- [Dr. Mike] Wait, wait I wanna get a good shot.
Okay, go, go. - [Yvette] You ready?
One, two, three.
- All right, it's a bright and early day.
It's time to be a doctor.
(upbeat music)
He has such an aggressive tongue.
All right, let's take this little guy for a walk.
You ready?
Let's go.
(upbeat music)
Look at that, peeing right on the grate.
Did not make a mess.
I trained him well.
You can't see the Empire State Building.
It's right there.
Touch it.
As any veteran dog owner will tell you,
one of the biggest struggles of having a pup
is when you're walking them in the morning
and you wanna get to work
and your dog refuses to poop.
Bear, go poop.
(upbeat music)
My first patient today is actually at 8:00 a.m.
but I wanna get in a little earlier
to start working on my notes from the other day.
Notes are the bane of the existence of a doctor
because not only do we wanna see the patients,
spend time with them, but then we become slaves
to the electronic medical record.
It's pretty brutal.
What is that?
Bear, you wanna put that away?
All right, let's get to work.
Today I'm gonna be working a long 12, 14 hour shift
as an outpatient family medicine doctor.
Now what does outpatient mean?
It means that I'm gonna be seeing patients
in an office setting where I don't have
to admit them, meaning that
they are not gonna stay overnight in the hospital.
So it's basically when you go in for your doctor's visit
for a check-up, for a problem,
that's what I'm gonna be doing today.
That's primarily actually what I do.
So today we'll probably have around 30 patients
where maybe after each visit I'll come
and tell you what I did
and we can have a little learning opportunity.
(tone dinging) (banging)
Oh my God.
Major fail.
When I see patients in my office,
I see them for anything.
Acute problems, meaning like they get sick today
or they have pain today
or something's going on where it's an urgent matter,
but I also see them for primary care,
meaning that they're coming in
for chronic disease management and counseling.
So I have diabetic patients that need
to check their numbers,
make sure they're taking their medications optimally.
It's a really fun job
'cause you really never know what's gonna happen.
You don't know what kind of patient's gonna walk in.
(tone dinging) (banging)
God if you guys didn't know any better
you would have though I got into an accident.
My commute isn't that bad.
It's around 45 minutes.
It's a reverse commute.
Some people are like, wait,
you work in New Jersey but live in New York?
Yeah.
That's actually a great strategy
because I do a lot of TV stuff in New York
so I have to be here,
but then I love working in New Jersey
'cause that's where I did my residency training,
and I built up this patient panel of patients
I actually love and have a connection with.
I'm growing old with them.
It's kinda funny to say.
I think we've got some great content.
(tone dinging) (banging)
God.
I wonder what kind of clip I need to buy
to keep this in my AC vent.
(tone dinging) (banging)
By the way, now that we're just hanging out here,
I'm having some water and I'm driving to work,
I need you to hit
that subscribe button
and that notification bell
and set your alerts to all
just so that YouTube algorithm doesn't mess with us
any further.
I know only 15% of you have done that so far.
Step up your game.
You can do better.
Hit that notification bell.
(engine revving)
I'm gonna get in trouble.
Who's excited for work? - Michael, how are you?
Good morning.
- Are you excited for work Jenny?
- Oh I'm so excited to see your face.
- Isn't it a great day to save lives?
I'm gonna sit on this garbage can here.
- Don't sit on the garbage can.
- No, I'm gonna sit
on the garbage can.
Don't tell me what to do. - Oh Michael.
- You're not my mom.
Maybe my work mom.
What's the craziest thing you've ever seen?
- You're making me think back here.
- Yeah.
- People that have passed
and there's a smile appears on their face within seconds
of them totally passing away.
That's pretty amazing.
- Any good stories Jenny?
Let's cheer people up.
- Michael, the good stories is there's lots
of men walking around with nice scrubs.
- Ooh. - That's the best stories.
- Jenny's getting feisty today.
- (laughs) Get out of here.
- Let's talk about INR.
- Okay, what about INR?
Let's talk about it.
- Not on the vlog.
- Why not? - Okay.
- INR is when a patient comes in
for a test to see if they're taking their coumadin properly
and appropriately, so let's check it out.
So when you're looking at an INR,
what I'm looking at is to figure out,
A, is the patient's dosage correct?
B, are they coming in at the right intervals?
So if their levels are all over the place
and we can't get any stability,
we have to figure out why that's happening
and we have to check them more often.
But if they're consistently having good numbers,
we can spread 'em out.
- Hey, hey hey hey hey.
- Represent.
- Represent, yes.
- Jose, what's up baby. - (laughs) (mumbles)
Where'd you get this from?
- Today's a hospital vlog day, baby.
- Woooo.
- You ready for it?
- I'm ready, I'm ready. - You gonna try
and get Liddy?
- I'm ready, I'm ready to get Liddy.
- Yo, you gotta DJ it up.
- (laughs) Whatcha wanna hear? DJ-ing
for our patients. - Whatcha wanna hear?
Whatcha wanna hear?
- I wanna hear Reggaeton.
- All right, I got you.
- (mumbles) Reggaeton. - Oh my god.
What is going on in here? - [Jose] Them bones them bones
- Come on, come on it's a party.
(laughing)
All right Jose, how many patients you checking in right now?
You don't think you're working too hard.
- I just got in.
- All right, go do your job. - All right.
- 'Cause I need to see my patients.
So my typical day goes like this.
I come in.
I try and catch up on the computer
to call patients back,
to look at results,
to write some notes that I missed the previous day,
and then I go in
and every 15, 20 minutes I have a new patient.
I'm in and out of the rooms.
I'm in and out of the rooms,
like I just came out of a room
with a patient who was complaining
about really bad allergies.
That's really interesting
'cause typical pollen season is now over
and now we're getting into that wintertime allergy season
and sometimes if you're using the same allergy medication
for too long you can actually build up a tolerance
to it and you need to rotate them.
So what we're doing for this patient is
we're changing up the allergy medications.
We're also giving medications directly
for where the symptoms are present,
so you think about the nose, the eyes,
and we're really trying to get them better
by thinking big picture 'cause it's not enough
to just think about prevention.
We also need to think about treating the active symptoms.
Today's gonna be a busy day but I'm excited to get started.
So I just had to call a patient back
for his ultrasound.
He came in with gynecomastia,
which is he had a breast mass,
basically breast tissue developing.
And when we do that, we have to check hormonal levels.
If those hormonal levels are elevated,
then we gotta do an ultrasound.
If the ultrasound is negative then we gotta do a CAT scan.
If that's negative then we need to know something.
So it's really interesting how we have
to follow these sets of guidelines
so that we don't do extra testing
and we don't do undertesting.
It's a very fine line that we have to follow here.
What's going on?
- What's good?
- You wanna tell the peeps if you get any crazy calls
with people asking to come see me?
- Uh, yeah.
Hi, can I speak to Dr. Mike?
Uh, no.
Can I help you?
Yeah, but can I just talk to him?
Can I have his number?
No, no no.
We don't deal with that here, sorry.
- So I'm with Dr. Stewart Green here.
- Hello, hi.
- Who is an expert in everything when it comes
to mental health.
- (laughs)
- Taught me everything I know.
I talk a lot about anxiety and depression
on my channel, how rates are going up.
Is that something you've noticed?
- There is a lot more sort of tension,
the large surrounding environment
of the country these days,
and those things of course impact patients' lives
and people who are susceptible
to developing significant anxiety and anxiety disorders,
as we say.
So yes, there's more of it,
and it's affecting youth as well.
- All right.
'Cause I got a really long day,
I only get to eat once before I get home
which is gonna be around like 10:00 p.m.,
so I picked up some Chipotle.
All right Tia.
What are you gonna tell me?
You gonna tell about a public patient
who is here for an employee physical?
We do that here, right?
- Yes we do actually.
- And what do we do generally for those patients?
- We just make sure they can breathe
and they have a pulse.
- What?
What does a CMA do 'cause no one could answer this question.
- Oh, okay.
Well generally it's a medical assistant
so I'm still able to, like nurses back in the day,
bring patients in,
do vital signs, draw blood, give injections,
and assist with procedures like skin biopsies,
toenail removal.
- You gave the greatest answer so far.
- No problem.
- You're a rock star.
- Yes.
- So I just had a pretty interesting patient encounter.
Patient's coming in for an earache.
I looked through the patient's notes
and she's been here a lot,
and I see that she's been diagnosed with cancer,
was familiar to me so I looked back in my notes
and I found that I saw this patient
about a year ago.
And it was actually me who caught the cancer.
I didn't know this.
When I walked into the room the patient was basically
in tears because she was happy to see me
because I was the one that initially got the x-ray
to find her cancer
because what happened was she had pneumonia.
They did an x-ray,
but then when you get a pneumonia,
the way it shows up on an x-ray
it can actually cover the cancer,
if there is a cancer or anything there.
So that's why whenever a person gets better
we ask them to come back in for a follow-up x-ray
to make sure that there's nothing behind the pneumonia.
And what do you know,
she was still a little bit coughing.
Month went by.
I said let's get another x-ray.
Boom, there was something else there.
I ended up getting a CAT scan a few days later
and we found a cancer that was treated
and now she's doing great.
But now for her to come in for an earache
and be doing well after being diagnosed, treated,
and her being really happy,
she told me something really cute.
She says, "My kids, especially the little one,
are such big fans of yours."
I said because of YouTube?
They're like no, because you saved my life.
And I said, oh how old is your little one?
She's like 39.
We have one of our staff members that's been here
for almost a decade and a half
so we're gonna go say good-bye to her,
but she's not ready.
It's a surprise.
Hey!
(clapping)
We love you.
Cut the cake. (cheering)
Cut the cake.
Yvette we're trying to teach everybody how
to be healthy and happy and what are you doing?
What are you doing here?
- You really have the (mumbles)
to call me out after I (mumbles) your cake--
- I didn't eat cake.
I didn't eat no cake. - (laughs)
- [Dr. Mike] Look at that, what is that?
- He had cake.
I didn't have cake.
- Cut the cake.
Cut the cake.
Can you tell I'm a little tired.
Yeah, it's past 8:00 p.m.
We started this day at six.
I'm almost there, the tail end.
Just so you understand the struggle
that a doctor has to go through,
like I've worked non-stop pretty much all day
for these 12, 13 hours,
whatever I worked,
but my notes aren't all done.
So I either have to sit at my desk finishing these notes,
or I have to go home,
do them at home or tomorrow morning wake up extra early
before I start doing my other stuff
and do the notes.
So as you can see,
burnout can start happening very soon
and very easily for physicians.
So the struggle is real but it's worthwhile struggle.
Yvette, I'm scared.
I don't wanna get the flu shot.
Gives you the flu.
It does all this bad stuff.
I don't want it.
- You better get it or you gonna wear a mask
all flu season.
Would you like some cold spray first?
- I don't, do I want cold spray?
No, I'm already cold as it is.
- [Yvette] It will numb the area.
- Oh my God.
I wish I wore an undershirt today for the video.
She said no heavy lifting but why?
I wanna heavy lift.
- No, no, no irritation
just in case - Please.
- You have some type of discomfort,
elevated temperature.
You can take whatever you normally take.
Drink as much fluid - [Dr. Mike] It's happening.
- as possible. - [Dr. Mike] It's happening.
- Take the pressure off a your arm.
Let it hang free so if you could just sit up a little bit.
No pressure on your arm. - [Dr. Mike] Oh my God.
It's happening. - Just let it hang.
- [Dr. Mike] There's so much
nudity here. - [Yvette] Are you ready?
- [Dr. Mike] Wait, wait I wanna get a good shot.
Okay, go, go. - You ready?
One, two, three, 35.
- Ooh, ooh, I'm just kidding.
It doesn't hurt.
- It actually doesn't--
- It actually feels good.
It feels like a relief
because I'm no longer gonna get the flu.
Well at least 40 to 60% of the time.
- (laughs) 40 to 60.
- I went to walk out of the office without my tie.
Straight Magic Mike style.
This is what happens when it's almost 10:00 p.m.
Do you know where your children are Yvette.
- Yes.
- Where?
- Home and in school.
- Margaret, do you know where your child is?
- [Staff] I don't have any. - Not really.
I know where one of them is, but there's three.
- Well at least you got 33%.
Woo, long day in the office
but we saved some lives.
Took care of business.
Now I'm gonna head home,
walk and feed the Bear.
Maybe do some more work at home,
but that's what a day in the hospital's like boys and girls.
Hope you enjoyed.