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Оглавление (3 сегментов)
Segment 1 (00:00 - 05:00)
Sometimes the best way to talk about uncomfortable medical subjects is through humor. So, let's watch and react to some South Park. I hope they're going to solve our insurance crisis. — Wow, look at this place. — Well, hello there. Looking to get some insurance? — No, my friend's mom already has insurance with your company. — Oh, great. You're here to pay your bill? — No, we're not here to give you money. We're here to file a claim for my friend's medication. — Oh, you want money from us? Right through that door over there. — It's like a door to hell or something. — All these companies have the most amazing technology, AI, this that. But whenever you think about their processing claims department, it's this poor dude. — We want to file a claim to get my friend's weight loss drugs paid for. — Oh, okay. — With a typewriter, one finger at a time. This is the constant struggle I have like to get my patients who need GLP-1 medications either for weight loss or for diabetes. It's a struggle. But then get this, some of my patients have been on the medication doing phenomenally well. We're keeping them out of the hospital cuz their diabetes under control. Their weight's going down. They're needing to see us and the health care system less so that they're spending less money of the insurance company. But they then take the GLP1 off their formulary and no longer cover it. — What the heck? — Let me just speak with our medical director first. — The rotary phone. And you laugh, but approvals and denials still happen by facts. — Yeah. Okay. — Sorry, but we don't pay for medicines for obesity cuz it's not a disease. — Who was that? That was the medical director. The medical director decides what claims are valid for us to pay for it. — But you didn't say who the patient was or what was wrong with him. — Right? The medical director's job is just to say no. The more they say no, the more the profits go up. And look, I'm not trying to paint them in an all bad light. But the idea of them making things a little bit harder in some instances in order for you to give up and not actually proceed with the claim or the reimbursement works in their favor. And they definitely know that. They're aware. — My friend's mom has been paying you people for years and his doctor says his weight is a medical concern and obesity is a disease. OPRAH WINFREY SAID SO. — OKAY. Calm down. — Whether you think obesity is disease or not doesn't really matter because by treating the obesity, the risks of other diseases that you will inevitably have to pay for go down. It's a profit savings for you long term if you keep the same person insure. But because everyone's constantly switching plans, that's a big problem of our hybrid system. I didn't realize I was dealing with someone who had so much determination. If you do a little more work, I think we can get your medications paid for. — Well, we can. — Yeah. You see, the doctors and the pharmaceutical companies and the insurance companies all kind of work together. So, all you have to do is navigate the American health care system. — They don't actually work together at all. It's the most discombobulated system ever. — We're going to navigate the American system. It's there for you and me. — Just fill out these forms. — Why is there like some kind of dialysis pump or it looks like it's one of those things where you blow into and the ball hovers around the cup. — I need to send you to imaging. — American healthare. I just filled them out the last place. It's so much fun to be getting it done. — I can't sign this for insurance. His original doctor needs to sign this. — We go back to the thing for insurance. — This happens to me so often of me ordering something for a patient, explaining the necessity, putting the diagnostic codes only for them to say, "Oh, well, we cover it for this diagnostic code, but your diagnostic code is missing an R at the end. We need you to get a second opinion from a doctor who's in network. — American healthare. — Why is he wearing a patient gown everywhere he goes with his butt out? This is a tip that I can give here with South Park. It's so tempting to get mad, but the second you get mad, the more those people who are already annoyed with everyone yelling at them all the time, cuz it's not actually their fault, the less likely you are to succeed. And I know that sucks to hear, but the nicer and clearer you can be in your communication, even when you're fed up and you understand that it's not that person blocking you, the more effective you can be at times. — Yeah, that's a pretty bad lies problem there. Good thing they pulled you out of school. — But why me, doctor? Why me? How did I get this? — A lot of people will feel ostracized by their classmates because they think that getting lice is like a moral failing or
Segment 2 (05:00 - 10:00)
that they're dirty. In fact, lice enjoys a clean head of hair. Remember, it spreads by contact, close contact. Lice don't jump. They crawl. So, it's literally kids making contact with each other's heads or sometimes through surfaces. In fact, the American Academy of Pediatrics says like don't go crazy cleaning your entire house. Maybe vacuum, wash the most recent clothes that you wore, pillow cases, but like going too far doesn't usually help. And lice, head lice don't spread disease. So, while yes, they can irritate your scalp and lead you to scratch and then create an infection from the scratching, they themselves look more evil than they are. And if you never saw head lice under a microscope, or dare I say head louse under a microscope, here you go. Good luck sleeping tonight. And I bet your head is tingling right now, cuz mine is. Well, believe it or not, some lice can actually attach themselves to flies and then wait for the fly to land on someone's head where they can reproduce. — I've never heard that. Sometimes people blame pets for this. Lice don't like to live on pets, so that's not a thing either. They're not a spreader. — This shampoo should take care of it. Use this in the shower. — Yeah, we have medical treatments with uh certain chemicals that can kill the lice and the knits. We also have what people refer to as less toxic options. We have this very interesting louse buster heat technology that is not as hot as a blow dryer and it can kill like 90 plus% of uh the lice there and the knits. And there is uh a world for wet combing which is a whole technique on its own that some people super specialize in order to remove the lice one by one. It's not an easy technique. Things get missed there. I think they're trying to do a play on Nyx, which is a common over-the-counter lice treatment that we sell here in the States. — What is that? — It actually doesn't burn through their skin. It like paralyzes their nervous system, which isn't any better, but still. Do it. — DON'T DO IT. You will not fly with a 4x4. What is that? — Oh, thank god there was snow. Hell's Pass Hospital. He's got a raccoon eye on one side, so you're worried about a really bad basil or skull fracture, multiple bruises across the face, an oxygen mask, and he's on dialysis with a cord going nowhere. He thought he could fly with cardboard wings. The stupidity is so severe that it caused a fall which has put him into a deep coma. — See, we are looking for the root cause, but perhaps not that deep of a root. — Coma? My god. For how long? — There's no telling. — Usually, we'll keep patients in an artificial coma if there's swelling of the brain in order to decrease the metabolic demand onto the brain. Therefore, potentially decrease some of that swelling. And sometimes the swelling is so bad that a cranottomy needs to be performed especially if there's bleeding. There's actually things that we do to help patients who are having cerebral edema. Whether it's changing their position to elevating the head of the bed, giving them specific manitol concoctions. This is a tried andrue proven way to decrease swelling inside the skull. Cuz remember, swelling inside a closed uh environment only yields more pressure and more damage. — Oh, you finally come back. It's a miracle. You're at the hospital, Eric. You've been in a coma for some time. — Coma? How long? — It's been 2 days. He grew a full beard. Nurse, you can remove his face warmer now. — Yes, doctor. — Face warmer. We do oral treatments for those who are uh in a coma because, think about it, they're not creating enough lubrication. They're not speaking. They're not swallowing. So, it can get pretty mean in there. So, you need to uh do some magic mouthwash every now and then. — Eric, you've suffered massive head trauma. Your road to recovery will be long and arduous, at least another two days. — During neurologic injury, you don't know how long the road to recovery is until you monitor it clinically and you start getting a sense of how the patient is progressing. Literally, you watch and see how much they improve dayto-day. You keep objective values in place and from there you can sort of make a trajectory, but otherwise it's hard to predict. — I'm sorry detectives, there was nothing we could do. Damn it, another murder victim. We better get back to the station, sir. — Good, because you have kept me up for 3 hours. — All right, let's go, Murphy. Hang on a second. Where are my car keys? — Probably in your front pocket, dumbass. — Doctor, didn't you say that kid suffered head trauma? — Yes, it was pretty severe. What is it, Lou? I've heard cases where people suffering head trauma awaken to some psychic abilities. No, but some people
Segment 3 (10:00 - 14:00)
and I'm going to show you the clip so you believe me, people out of a coma or after an injury develop different accents. — It wasn't until I was in ambulance on the way to the hospital. She actually say, "Are you aware of the way you're speaking? " And I say, "Oh, I sound like I have a solor. " And she said, "No, you sound like you can work at a Chinese arable. " — Don't make me swallow this. I'll do it. — Is that an M& M? It's an almond M& M. I'm very allergic to almonds. — What? No. Don't. He's going to go into aniflactic shock and then his oral ferinx is going to swell and close up and he's going to have hypotension and gastrointestinal discomfort. This is a serious problem and benadrol won't help here. You need epinephrine. — Just leave me alone. Then you have to tell us well — I'll stay away. Don't let him swallow it. Pry his mouth open. He ate it. Butters, where are the ballots going? Where are they going? Why is he foaming in the mouth as if he's rabid? I mean, I'm not going to lie. If the swelling is so bad and you can't swallow, there could be some salivation. — Your friend has had a severe allergic reaction. — Can we please just try and talk to him? — All right, but don't take too long. — Oh, wow. That's fullon facial angiodma right there. — I didn't want to have to do this, but if you don't tell us, I'm going to tell your dad you helped get the wrong person elected president. Please, — then just tell me what Carmen is up to. — I think he should be in the ICU with that level of swelling, especially swelling surrounding the oral airway. — What did he say? — Oh, great. The worst person yet the best person to translate that. — Butters, where is Carmen supposed to hand over the ballots? — Where the — huh? He said at what red? — Oh, red lobster. — Red lobster. That's where people really have aniflaxis if you're allergic to shellfish. — How does he have the upper body strength to pull himself up a burning broken bridge? I can barely do that. And I consider myself semifit and not a chef. — Oh, damn it. — OH, LORD. I'm worried about the spinal cord. I'm worried about lower extremity paralysis, bowel incontinence. Remember, the nerves that come out of the spinal cord lower there are just gone. The entire dermatome. If I'm a rescue work, I would cut the branch from behind him and bring them in like that because it's probably putting pressure on the areas that are bleeding, therefore decreasing the bleeding. So, you'd want the trauma surgeons to actually remove the branch, but I have a feeling that something more vicious is going to happen. — Oh. Oh, it's eating his limbs. — You can't lose another member. Shoot it. — Oh, they shot him. Stop shooting chef. That went straight through his aorta — and a bear. Okay, he has zero chance of survival. This is like Mortal Kombat fatality situation. Oh, that's a del gloving injury of the face. Ouch. Ouch. — Maybe he's still okay. — He's not, champ. landing a 100 ft fall onto a sharp branch that penetrates the abdominal cavity and severs the spinal cord. Then bleeding extensively out, extanguinating lions and bears mutilating and tearing apart limbs is not compatible with life. And I'm sure one of you in the comments is going to be like, "But my uncle was once camping and he fell and a mountain lion chewed off his finger. " Doesn't count. Not compatible. They say the last thing you do before you die is crap your — That's not true. I mean, once you're dead for a period of time, fluids come out, but — Oh, never mind. — These guys have no hospital etiquette. In fact, here are things you should never do or say in a hospital. Click here to check that out. And as always, stay happy and healthy.