to get scoped early they're not actively bleeding so if I send them to the era neither no one's going to accept them they're going to say you need to go follow up but they're actively experiencing serious symptoms and serious discomfort I'll get them an appointment in two days wow yeah so I think the GPS here would probably more and more ask if they have Private health care and they could make that referral got it um but if there's no kind of red flags then it will you know they'll just make a referral to the system and how long does that take well it depends on I wouldn't know actually so well give me like an average but it'll be weeks to months like people can people can wait a year for a hip operation a year yeah if they've got arthritis of the hit yeah this is how long yeah and the thing is within that there's problems right because they keep coming in you know hip-hop brains are bad example for this but say they've got sort of back pain they're waiting to see uh a surgeon they'll keep coming to a e within that time of course because for their appointment six months uh and they'll you know the problem's still there so they keep coming to a e so it's almost a false economy right creates more work in in the in the sharp end and when it should be dealt with that's so problematic in so many ways but also the NHS at the moment I don't over here is getting hammered why is that everyone is striking doctors are on strike I'm on strike at the moment really this is not why I'm here wait I will really strike at the moment yeah so do they have like uh people that fill in for doctors while you're on strike yeah so really who are those people nurses are on strike and paramedics are on strike but yeah we have yeah so the it's the the juniors are on strike the Consultants of the attendings are covered currently covering the strikes ended last week so it's it's we we just do a few days at a time and you don't want to make the strike too uncomfortable for this yeah um well this this is the thing it's a very and what is the strike what are you requesting yeah well also I don't want to say too much as well because the unions are very much like doctors should not be on media talking about the strikes because it undermines the messaging because we won't get the messaging accurate we're not trained by the union we need to do this properly okay so since 2008 the junior doctor pay has gone down by 26 percent so gone down yeah so in in relative terms I'm sorry what's a junior doctor so a junior doctor is anyone before an attending so like a resident yeah a resident would be uh one of the junior doctors yeah so you're not a junior doctor yeah yeah wait you're a resident um well I've we don't really have those terms that's difficult but I'm saying you take me through the medical education yeah NH in the US sure okay sure so I'm gonna have to yeah there's we have a system that was used like 20 years ago and everyone uses the terminology from that but we have a new system with new terminology that people rarely use but let me just summarize it so straight out med school what do college start with yeah okay so you can go to med school at 18. wow yeah and it's five years um so you can be a doctor at 23 in the UK okay so you're a doctor of 23. imagine that like I did an accelerate program so I was a doctor at 24. so I'm not that oh okay cool so we yeah so from there you then do two years what we call foundation training and that is where you get put on six different Specialties so you're sent around you have to do you have to do medicine hospital medicine have to do Hospital surgery you have to do a community are you practicing yeah so you're practicing under the supervision exactly for those two years okay yeah so seven now yeah so and you'll do community so typically Family Medicine okay and then and you'll do a range of Specialties as well so you might do Ops and guy I think that's what I did I did palliative medicine as well and it's I had a fantastic time my Foundation really great Hospital like really supportive and you know you learn lots of stuff and you learn what you want to do as well of course um and in the and actually in the second year of foundation that's when you're fully registered so in the first year of foundation training you're kind of like partially registered you can still prescribe see patients but you you know your consultant has a bit more involvement but then after that you're essentially working independently as an F2 foundation too you then go into core training and that's when you apply to be yeah so let's just say in general it's medicine or surgery or family meds but there are lots of different ones you can go straight into you know neurology you know neurology you can go straight into Radiology there's past ways in but generally people do the core training then after that you'll go into specialty training so the core training I don't know I'm just blowing your minds here the core training would just be general surgery and how long is that two years but then you might say I want to do lower GI I want to do orthopedic and then you're going to Specialty training after that and they're all different could be a few years could be you've got it all so to be any emergency doctor you do two years Foundation you then do two years core training and then you go into your specialty training and how long does that take um it takes five years specialty training hold on a second so you're doing five years med school yeah two years Foundation yeah two years core yeah and then another five years ER training yeah you're training for like 15 years yeah that's longer than ours it's a long time significantly longer do you know how it is here so you you apply straight after don't you that's right after med school yeah yeah so you do college four years med school four years your residency let's say you want to become ER I think ER is a four-year residency and after that's it yeah or you could sub sub-specialize you do a fellow but that's it so 23 you you finish school two years Foundation you're 25 two years core you're 27. and then five years yeah I think it's something 32 33 you could start as an ER physician yeah well as a yeah this is the thing as an attending but with all that time you're doing the job of course yes yeah so you're in your five years um so oh this gonna confuse you even more so I basically do um a slightly different route because I wanted to do a bit of teaching I wanted to do like the YouTube and things so I I finished after I did my foundation training and then I did a teaching fellow for three years that you step out of the whole system so I was teaching Med students and doing my clinical work in ed [Music] and then I from then I just do Locum work so you essentially work as you know pick up shifts when you like and so I'm basically working at the level of a core trainee a junior but I'm not and you get paid less for doing that yeah yeah okay um so for me to get to the next so given how much time I've been a doctor I should be kicking on more than I am because I've decided to do other stuff I got it okay I'm kind of uh such an interesting route it's very weird isn't it but people are very doctors aren't enjoying training at the moment well I wouldn't either if it's so complicated yeah but there they don't think they are service provision as in they're there just to see patients which okay people want to and be like yeah right that's the job but you're supposed to have an afternoon training a week you're supposed to be sent on courses you're supposed to have Consultants witness you do things of course to progress you instead you're just working it is so bad in the hospitals at the moment the in a e at the moment I don't know if it's the same in the US we are capacity and then some if you were in my Hospital in the last few months every single Bay has two patients soon and then there's hallway patients and there's all along the hallways to bring a patient in from the ambulance so the ambulance weights are crazy high I think all the main Pro like the top priorities are getting seen just about but then what happens is that all the other ones suffer increasingly more if they're less priority when you bring a patient in it's down a corridor lined with trolleys that only fit two trolleys through so everyone has to move out of the way when the trolleys come down and you'll you have to see your patient assess them on a trolley patient dignity out the window you have to examine them you either bring them now right you have to you'll either bring the curtains around the wheel and then that blocks the whole Corridor so no ambulances can bring anything and it's horrendous would you I just you can't think too much about it because you just wouldn't want to do it and when I walked through the hospital I have my eyes on the floor I can't bear to look people in the eyes because you know if they're like like your family members mate it's it's shocking and the waiting room's completely full there's you know patience in every chair relatives are asked to leave because there's no room for them people are like you know on the floor you know this isn't happening like every week you know there's every day but it happens every week where it's and everyone you come in and it sounds like I'm dissing the staff here but it the complete opposite everyone is yeah that you work with trying their best they are just doing the amazing job and they you know they deserve these pay Rises that they're striking for because they're striking for the future of the profession to to work within this environment you know they deserve deserve to get some yeah to be paid you know we can't afford to pay them what they're worth but let's give them at least something yeah yeah wow it's interesting to hear you talk about it like this because whenever I'm asked a question about our Healthcare System sucking everyone's like we gotta we gotta switch over and be NHS and I'm like I understand why not worrying to pay for something would be a burden off someone's shoulders but at the same time there's problems new problems that will arise that we have to fix and here at least anything that the government does like the frequent example we give here is our Department of Motor Vehicles DMV where you go to get your license car registration all these things it's terrible because when the government runs it they run it ah no one cares no one shows up you can't really get fired like it's very lackadaisical so no one cares whereas if you go to a corporate company they're like on top of it there's metrics because it's Financial so they want to make sure it's optimized so I'm like oh my God if we just go to a full nationalized Healthcare System seeing how bad anything that the government fully handles is terrible what happens here I don't know what that answer is it's scary so do you have a solution for the NHS I think I don't know what yeah the raise taxes give us more funding yeah I mean I I chat to this to my mates like they come but how is it Ed and I'm like it is horrendous and then they're like well what can we do and it's like I don't know I I literally don't know because everyone's trying their best like I think one of the issues is that the social care needs to be sorted out like people come into Hospital you know for example if you have um an elderly patient that's come in maybe they've got a urine infection they're a bit confused they are the sole carer for their partner that has dementia suddenly that's two people coming into Hospital they're not safe to go home they've got no support package at home they've been struggling for maybe two years and this is like Crisis point maybe that's you know contributed to the illness they come in they you know assess from a medical point of view these you know these patients are maybe waiting on a trolley for a day or two in the Ed and then they find a ward then they get medically optimized the the husband as well is you know got a bed and then we can't get them home we can't discharge them from hospital because that's safe it's not safe they'll just bounce right back right there's no to try and get the care put in and and assessed just okay so in your rehab or something yeah right those things exist but it's all just so backed up yeah and what happens is so the hospital beds get full up then it kind of goes back to the hallway yeah right and then so as soon as soon as it's busy in a e people like what can we do about it now it's like the problem was three weeks ago exactly it's you know there's nothing we can basically do now we also have I mean we see a lot of people with with mental health problems well yeah you know Community Mental Health is is under massive strain as well and and and GPS as well they're getting a lot of flack and I think the general public are kind of turning against them because they're struggling to get appointments um and I think they almost like blame the GPS yeah like work harder take more more patience right and the GPS my friends that work as GPS it is just horrible for them they're seeing far you know more patients than they ever seen and it's quite easy I think being a an Emergency doctor is you can go in and take and kind of leave and your work kind of goes because you hand over the patients you're worried about or the patients you've been discharged they've kind of gone to the family medicine doctor there's no follow-up yeah and that is that stress you know you worry about people but this there's not the responsibility but for GPS for that have a caseload or people that are Community nurses or community mental health workers when you have a caseload of people that you're responsible for and the case is growing people have more complex issues they're not getting treatment it's I don't know how you live without chronic stress having that responsibility it's hard speaking of chronic stress um you know I kind of wanted to do a segment where we do ER versus FM Ed and I may share similar views on health care and make similar YouTube videos we do have one major irreconcilable difference our Specialties I practice Family Medicine where Dr hope works in the emergency department so we stepped in the ring to defend our Specialties and see who really has it harder when they go into work what drove you to go down the path of ERM as opposed to a different specialty yeah I love the variety I love the fact that I don't deal well with chronic stress like stuff that builds up I don't like having loads of stuff planned in in the future I like going in solving it yeah I love the teamworking aspect and that's probably why I didn't choose um something like family medicine because I like working with like lots of different people um so yeah they were the main draws but I honestly loved every area of medicine I really tried like when I was doing that you know I thought they all had really interesting things about them so yeah what about you what was yours well Family Medicine uh I felt fit my skills well in that I liked interacting with people conversing having a good conversation I think that helped a lot when it comes to educating someone about their health or helping them come to a decision also like you I loved every aspect of medicine so I couldn't see myself specializing in one system because I felt like it would kind of disconnect me from the rest of the body and the number one thing is the continuity like the thing that you say is stressful and maybe even dislike I found really rewarding in that if I on day one have some sort of intervention for a patient about their lifestyle ten years later I could see the benefits of the change that I made 10 years ago and it allows me room for celebrate or to see the work that was put in or for example I delivered a child that child is now my patient they're six years old and I'm watching them grow and I was the one that facilitated the process like that's really rewarding we're seeing like more Generations now you've been in long enough to see yes yes there was actually a family I talk about them quite often who um they were some of my first patients that I saw as a young training doctor and they were having trouble conceiving a child the father was on a medicine for his prostate and that medicine actually in had some sexual side effects for him we changed the medicine got him on a different one they were able to conceive I delivered the child the child is now my patient so I'm like this is like crazy to have this whole thing yeah yeah it brings it back to when there was one doctor in the village and they yeah yeah right I mean it's kind of the opposite of a e we see people when it's gone wrong again yeah it's like oh oh you're back with your you know going into uh dka yeah right it's like welcome back yeah and I mean the number of times patients say to me uh you know thank you I hope I never see you again that's like a general uh General patient quit but you know happy to uh yeah that's great so I've got you I write some notes actually about um what's good about emergency okay so look how much more organized you are but I think yeah but I can't come up with it on top of my head so I mean I I thought it was more of a challenge right okay a challenge to come up with things well no no not a talent is in I thought I would have to prove that emergency is better let's hear it do you know what I mean I'm gonna fight it right now yeah I'm getting my back but just so everyone knows this is a joke okay no I'm not going too hard I don't want to get clipped and then you're getting we're canceling you after this okay you can't be at one point who who do you think is cooler okay John Carter Dr John Carter from ER yeah not the uh caveman guy from that last movie I didn't watch that yeah that's it well not him who's call that John Carter or Dr Phil that's not a fair collaboration okay comparison because Dr Phil's not a medical just uh yes John Carter there you go see emergency medicine better okay um a TV training in the UK three years six years emergency training oh so what's harder twice as hard twice as long yeah so that's that that's like a viago commercial yeah twice as hard twice as long um yeah I thought here um the environment I thought you want you win on actually okay why is that because Ed's not not as nice I don't think okay in terms of what like quality of life no in terms of like working in that environment I think the actual stress yeah maybe a lot of burnout for ER doctors here right in fact a huge percentage that majority but a huge percentage of ER doctors end up swapping to an Urgent Care model because they burn out after 10 years of working in an ER right and Urgent Care are you familiar with that model yeah but it's I think creeping into the UK yeah it's it's actually quite here in the US because it's turned into a financial model more than a medical model like hedge fund companies are investing in large groups that run these urgent cares and they essentially were supposed to act as an intermediary between a general practitioner's office a family medicine doctor and an ER so you cut yourself you have a giant open gash you don't need to go to the ER uh but your family medicine doctor has no appointments today only tomorrow you go to the Urgent Care so it's supposed to fit that Gap unhust offset um either FM doctors or ER doctors anyone can really staff at as long as you have a medical degree or train um but what it has become is The Young Person's I only need medicine when something goes wrong model so now they don't have primary doctors they just whenever they have something wrong they go to their Urgent Care they see the doctor they send them out with the incorrect treatment the huge majority of the time because they don't know this person well or they over treat because the patient is paying for this out of pocket most of the time and they say if I'm paying out of pocket for this I want something you told me I have a virus but I want an antibiotic and to make sure that they have good reviews for this company they give them whatever the person wants so it's a very shady model not a fan of it at all so I I think those are going to come back to haunt us in the U.S yeah I think the way people exactly what you say people are interacting with Healthcare differently and I think it's because Society has changed in a way like we are used to getting an Uber like that we are used to so grocery delivery yeah people interact with Healthcare like that which is not the traditional model we I think I'm not blaming people that's just Society so we kind of need to move you know how can we get that I know I know in the UK lots of like telemedicine is happening now like companies you know GPS are working and these are all private yeah I mean you know teleconferencing and stuff happens within GP practices now it's exploded since the pandemic but private companies offering this and I think a lot of the time young people they they're happy to spend that just to for the convenience yeah but that's not always ideal yeah I mean I I have sometimes a telemedicine appointment and it's like I have stomach pain how the heck am I supposed to diagnose a stomach pain without a physical exam she's like I mean it's not going to be a good diagnosis I'll be guessing so you just put the camera yeah but even then like oh I know I know it's it's hard and they've even come up with some tools where you have like an otoscope that you can put in your own ear love it and I'm like God this is gonna end in this or like a stethoscope you can put on and listen perfect brilliant and endoscopy yes why not yourself yeah so we need to think ahead like I've heard like people you know put in like haptic suits and stuff like that I mean come on I think it's too far yeah right I mean you don't fix what ain't broken right exactly that's not the broken part of this yeah and now I'm starting to see all these companies that are like oh chat with our doctor and get a prescription for erectile dysfunction or hair loss or this and that there's no chatting with a doctor it's it's say that you have hair loss and check off boxes that you don't have these other problems and we'll send it to you but you're not getting a real evaluation I can't tell you how many men have come to my practice asking for erectile dysfunction pills and I found that they were diabetic and we actually saved Our Lives by starting to treat their diabetes but now those people are just going to go on this website get their erectile dysfunction pills and stay with her diabetes undiagnosed so it's it's not ideal and I think the pendulum is swinging a little too far and we gotta guide the pendulum back to the middle a little homeostasis is necessary I don't care all right what other jokes you got well they're not really jokes they're just uh facts yeah so I actually put this into um chat GPT oh I said you know what's better and I said to chat GPT can you compare them and use some cultural references okay okay and it said it was very kind to emergency medicine it said that emergency medicine doctors were like The Avengers oh sort of swooping in saving the day instead of you need CPR you should find an emergency doctor and I was like well that's not true any anyone as you know as you've preached a lot I mean you don't want a dermatologist performing CPR I think or a pathologist yeah I know they can but if you have to select you're not like give me the pathologist yeah maybe we do it more often than a pathologist yeah um but you know it doesn't take an expert to do the CPI okay it helped you know go on a course definitely but yeah it's in hospital what we do compared on the street is very very different well I'll put it this way you don't want on an airplane emergency a dermatologist standing up saying I'm a doctor right I'd rather an emergency room physician I think we um the funny thing is out in the public if there's a cardiac arrest and we did a CP you know how to do CPI obviously I'd be the one on the chest in in the sort of a e it's the most Judy person but it's like I think I think it's people feel like it if the people you know that's how you say the lights all the other stuff well it's the same thing with like blood draws they're like oh I want the doctor to do I'm like no you don't yeah it's my nurse who does 50 of them in a day it's the same thing actually when people come in because they can't into a e when they can't get an appointment with a family medicine doctor like oh I've had this thing for a while I'm like you and they think that we know more but this is the thing that like we're Hospital doctors yeah you know we we must know more than the family medicine doctor and you're like you though no they are experts in seeing this stuff we are you know very yeah yeah okay and then it said so it said we're like The Avengers oh my God is it going to give something bad to no it said that you guys were like the sidekicks yeah are we your Sidekicks yeah they said they're reliable and stable they're like the friends of the Avengers that's terrible I know I'll send you the clip so you can I say that are they suitable you'd have to ask them that okay they'll probably give because that's ridiculous and they call the sidecast my name unbelievable so yeah that was the the GPT and you know I think that's I think it's great although it did um it did put me as a female doctor on tattoo it did yeah when you searched your name yeah is it Dr Mama Jones she um she wrote who are the top female doctors in on YouTube and I would think number four oh so great interesting yeah maybe Chad GPT is uh not 100 accurate yeah or maybe it knows something about me I don't oh my God this is you think he knows that much it's like you know the tick tock algorithm some people say like it led them to question their sexuality because right it started showing right of the opposite and then like oh maybe this is what I really want that does freak me out though these algorithm things of course it must what it knows about you I mean the whole AI we're just talking about this like it's the scariest thing on the planet because if it learns that fast yeah how useless are we gonna be unless you can code or fix code or fix a computer you might be useless and I think I've been sleeping on it a bit you know I didn't think it would be here now it just suddenly arrived in the last year and it's now just obviously they've been using it uh Lots in research and you know in any social media apps for a while but it suddenly feels like now it's there is a breakthrough and now it's exponentially exponential yeah it's scary I don't like it so what else have I got here um I mean I think I think that was it really okay oh I put we've got cool gadgets ultrasound machines um we get to intubate people we get to reduce fractures well you know what's interesting is like I for example don't work inpatient but that's simply because of my choice a lot of my colleagues see patients in hospital yeah right so they spend half the time outpatient so they're doing a lot of these things too in hospital it really depends on your scope of work like there's Family Medicine doctors in Alaska that are like delivering babies performing minor surgeries like there's a there's a broad spectrum to FP but in the UK it's not like that right GP is strictly GP office space yeah it's it's GP I mean obviously this is tongue-in-cheek I have lots of respect for my GP colleagues I think it's one of the hardest hardest jobs to do but yeah lots of GPS I work with day to day we always have a GP in the in the hospital I work at but you know I think part of the reason because people are using the Healthcare System differently and also it's you know they're great to have a diverse set of skills available um so yeah we have an urgent treatment center associated with our hospital and then you know at night we have one GP and so yeah it's collaborative effort and I think they really enjoy it as well because they get the team aspect and also must be frustrating sometimes like I need a chest x-ray for this patient that's come in it's kind of useless I can do a few bits but it's like they can get it there and then and you know get blood taken and stuff so yeah it's sometimes it's messy where I have a patient coming in with like a questionable pneumonia or something like a fracture and I'm like okay go to get an x-ray now I'll stay a little late to get the result or I'll have my resident follow-up overnight it's like it's messy sometimes but you can figure it out make it work I wouldn't say that's the issue I feel like our biggest issue is a finance issue can patients afford their care is the cost of it fair and a lot of times the answer is no even if they're insured sometimes the answer is really it's also messy for example if a patient comes in and they're uh let's say that their neck hurts and I'm like when did the neck pain start and they said I was you know I was in a car accident three weeks ago and the neck pain never got better and I want to do some rehab I'll see them do the visit I'll say Keith needs a physical therapy maybe a muscle relaxer whatever something and I send it to their insurance insurance said Hey in this note you said they were involved in a car accident we're not paying for this his car insurance should pay for this and the car insurance like somebody filed it late father late so I'm not paying for this and they start arguing amongst each other or they'll be like oh he was in a car but the patient was driving to work this should be a workers insurance so it's it's not clear in that sense we definitely don't have that but my biggest issue is the the quality of the care we provide sure I feel like we always for the most part it's safe but it's not what people deserve that's that's for me the biggest thing the NHS and we have that same problem too don't worry there's a lot of mistakes no socomial infections and this and that and it's very messy okay so you and I are gonna fix it yeah cool we'll start our own Nation we'll call it Avengers and sidekicks and uh we'll we'll give the best medical care love it I just don't know who pay for it but maybe our YouTube ad sets can pay for it that is a hell of a model I mean this is getting Mr Beast territory now yeah like you know a self-funded hospital basically sure sure just sign here we're gonna live stream your endoscopy yeah and we'll pay for it yeah because we're like put it on Twitch hi welcome we're entering the the stomach now going around the duodenum that's Amina that would be captivated television wow okay click here to watch my first ever Gray's Anatomy reaction video the one that started our drama way back when or at long last click here to see Dr hope react to it as well check them both out to see how far we've both come as always stay happy and healthy