Under is a flippantly edited, AI-generated transcript of the “First Opinion Podcast” interview with Will Flanary, aka Dr. Glaucomflecken. Make certain to join the weekly “First Opinion Podcast” on Apple Podcasts, Spotify, or wherever you get your podcasts. Get alerts about every new episode by signing up for the “First Opinion Podcast” publication. And don’t overlook to join the First Opinion publication, delivered each Sunday.
Torie Bosch: Will Flanary is best often known as Dr. Glaucomflecken. He’s social media’s most well-known comic slash physician, and he’s not afraid of punching up.
Welcome to the “First Opinion Podcast.” I’m Torie Bosch, the editor of First Opinion. First Opinion is STAT’s residence for giant, daring concepts from well being care suppliers, researchers, sufferers, and others who’ve one thing to say about medication’s most necessary and attention-grabbing subjects. This season, we’re actually targeted on the intersection of medication and tradition.
In the present day, I’m talking with Will Flanary, the ophthalmologist higher often known as Dr. Glaucomflecken. After a fast break, I’ll carry you our dialog about advocacy, medical doctors behaving badly on social media, and the attention surgical procedure he simply hates.
Will Flanary, aka Dr. Glaucomflecken, welcome again to the “First Opinion Podcast.”
Flanary: Oh, it’s good to be again, thanks.
Bosch: So I’ve to cop to a disappointment, which was that my authentic aim for having you on the present for a second time was to attempt to get somebody from “Scrubs” to affix us so we may simply speak medical comedy —
Flanary: That’d be nice.
Bosch: They rejected me, I’m very sorry about that.
Flanary: Discuss nostalgia, man. It’s thrilling to see them again.
Bosch: How did you are feeling in regards to the reboot?
Flanary: To this point, so good. I’ve solely seen one episode to date. I’m 40 now. So, you understand, I grew up on “Scrubs,” and it nonetheless holds up fairly nicely to date, the outdated episodes. But in addition the brand new present, it’s sharp. It’s good.
Bosch: I fell off of “Scrubs” after a number of seasons, however now I feel I want to return and watch it as a result of the reboot captured one thing.
Flanary: Yeah, return. It holds up nicely. It does.
Bosch: All proper. In order a lot as I’d love to only discuss “Scrubs” for the entire time, I assume now we have to speak about actual issues, too. So I needed to ask you about one thing you’ve been spending quite a lot of time on, on social media, which is one thing that’s taking place in Eugene, Oregon. So are you able to give us the CliffsNotes on what’s taking place there and why you’re concerned?
Flanary: Let’s see, I’ll attempt to do that as rapidly as potential.
So it actually begins a number of years in the past. I feel it was 2023. So Eugene, simply to set the stage right here, Eugene is just like the second-largest metropolis in Oregon, and it’s the place the College of Oregon is. And in order that metro space is about 200,000 individuals. And some years again, there had been this hospital for a very long time known as College District Hospital within the metropolis heart of Eugene. And PeaceHealth, which is a big hospital system within the Pacific Northwest, determined to shut that hospital — I’m positive there’s quite a lot of causes to try this — together with the emergency division there.
And every time information that this was gonna occur got here up, there was a fairly large outcry, notably from quite a lot of the employees and the emergency physicians there, as a result of they knew. Like, “that is going to make life a lot tough over in Springfield at RiverBend Hospital, which is now like the one hospital on this space. All of the sufferers that had been going to College District at the moment are gonna be shunted over right here. And we don’t have the employees, we don’t have the tools,” simply outlining all these issues.
Properly, PeaceHealth, they did it anyway. Closed College District Hospital, and guess what occurred? Precisely what these medical doctors had stated was going to occur. Wait occasions, and notably within the emergency division, wait occasions had been skyrocketing, affected person satisfaction, and everyone was simply typically sad. There wasn’t sufficient employees, not sufficient tools, not sufficient rooms. You had individuals boarding within the emergency division ready to get a room within the hospital. So only a mess.
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And it’s been like this for a pair years now. And late final 12 months, the CEO of RiverBend Hospital determined that he was going to name for proposals for the emergency division contract. So for the final 35 years, the emergency division at RiverBend Hospital has been staffed by Eugene Emergency Physicians, which is a democratic, physician-owned group filled with about 40 physicians. They’ve been working there, dwelling in the neighborhood. They’re a part of the group. And RiverBend determined, “OK, nicely, we’re not gonna go forward and renew your contract proper now, we’re gonna get some proposals. We’re gonna see if anyone we expect may do a greater job as a result of we’re having all these issues.” None of which had been created by the physicians, by the way in which.
So Eugene Emergency Physicians, they put of their proposal, and there’s a handful of different proposals. And positive sufficient, RiverBend went with ApolloMD, which is a company administration group based mostly out of Atlanta, Georgia. This can be a large deal. You’re taking, you understand, native medication run by individuals in the neighborhood who know the group, know the sufferers, know the opposite physicians. That’s actually necessary in emergency medication as a result of there’s a lot interplay with different areas of the hospital and realizing what the social companies are within the space, the place sufferers can go, what’s obtainable to individuals. All that institutional information, you’re simply gonna like give that away?
The query is, OK, nicely, why did they do that? And we nonetheless don’t actually know as a result of the CEO is on document saying it’s not, it wasn’t a monetary resolution. OK. It wasn’t performance-based, OK. Properly, then what may it’s? And that each one we’ve gotten is, “nicely, you understand, ApolloMD simply had an excellent proposal.” They’re identical to, “we simply preferred what they needed to say.”
Properly, that’s sufficient to take away native physicians and power them to both be part of this company group out of Atlanta, Georgia, or depart the group altogether as a result of there’s no different choices.
And so this large outcry, I came across this story by means of a number of totally different locations, and it’s principally in my yard. I’m simply south of Portland. And so it’s taking place in my group. It’s necessary to me, however the place I feel it is a totally different story versus different locations across the nation that this occurs, as a result of this isn’t a singular factor, proper?
Folks would possibly say, “nicely, you understand, that is enterprise. That’s simply the way it works. Generally you don’t get the contract, and any person else had a greater proposal.” There’s a few issues unsuitable with that.
Initially, as of 2025, Oregon has a company apply of medication legislation in place. And that’s one of many main issues that makes this a special story, as a result of now there’s lawsuits. There’s been hearings on the Capitol constructing. The governor of Oregon has weighed in saying, “hey, let’s maintain off on this transition as a result of this may be in violation of now state legislation.” As a result of this new legislation, this company apply of medication legislation in Oregon is particularly designed to stop issues like this from taking place — the place these company teams who don’t have any physicians licensed to apply within the state who personal this firm, ApolloMD, they’re coming in and working towards this within the states. In order that’s what they had been attempting to stop from taking place with this new legislation.
This isn’t a finished deal by any means, however PeaceHealth hasn’t backed down. They stated, “We’re gonna go forward with this transition. We expect it’s not in violation of this legislation.” ApolloMD has simply stated, “That is what our enterprise is. We’re simply gonna take the contract” — enjoying type of harmless, like, “Oh, it’s, we’re simply doing what we often do, now we have nothing towards these medical doctors or something.” However they’re complicit on this complete course of, proper? The whole mannequin that this represents, which I feel is unhealthy for well being care. We wish, we have to hold medication native. I feel that’s good for sufferers, it’s good for communities, after which the newest factor — are you with me?
Bosch: Completely.
Flanary: We’re good. OK. So, in order that’s not even the tip of the story. It will get juicier. Not too long ago, like inside the final month, there have been emails which have come out that present going again to 2023, 2024 [involving] the RiverBend CEO, who has an administrative license. That’s a really particular sort of medical license that doesn’t permit you to really make scientific choices. He’s a doctor, however he doesn’t have an energetic medical license to apply medication.
A handful of emails from totally different medical doctors, not even simply emergency physicians, however you understand, there’s neurologists, others, that present that the RiverBend CEO was attempting to affect scientific decision-making from the C-suite workplace. Issues like, “Are you positive this affected person must have this MRI? Why are we doing this? Why can we admit this affected person? Why did we make that call?”
And that is coming from the CEO. And for those who’re an worker, how are you going to really feel comfy going towards what the CEO says? It’s your employer, proper? That’s scary, you might lose your job.
And so the emergency physicians acknowledge that this isn’t OK as a result of he’s attempting to affect all this scientific decision-making. And by the way in which, I imply, he’s not inspecting these sufferers, proper? He’s not even doing the work. And so how are you going to even say “this was what must be finished”?
And they also pushed again. And it received to the purpose the place a number of the emergency physicians went to PeaceHealth management, like the general CEO of PeaceHealth, like, “Look, now we have some issues about what’s happening with our management right here.” Properly, phrase trickled right down to the CEO of RiverBend, PeaceHealth RiverBend. And wouldn’t you understand it, a short while later, he requires proposals for the emergency division contract.
It doesn’t take an enormous leap to assume this may be retaliation towards the emergency physicians. Once more, no points with their job, he’s on the document. No issues there, like they’re doing nice work. All proper, not monetary. What’s it? What may it’s?
You recognize, there’s solely so many choices. And in order that’s the place we’re at now. And, you understand, I hate that that is taking place, however I’m actually excited to only assist out in no matter means I can with my platform and on this fundraiser that now we have developing.
Bosch: Yeah, so inform me about the way you’ve been serving to out.
Flanary: So, simply making content material about it. What I’ve realized is that for those who make an enormous stink on social media about well being care system-related issues, you’re gonna get quite a lot of assist. As a result of there’s quite a bit individuals in hospital administration, in medical insurance, in non-public fairness, doing unhealthy issues for sufferers and for medical doctors. And one unifying attribute of each story, identical to I simply described, is that they don’t need individuals to know what’s taking place. They wish to hold it out of the information. They wish to, hold it away from the type of nationwide, ’trigger they don’t need this sort of scrutiny as a result of they know that is actually unpopular and that perhaps this isn’t the perfect for affected person care, nevertheless it’s perhaps good for pocketbooks, perhaps good for different causes that aren’t as altruistic, you understand? And they also attempt to hold it beneath wraps.
Insurance coverage has been doing this for many years, proper? They’ll change little insurance policies right here and there, and hope nobody notices. Like in ophthalmology a number of years in the past, they determined to require prior authorizations for each single cataract surgical procedure, Aetna, simply on a dime. Like, “you understand what we’re gonna do? Attempt to restrict the quantity of those surgical procedures that had been taking place.” And we made an enormous stink about it, social media and in any other case, they usually reversed the choice as a result of they don’t need individuals to know.
That’s what’s taking place right here. Once more, that is simply my opinion, however I’d enterprise to guess that PeaceHealth didn’t need individuals to know a lot of the info that we’ve already talked about immediately, all proper? They wish to simply hold it native as a result of it’s unhealthy press, unhealthy no matter. And so by getting on social media with my platform on the very least and simply inform them the story as a result of it’s a fascinating story and the implications that this has for the remainder of the nation, particularly with this company apply of medication legislation. As a result of if these medical doctors are profitable in preventing this, utilizing that legislation, you higher consider that the opposite states are gonna be like, “Oh, nicely, perhaps we should always have a legislation like that, proper?”
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And there are a number of others on the market, however we want extra. And so, there’s a lot that may be finished advocacy-wise and altering well being care and making issues higher that may begin simply by making noise. Let everyone know what’s taking place and then you definitely get the eye of lawmakers, of the general public, the group. That is probably the most unpopular factor that’s occurred, you understand, that PeaceHealth has ever finished. I needed to guess, simply due to all of the press. Yeah, that’s why I needed to leap in.
Bosch: Do you get any pushback out of your viewers about this sort of advocacy?
Flanary: No. I imply if I do, it’s like, nobody’s ever going to be 100% on board with something you say on social media, proper? You’re at all times going to search out feedback of individuals. Even once I discuss medical insurance corporations and the unhealthy issues they do, there’s at all times any person that’s like, “nicely, you understand, they’re simply looking for individuals. They’re simply ensuring medical doctors aren’t abusing their energy.” Like, what are you speaking about?
I’m used to it now, however at first once I noticed these forms of feedback, I used to be like, “how anyone on the insurance coverage’s facet?” And so for stuff like this, all of us see it. Well being care staff see it, the general public sees it, they usually’re not shocked by it. And so, no, I get little or no pushback on stuff like this — simply from the those who I must be getting pushback from, which is PeaceHealth, ApolloMD. They’re not gonna be proud of what I’ve to say, however I don’t care. I’m proper.
Bosch: “I don’t care. I’m proper” is a superb motto to reside by, I feel.
Flanary: That’s what I inform individuals nearly, you understand, medical individuals about social media usually. Like you may take a stand for one thing and for those who 100% consider that you’re proper, that you just’re doing this for the fitting causes, then stand behind it, and you should still be unsuitable. However once more, if it’s a deeply held conviction that you’ve got and also you’ve finished the analysis, you’ve finished the work, you understand what’s taking place, and you’ve got a stance on it, stand behind it within the face of criticism. Since you’re gonna get some criticism, all proper? It’s simply going to occur on social media. However not all criticism must be listened to. Generally criticism must be listened to, however not all of the occasions.
Bosch: Properly, talking of criticism on-line, I really feel like there’s been a number of examples just lately, and we don’t have to call names — although for those who wanna identify names, you’re actually very welcome to — however there’s some examples on-line of medical college students and physicians form of getting main backlash over content material, over issues which might be perceived as insulting sufferers, issues which might be probably unethical taking place. Are you seeing any form of change in the way in which that medical doctors are intersecting with social media?
Flanary: I do know a number of the examples that you just’re discussing. I feel the extra necessary dialog is simply extra simply typically about ethics, proper? And what’s it OK for medical doctors to do on social media? That is an evolving matter, and it’s a very sizzling matter proper now as a result of an increasing number of medical doctors, med college students, even premeds, residents have gotten quote unquote influencers. They’re getting a platform. And it’s so simple to lose your integrity as a doctor. And so it’s a subject that deserves quite a lot of consideration, actually, simply due to the place we’re in society proper now.
I feel training must meet up with how medical doctors must be behaving on social media. That’s why I’ve made some content material about this, about the place are the strains, the place do you have to draw the strains? And definitely we’ll begin with making enjoyable of sufferers. That’s primary. You don’t do it.
Bosch: Simply to get just a little extra particular, perhaps, one of many examples I’m referring to right here, and, once more, not gonna use a reputation, nevertheless it’s a medical scholar slash extremely popular influencer. And I feel there’s a monetary element right here, too, proper? Which is that a few of these college students, residents, are paying for this enormously costly medical college by means of social media influencing and extra provocative content material goes to assist them pay these payments. However on this case, a scholar posted at the least two movies that had been extensively perceived as form of shaming ladies for the way in which their our bodies work. And there’s a substantial amount of pushback to that.
Flanary: I noticed the content material, and it was clearly not OK. And it’s precisely what we’re speaking about. It’s making enjoyable of sufferers and affected person our bodies. I don’t have any affected person characters for a really particular cause, as a result of the very last thing you wish to do as a doctor or any person simply in well being care is to place out content material that can undermine the general public’s belief in us. I feel the rationale individuals can discover themselves down this path is as a result of there’s quite a lot of monetary stakes right here. Not simply the cash you’re borrowing to go to med college, but in addition simply the cash you’re making, you may make from social media.
And you’ve got med college students now who even have platforms of like 6,000 those who comply with them getting supplied to hawk dietary supplements, getting 1000’s of {dollars}, which is life-changing whenever you’re not making any cash and also you’re going into an amazing quantity of debt. Like, are you kidding me? You’re telling me you’re gonna give me $5,000 to make 20 movies, selling a complement for intestine well being?
You’ll be able to see how that may affect your resolution on what you’re posting on social media. After which from the lens of comedy, as a result of that’s what I’ve been doing for the final 10 years, there’s this psychological feeling like it’s a must to hold going. That folks will lose curiosity in you for those who don’t proceed to love push the envelope and get extra outrageous, get funnier, simply do what you may to love sustain. And it might probably push you into areas the place you actually don’t must be going.
And so for myself, I’ve these moral guardrails for myself. And one in all them we’ve already talked about, nothing affected person associated, no HIPAA violations, none of that. It’s that outdated adage, you understand, punch up, not punch down. I will likely be a lot meaner to insurance coverage corporations and hospital programs than I’m to my fellow physicians or to med college students or residents or nurses. Simply preserving these hierarchies in thoughts is so necessary whenever you’re attempting to inform jokes, you’re attempting to be humorous on social media. So it’s difficult. However you may actually get your self into bother and when it comes to, you understand, shield your self, you actually have to only put these guardrails in place.
Bosch: And talking of social media and perhaps lack of guardrails, I’d like to speak to you about eyes.
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Flanary: Oh, sure, please. Love speaking about eyes.
Bosch: I’m fully horrified by a documentary I noticed on Netflix just lately known as “Caterpillar” a couple of man who in 2019 traveled to India to get the colour of his eyes modified, which I had not realized is a factor, however apparently there’s, in actual fact, not only one firm that can do that, however there are a number of approaches.
Flanary: And there’s ophthalmology influencers who do these and publish these outcomes, these sufferers that they deal with on social media and get individuals all enthusiastic about coloration change surgical procedure, eye coloration change surgical procedure. And I hate it a lot.
Initially, simply what they’re doing is you’re not altering your eye coloration. You’re altering the looks of your eye coloration. Your eyes are the identical, however what they’re doing is that they’re implanting a disk that has a coloration to it. And it’s principally overlaying excellent on prime of your iris. So that you’re introducing a international physique into the attention. Into eyes which might be completely wholesome, that see 20/15, good. You’re subjecting them to this beauty surgical procedure.
Now there’s different beauty surgical procedures which have much more knowledge and security behind them, like LASIK. It’s a beauty surgical procedure, and even that’s not with out dangers. You’ll be able to have devastating accidents and outcomes from LASIK. However now we have sufficient security knowledge to say that is really OK to do from simply from a security standpoint.
We don’t have that sort of information for such a surgical procedure. And I feel it’s unethical. It shouldn’t be finished. There are causes to have iris implants. If in case you have a foul harm to the attention the place you lose a part of your iris, you want the iris as a result of that’s what limits, what modulates the quantity of sunshine that comes into your eye. So for those who didn’t have an iris, individuals with aniridia, no iris, they’ve large mild sensitivity since you don’t want, all of the lights simply coming proper in, touchdown on the retina and it’s one thing that may be uncomfortable. If in case you have an harm the place you lose a part of the iris, similar factor, an excessive amount of mild coming in. You don’t have a full functioning iris to modulate that mild because the pupil opens and closes. And so for these sufferers, yeah, it’d make sense. That’s why these items exist, all proper? It’s not meant for a beauty process. There are actual medical the reason why you’ll have these implants. And so the presence of those implants is simply being abused by sure medical doctors. And it’s unethical. And I gotta see this documentary. It’s simply gonna make me offended, although.
Bosch: Properly, I’d love to listen to what you concentrate on it. So these sufferers go to India, I don’t know if this firm, it was filmed in 2019, who is aware of what is occurring now, however the medical doctors at this clinic in India are saying, “nicely, ensure you’re getting follow-up care.” And I’m simply type of imagining what it’s wish to be the ophthalmologist who walks into the room to see a affected person who received an eye fixed implant abroad they usually’re asking for follow-up care.
Flanary: Yeah, I haven’t come throughout that problem, happily, but. And hopefully I don’t. However this simply underscores why we want physicians on social media, you understand? I imply, not simply any doctor, like we want moral physicians, individuals who apply evidence-based medication, who can set the document straight on stuff like this. And also you see dangerous content material from any person, and you’ll communicate out towards it. And at this level, we received to be on the market. We don’t actually have a selection. There’s other ways to do it, proper? Not everyone has to decorate up in costumes and like document themselves speaking to themselves alone. There’s other ways of doing it. It’s simply the way in which I do it. There’s a lot of other ways to do, it might probably simply be to your 100 followers or simply your local people on Fb, and even simply along with your sufferers. Take the time when sufferers are available with questions on stuff they’ve seen on social media, like take the time and debunk it, if it’s price debunking. So now we have to remain on prime of these things, as a result of if we’re not there, if we don’t have moral evidence-based individuals on the market, then social media is simply gonna proceed to be overrun by wellness influencers and unhealthy actors.
Bosch: Is there something you’ve needed to debunk on your sufferers quite a bit just lately?
Flanary: The one which comes up fairly routinely is this concept that sporting glasses could make your imaginative and prescient worse, which is one thing that’s been like a wellness industry-type factor. Like, “no, you don’t wish to, for those who put your child in glasses, they’ll be depending on them. As a substitute you must stare on the solar three minutes each morning.” After which this will get additionally into like iridology. It’s principally like palm studying, however on your iris.
The entire “glasses make your imaginative and prescient worse,” that may be harmful for youths. As a result of if in case you have a guardian that’s been influenced by such a rhetoric, they might not have their youngster put on the glasses that had been prescribed by their eye physician. And if that occurs, you may find yourself with amblyopia and lack of improvement of imaginative and prescient in a single or each eyes. And then you definitely’re setting that child up for lower than regular imaginative and prescient the remainder of their life.
In order that’s what can occur. … It sounds benign. However that may really trigger irreversible imaginative and prescient loss for individuals and for youths. And in order that’s at all times one which comes up from time to time. There’s only a handful of different ones, simply homeopathic eye drops, no, don’t. There’s a cause like each few years we hear about any person having some horrible Pseudomonas an infection of their eye as a result of they’re like utilizing these unregulated eye drops. So quite a lot of misinformation round eye drops.
Bosch: As we begin to wrap up, you understand, we’ve received issues taking place with the well being care system, rampant misinformation on social media, all of these items that you just sort out. How do you retain discovering the humor in medication regardless of what’s happening?
Flanary: That’s a coping mechanism. That’s the way it began for me. And I feel on the core, that’s an enormous a part of it nonetheless, nevertheless it’s, it’s now modified to as soon as I spotted that for those who conceal issues in comedy, not conceal them, however identical to encompass an thought with humor on social media, you’re more likely to have individuals take note of it. That’s the way in which consideration is shifting. One thing’s gotta be leisure. It’s gotta to be catchy. You gotta have a hook.
Along with, I simply love making individuals snort. I’ve realized like take these well being care system issues that I would like modified or one thing, like what’s taking place in Eugene, Oregon, and add just a little humor to it, flip it right into a skit. And rapidly, like individuals laughed at this factor, however by the tip of it, they really realized one thing. That’s been a problem that I’ve actually loved is like, how do I make pharmacy profit managers humorous, whereas nonetheless letting individuals know what a pharmacy profit supervisor is? I like that type of stuff.
And in order that’s been, once more, my driving power now for a few years. But it surely modifications over time, why I do that, you understand? Throughout the pandemic, it was, I had individuals simply telling me like, “I haven’t laughed in six months, and I noticed your video and it made me snort. I used to be capable of share fun with my fellow ICU medical doctors.” There’s solely a lot an ophthalmologist can do throughout a pandemic, a respiratory pandemic. And so if I can at the least make somebody snort, who’s seeing loss of life and illness all day, that’s one thing. And in order that stored me going for some time. So it simply modifications. So long as it’s nonetheless enjoyable for me and it appears to be serving to individuals, I’m gonna hold doing it.
Bosch: All proper, nicely, Dr. Glaucomflecken, Will Flanary, thanks a lot for approaching the “First Opinion Podcast.”
Flanary: Thanks a lot.
Bosch: And thanks for listening to the “First Opinion Podcast.” It’s produced by Hyacinth Empinado. Alissa Ambrose is the senior producer, and Rick Berke is govt producer. You’ll be able to share your opinion on the present by emailing me at [email protected]. And please depart a overview or ranking on no matter platform you employ to get your podcasts.
Till subsequent time, I’m Torie Bosch, and please don’t hold your opinions to your self.
