What’s up with the new kids?

[pgg]

It’s too long a video. What’s the Cliff notes
Version?

I fast forwarded through most of it but impression I got was that he's a neurosurgeon who practiced for 10 years and got burned out for a lot of the same reasons that frustrate us with medicine. Mostly seems to be frustration with the futility of some/most spine surgery, bad work life balance. He quit, and is now retired putting on airs of being unemployed to bait clicks on YouTube.

He was a well paid practicing neurosurgeon for a decade. I'm sure he's doing all right

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[Southpaw]

Everybody wants to pretend medicine is some big money making machine preying on innocent patients when the truth is everybody knows the right answer but nobody wants to take the steps necessary to implement it.

That's a fair point, but not really what I took from his message. And maybe he's exaggerating because he wants views/income from his youtube channel. Anyway, I took that some of his patients got better after lifestyle changes and didn't need surgery. Some didn't and still needed surgery. Surgery helped some people, some remained the same, and some got worse. He started out by saying he wanted to heal with surgery so he started out extremely idealistic (like many). Anyway, in the end he seemed to find it an endless cycle of lifestyle leading to disease, disease needing lifestyle changes and/or surgery, surgery not completely fixing the problem or at times making it worse, etc. etc.

I don't find his realization dramatic or terribly remarkable, just yet another example of someone who started about very idealistic and in the end got chewed up by the capitalistic aspect of American healthcare. Basically what has occurred with the entirety of Emergency Medicine and lots of other corners of American medicine (private equity, physician burnout, midlevel expansion, representative organizations selling us out, admin destroying our morale, etc. etc.)

 

[Southpaw]

He quit, and is now retired putting on airs of being unemployed to bait clicks on YouTube.

Yeah, I mean there it is. The dude wants income from somewhere, so he's moved onto influencer. Many of us will be envious. No one tells the guy where to be anymore and when to be there. He's not listening to constant complaints from patients about their back pain. But the reality is he still wants income so he's chosen to derive it from youtube or other social media stuff.

I don't find it dramatically different from White Coat Investor, Physician on Fire, etc. As a resident, like a decade ago, I loved the the FIRE message, super saver lifestyle, saavy investment mindset, and avoiding financial planners who didn't really know anymore than we knew. In the end, to derive the desired income they keep producing posts beyond what I found useful so I stopped reading.

Mr. Money Mustache was the same. Stopped doing whatever it was he did. As it happened, he could derive income from blogging. He also just happened to be very handy and able to derive income from real estate (effectively remodeling homes almost entirely on his own). Skills like that help when income is desired.

Medicine is fine and it pays well. So I stick with it.

 

[Ronin786]

That's a fair point, but not really what I took from his message. And maybe he's exaggerating because he wants views/income from his youtube channel. Anyway, I took that some of his patients got better after lifestyle changes and didn't need surgery. Some didn't and still needed surgery. Surgery helped some people, some remained the same, and some got worse. He started out by saying he wanted to heal with surgery so he started out extremely idealistic (like many). Anyway, in the end he seemed to find it an endless cycle of lifestyle leading to disease, disease needing lifestyle changes and/or surgery, surgery not completely fixing the problem or at times making it worse, etc. etc.

I don't find his realization dramatic or terribly remarkable, just yet another example of someone who started about very idealistic and in the end got chewed up by the capitalistic aspect of American healthcare. Basically what has occurred with the entirety of Emergency Medicine and lots of other corners of American medicine (private equity, physician burnout, midlevel expansion, representative organizations selling us out, admin destroying our morale, etc. etc.)

Maybe my response shouldn't be only pointed towards him, but I've recently encountered an increasing number of non-medical, but educated individuals that truly believe that healthcare (and physicians) has a uniquely sinister focus in treating patients with bandaids that keep them in the system rather than an earnest desire to make them healthier.

Some of it stems from the weight loss medication boom, where "if only doctors told the public to eat healthier and exercise more, but instead they'd rather prescribe a drug to increase profits". There's definitely truth to the cash generating potential of the work we do, and I'd be lying if I didnt feel like I was just feeding the machine somedays. But the reality is "the machine" is built of all of us, this world of quick fixes and it's not like healthcare is some nefarious aspect poisoning folks rather than just another feature of the design of our society nowadays.

There are so many influencers out there nowadays telling people to live healthy lifestyles, eat good, avoid stress and be happy. But explain to me how someone with two kids, a working spouse and a combined income <100k is supposed to do any of the above? So yeah, when they herniate a disc lifting boxes at Amazon while smoking 2 PPDs to deal with stress and eat unhealthy because it's cheaper and easier then they show up at your neurosurgery clinic, operating on them is actually the only way in your power to help them out since the actual fixes are not realistically implementable.

 

[deleted1183938]

I fast forwarded through most of it but impression I got was that he's a neurosurgeon who practiced for 10 years and got burned out for a lot of the same reasons that frustrate us with medicine. Mostly seems to be frustration with the futility of some/most spine surgery, bad work life balance. He quit, and is now retired putting on airs of being unemployed to bait clicks on YouTube.

He was a well paid practicing neurosurgeon for a decade. I'm sure he's doing all right

Thank you. Of course operating on mostly obese peoples spines is not gonna lead to long term good outcomes. And these surgeons and patients run into surgery way too quick to repair these spines. Why aren’t they focusing on the heads?? The ones that really need help??

Anyway I tell anyone in my family or friend circle to avoid spine surgery like the plague unless of course an accident w instability or tumor. My BF almost bit the bullet and went back for his second fusion about four months ago. I kept discouraging him but he was so damn miserable and making me miserable that I gave up on encouraging alternate therapies and said screw it go ahead but don’t say I didn’t warn you . He had CA and had to have a resection and fusion.
Fast forward four months later no surgery and no pain with conservative mgmt. I think if I hadn’t been there he would be well on his way to failed back syndrome. Not saying this is gonna last forever but we all know if these surgeons got paid like they do in most other countries these spine surgeries wouldn’t be happening at this absurd rate with often terrible outcomes.
There is this spine surgeon on TikTok who has a huge following (millions) and constantly shows off her cars and shoes and vacation lifestyle and I just throw up a little inside thinking of all the people she’s creating more problems for. Spine surgeons are some of the most money hungry docs around as we all know.

 

[Coffee PRN]

Thank you. Of course operating on mostly obese peoples spines is not gonna lead to long term good outcomes. And these surgeons and patients run into surgery way too quick to repair these spines. Why aren’t they focusing on the heads?? The ones that really need help??

Anyway I tell anyone in my family or friend circle to avoid spine surgery like the plague unless of course an accident w instability or tumor. My BF almost bit the bullet and went back for his second fusion about four months ago. I kept discouraging him but he was so damn miserable and making me miserable that I gave up on encouraging alternate therapies and said screw it go ahead but don’t say I didn’t warn you . He had CA and had to have a resection and fusion.
Fast forward four months later no surgery and no pain with conservative mgmt. I think if I hadn’t been there he would be well on his way to failed back syndrome. Not saying this is gonna last forever but we all know if these surgeons got paid like they do in most other countries these spine surgeries wouldn’t be happening at this absurd rate with often terrible outcomes.
There is this spine surgeon on TikTok who has a huge following (millions) and constantly shows off her cars and shoes and vacation lifestyle and I just throw up a little inside thinking of all the people she’s creating more problems for. Spine surgeons are some of the most money hungry docs around as we all know.

I actually watched the whole video while I ate dinner, and this is what this guy’s main message was. His treatments (spine surgery) were not that effective, and for someone who seemed very driven to heal people, he had a crisis after realizing this. The most effective treatment he saw was lifestyle changes, so now he vlogs and makes videos trying to encourage people who live happier and more fulfilled.

To be honest I believe him, I think most physicians agree spine surgery is a 50/50 at best.

 

[deleted1183938]

I actually watched the whole video while I ate dinner, and this is what this guy’s main message was. His treatments (spine surgery) were not that effective, and for someone who seemed very driven to heal people, he had a crisis after realizing this. The most effective treatment he saw was lifestyle changes, so now he vlogs and makes videos trying to encourage people who live happier and more fulfilled.

To be honest I believe him, I think most physicians agree spine surgery is a 50/50 at best.

Duh!!! We already knew this from the other side of the drape. These surgeons do it for the fat fee they collect to live their fancy lifestyles.

 

[kidthor]

Duh!!! We already knew this from the other side of the drape. These surgeons do it for the fat fee they collect to live their fancy lifestyles.

That and for the ego boost from the absurd blond device reps fawning over them.

 

[deleted1183938]

That and for the ego boost from the absurd blond device reps fawning over them.

I have only ever seen male reps in those roles. Ortho Bros, Spine Bros!!

 

[Ronin786]

I know many spine surgeons that aren't greedy hacks.

 

[Southpaw]

Maybe my response shouldn't be only pointed towards him, but I've recently encountered an increasing number of non-medical, but educated individuals that truly believe that healthcare (and physicians) has a uniquely sinister focus in treating patients with bandaids that keep them in the system rather than an earnest desire to make them healthier.

Some of it stems from the weight loss medication boom, where "if only doctors told the public to eat healthier and exercise more, but instead they'd rather prescribe a drug to increase profits". There's definitely truth to the cash generating potential of the work we do, and I'd be lying if I didnt feel like I was just feeding the machine somedays. But the reality is "the machine" is built of all of us, this world of quick fixes and it's not like healthcare is some nefarious aspect poisoning folks rather than just another feature of the design of our society nowadays.

There are so many influencers out there nowadays telling people to live healthy lifestyles, eat good, avoid stress and be happy. But explain to me how someone with two kids, a working spouse and a combined income <100k is supposed to do any of the above? So yeah, when they herniate a disc lifting boxes at Amazon while smoking 2 PPDs to deal with stress and eat unhealthy because it's cheaper and easier then they show up at your neurosurgery clinic, operating on them is actually the only way in your power to help them out since the actual fixes are not realistically implementable.

I think you and I are very likely in agreeance. The feeling that we are part of the problem, in my opinion, comes from the fact that we are loosely associated with hospitals and with insurance companies. UnitedHealthcare reported $23 BILLION in profit in 2023. It's CEO made $24 million.

Every time a patient asks us what X will cost we conveniently say 'I don't know I'm just here to take care of you, feel free to call our billing office if you have those types of questions...' or something of that variant. We do profit off of all the surgeries that occur. We aren't completely innocent in this game.

I'm one of the most liberal posters on this board. If we are going to lament the plight of the lower/middle class, then brother lemme tell ya you'll find a shoulder to cry on in me. I don't have all the answers - but I think all here will agree that surgery doesn't magically fix all problems, especially those related to lifestyle, and if people actually do want to get better, feel better, and live longer, then it's largely their lifestyle that needs fixin'.

 

[sevo00]

Always remember to ask the ortho bro reps what college sport they used to play

 

[anonperson]

Not anesthesia, but relevant.

Well he got his little viral moment.

The guy sounds like a tool. He's annoying, the bugs are annoying, and his message is annoying.

It's not our fault that spine clinic is probably terrible and a fair amount of spinal surgery can be questionable.

Modern medicine is amazing. There are issues for sure but what can be done to help patients is miraculous.

I've had family members need cataract surgery, 3 vessel CABG, knee replacements etc all with huge improvement on quality of life and literally life saving.

I do a fair amount of quality of life surgeries (prolapse and incontinence) and can objectively say that a majority of patients feel their quality of life has improved. Even more medically managed patients who are happy.

Dude sounds like a child. "If I do a perfect surgery, people will get better."

What cocoon was this guy living in during medical school and residency? What surgeon really ever thinks that? You can do the perfect surgery but still have complications/post op issues. That is not a moral flaw, that is the reality of life.

So this guy's patients are getting healed a month/week before surgery and he's attributing that to low salt diet, sauna etc? He's got enough time as a neurosurgeon to delve into their sleeping habits etc?

And I like how releasing stress into the world will cure my ills. What kind of vague pseudoscience is this?

Nearly every doctor I know is telling obese patients to lose weight. I know I do. We offer nutrition referrals, bariatric surgery referrals. The PCPs are prescribing ozempic/wegovy.

It's not some big secret. The reality is most patients/people are lazy. Eating like crap and being sedentary is more comfortable.

The MA/LVNs in my clinic routinely eat McDonald's/Chick fila/Boba tea at lunch. Meanwhile, I use my lunch time to go for a walk in the local park.

This guy should shut up and keep making little hiking videos. He's easily worth millions from his 10 year stint as a neurosurgeon.

 

[nimbus]

Spine is the wrong specialty if you want predictably good outcomes or help the majority of your patients. He should have gone into OB, medspa, or anesthesia

 

[kidthor]

I think you and I are very likely in agreeance. The feeling that we are part of the problem, in my opinion, comes from the fact that we are loosely associated with hospitals and with insurance companies. UnitedHealthcare reported $23 BILLION in profit in 2023. It's CEO made $24 million.

Every time a patient asks us what X will cost we conveniently say 'I don't know I'm just here to take care of you, feel free to call our billing office if you have those types of questions...' or something of that variant. We do profit off of all the surgeries that occur. We aren't completely innocent in this game.

I'm one of the most liberal posters on this board. If we are going to lament the plight of the lower/middle class, then brother lemme tell ya you'll find a shoulder to cry on in me. I don't have all the answers - but I think all here will agree that surgery doesn't magically fix all problems, especially those related to lifestyle, and if people actually do want to get better, feel better, and live longer, then it's largely their lifestyle that needs fixin'.

We are definitely part of the problem. Doctors gave up control of healthcare by selling out to private equity and corporations and now there’s no way out. Our professional associations are all loathe to say anything bad about their corporate overlords, with the
sole exceptions of AAEM and partially ACEP (with EM being the premier example of being reamed over, with the rest of us now following on).

ASA is the quintessential sell out group. Any time I’ve engaged with ASA on topics of private equity or corporate medicine they basically don’t want to talk about it. They don’t want to bite the hand that feeds them. They want to keep groveling for the status quo for as long as they can without being actual leaders. They're the ones who came up with the “perioperative surgical home” (aka being worse than a surgeon’s PA) and then came up with the absurd name of “physician anesthesiologist”. The fact that ASA PAC is the best funded medical PAC and yet we have such absurdly poor lobbying outcomes should tell you something.

As Upton Sinclair said - It is difficult to get a man to understand something when his salary depends on his not understanding it.

 

[deleted1183938]

Thank you. Of course operating on mostly obese peoples spines is not gonna lead to long term good outcomes. And these surgeons and patients run into surgery way too quick to repair these spines. Why aren’t they focusing on the heads?? The ones that really need help??

Anyway I tell anyone in my family or friend circle to avoid spine surgery like the plague unless of course an accident w instability or tumor. My BF almost bit the bullet and went back for his second fusion about four months ago. I kept discouraging him but he was so damn miserable and making me miserable that I gave up on encouraging alternate therapies and said screw it go ahead but don’t say I didn’t warn you . He had CA and had to have a resection and fusion.
Fast forward four months later no surgery and no pain with conservative mgmt. I think if I hadn’t been there he would be well on his way to failed back syndrome. Not saying this is gonna last forever but we all know if these surgeons got paid like they do in most other countries these spine surgeries wouldn’t be happening at this absurd rate with often terrible outcomes.
There is this spine surgeon on TikTok who has a huge following (millions) and constantly shows off her cars and shoes and vacation lifestyle and I just throw up a little inside thinking of all the people she’s creating more problems for. Spine surgeons are some of the most money hungry docs around as we all know.

I usually don’t quote myself but here is that spine surgeon and her takeaway from all of this. Very well crafted take lol. People think she missed the point. Haha. She knows what she’s doing.

Damn it, can’t figure out how to paste on here.

 

[Burned_Out]

Nightmare scenario regarding oral boards via zoom.



Skip to about 4:40 if you don't want to hear about his educational background.

Well you can have a book in front of you.