What is The Future of Medicine and Should it Matter to You?

Introduction

Dr. Ryan Gray: The Premed Years, session number 208.

Hello and welcome to the two-time Academy Award nominated podcast, The Premed Years, where we believe that collaboration, not competition, is key to your success. I am your host Dr. Ryan Gray, and in this podcast we share with you stories, encouragement, and information that you need to know to help guide you on your path to becoming a physician.

I should have had the sound effects wound up, and like balloons and confetti falling, and celebration because we have a new president. Oh wait no, not because of that, because we’re celebrating four years of this podcast here. Hi, Allison.

Dr. Allison Gray: Hi, Ryan. Hi, everybody.

Dr. Ryan Gray: Where have you been?

Dr. Allison Gray: In Colorado where we live.

Dr. Ryan Gray: Yes you have been there.

Dr. Allison Gray: I’ve been doing stuff, you’ve been doing stuff.

Dr. Ryan Gray: Yeah, I haven’t been letting you on the podcast.

Dr. Allison Gray: No you’ve had too many other important people on.

Dr. Ryan Gray: Every week you’re like, “Ryan, can I come on the podcast?” and I’m like, “Nope. My audience doesn’t like when you’re on.”

Dr. Allison Gray: Nice, thanks. Thank you. Well hope you’re all doing well out there.

Dr. Ryan Gray: Everybody’s doing great, everybody’s doing great. You know why they’re doing great? I hope they’re doing great because they’ve been listening to this podcast for four years.

Dr. Allison Gray: Nice, that’s pretty awesome. Four years, who would have thunk it?

Dr. Ryan Gray: Not me. That’s crazy.

Dr. Allison Gray: It is.

Dr. Ryan Gray: It could be like four and a half years if I would have grown the courage to release those initial episodes that I had recorded and then never did anything with for a while.

Dr. Allison Gray: That’s okay, it happened as it happened.

Dr. Ryan Gray: It did.

Dr. Allison Gray: Yeah.

Dr. Ryan Gray: Anyway, four years. I wanted to thank you listening right now for taking time every week- if not every week, however often you listen. I want to thank you for taking that time to turn on your phone, your computer, put on your headphones, blast the radio in your car and listen to me every week, and sometimes Allison, share our wisdom, share our knowledge, and encouragement, and motivation to help you on the path. One of the things that I wanted to do to celebrate the fourth anniversary of this podcast was to give away some coaching, and some mock interview prep, and some other stuff. And so I want to mention one person on here that is going to win premed coaching with me for their application cycle, and that means I’m going to work with them getting their letters of rec settled, their extracurricular activities done, their personal statement, do some mock interview prep, all their secondary essays. I charge a good amount of money for this, it’s a lot of work and the students that I’ve been working with have had a lot of success. It’s $250 a month right now as I’m recording this, it will probably go up in the near future, so it’s not a cheap thing that we’re giving away here, and I’m excited to announce Annella Byrd as the winner of that. I will email you Annella if I haven’t already emailed you as you’re listening to this, I will email you. And I have- I used a random number generator to select the winners and I will be emailing other people that won some of the bigger packages like mock interview prep with me and some other things. Everybody that registered, I’m going to send you a copy of my book just to say thank you for entering to win, so everybody will get an email from me. And yeah, thank you, I appreciate it. I loved reading- one of the questions- if you didn’t enter to win the contest that’s okay, one of the questions on the contest was ‘Why do you listen?’ and I loved reading all of those reasons. It was pretty great. So thank you for everybody that did that, thank you Annella. She won this grand prize, but she was also the first person to enter too, so that was kind of cool.

Dr. Allison Gray: Cool, yeah. Very cool. Very cool- I don’t know what you call it. Game? Contest.

Future of Healthcare under Trump Presidency

Dr. Ryan Gray: It was a contest. Alright so I made a little joke at the beginning celebrating that we have a new president and that the confetti is falling. Now likely half of you are mad about our new president, and half of you are ecstatic about our new president. It’s just the way it works I think every election cycle. This election cycle obviously seemed to be more polarizing than the rest. We’re not going to talk politics, but I want to talk, Allison, to you about the future of healthcare and what premed students- obviously the person listening to this right now, likely a premed student, what they should be thinking about if anything about the future of medicine, and what Trump’s new policies are going to come into play. He talked a lot about repealing Obamacare, it’s like the first thing he was going to do is get rid of Obamacare. It sounds like he’s kind of back peddling on that a little bit. Does this matter?

Dr. Allison Gray: Yeah I mean so it definitely matters, and I think- I mean as a physician I have concerns about- just when I think about all the people who I think did acquire health insurance who were not previously insured, and now are at risk of losing that. I actually have some family friends who are at risk of losing their insurance because they only got insurance because of Obamacare. So I think as a citizen, as a person I think that’s very concerning, and as a physician. But I think at the end of the day if you’re a premed out there, I think the most important thing really is to stay informed about it all, to try to keep your ear to the ground, and just keep informed so that when you do show up at an interview and someone asks you, “What do you think about the-” like Ryan’s question, “What do you think about the future of Obamacare possibly being repealed?” And so that you don’t kind of sit there like a deer in headlights. Whether or not that should change your course, change your life, change your dreams, your ambitions, I don’t think so. That’s not what doctoring is about. Doctoring is about healing, is about providing service, is about trying to make the world a better place one person at a time. It’s not about health policy per say. Now it depends, if you want to become a physician and devote your career to health policy, that’s a totally different matter. But if you’re out there as a premed wanting to become a physician to practice medicine, to be involved in clinical medicine, then this election and the results, and everything that is happening, as kind of crazy and polarizing as it all is, I don’t think should change your course, your dream.

Dr. Ryan Gray: It’s funny, on Facebook I’m in a bunch of physician groups and one of them- somebody posted I think the day after the election like, ‘Now that Trump is in, and Obamacare is likely done, what’s next?’ And then I commented in my normal kind of snarky way, I said, ‘We go to work like always.’

Dr. Allison Gray: Right. Exactly, yeah. I mean yes politics will always change, and there will be republicans and democrats and independents. I don’t know it’s kind of funny Ryan, because when you talk about being in the military, or previously being in the military, you’ve said in the past that you sort of have to just respect whomever is your President anyway because they’re your Commander in Chief. So it’s kind of a little bit the same in that if you’re going to be a doctor, or you already are a doctor, you’re going to need to be doing the same thing. You may have different constraints and different rules and different regulations imposed upon you, the face of healthcare may change again, but that’s the day- that’s the time we live in, things are changing. And it’s very broken, the system we live in anyway. So it’s going to change, I don’t know, maybe it’ll be better, I don’t know. Again, we’re not going to get political but-

Dr. Ryan Gray: What do you mean by that, ‘it’s broken’?

Dr. Allison Gray: Well I mean there are a lot of things that don’t work, there are a lot of people that still don’t have health insurance. Our healthcare system is extremely expensive, we spend trillions of dollars on things that we probably shouldn’t. And the funny thing is we’re like 35th in the world for how healthy we are as a population of people, so there are a lot of things that even though we spend a ton of money on healthcare, we’re not doing necessarily very well.

Dr. Ryan Gray: We have good fast food.

Dr. Allison Gray: Yeah, right. We add sugar to all our food, that keeps people really healthy. So we- and you know, the whole- just the way the insurance works in this country with denying things, and physicians having to fight to get the care that they need for their patients. There are a lot of things in our system that just don’t work, and so again this is just going to be I think another big change, and we don’t know yet what’s going to happen. He may repeal all of it, he may try to get rid of some of it, who knows really? But I think again, my opinion about it all is that as a premed the goal is that you stay informed, that you try to just be aware of what’s going on so that you can at least give an opinion about it, or speak knowledgably to some degree about it. When I was a premed essentially that’s what I tried to do. I tried to just learn what I could about what was going on so that if I was asked about it I could give a reasonable opinion. But other than that-

Dr. Ryan Gray: I’d be interested to know if anyone listening went into medicine because of Obamacare and now is thinking, ‘Oh never mind, I don’t want to do it now that Obamacare is probably gone.’

Dr. Allison Gray: Well and that would be sad, but that would make me wonder about what their- what was their reasoning in the first place? Like why would you go into medicine because of Obamacare? Maybe they had some sort of very personal start that affected their family, but again it’s more politics, it’s policy, it’s not the practice of medicine. Does it affect us? Yes. Should we be informed about it? Absolutely, and I’ve been getting emails from the American Academy of Neurology, and the American Medical Association, and people talking about how they’re going to lobby for X, Y and Z, but I quite frankly don’t have time also to get bogged down in all of that. I have a lot of work to do every day taking care of patients, and so if I spent all my time getting wrapped up in the politics of it all, I’d lose my focus and I wouldn’t be able to do a good job.

Dr. Ryan Gray: So talk a little bit about this election cycle, being a physician, and having obviously your own thoughts and opinions about who’s running, and what’s happening, but having to temper that with patients coming in, and their opinions and thoughts. How do you juggle all of that?

Being a Physician During Election

Dr. Allison Gray: Well one of the interesting things about this election in particular is the amount of anxiety I think, and change in mood that a lot of people have had. And there was even something I read recently about the burden on- if you want to use that word, or the challenge or the burden on psychologists and psychiatrists in the last few months with patients coming in being really, really upset, and anxious, and upset again about what has been going on with the election. And it was a pretty nasty election too, there was a lot that I think on both sides made all of us very upset. And so probably my guess is that the psychiatrists and psychologists sort of inherited the worst of it. But I definitely- I had patients come in and talk about just sort of freely how upset they were about it. I had one woman tell me that her anxiety was up and her blood pressure was elevated that morning probably because ‘a Nazi was running for president.’

Dr. Ryan Gray: Her words, not yours.

Dr. Allison Gray: Correct. And then a few days later we had somebody walk in with a big red hat saying ‘Make America Great Again.’ And so you see these things, and some people are very vocal, and very strongly opinionated about it, but at the end of the day it’s like anything else, you can’t let any of that get in the way. And I personally don’t think there’s any point or reason to get involved in any kind of political discussion with a patient, it’s not why we’re here, and it’s not the focus. And I think you also don’t want to do anything I think that’s going to detract from really what you’re trying to do for that patient, which is again to provide good care for them, to help with healing. If you get into an argument with them that’s going to be a really big problem and they may complain about you to the people you work for, and it’s just not- it’s like with family, you don’t talk about politics. I personally- I don’t think it’s a wise thing to talk politics with your patients. I mean unless it’s somebody that you’ve been taking care of for twenty years and you both know that you’re both staunch liberals, or you’re both staunch conservatives, or something like that, and you enjoy that part, that’s part of your rapport with the patient. But for most people, especially with people you’ve not really met before, getting into a political discussion with them, probably not a good idea.

Dr. Ryan Gray: Yeah. So you work in a large healthcare organization. During an election cycle like this, how much is coming down from the top to inform you about candidates’ policies, and what you should be thinking about, and other things like that?

Dr. Allison Gray: Well the most interesting thing I think in Colorado has been more about some of the ballot questions, and- for example we in Colorado just voted on whether physicians should have- or excuse me, not physicians, whether patients should have the right to die, to ask a physician to help them end their life if they have a terminal illness. And that actually won, so that’s going to be a change. And there was another big thing- what was the other big one?

Dr. Ryan Gray: ColoradoCare.

Dr. Allison Gray: Oh of course, right. So Colorado was up on the ballot for being the first state in the country to have a single payer healthcare system. And so the healthcare organization that I work for gave us sort of information about their position so that if any patients asked about it, they could say, ‘This is our position and that’s that.’ But I think in general they wanted people to kind of stay out of it, you know kind of inform people if they had questions but not really again, get into big political arguments or discussions with people because that’s not what we’re here for. That’s not our purpose. That’s sort of what I did, I sort of just did what I did every day. Just like Ryan said, just go to work, just try to do the best job we can do.

Dr. Ryan Gray: So every day you go to work behind closed doors, and I’ve talked about this before that behind closed doors, no matter who’s paying the bill if it’s Medicare, Medicaid, a big HMO, private health insurance, whatever it is behind that closed door, it’s a relationship with a patient, and that will never change.

Dr. Allison Gray: Absolutely, I mean I completely agree. And you shouldn’t let your political- I mean that’s the other problem. Let’s say you get into a political argument with a patient, then that could bias your care, it could bias your ability to provide good care, and that’s terrible. That’s really not a good thing at all.

Dr. Ryan Gray: That was in the news this past election cycle.

Dr. Allison Gray: Was it?

Dr. Ryan Gray: Depending on your political views, you practice medicine differently.

Dr. Allison Gray: Well and that’s fine, but in individual patient interaction, if you allow your political- what’s the word I’m looking for? Tendencies- political beliefs to interfere with the care of that patient, that would be terrible in the same way that if you-

Dr. Ryan Gray: That’s like when I was working as an intern and taking care of prisoners, you- that person in front of you is not a prisoner, they’re your patient.

Dr. Allison Gray: Right, absolutely. Absolutely. We’re called to do a job that is different than other jobs, and it’s not like in a business where you can turn somebody away and say, “We’re not going to provide service here for you.” You can’t do that and I think it actually- it is a disservice to yourself if you start to get all invested in talking about somebody’s- their politics, their race, their background, their religion. That’s the opposite of what you want to do. You want to remove all of that and look at them as an individual that is just like yourself that needs help. And so that’s what I try to do, I just don’t go there. I just don’t think it’s wise, and that’s me. I have a different way maybe of practicing than other people, but I think that- I don’t know. And I try to just- if somebody brings it up I’m not going to just shut them out or close the door in their face, but I sort of just listen, and smile, and nod, and maybe I’ll kind of agree with them even if I sort of don’t agree at all, but I’ll try to just move things along because I think that’s what you need to do. So I mean if any of your other physicians, or maybe you’re nurses, or PA’s, and nurse practitioners, or you’re an MA, I’d be interested to hear what your perspective is when you’re in a room with a patient and they get into a political discussion with you. But I think-

Dr. Ryan Gray: You stick your fingers in your ears and go, ‘La, la, la, la.’

Dr. Allison Gray: Yeah no, that’s not appropriate either. But yeah it’s been very interesting, it’s been emotional. I mean even just the day after, going in after election into the office, and one of my colleagues, his daughter who’s seven had been crying that morning and he was trying to console her, and I think it affected a lot of us just as people, and it’s hard to sometimes shut that out and just continue your job as always, but that’s what you’ve got to do.

What Socialized Medicine Would Mean

Dr. Ryan Gray: So have you looked into what it would take to be a physician in Canada?

Dr. Allison Gray: No because I know that when I was a student there as an undergrad, it’s not the easiest life for physicians in Canada either. Socialized medicine has its issues as well, and I was a patient there too, I remember I sprained my knee in Canada when I was up skiing there and I waited like seven and a half hours in the ER to be seen by someone which was pretty-

Dr. Ryan Gray: It’s normal.

Dr. Allison Gray: I know but it was pretty brutal. I mean and I remember talking to- I mean right, that’s a small deal, but I remember talking to friends of mine who talked about how they were paying for their neighbor’s healthcare, it’s part of the way the system worked, and it’s just very different and they talked about how it wasn’t perfect, and they had to wait sometimes many, many, many, many months to receive care whereas here it probably would not be the same.

Dr. Ryan Gray: Yeah how bitter would you be if like your neighbor was dying of lung cancer, living with lung cancer, and was smoking and had liver cirrhosis and was drinking, and you’re like, ‘Um that’s my money paying for you.’ But it’s not much different here with Medicare and Medicaid, our tax dollars pay a lot of healthcare.

Dr. Allison Gray: They do, they do but you know people are going to get sick because of decisions they make, and people are going to get sick because of bad luck, and it’s just the way the world works. Physicians don’t get paid very well in Canada too, from my recollection.

Dr. Ryan Gray: Yeah. With the election now over, and we’re yet to see what will come of Trump’s policies, and what he will do to the Affordable Care Act, and everything in healthcare moving forward, and even it’s in the news that they want to get rid of Medicare and Medicaid.

Dr. Allison Gray: Whoa I didn’t hear that.

Dr. Ryan Gray: Yeah.

Dr. Allison Gray: How is that possible?

Dr. Ryan Gray: Anything is possible when you control-

Dr. Allison Gray: Wow. Medicare is a beast and I mean gosh that- oh wow, I didn’t know that.

Dr. Ryan Gray: I think it’s been on Paul Ryan’s to do list for a long time.

Dr. Allison Gray: To get rid of Medicare and Medicaid?

Dr. Ryan Gray: Yeah.

Dr. Allison Gray: What does he want to do instead?

Dr. Ryan Gray: I don’t know.

Dr. Allison Gray: I need to see- I need to become more informed, I need to read. I’m trying to read every day but it’s a little much.

Dr. Ryan Gray: Yeah so let’s make that another talking point, the fact that what we’re saying here is not- we’re saying that for you the premed, what happens doesn’t matter. We’re not telling you that you shouldn’t be informed, and you shouldn’t have an opinion, and that you shouldn’t be active and try to get out there and be an activist, or just get your voice heard. That doesn’t mean you hide in the corner and don’t say anything. You can be active, and get political, and all of that stuff. But what we’re saying is no matter what happens, if you’re going into this for the right reasons, then it doesn’t matter what happens.

Dr. Allison Gray: Absolutely, yeah.

Dr. Ryan Gray: So talking about what happens with what just happened, where do you see- if you had a crystal ball, what’s going to happen in ten years?

Ten Year Predictions

Dr. Allison Gray: Oh dear, I don’t know. Like in general?

Dr. Ryan Gray: With healthcare.

Dr. Allison Gray: Gosh, I don’t know. I mean people have been talking for years about there’ll be some kind of breaking point at which time we are just not going to be able to- what we are doing now will be untenable, will just not- we want enough money to support what we’re doing, something will break, the system will just- there will be some straw that finally breaks the camel’s back. I don’t know. You know the thing is that hospitals have also been really consolidating and sort of becoming big monsters themselves, and your tiny little private practices that is becoming a thing of the past, everybody is getting into these big groups. So I don’t know. I mean I think that it’s changed a lot already if you look at. My parents’ physician, he was in practice in the same office in the same location, maybe with like a move down the street or something, but for forty years. That is not something you’re seeing either. People are changing jobs, they’re changing what they’re doing, and it’s just a changing landscape. I don’t know Ryan, I don’t know how to answer that question. I think-

Dr. Ryan Gray: Let me ask it a different way. Are you worried about being a physician now?

Dr. Allison Gray: No because- and here’s the interesting thing about that. Being a physician is so much a part of my identity that I know that no matter what happens I will be a doctor, and I will find a way to practice medicine, I will find a way to provide care for other people, to practice neurology, and if that ends up looking really different than what I’m doing now, I’m okay with that because at the end of the day I went into medicine, I became a physician to provide care for other people, to make a difference in the world, to make a difference in people’s lives. So I’m committed to doing that for the rest of my life, or until I retire. But I think that that’s the thing, is being a physician, I really do consider it as a part of my identity, as a part of who I am. And so to me you can’t lose that, it’s not something that can break away from you even if the construct of everything around you changes because it’s part of who you are. So do I worry about it? No, I worry more about how things are going to change in the world. I worry about foreign policy and our interactions with other nations in the world, and I worry about what things will look like for my daughter growing up, and what schools will be like for her, and- but I don’t worry about gosh am I going to be able to practice? Or is medicine just going to go to hell in a handbasket? No we’ll find a way, we always have, we will find a way. If you think about like the zombie apocalypse, you know if that happened physicians would still find a way. They would have to take care of people who may have gotten their faces eaten off, but they would find a way. So yeah it’s kind of interesting. I don’t worry about that aspect. Maybe I should, but I don’t, I don’t. Do you?

Dr. Ryan Gray: Well I don’t practice.

Dr. Allison Gray: Well but if you think about just what it means to be a physician. I mean do you worry about- I don’t know.

Dr. Ryan Gray: So one of the things that doesn’t necessarily worry me, but I think is a huge landscape shifter, is technology. So outside of politics I think technology is becoming a huge part of our environment.

Dr. Allison Gray: You think we’re going to be on Star Trek with like the tricorders and they’re going to-?

Dr. Ryan Gray: With the tricorder and like one little pass over your body, it’s like, ‘Alright here’s what I know what’s wrong with you.’

Dr. Allison Gray: You loved that in Star Trek the other night- well we won’t spoil the movie, but we watched Star Trek Beyond finally, and there’s the scene where the guy like holds up this big screen in front of this guy who’s on the ground- I think it was Spock. Anyway sorry if you haven’t seen it, anyway he’s holding it up and it says like ‘Critical Alert.’ Anyway Ryan’s like, “That’s so cool.”

Dr. Ryan Gray: Yeah tech is interesting. And I’ve had this discussion when I was at the UC Davis conference with students interested in going into radiology. I said, “I would be very careful thinking about radiology as a field right now because we’re getting to a point with computers, and with artificial intelligence that computers are going to be able to read x-rays, and read CT scans, and read MRIs.”

Dr. Allison Gray: You think so? Interesting.

Dr. Ryan Gray: Yeah it’s happening now.

Dr. Allison Gray: Is it really?

Dr. Ryan Gray: Yeah.

Dr. Allison Gray: Wow. Yeah that’s a little alarming if you’re a radiologist I would imagine.

Dr. Ryan Gray: Yeah obviously for interventional radiology you’re interacting with the patient and doing procedures that’s different, but for just sitting in a room and staring at a screen? I would much rather trust a computer than a human’s eyes.

Dr. Allison Gray: True, true. I don’t think- this is my belief, I don’t think artificial intelligence will ever be able to replace a diagnostician.

Dr. Ryan Gray: I’m talking about radiology, I’m talking about maybe anesthesia.

Dr. Allison Gray: What about surgery?

Dr. Ryan Gray: Surgery? No because you will have a human controlling the robots, and we already have robots. We have da Vinci in the operating room which is awesome to watch. But I think- we have Watson, right? Watson is all over TV with commercials about reading medical reports, and reading medical charts for patients, and going, ‘Okay here’s my differential.’ But it’s a physician that is interacting with the patient, and asking those key questions. At this point a computer can’t do that and interpret what the patient is saying, how they’re saying it, and-

Dr. Allison Gray: Teasing out those key things that- yeah, absolutely.

Dr. Ryan Gray: I think computers will be by our sides as we move forward as physicians, and we’ll use them and utilize them. I think medical education will change dramatically because we’re not going to need to know everything that’s being taught nowadays, we’ll have a computer for that.

Dr. Allison Gray: Interesting.

Dr. Ryan Gray: It’s going to be a lot more of the humanities side of interacting with a patient and not necessarily the book smarts of knowing everything because we’ll have Google right there.

Dr. Allison Gray: Well and you think they’ll have- they won’t use cadavers anymore, and they’ll go to all computerized-

Dr. Ryan Gray: Well cadavers is important, you need to know that anatomy, not like a computer program or a sim lab will ever replace that experience.

Changes with Electronic Medical Records

Dr. Allison Gray: Yeah I agree with that too. Well it’s interesting. I think something will change ultimately with electronic medical records because I think that the demand on physicians now is so intense. Not to scare any of you out there, but the thing that most physicians gripe about nowadays is the amount of time it takes to chart. And so these EMRs, these electronic medical records that were supposed to make things faster and easier, they have in some ways but the thing that a lot of my friends who are physicians talk about is that after they put their kids to bed at night they’re up doing their notes, and charting, and doing things in the electronic medical record- and I certainly have done that myself. And so at some point I think as patients can email us, and call us, and read their notes that we’re writing, and ask us questions about that, and we have to write our notes all day and then into the night, I think that that will eventually change. I don’t know how but I think that the pressure, physicians will just sort of almost demand that it will change. Again I just try to do my job one goldfish at a time, because there’s no other way and I think if you get wrapped up in ‘woe is me, and oh this is hard, and this could be better, and oh my God I’m worried about the future,’ you lose sight of what you need to do here and now.

Resources and Book Recommendations

Dr. Ryan Gray: Looking back at your journey, has there been one book out there that has helped shape some of your thinking with patient interaction, and humanities, and anything like that?

Dr. Allison Gray: There’s a book that I read in medical school called ‘The Spirit Catches You When You Fall Down,’ which I think is phenomenal, and I do think about that from time to time. It’s a book about a family who- they have a daughter who has bad epilepsy, she has really, really bad seizures, and because of the almost insurmountable language barrier that they have, the family and the clinicians taking care of them, it is devastating for the child. And it’s just- it’s really a page-turner, you can’t put it down and it’s really- it’s humbling, it’s sort of humbling to see how much these physicians want to help this family and this child, and how much that language barrier and that cultural barrier gets in the way. And I think about that sometimes when I’m seeing my patients who are there with interpreters, and how- and asking myself, ‘Are you missing things? Are you really getting it?’ We have the same amount of time afforded for a visit with someone who speaks English, and a visit with someone who doesn’t, and with a translator- and I wonder also whether that’s appropriate because I think that you need more time. So that was a very- a great book that I loved, and I think was just really a great read, and really important to think about. Because as a physician you will be taking care of people of all backgrounds and languages, and the decisions that you make can really, really affect what happens. So that’s a good one, what about you?

Dr. Ryan Gray: A book.

Dr. Allison Gray: Stumped yourself.

Dr. Ryan Gray: I have a terrible memory for that kind of stuff. I don’t know- well-

Dr. Allison Gray: Oh well what about Atul Gawande’s books, those have been phenomenal.

Dr. Ryan Gray: All of Atul Gawande’s books, and then I finally just read the Paul Farmer book, the ‘Mountains Beyond Mountains.’

Dr. Allison Gray: Oh I’ve wanted to read that, I haven’t read that yet, yeah.

Dr. Ryan Gray: That was a great book. Very interesting, amazing phenomenal dude that- doctor dude that just-

Dr. Allison Gray: Phenomenal doctor dude, can we hashtag that?

Dr. Ryan Gray: #PhenomenalDoctorDude, yeah that just his level of compassion, and empathy, and drive, and motivation just makes us look like puny little ants.

Dr. Allison Gray: Wow, yeah.

Dr. Ryan Gray: It’s incredible.

Dr. Allison Gray: I need to read that.

Future of The Premed Years Podcast

Dr. Ryan Gray: Alright so I need you prognosis. Where will this podcast be in four years?

Dr. Allison Gray: I was like, ‘where’s he going with this?’ Where will this podcast be? Right here, Ryan Gray. It will be here in eight years you said?

Dr. Ryan Gray: Well four years, another four years.

Dr. Allison Gray: In four years? Another four years, oh right so eight years total. Yeah you’ll be- what episode will that be? I’m terrible with math.

Dr. Ryan Gray: Well this is 208 times two is 416.

Dr. Allison Gray: Oh boy. Yes gosh I think you’ll be doing this now, what you’re doing now, and I think it will just be more, and more, and more awesome, and you’ll have more things that you’re doing with students, and more knowledge to bring to bear, and I think you’ll have more books.

Dr. Ryan Gray: Of course, yeah.

Dr. Allison Gray: And we’ll both be older, and- oh I know what else, I prognosticate that you will have more- not the right word at all. I suspect that you will have more equipment and it will be upgraded. Recording equipment.

Dr. Ryan Gray: More recording equipment. I don’t know, I’m happy with it.

Dr. Allison Gray: For now. He’s always improving. It’s good, he keeps it very good quality.

Dr. Ryan Gray: Okay well it’s been an amazing four years, thank you for taking that journey with me, Allison.

Dr. Allison Gray: Absolutely.

Dr. Ryan Gray: And allowing for me to go on that journey.

Dr. Allison Gray: Absolutely it’s been a blast. I feel like I support you from the background and I am rooting for all of you out there. Ryan lets me know how things are going, and I get the emails, and I see the reviews, and I’m sorry I’m not more involved than I could be but he’s just- gosh he’s really awesome.

Dr. Ryan Gray: You will be involved in a new podcast soon.

Dr. Allison Gray: Which one?

Dr. Ryan Gray: When we release the Specialty Stories Podcast.

Dr. Allison Gray: Yes, that’s exciting, I’m excited about that.

Dr. Ryan Gray: We will have an episode about neurology and we will talk about your life as a neurologist. I have a bunch of interviews lined for that, so that’s exciting. Look forward to that, or look for that in about a month or so as we release this. So sometime end of 2016, beginning of 2017.

Dr. Allison Gray: That’s another thing I expect, that you will have more podcasts as part of Med Ed Media. I definitely expect that.

Dr. Ryan Gray: That would be fun.

Dr. Allison Gray: You’re going to be some throat lozenges because you’re going to be talking a lot.

Dr. Ryan Gray: Yes I will. Alright well Allison, thank you for joining me.

Dr. Allison Gray: It was my pleasure Ryan, nice to be here.

Final Thoughts

Dr. Ryan Gray: Alright well there you have it. Session 208 is in the books, four years of The Premed Years, which used to be known as the Medical School Headquarters Podcast, or the Medical School HQ Podcast depending on if I was feeling lazy that day. I want to thank you again for joining me every week here, and for allowing me to help guide you.

Part of the contest that I mentioned earlier was leaving a review in iTunes, and so we have a ton of new reviews that I want to go through.

This first one here is from RE M. that says, ‘Mentors you wish you have at your university.’ I’m just going to read the titles here, and maybe if I pick out a sentence here. It says, ‘Thank you very much for all your hard work and I look forward to listening to your future episodes.’ Thank you for that one, RE M.

We have lloza0913, it says, ‘Best podcast around for premed students. This podcast has some of the best information out there in terms of MCAT, med school, and interviews.’ I thank you for that one, lloza.

We have JoannGia that says, ‘The best podcast ever.’ I don’t know about the best podcast ever, maybe the best premed podcast ever. I think Serial- that first season of Serial was still pretty amazing. So thank you for that.

And let’s do two more here. We have- Lee – fan since 2013, that’s his username, says ‘Close to applying but a fan for over three years. Love the show. Will be applying in 2017 and hope to use what I have learned from the show to help me get in.’ That’s awesome.

Alright and one more here from Non-trad premed, ‘My go-to premed advisor,’ and that’s the best compliment that we can get, is when students say that we are the go-to premed advisor. I started this podcast because my premed advising was pretty bad, and Allison’s premed advising at a Canadian school was bad, and I wanted to kill Student Doctor Network. Or not kill them, but I wanted to reduce their grip on the premed world, and I think I’m doing that slowly but surely. So I love when it says- when a user or listener says, ‘my go-to premed advisor.’ So thank you for that.

Alright if you would like to leave a rating and review, www.MedicalSchoolHQ.net/iTunes is the place to do that. Thank you again for being here every week for four years. Or I guess I’ve been here every week for four years, maybe you haven’t, but thank you for every week that you do join in. If you want to help us out, spread the word, go tell your classmates, go tell your friends, your family. What I will tell you, a week or two ago I jumped on a Skype conversation with the University of Houston, their premed club. So if you are part of a premed club and you would like me to talk to the premed club, and give a presentation on something, or just be there to answer questions, let me know. Shoot me an email, Ryan@medicalschoolhq.net. I love doing that, it’s a great way for me to reach a lot of you at one time. So Ryan@medicalschoolhq.net, let me know if you’re involved in a premed club, let your premed club president know, whoever’s in charge of scheduling those meetings. So I would love to help you out there.

Alright, have a great week and I look forward to being here for another four years of The Premed Years Podcast, and all of the podcasts that we’re doing at the Med Ed Media network.