Going Under: Anesthesia Answered with Dr. Brian Schmutzler
Going Under: Anesthesia Answered is a podcast with renowned physician and anesthesiologist Dr. Brian Schmutzler. Together with Award-Winning Co-Host and television journalist, Vahid Sadrzadeh, the podcast aims to answer not only your most pressing anesthesia questions but to provide the most up-to-date medical data available.
This weekly medical podcast will release a new episode every Thursday at 5 am. Thanks in advance for being a listener.
Don't forget to send your questions to Dr. Brian Schmutzler on social media and his website at www.drbrianschmutzler.com.
Going Under: Anesthesia Answered with Dr. Brian Schmutzler
Medical Forecast: Fitness Tests, Global Viruses, and AI's Growing Role
In this special episode of Going Under: Anesthesia Answered, Dr. Brian Schmutzler and Vahid Sadrzadeh take a closer look at the 2nd half *MEDICAL forecast in 2025.
We discuss the latest medical concerns and healthcare developments, examining the Chikungunya virus outbreak, the return of the Presidential Fitness Test, and the evolving state of medicine in 2025.
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This is Going Under Anesthesia, answered with Dr Brian Schmutzler. I'm Bahid Sadarizadeh and we're brought to you by the Butterfly Network.
Speaker 2:Yes, we are All right. I'm going to let you in on something that's completely changed the way I practice. I've been using butterfly probes for years. It's a portable ultrasound that plugs into my compatible smartphone or tablet so I can start scanning bedside in minutes. If you've used the older versions, or even if you're new to handheld ultrasound, let me tell you why this new IQ3 is a game changer and really impressive. First, iq3 is a game changer and really impressive. First off, having an ultrasound that literally fits in my pocket or in my butterfly belt bag.
Speaker 1:Satchel.
Speaker 2:Yes, butterfly belt bag, belt bag, belt bag. It means I can move faster, whether it's vascular access, procedural guidance or just getting real-time insights from my patients. And the tech inside this tiny device is pretty incredible. Biplane imaging lets me see short and long access simultaneously, which is huge for procedural guidance and also great for teaching some learners that work with us from time to time. The new needle out of plane preset even shifts the scan plane digitally, so I can see the needle tip sooner, which makes a real difference when precision matters and the image quality. Honestly, the IQ3 holds up against all the high end cart based products that I've used in the past. If you're looking for a device that supports your practice, I can't recommend the Butterfly IQ3 enough, and right now they're running a special offer. You can get $750 off the latest IQ3. Check it out at ButterflyNetworkcom. And what's my code again? Brian25. Brian25.
Speaker 1:Got it. At least I remember that one Got it. At least I remember that one Got it. Shout out to Fabletics, I really like this color, by the way.
Speaker 2:What is it called? Is it called Desert? I think, Desert, desert, desert, sand, something like that.
Speaker 1:I like it. I like it Right up my alley. So big thank you to Butterfly Network. Hope everybody has had a great summer so far. How has your summer been?
Speaker 2:Busy, Lots of traveling, lots of working. I bet Just started football, so it's keeping me busy now too, Coach Schmutzler. Coach. Yes, Call me Coach.
Speaker 1:Coach, how are the Eagles looking this year?
Speaker 2:Looking good, looking good. Two solid practices so far.
Speaker 1:Nice we're coming after your Raiders. Hey, listen, oh yeah, the Raiders are stacked this year, oh wow, yeah, yeah, and you guys practice.
Speaker 2:What's funny is you practice about five minutes from my house and I practice about 10 minutes from your house, except we have to travel 35 minutes each way, that's a bummer Fun.
Speaker 1:So today, kind of an impromptu, let's get together, let's see how the state of medicine is in 2025. I know we made our predictions a while ago, but let's see. Maybe are they coming to fruition, are they not? What's the state of medicine? We're going to talk about two subjects in particular and then kind of going to give you the layout of what's happening for this year with us in the fall. First of all, we're going to touch on the chikungunya gunya virus which is the latest outbreak. Yes, yes in china.
Speaker 2:True or false, we should be worried uh, so everything I've read it's contagious, but not that not coronavirus yeah it's.
Speaker 2:It's probably not the same contagious level as coronavirus, but but also it's. It's nowhere near as deadly, so it's like 0.01 percent fatality rate. Um, there does seem to be a bit of morbidity with it. So you get the typical prodrome, which is high fever, severe joint pain, fatigue and rash, and then oftentimes many of these symptoms can last to some degree for a long time. So it's almost like you know, we talk about long COVID. Whatever you think about that Comes from mosquitoes. You know, I don't know, there's some person-to-person transmission, I don't. I mean, it's a fancy headline. I don't think this is going to turn into anything too crazy, but I'm sure there's going to be all kinds of lockdowns and stuff in China.
Speaker 1:Well, I was literally about to ask do you think there will be any lockdowns in the United States?
Speaker 2:It's not happening in the US? I doubt it. I doubt it, and so let's see. I guess it's been around for I don't know 20 years or something, but there's been 240,000 cases across 16 countries. That's pretty big. Yeah, they have a couple vaccines, but nobody, nobody gets them. Okay, um, and then they apparently they're using mosquito eating mosquitoes to control it. So it's only one type of mosquito and I'm not a botan or I mean a, uh, you know, a bug specialist. But yeah, um, there's some sort of mosquito that eats the mosquito that passes along the disease, and so they're releasing these mosquitoes that eat the bad mosquitoes into the wild?
Speaker 1:Yeah, and what are those mosquitoes carry? Who knows? You know, that's the question, right?
Speaker 2:Then there's some sprays that you can do for it and there's some, like you know, conservative treatment stuff, but nothing to be. I'm not worried, I don't. I don, at least based on everything that's showing up now. You know It'd suck if you get it Like it's no fun Headache, fever, rash, joint pain Although that's like being 40, so whatever, that's what I experience every morning getting out of bed.
Speaker 1:Do I have the chugungara virus, or am I just 40? No, yeah, that's what I ask myself every day. If I can pronounce it Every morning Getting out of bed, do I have the chugungara virus, or am I just 40? No, yeah. Yeah, that's what I ask myself every day. If I can pronounce it. Yeah, it's a difficult one to pronounce.
Speaker 2:Yeah, I mean I don't know. They find that there are quite a few places in China and all over the southeast um, southeast asia, where from the tsunami that happened and and all the additional water.
Speaker 2:Apparently the, the um, the mosquitoes breed in that type of water, whatever the pacific ocean brackish, whatever type of water. So they're getting more and more cases now, which is they think it's from, you know, the tsunami and all the stuff that happened with that. So you'd imagine that if that's the case it's going to go back down once all that stuff sort of resolves.
Speaker 1:So on that one is probably false reason to be concerned. No, no.
Speaker 2:I mean, I give it a less than 1% chance that this turns into anything serious.
Speaker 1:Okay, let's continue the quick hitters here, true or false? Trump, bring back the fitness test is good for kids and america true, true, I love it.
Speaker 2:Okay, I love it. I'm not sure why we got rid of it. We got rid of it like 15 years ago, 2012.
Speaker 1:Oh so it was I thought it was a way long time ago.
Speaker 2:No, no no, no, and I've got it. I've got it here. So you do a one mile run, and when I did, you had to do the mile in under six minutes.
Speaker 1:Wait, what did the?
Speaker 2:This is elementary school, college, high school, all the way through Elementary middle school, I think Okay, I think even high school Okay.
Speaker 1:I had a fitness test in high school, for sure.
Speaker 2:Yeah, I think it One mile run under six minutes. Max sit-ups in a minute. Push-ups or pull-ups, depending on whether you have a pull-up bar.
Speaker 1:This is right up your alley, oh yeah.
Speaker 2:Flexibility testing, which is not right up my alley. You're supposed to be able to bend over and touch your toes and then sitting, be able to touch your toes and then a shuttle run.
Speaker 1:Okay.
Speaker 2:All timed and there's certain benchmarks that you have to do and stuff, and then they used to I don't know if you remember this like in gym class in middle school did they do fat testing. Did you ever have that done?
Speaker 1:I don't think so. We had that done in middle school, you did.
Speaker 2:Oh yeah, like the calipers. Oh like they, yeah, they'd fat test you. Yeah, yeah, yeah.
Speaker 1:That's a football thing right In front of it in middle school, just gym pe class. So it has been reinstated. By the way, immediately effective july 31st, yep, um, and it states that, um, so they'll introduce a presidential fitness award, which they had before, by high school and education departments beginning next year. So really the reason for this is childhood obesity, inactivity and poor nutrition, which is what we kind of talked about with the BBB, the Big Beautiful Bill. So is it a surprise that this is coming out right after the Big Beautiful Bill?
Speaker 2:No, I don't think so. I mean Trump listens to that other person who serves as the HHS secretary.
Speaker 1:So, here's my question for this, though, so supporters praise its tradition, yeah. Critics are worried about psychological stress, body shaming and a return to competitive fitness. What so? What are we hoping to gain out of these? I think that's the ultimate question that people are asking is what are we gaining from this? So?
Speaker 2:I don't think the test itself is what matters. It's that in gym class or PE or whatever they make you train for it. You don't just go out and do it on.
Speaker 1:You're not just pushing a balloon up. Yeah, go, go under it.
Speaker 2:Yeah, exactly no, you're not just going out and doing this test. They spend several weeks helping you train for it, which is improving physical fitness Sure.
Speaker 1:And then in the meantime you talk about like hey, if you're physically fit, not only do you do this fitness test, but also you eat well and you don't sit in front of the TV all day long, and all that kind of stuff. And what about the opposite? What about reaping the benefits?
Speaker 2:of physical activity, which is, you know, stress relief, reduce weight, longevity, all kinds of stuff. I mean exercise is like the.
Speaker 1:So why did they get rid of it in the first place? Do we know why they?
Speaker 2:just said, it made people feel bad Critics. It made people feel bad Psychological stress, whatever Competitive fitness.
Speaker 1:Unpopular opinion. There are no participation awards this is just the old school where I'm from okay that now I sound like a boomer. Clearly I'm just saying no, no participation awards. You know, obviously there's winners and losers, but there's there's good in that right.
Speaker 1:I mean, like we, we came up in the age where you got hit in the mouth and you go back and you do it right. Yeah, um, and I'm talking about physical fitness, I'm not talking about anything else. Um, so when you're talking about physical fitness, well, it's a pride thing, right. I mean, you take pride in it. We realize that everybody's not the same, um, and that's okay, but I don't see anything wrong with it.
Speaker 2:I mean it's. I mean competition's good right, and especially, you know, especially middle schoolers right. They're always in competition. Like you know my dad's stronger than your dad, or you know, my applesauce tastes better than your applesauce like, why not make it something that's actually somewhat valuable to people? And then you I mean in the real world nobody gives you a participation trophy If you show up to work late. Your boss is not like oh, thanks so much for just coming in today.
Speaker 1:No, why did you show up late? Get to work. Accountability, exactly, it's the number one word, yeah. And so that leads me to my third and final question yeah, yeah, yeah, which is uh, true or false? Um, the state of medicine in 2025 has improved.
Speaker 2:That's interesting uh, it's a general question, but so, so do I think people are getting healthier in 2025? No, I think they continue to get less healthy. Do I think that having disruptors in the government at the federal, state and local level is sort of breaking up some of these things that are probably causing us not to be healthy? Some of these things that are probably causing us not to be healthy, meaning that our food is poison, that we sit in front of a TV all day long, that we, you know again the physical fitness thing, like you're pushing physical fitness, this is something you need to do to stay healthy. I mean, I think that's potentially improving. I think AI is helping medicine. I do, yeah, yeah, I think, for sure, ai is continuing to help medicine. I think it's improving diagnosis, um, potentially improving treatment, um, improving access. For sure, um, I think it's improving the lives of clinicians. You know, the ai-based scribe stuff is huge. There's a lot of ai-based stuff now, so We've talked a lot about.
Speaker 1:Marginally, marginally improving. We've talked a lot about AI. Where and I don't know, did we talk to Zane about this, I can't remember but essentially, where they can control surgery from another city or a country Robotic surgery I think that was ASMBS that we were talking about that that they can do robotic surgery from you know, overseas, right, and still have control, and you know, talking about the ai improvements and the lag time and all that stuff. Ultimately, if you're looking ahead to 2055, is this and our kids are running the country. Is this good for medicine to have that type of capability? Are we ever going to get to a point where doctors are obsolete? No, I don't think so, where the robots are doing surgery for us.
Speaker 2:Yeah, I mean there's probably going to be some, and is that a good thing? There's some degree of automation or, um, you know, robots doing surgery. You're still not gonna. I don't know that the general public is going to accept that a robot with no physician present is doing their surgery or doing their anesthesia. Um, you know, it's it. Ai is probably going to be a problem for primary care docs, where it's strictly diagnosis and very little treatment, or at least not acute treatment.
Speaker 2:Sure it's sort of chronic treatment, and it's already a problem for radiology, because AI is reading a huge portion of the scans.
Speaker 1:It is Okay, I didn't know that.
Speaker 2:Yeah, of the scans, but with backup of a physician. So I mean, again, we talk all the time access, right, we don't have enough physicians, we don't have enough clinicians, we don't have enough people to handle all of the people who need care. So you know, if it works the way that automation worked in, you know, the auto industry, the manufacturing industry it's going to create different jobs or different ways to do your jobs. I don't think it's going to eliminate the majority of anything that you actually have to do with your hands. I don't think it's going to eliminate things like and this, we've talked about this before contract attorneys. You know any, any attorney, aside from litigation, it's a decent chance that a bot can If the bot's good enough.
Speaker 2:It can write a contract. It can redline a contract. It can tell you everything you need to know about a contract.
Speaker 1:Well, I mean, look at the race with Meta, right? Yeah, I mean, what tells you more than Mark Zuckerberg just signing on a 21-year-old to a $250 million contract?
Speaker 2:Yeah, to do AI.
Speaker 1:The race war for AI. Yep, the race for AI is a war right now.
Speaker 1:And so it is pretty unprecedented where we're headed. I agree with you, I don't think it's ever going to change that Primary care to me is already kind of I don't know, like without AI is kind of in trouble, like what we've been talking about. Yeah, for sure is kind of in trouble like what we've been talking about. Yeah, oh, yeah, it's for sure. Um, so you introduce ai and people are already thirsting for knowledge. Right, meaning, when you're sick, you want that you look online.
Speaker 2:Yep, oh yeah you look online google yep, you're your own worst doctor.
Speaker 1:Yeah, right, um, but what, what, what? I think butterfly does well, and this is a shout out to. Butterfly. But seriously, what they're doing well is they're trying to get these devices into the hands of people who don't have access to medicine.
Speaker 2:Correct, so you're 400 miles away from the nearest hospital or the nearest physician.
Speaker 1:Right from the nearest doctor. Why aren't we utilizing that with ai, with medicine right now, like why? Why aren't we saying, hey, people in in far reaches of africa or south america or asia or alaska right why aren't we giving them the tools to this ai technology now, so they can be better equipped to handle stuff like this?
Speaker 2:I think it's new enough we don't know what we don't know, so if we just send it out there and say, you know, hey, whoever in the middle of nowhere africa, just use this thing and figure out how to use it, I think we don't know what we don't know, so we don't know how accurate they're going to be, whether they're going to over diagnose right, because that's it. That's a problem too. Over diagnosis and over treatment is a problem too. Now, not in an area we don't have medicine right now, but it would be. If you give them something you know they're gonna, if you're, if your positive predictive value is low, and then you find something, you're all of a sudden going to be treating something that may not be real. So I I just don't think there's enough knowledge about it yet.
Speaker 1:It will get there eventually but some of the things that you're looking forward to discussing this fall. I know some of the things we don't know because we do breaking news sometimes and discuss, you know, but we're looking forward to having more guests on yep. Um, but what are some things in medicine, maybe in the later half of 2025 you're looking forward to?
Speaker 2:discussing. Yeah, I mean, you know, obviouslyhesia. There's still a big shortage in increasing costs and all that sort of stuff, so I think we'll probably have, you know, several more discussions about the state of anesthesia.
Speaker 1:I do want to talk about work life balance.
Speaker 2:Yeah.
Speaker 1:No, I do, Because I think, you know, does it exist? Not really, but with any profession, right, it's not just with anesthesia it's not just with. You know medicine, I think you know, maybe talking to somebody about you know what does that look like for a physician? Right, because every every career is different.
Speaker 2:Sure, I could say I don't have a work-life balance right, right, well, if you own your own company, that's a whole different deal, right? Um?
Speaker 2:so I mean, maybe, maybe the anesthesiologist who just clocks in and clocks out and goes to work and doesn't have to worry about running a business, doesn't have to worry about being a medical director of a facility. There's probably work life balance there. I mean, I, you know, I probably have some degree of work life balance, meaning that if I need to do like I need to go coach football every night this week, you'll do it, I'll be there right, so you know. But that also means that I got to get up earlier, do more during the day and probably do some work when I get home afterwards.
Speaker 2:But you've also developed that seniority over the course of the last 20 years, right, I mean.
Speaker 1:so there is a little bit of you kind of put your time in Right.
Speaker 2:I guess you would say I have work-life balance because my clinical work doesn't consume all of my time and so I choose that balance. On that work-life balance, I choose to do administrative work and run a business and do social media and all these other things. So, yeah, am I insanely busy? Yes, but does that mean I don't have work-life balance? No, because I'm not sitting in an operating room 80, 90 hours a week.
Speaker 1:And that's a choice Right exactly. We'll discuss that. That's a good topic to discuss.
Speaker 2:There's some of that. I think there's going to be continued push for direct primary care and basically cash pay, direct-to primary care and, and you know, basically cash pay direct to consumer. Yeah, direct to consumer stuff in medicine. Um, you know, ai is going to be a huge topic. There's going to be new stuff coming up. Probably every week we do a podcast. There's going to be new stuff coming up with with ai. Um, you know, I think there's going to be a lot of stuff that happens in hhs. You just see, you know that just today they were talking about how they've put some restrictions on mRNA vaccines. I mean, we can talk about vaccines. I'd love to have a vaccinologist, somebody who studies vaccines. You're asking the wrong person.
Speaker 2:I would guess this vaccinologist, but I don't know that would be great to have somebody on who could actually tell us about that. So sure yeah.
Speaker 1:All right, have somebody on who could actually tell us about that. So sure, yeah, all right. Well, we're looking forward to another full season of um anesthesia answered, going under anesthesia answer with dr brian schmutzer, and, of course, we'll start these podcasts up in september, so september, through the end of the year. And we're looking forward to partnering with butterfly. Of course, talking to somebody from butterfly, oh yeah, we'll have'll have a couple of their people and maybe go out to their conference again next year, which was awesome. I know they have that yearly conference.
Speaker 2:And we'll eat some masa chips too. Just a big shout-out.
Speaker 1:All right, shout-out to masa.
Speaker 2:It's the new white corn flavor.
Speaker 1:So we've got to try it. Podcast again.
Speaker 2:Yes, we do, he likes these. So what is this one? White corn, white corn chips.
Speaker 1:I've never had one. That's a bad, massive chip. No, yeah.
Speaker 2:Oh, very good, you can hear the crunch.
Speaker 1:That was a huge crunch by the way. You pair these with some ground chicken or ground beef and some salt turkey ma'am, it's good flavor, good flavor. You could hear the crunch all the way from pittsburgh.
Speaker 2:All right, now I'm gonna, I'm gonna close this up. So I don't want dr cn to be mad about having stale masa chips.
Speaker 1:Should I blame my? I think she's the one that leaves it open. I wouldn't. I want to be married by the end of the day. Yeah, I would cut that part out of the podcast.
Speaker 2:I would blame it on me before you blamed it on your wife.
Speaker 1:I'm not going to blame you.
Speaker 2:Just blame it on me. They're my chips, it's fine.
Speaker 1:Well, this has been Anesthesia Answered, going Under, going Under Anesthesia Answered With Dr Brian Schmutzler. I'm Vahid Sadrazzadeh. We're brought to you by the Butterfly Network. We'll see you guys in a couple of weeks, full time until the end of the year and football season starts up. Yes, it does. All right, we'll talk to you soon.
