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
Harmful To Your Health: Online Medical Misinformation Is Spreading
In the Season 4 opener, Dr. Brian Schmutzler and Vahid Sadrzadeh discuss the dangerous trend of medical misinformation online and explore how resident physicians and other practitioners sometimes present themselves as experts outside their scope of practice.
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Welcome back to Going Under Anesthesia. Answered with Dr Brian Schmutzler. I'm Vahid Sadarzadeh, season four is underway. Nice phabletic scrubs you. Gotarzadeh, season four is underway Nice phabletic scrubs, you got there. Thank you, hibiscus. Hibiscus, I actually it pops, it does pop it pops.
Speaker 2:We've got content coming out this week or next.
Speaker 1:Nice Alright so look for that. We are brought to you, as always, by the Butterfly Network.
Speaker 2:Alright, 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 right into my compatible smartphone or device or tablet so I can start scanning at the bedside in seconds. If you have 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 off, having an ultrasound literally in my pocket means I can move faster, whether it's vascular access, procedural guidance or just getting real-time insights for my patients.
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Speaker 1:Don't forget that I have the, but you gave me the butterfly belt. Yes, yes I did, is it? As a gift.
Speaker 2:No, it's not a gift. Oh, it's yours, it's mine. Yes, you left it here, I left it here yes, yes, I need a butterfly bag you do. It's like a little fanny pack but it carries your butterfly. It's great. I like it.
Speaker 1:We've got a cool couple reels coming out for Butterfly this month too Nice. I'm excited about those. I'm excited for season four. We've got a lot on deck. We're going to talk about AI.
Speaker 2:Yes, again, over and over again.
Speaker 1:We're going to talk about AI, probably until we're about 75 years old, if we make it that long Skynet doesn't take us down by then.
Speaker 1:That's true. So we're going to be talking a little bit about AI, this. So we're going to be talking a little bit about AI, this. I was going to say this semester, yes, this fall semester of your season year, your senior year, season four so lots of interesting content coming your way. But today we do want to talk a little bit about, kind of the intro to AI, and that is where people are getting their information, or misinformation, online. And I know social media can be a huge part of that, but, medically speaking, misinformation can be horrible, right Right? I mean because you can be getting your news from any source and people will believe it, right, right. So talk a little bit about why we're talking about this today.
Speaker 2:Yeah, so I had a little bit of back and forth very respectful but a little bit of back and forth with somebody who posted on the MedPage Instagram page. So I don't know, for those of you that don't know, MedPage has got their own sort of thing where they put articles on. It's sort of almost just like a clearinghouse Yep, I follow them, I go through their articles and stuff like a clearinghouse Yep, I follow them, I go through their articles and stuff. And there was something that popped up with somebody talking about how you know to present information, medical information you have to have the cachet and the competence and the background and the training and stuff to do that, which I in theory agree with.
Speaker 2:The problem I had is that it was a psychiatry resident making that comment. So I put a comment on there that perhaps that wasn't the best person to be commenting about medical professionals having the competence and credentials to comment on medical things. So we went a little bit back and forth on that. On medical things, yeah, so we went a little bit back and forth on that. So this brought me to a bigger point of. I really have an issue and there's even the big TV stations MSNBC did this as well, with media companies cherry picking resident physicians, posing them as experts and then having them make claims about things that they really don't know. Right, Okay.
Speaker 1:Yeah, go ahead. So so back up just one second. So um a resident, yes, oh yeah, we should probably go, yeah, back to training, yeah. But just for kind of the, the layman's terms here. So resident is somebody who just came out of medical school and is doing training. So so somebody who just came out of medical school, yep, and is doing training. So they have four years of undergrad, yep, four of medical.
Speaker 2:Presumably four years. Yeah, it depends. There's some combined, most are four.
Speaker 1:95% of them are four Residency is the year after medical school, that's intern year.
Speaker 2:Okay, yep, so you do one year of internship, which is also considered under the umbrella of residency and then residency. You do somewhere between three and seven years, depending on your specialty.
Speaker 1:Okay, so were they a first year. Second year Does that matter?
Speaker 2:I don't know, I didn't get into it that deep. The problem, though, with residency is you don't practice on your own, so you have no independent practice, which, in my opinion, makes it difficult to realize what's happening in the real world, right? I mean, it's a lot easier to make claims about things when you've got somebody who's always signing off on your charts, always watching you do a procedure, always, you know, basically taking all of the responsibility for you.
Speaker 1:So it's almost like you're working for someone. It's basically an apprenticeship Gotcha, basically what it is. So you're always under somebody who has been in the position for years and years and years. Correct, correct.
Speaker 2:Gotcha. So that's like again, in my opinion, that's like a pipe fitter apprentice getting on social media and making claims about pipe fitting Like they're the expert on pipe fitting, even though they're an apprentice, right, gotcha. So you've got this particular instance and what actually she was saying I agree with, and I'd like to dive deeper into social media and this information on social media. What she was saying I actually agree with, which I said when I commented, but my problem is that MedPage is presenting her as an expert when she's a resident. She's not an expert in anything as a resident, I mean, let me take that back she's not an expert in anything medical when she's a resident right, maybe she's, I think she's got an MPH, so maybe she's an expert in public health or something else, but she's not an expert in anything medical if she's a resident and this takes me back to MSNBC. I think is who it was, and don't quote me, it could have been CNN.
Speaker 2:Brought on right after Trump won the election and there was so much angst between conservative and liberal, republican and Democrat. Brought on again, a psychiatry resident. So I don't know, maybe it's a psychiatry residency thing, but brought on a psychiatry resident and the psychiatry resident said you know you should for your, for your mental health, if, if you're, if your family voted for Trump, you shouldn't go to Thanksgiving dinner with them. You should isolate from them, which Okay. So again, I'm not an expert in psychiatry. I'm not a psychiatrist.
Speaker 2:I do have a bachelor's degree in psychology, so I know a little bit of psychology. What I remember is that social networks, strong, supportive social networks, are a really big a psychiatry resident, not board certified tell the American public don't go spend time with your family because they voted for Trump Seems political, not medical to me. So anyway, so those two things together, I just I, I kind of. This is kind of a diatribe, but I just kind of. I was just upset that this person was posing as an expert in either one, the one on MSNBC and this one posing as an expert when they were a resident. So to me, what it looks like is these news outlets and maybe you know better than I do these news outlets have a predetermined story they want to tell and they go find somebody to tell that story for them, and the only ones willing to tell that story are residents.
Speaker 1:So let me tell it from the news perspective. Yeah, let's hear it. No, two news outlets are the same. So let me basically put that. So we all know, networks own local TV stations, right? So, like, if you're an ABC affiliate, if you're an NBC affiliate Fox, fox, CBS, whatever You're owned by a media company Sure, now, it's well known that CBS stations across the country were supposed to read something during COVID, right? Right? Sure, so every CBS news station that we're it's the same thing Reads the same thing. So let me break that down even farther though. So news outlets, if you're a reporter or a producer, will try and tell the story. That takes the angle of whatever you're trying to tell the story about.
Speaker 2:Okay, so you're going to tell the story about. Okay, so you're going to change.
Speaker 1:Yeah, you're going to change. So if I'm trying to tell a positive story about you, know I'm just whatever Just make something up, yeah.
Speaker 1:If I'm trying to tell a positive story the Highway Patrol, yeah. Or the NFL yeah. If I'm trying to tell a positive story about the NFL, I'm probably not going to reach out to the NFL PA person, right, right, right. Like I'm not going to talk to the Players Association because they've been telling stories on the opposite side for years, I get it. Yeah. If I'm trying to tell a hey, maybe I'll reach out to the office. They'll give me somebody that can tell that story in a positive light. That can tell that story in a positive light. So if I'm trying to tell the story of psychiatric whatever, I'll say, hey, choose this person, or this person can come on and talk about this event.
Speaker 2:But it makes me so. It makes me think one of two things either, which this is probably the more likely these smart news stations will choose both sides to get both opinions.
Speaker 1:So I'm just speaking journalistically here.
Speaker 2:My guess, my number one guess, is that they don't know the difference between a resident physician and a practicing attending physician. That is my guess.
Speaker 1:So this is Med News right.
Speaker 2:Med Page, I think, is what they're called.
Speaker 1:That's the one who posted this person.
Speaker 2:Yeah, so maybe not them. Msnbc, I'm guessing, doesn't know the difference between a resident physician and an attending physician. I'm just saying so that's the most innocent explanation. The more detailed or divisive explanation would be they couldn't get a practicing, attending whatever psychiatrist or whatever to say the things they wanted to say. It was easier for them to find somebody who didn't have experience.
Speaker 1:Can I ask? Can I ask you the deep question what? What were they trying to say? What was the information they were trying to put out? You don't have to say everything, but you know, maybe just in generalities. So the the what, what in the 10 ding attending have said it differently, Probably.
Speaker 2:So I think that on the med page, what they were trying to get at is, if you're going to and it's funny because she's a resident but if you're going to put yourself out there as an expert in something, you should actually have some expertise in that, which I don't totally disagree with.
Speaker 1:So what in the medical community, an expert in something may be different to a community or specialty than something else. So like in the medical community. So you're considered an expert.
Speaker 2:If you are board certified, you're considered an expert in your specialty, if you're a board certified Correct and how soon after residency can you get board certified Within? A year or two.
Speaker 1:Okay, yeah. So I'm not an expert, but that is the threshold.
Speaker 2:Yeah, correct.
Speaker 1:If we're talking about the threshold, correct. I just wanted to yeah.
Speaker 2:And I think it goes to a bigger point of people dive into areas they don't know much about, right, like I'm not a virologist or an infectious disease doc, right. So I talk about COVID to the extent that I know COVID, but I don't know it like an infectious disease doc. But that doesn't mean that I can't speak on my experience of COVID as an anesthesiologist, right. Right, I mean in my general medical knowledge.
Speaker 1:It's funny we're having this conversation because we've gotten some emails lately about people who think they know broadcasting or think they know how to broadcast the show, whatever. Right Right, you can speak from your experience as a viewer, right Right, you can speak from that point of view, yeah, but certainly don't speak from the other point of view, saying you're an expert in the broadcasting field right, right, and so I think I think actually that brings up a good point.
Speaker 2:And to get away from the negative, the only reason I brought up the negative is because the exchange was a little bit tense I mean reasonable, professional, but tense correct between us, um and and to, to speak to the particular psychiatry resident that went on MSNBC, I think their point there on MSNBC was to deride anybody who voted for Trump, right?
Speaker 1:So that aren't medical experts, particularly and this is a big thing going around all of the kind of medical community.
Speaker 2:Yeah right, Is chiropractors claiming to be able to diagnose and treat disorders that aren't just musculoskeletal disorders? So there's a Wait, like what? Colitis? Like inflammation of the colon? So they're not an internist? Yeah, right, exactly. And taking x-rays for non-musculoskeletal things? Right, so that's a huge issue, right? If you're a chiropractor, you are not certified to diagnose and treat medical conditions not related to the musculoskeletal system. So that that's a whole big, big issue. That I that I think, if that, if she had come out and said something like that, then I totally agree, right? Um, not just this sort of broad, sweeping statement of you have to be competent and and, uh, you know, credentialed to be able to speak to things, things so. But there's a lot of chiropractors out there talking about things that they have nothing, they have no knowledge of, right, um?
Speaker 1:why do you think that is for most like if it's happening in the chiropractic industry? Why do you think that is?
Speaker 2:um, because everybody wants to get their hands in the medical field, right? Nobody wants to stay in their lane of chiropractic or physical therapy or whatever. So, yeah, and that's dangerous, right, if you're giving people medical advice and you're not certified to give that medical advice, but you are. It's not like it's just. You know, susie, your next door neighbor, it's a chiropractor who actually is certified in chiropractic and is licensed in the state that has certain, you know, absolute rules and regulations they have to follow giving medical advice outside of their profession.
Speaker 1:I just don't understand that. Like what I mean, I don't know, keyboard warriors, I call them.
Speaker 2:Well, yeah, but these are influencers who have, you know, millions and millions of followers. Yeah, I can't remember the name of the and somebody. If somebody knows who I'm talking about, there's a whole set of chiropractors, I think they're on the West Coast.
Speaker 1:Yeah.
Speaker 2:Who like talk about all these medical things and make all these, you know, huge medical claims that they have no right and no expertise to be able to do.
Speaker 1:I just don't understand.
Speaker 2:I mean, I do understand Money, Right Money right, they're trying to get followers and make money.
Speaker 1:Yeah, I just for some reason. I mean, we all know that online presence is a very fickle thing. Sure, of course I mean um, whether you're a follower of a football team or follower, sorry, football is just on my brain. Um can't imagine. Yeah Right, um heartbreaking. Don't really want to talk about it, even though I picked Miami, I know Um you changed it last minute though. Yeah, but on paper I still got called out by many, many people you picked my hand.
Speaker 1:Yeah, they're like, how could you? I can't believe it. I'm like, listen, truthful, just right, like I'm a realist, if anything else. And I was right, yep, originally, um, but I just you know, yes, I get the purpose money, yes, but when you're committing fraud online and nobody's there to call you out on it, right, I mean, how many falsities do we see online? A lot, and I mean you type in WebMD and try to diagnose your own thing, right, webmd is pretty well regulated. I'm not saying that's wrong.
Speaker 2:I'm just saying I get your point, just Google, you just go to.
Speaker 1:Google, right, and now it's like what website's real, what website's not? Yeah, people and I'm talking from experience on scrolling through TikTok Facebook Instagram, experience on scrolling through TikTok Facebook Instagram and seeing what people share do they realize that half of this stuff is not real?
Speaker 2:Well, it's confirmation bias too, right? So if you go online and you say I think that I don't know, make it up that pure leaf tea I'm not making a comment on pure leaf tea, although I do love it, that pure leaf tea cures cancer and then you go online and you find somebody who says pure leaf tea cures cancer, right. And then you keep finding more and more people who say pure leaf tea cures cancer, it's confirmation bias. But here's my point on that is, we should be policing our own, right. So the best way to combat that is in the court of public opinion, right? So the best way to combat that is in the court of public opinion, right? So and I made this example, I think even in the conversation I had on MedPage guys like and I don't own, and that basically, guys like Dr Mike Dr Mike is a I think he's a family physician, but he's out there and he's very evidence-based talks about. You know, this is correct. This is not correct. You got guys like Jerome Adams, right? Jerome Adams is great, he's out there debunking stuff. Um, you've got, uh, that, that foot doc. I can't remember her name. I think she's married to Doc Miro. You know what I'm talking about. So she does all kinds of stuff about podiatry and foot diseases and all that sort of stuff. But she also debunks people who are saying stuff that's wrong.
Speaker 2:So I don't totally agree. I mean, jerome Adams is a friend. I don't always agree with everything he says, dr Mike you know. So I don't totally agree. I mean, jerome Adams is a is a friend. I don't always agree with everything he says. Um, dr Mike, you know, I don't always agree with you what he says.
Speaker 2:Zane, right, zane, zane Hassan is a friend of the show. He's debunking some you know, wrong stuff out there. Again, I don't always agree with what he says, but he's definitely, he's definitely knows what he's talking about, right. So that's my opinion is we've got to be out there as physicians, as medical professionals who know what's right and what's wrong medically, to go out there in the court of public opinion. And Dr Mike does that a ton. I mean he has like roundtables where he brings in 50 people and debates them about whatever vaccines or, you know, nutrition or whatever. So that's the way to go, I think, not having MedPage put out there, you know, we should make sure you know, check people's credentials before they do anything and blah, blah blah, that's. I think it's a little much. I think we find them in the court of public opinion.
Speaker 1:There's so much misinformation out there. People are trying to get attention. People are trying to get money. People are trying to get money. People are trying to establish themselves as influencers, even though they, you know, look what Chad GBT is doing. I love Chad GBT on one hand. On the other hand, it's very interesting because anybody can go to hold a Chad GBT.
Speaker 2:And it's not always right. Right, it's not always right. Right it's not. It's not always right. Yeah, it's not. It's not perfect. It messes up a lot. I mean, even if you put in stuff like about anesthesia, yeah, it'll screw stuff up.
Speaker 1:So so I mean it is, um, I think we're at a balancing point of you're right, people should be policing other people and we don't always agree with what everyone has to say, but at least we should be policing those who are trying to pose as somebody else. Yeah, oh yeah, a hundred percent Social media fraud. You know what I mean? Like, I mean it is true, though, and it's concerning at how many people are posting things that they don't know anything about, like they don't know the truth, right, you know, like, who's out there to?
Speaker 2:tell them, no, right? Well, and so that's also part of it there. To produce so much content and I can't remember who it was that was talking about this but, um, to produce so much content, to stay relevant in social media, sometimes you do have to go outside your area of expertise, right? Like, sometimes we talk about football Am I a football expert? No, but I have an opinion. Sometimes we talk about, just because it's relevant, ai, covid those are things that I'm not an expert in in any way, shape or form.
Speaker 2:Now, I know how to read papers, I know how to evaluate them and we evaluate them from a medical perspective, right? So I know the medical perspective, and then I learn about the AI and I learn about COVID, and I learn about public health and that sort of stuff. So, you know, I try to stay as much in my lane as I possibly can, but there is a push, if you're a social media influencer, to produce enough content, and to produce enough content, you're going to start talking about things that are outside your area of expertise. So qualify it as.
Speaker 1:I'm not an expert in this, but this is my opinion based on X, y, z. Well, some of the people that I follow on YouTube are certainly not experts in everything that they do, sure, but they're experts at YouTube because they probably have spent 10,000 hours doing whatever it is to master YouTube. But that goes to your social media influence profile of hey, maybe we're stepping out of our comfort zone to do something. Maybe we're talking about, you know, I'm no expert in. I never claimed to be an expert in football. Yeah, but I do analyze football because I see it for a living. Yep, you know, um, I'm, I'm a storyteller. That's what I'm an expert in, right? Um, and so you know, I've been following football for years, but I'm never claiming to be.
Speaker 1:You know, you're no tony romo. I'm no tony romo, I'm no Tony Dungy. You know those are experts, right? You know to spend thousands of hours doing something and make it your livelihood. And to, you know, they can speak on those topics. And there's a reason that they switched to color analysts for football games Because they know their stuff. That have played football, because they know what they're talking about, have played football, because they know what they're talking about. So it's. You know, there there is a sense of there first has to be self-policing, and if you're not mature enough to do self-policing, then if you're going to be called out by somebody on social media, like I'm sorry, like, but they're going to call you out, yeah, you shouldn't be posing as somebody that you're not.
Speaker 2:Exactly that's the way I feel about it or at least qualify it, as I'm not an expert in this, but this is my opinion based on my expertise. My expertise and my experience correct, my experience and I. I have no problem with that. But yeah, people who pose as experts, particularly the whole chiropractic thing where they pose as medical experts, is just, it's just crazy to me.
Speaker 1:Plus, like you know, yes, I'm an expert at how to use a camera, but I'm not always like raising my hand to be like, ooh, Let me tell you about this camera, let me tell you about this, this, this and this, because there are plenty of other experts in the field that probably know more than I do. Yeah, so if you're the person who's posing, aren't you afraid that there are some people that will call you out, yep, yeah, and when that happens, if that happens, when that happens, you know, just try not to be nasty about it.
Speaker 2:You lose credibility, you do. But then the question is do you care If you've got 2 million, 3?
Speaker 1:million, 10 million followers. Well, at that point, no, because that's how you. Is that how you've gotten your followers?
Speaker 2:Do you care about losing credibility at that point? Right, so we have to be better. You know, again, if we're fighting and I'm just using this as an example I have nothing against chiropractors, there's a lot of great chiropractors, blah, blah, blah. But yeah, I'm just using this as an example we as a medical community have to come together and all of us who have any influence in the medical community have to say look, these guys are quacks and what they're doing is not medically based. Okay, and then maybe we fight it with that. But what I am an expert in is anesthesia, and there's a couple new anesthesia things that we should talk about, maybe later on in the season, but we'll just tease them. Yeah, please, do you like that transition there?
Speaker 1:Yeah, You're becoming an expert in broadcasting.
Speaker 2:Broadcasting expert.
Speaker 2:So one of them is there is more and more AI being built into anesthesia processes, anesthesia processes, and so there are several new things coming out that actually give medications, measure the medication sort of dosages and concentrations in the blood and then give you a feedback loop to tell you how much to give.
Speaker 2:And then there was also an AI model that I think they also did an actual trial on showing how anesthetics work, and they are showing that what their guess was, which is that they disrupt the outside of your cells, are kind of a fatty layer, the lipid bilayer. And so the thought was that most of the anesthetics that don't bind directly to channels, either GABA or whatever channels, go and kind of interrupt that lipid membrane and allow the cells to, you know, not depolarize as much or change, change all the change, all the mechanisms in the cell to make the anesthetic work. And so the AI models, combined with their actual testing, are now showing that some of that is true. So that's cool, because there are a lot of anesthetics. We have no idea how they work and this may be some of the ways they work, so we'll talk about that later on in the season that's awesome.
Speaker 1:I'm excited we're gonna have some cool guests on too. Um, I also I've been playing around with this idea. Maybe maybe you'll buy into. All right, let's see. But over, I would say, over the last couple of months, um, I've had some people that have been very, very close to me, some people that I know as acquaintances or colleagues or whatever, on top of the people that have been close to, who have never received anesthesia before, really general anesthesia, okay, and some people are afraid to death. Okay, some people didn't. Oh, I got the best sleep of my life, yeah, you know like. So maybe in the next episode, maybe we bring on like a little Q&A thing, okay, if you're open to it, sure, and we can have some of these people write up questions like you know what is general anesthesia? Like? I think there are people out there that really don't know Want to get into it from a Right.
Speaker 1:And you know, like, if you've been listening for the last three seasons, you know we do dive into other expertise and we have guests on and stuff like that. But really in that first season we focused on what is anesthesia, yep, and you know what are the ways we're using it in surgery and you know local, what's the difference between general and local? Yeah, but maybe diving into that with some patients.
Speaker 2:Yeah, we should definitely do that. I think that would be cool to you know, have it from a patient perspective and ask the questions that you know John Q Public wants to ask Because I'm just really surprised that how many people don't really know what anesthesia is.
Speaker 1:You know, I thought it was an app. Okay, before you knew Before we talked yes, okay, I mean literally like. I mean I just thought, oh, they put you to sleep, yeah, but it's not really yeah.
Speaker 2:No it's not sleep, definitely not sleep no-transcript on Anesthesia Answered going under.
Speaker 1:Anesthesia Answered with Dr Brian Schmutzler, brought to you by the Butterfly Network, brought to you by the Butterfly Network. We are back for another season, baby, we are. We'll see you next time. All right, we'll see you then.
