Hi and welcome to Medicine with Dr. Moran. I'm here with Dr. Keith Moran today and
we're going to be talking about how this channel can help you and why he started it.
I started this channel recently and the reason why I did that was because over the years I've made
patient information sheets for my patients that go over procedures that we're about to undertake
or medical conditions that they have with my suggestions so that they have an idea of what they
should be doing. What I wanted to do was to take these pages and turn them into videos. There's a
lot of things that I just simply can't put down on a sheet of paper that I can do in a video
and this is one of the reasons why I want to
allow not just my patients to see these but also the general public. It's important when
people are in my office to be relaxed and obviously that's never going to be the case.
Patients are always a little bit uptight. They may be frightened, scared, they're worried about
what I might have to say in terms of giving them a diagnosis that is not so good such as cancer
for example and so it's important that when you try to deliver information to them that they can
actually listen in a relaxed environment. So the patient information sheets on different conditions
allow them to understand things in a situation at home and of course if you're able to do that on
a video they're able to replay the video many times as they like which is really important.
I've also adapted my sheets over about 30 years. I have many sheets on different
topics both things of a heart nature such as stress testing, echocardiograms, heart monitoring,
blood pressure monitors, as well as endoscopy that I carry out.
I've got a number of sheets about different medical conditions such as vascular disease,
high blood pressure, constipation, diarrhea, symptoms, gas, bloating, chest pain, heartburn,
these sorts of things that I give out on a regular basis. I've received many
compliments on my sheets over the years and I wanted to sort of take it to the next level.
That's interesting. So what makes your channel unique and why should we subscribe?
That's a great question and the big thing about my channel is that you've got a full-time practicing
physician who's doing this. Somebody that can actually weed through the medical literature
and give sound medical advice. I think that's important. A lot of the stuff on the internet
things the patients bring into me often they're not able to put it in context and the reason why
I say that is a lot of the internet sources are written by non-health care people. They
may be allied health care professionals they may be people that aren't even in the medical
field trying to give sound advice and I think it's important because experience means a lot
and I think trusted advice is important. We may not know everything in medicine about different
problems but we try to do our best and we try to sift through what works and what doesn't work.
I can certainly tell you that over the years I've become a better and better physician primarily
because in medical school and in residency you just can't possibly know what the most
important things to do with any given patient are. Often you need that clinical experience.
One of the things that I can tell my viewers is obviously I can provide a lot of good medical
advice to them but unfortunately I'm not their doctor and they can't rely solely on videos
or the internet for their health care and it's important that they discuss their symptoms with
their health care professionals because that's the best way to treat things. It is though important
that they get empowered by knowledge and this is where I think I come in where I can actually
give people some knowledge so that they benefit more from their physician visits. What do your
patients say in general about their experiences researching common symptoms and problems online?
Well lots of people go online obviously to find out what's going on with their symptoms
because they're concerned and the internet is always available 24 hours a day.
So they often look up what symptoms they have and there may be a list of possibilities they find.
One of the problems we have with that though is often the source and the source may be someone
who's not even a healthcare provider or a non-physician and so when they look at the
information there they may not be getting what I would consider to be some trusted advice.
It's important when they're looking at things to try to be critical and try to ascertain what
kind of knowledge they're getting and where it's coming from. Sometimes there'll be a number of
possibilities for symptoms and patients typically key in as you can imagine on the worst diagnoses.
So if there's some possibility that cancer is causing their chest pain that's what they're going
to focus in on. Even though out of five or six hundred people a year that I see with chest pain
probably only one will have cancer and I think one of the things that you have to look at
is putting that in perspective and that's something where medical experience counts.
That's something people get in medical school and through residency but I can
tell you that every physician when they get out in practice the first five years their experience
really goes up and up and up and they start realizing what sorts of things
they're finding when they investigate people with different conditions because textbooks
in medicine often don't tell you that and while there may be a list of possibilities
it doesn't tell you what's most likely. So that's something that you get with years of experience.
One of the things that I tell people is that the history is the most important
thing so when people are telling me about what their symptoms are
for example chest pain it's important that we go over the history in great detail and often
the history actually tells you the diagnosis. You may want to do a test or two if necessary
but sometimes you can tell what's going on just by talking to the patient and asking them appropriate
questions. This is where it's important the patients know how to present the history
and that's something for another video but I think it's really important as patients don't often
know what to do before the doctor's visit and that's something that is really important because
you can sabotage your visit or you can make your visit much better simply by knowing a few things
ahead of time and writing down key facts about the history so that the doctor gets the best story
of what the problem is because obviously I can't be there when patients are having their symptoms.
What are a few of the common problems that people encounter when they're looking up
symptoms online? Well often they're hard to actually find and there are obviously websites
that are much more trusted than others but again you still have to put it into
a perspective and that a lot of the problems that are there they may not be problems that are common
and they may not relate to them. For example with chest pain there's different kinds of chest pains
and different kinds of different potential diagnoses and obviously you're not going
to get that on the internet for sure. What are some of the qualifications that you have
and what are the qualifications that you have that help your patients?
I went to medical school in the late 80s and early 90s I did my internship in Internal Medicine.
I then did a long residency program in Internal Medicine and then I finished that off with a
fellowship in general Internal Medicine and I did that because I wanted to work out in
the community. I wanted to see a wide range of problems and I wanted to help people who had
different kinds of problems but to be very good at different areas and the main thing in communities
are looking after people with heart disease, lung disease, and gastrointestinal disease,
and by gastrointestinal disease I mean problems with the stomach and the colon
and intra-abdominal conditions. So I tailored my residency to that so I spent a lot of time in the
rotations where we learned about heart disease. I did six months studying Echocardiography which is
our typical heart test that we do in many patients where we look at the heart with ultrasound it's
called an echo. I became certified in that. I'm board certified and I have recertified in echo.
I also spent six months doing Gastrointestinal Endoscopy. So I do Colonoscopies and upper GI
tract Endoscopies and that allows me to evaluate people with chest pain for example that actually
have a esophageal cause for their symptoms. I also spent a lot of time doing ICU care
because that's something that we need in the community that I'm in and that encompasses things
like intubating people, doing bronchoscopy, to put a scope down through the Endotracheal tube to
toilet the lungs which means to suck out clots or clogs of sputum that can get stuck there
which can cause the lung to collapse while we have people on mechanical ventilators
and in the intensive care unit there are many other procedures that we do such as putting in
central lines where we put intravenous catheters into the big veins and arteries of the body to
monitor things. So we can monitor arterial pressure, venous pressure, and also putting
catheters through the heart to measure cardiac pressures. I also do a lot of other procedures
including bone marrow aspirates where we take out a sample of the bone marrow to see why people have
low blood counts. Lumbar punctures where we take some spinal fluid out to rule out meningitis.
Thank you for watching Medicine with Dr. Moran. I'm Dr. Keith Moran. Get healthy and stay healthy.