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The Politics Chicks is a progressive politics podcast and politics news show hosted by Christy Branham and Monica Healy.
Every week, we sit down with candidates, elected officials, journalists, historians, policy experts, advocates, and everyday Americans shaping the future of our democracy. We go beyond the headlines with thoughtful interviews, fact-based analysis, and candid conversations about the issues that affect our lives—from elections and public policy to healthcare, education, civil rights, and the economy.
Whether we’re interviewing members of Congress, first-time candidates, medical experts, or community leaders, our mission is the same: to inform, challenge, and inspire.
If you’re looking for a politics podcast that values evidence over outrage, curiosity over division, and hope over cynicism, welcome home.
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@ThePoliticsChicks
Christy: Welcome to the Politics Chicks podcast. I'm Christy Branham
Monica: And I'm Monica Healy
Christy: Today's guest is someone who has had an extraordinary impact on my life personally. Dr. Patrick Hadorn isn't just an exceptional physician, he's my primary care doctor. As many of our listeners know, I live with multiple chronic illnesses, and I truly wouldn't be sitting behind this microphone today if it weren't for the incredible medical team that's helped me regain so much of my life.
Christy: Dr. Hadorn has been one of the most important members of that team. He's helped me navigate complicated diagnoses, coordinated my care, and has always treated me as a whole person instead of a collection of symptoms. The fact that I continue to be a part of the Politics Chicks is due in no small part to his care.
Christy: We wanted to invite Dr. Hadorn on not because he's my physician, but because every patient deserves a doctor who listens, partners with patients, values evidence, and understands that trust is the foundation of good medicine
Monica: Healthcare touches every family. Whether you're managing a chronic illness, raising children, caring for aging parents, or simply trying to make sense of the endless stream of medical information online, today's conversation is for you. Dr. Hadorn, we're so glad you're here. Welcome to the Politics Chicks podcast
Dr. Patrick Hadorn: Yeah. Thank you for having me, and Christy, thanks for the incredibly kind words. It's, uh, it's been a privilege being involved in your care and, uh, it's just a reminder of why, why I do what I do
Christy: just an aside, Dr. Hadorn just doesn't see me. He is the primary care doctor for my entire family. So he sees my husband and my kids as well, so he's kind of the, he's got the whole Branham family as his patients
Dr. Patrick Hadorn: That's the best
Monica: you well, but...
Monica: Christy knows you well, but let's introduce you to our listeners. Let's, um, start with your story. Tell us a little bit about where you grew up, what person inspired you to become a physician
Dr. Patrick Hadorn: Yeah, so I grew up in Northern Kentucky, kind of just south of, uh, Cincinnati across the Ohio River, where my family still lives, and moved here to Minnesota in 2015 after I finished residency, uh, at the University of Kentucky. Kinda did all my, uh, undergrad and training down in Kentucky, and then, met what would be my future wife down there, and, uh, we, moved up here in 2015.
Dr. Patrick Hadorn: I've been practicing, you know, primary care since then, and, just really en- enjoying the, uh, enjoying Minnesota, you know, winters aside, and yeah,
Monica: fair.
Dr. Patrick Hadorn: been great.
Christy: Well, and you trained in both internal medicine and pediatrics, which is a unique path that allows you to care for patients throughout every stage of their life. What drew you to both those specialties
Dr. Patrick Hadorn: Right. Yeah, so I didn't even know that was like an option when I started medical school. Um, I originally thought I wanted to do pediatrics. I grew up in a big family, uh, extended family, and just always, enjoyed working with kids through college And so I thought pediatrics, and then when I was going through my rotations in medical school, I met a doctor who was med-pedes, as we call it, internal med and pediatrics.
Dr. Patrick Hadorn: And I thought that was some kind of anomaly. I'm like, "Oh, did-- were you just overambitious? Did you just decide to double board in these things?" And, and they were like, "No, this is an actual residency you can do." And so I started looking into that, and then as I did more kind of internal med rotations, I realized, you know what?
Dr. Patrick Hadorn: I really like kind of complex adult care as well. And so, uh, when the time came to choose, that's what I picked. And a lot of us med-pedes docs, which there are a bunch of them in my practice as well, were kind of indecisive, you know? So we were like, "You know, we could do this or that, or we could just do it all."
Dr. Patrick Hadorn: and those of us that then go into primary care,I feel like it's even more of just, you know, we just never wanted to specialize. We realized we kinda liked, as you said, treating birth to all the way through the lifespan and, that has been the most rewarding part of my practice is just, you know, going from a six-month-old well child, say, to the next patient's a, you know, 85-year-old Medicare annual wellness or chronic disease management.
Dr. Patrick Hadorn: I think it's, it's really been kind of exactly what I hoped for.
Monica: You wanna talk a little bit about that evolution? Um, you are at Park Nicollet and Maple Grove, and Christy and I are both in Maple Grove. And, you know, from medical director caring for newborns at Maple Grove Hospital, what does the evolution of the last decade look like?
Dr. Patrick Hadorn: Yeah, so the first, five years, I've been there for I guess 11 now, it's hard to believe, but the first five years of that it was just all focusing on building my practice, patient care, clinical care. And so, and then around 2020, right, just before the pandemic, our previous, medical director decided to step down, focus on other things, and, um, they started sort of looking to see if anyone else had or anyone had any interest in filling that role.
Dr. Patrick Hadorn: And initially I did not. I really didn't go into it thinking I would ever get involved in leadership. but would say in a way it kind of fell in my lap. I applied for it, I got the spot, and, I've been doing that ever since. So I have probably about 20, 25% of my practice is, uh, the a- administrative medical director stuff, and then the rest is, is still clinical care, and I do newborn nursery rounding at the, at the hospital as well.
Christy: that is a really broad range of interests. And, you know, when we talked to you about coming on the show, I, I asked you to kind of list a couple of your areas of interest in medicine, and what you said was preventative medicine, chronic disease,management, maternal child health, mental health leadership and advocacy.
Christy: what is it about primary care that inspires you to continue in your profession?
Dr. Patrick Hadorn: Yeah, I think it's the relationships, you know, both with patients and colleagues. that's probably-- that's the thing that kinda is the backbone of it and that kinda keeps, us coming back. it's what I love most about my job. Um, and getting to see that kinda longitudinally develop over the years.
Dr. Patrick Hadorn: You know, I now have 10-year-old kids in my practice that I saw in the newborn nursery, and that's, that's just so rewarding. And, and then I think also in primary care, you, you never get bored because you're seeing a little bit of everything, you know? I mean, like I said, you, you-- any given day you could see such a variety of things, and that variety keeps it from, getting old and stale.
Dr. Patrick Hadorn: and then the medical director piece of it, I-- one of the surprising benefits of that for me personally has been that when I started it, I, you know, as I mentioned, I was about five years into my practice, and I was already starting to feel a little bit of, like, just hints of burnout at that point. And granted, this was even pre-COVID, so take that with a grain of salt.
Dr. Patrick Hadorn: and, and so the medical director piece gave me-- it was a little bit of, like, a relief valve on, not only could I kind of see sort of the inner workings of healthcare, um, in our organization, but it allowed me a chance to get to know some of my colleagues better because now I'm doing their annual reviews.
Dr. Patrick Hadorn: I spend more time rounding throughout the day talking to them. And, um, since we're a big clinic, that's not something that I kinda had before then. I mean, I knew everybody's name and everything, but you know, you don't get to know them on that same personal level. And
Christy: Yeah
Dr. Patrick Hadorn: to deal with a lot of challenges in that role, but also, again, it's kind of given me a greater respect for the complexity of healthcare and how we get paid and the insurance companies, all the other stuff we'll probably talk about a little bit later.
Monica: So let's step away from the exam room a little bit and tell us about you. You know, what, what do you do to recharge and enjoy life?
Dr. Patrick Hadorn: Great question. Yeah, 'cause you need that. Um, well, I would say number one is, you know, spending time with the kids. I have two daughters and, we like to travel. We like to go to all the local parks. Of course, they're getting a little older now, so I'm less, cool to them than I used to be. I got a, I got a teenager now.
Dr. Patrick Hadorn: but no, we, we just like to explore and we like to hang out and, I also love to read. I'm always reading. I love to play music and go to concerts and spend time outside when I can. so those are-- that's kinda what you'll find me doing when I'm not in the office.
Monica: What's the last concert you went to?
Dr. Patrick Hadorn: The last one I went to would've been a band called The Maine. Um, they're kind of a, I don't know, I, I wouldn't say pop punk, but they're kind of in that space, alternative punk kind of. I saw them at First Ave back in April, I think it was
Monica: Nice
Christy: you and Tom have so much in common, it's not even funny. Did you know his family grew up-- his dad is from Falmouth, Kentucky, which is Bracken County
Dr. Patrick Hadorn: Yeah, I know exactly what's that. Yeah
Christy: Yeah. So he grew up, you know, his family is from right where you grew up, and he is totally a punk ska guy. So that's his jam.
Dr. Patrick Hadorn: That was-- I was in a, I was in a band, I was in a band like that back in my, uh, sort of high school, early college days, yeah.
Christy: That's probably why he likes you so much. You know,
Dr. Patrick Hadorn: Then we have that, we have that
Christy: you're connected. Yeah. And you started practicing medicine just a few years before COVID fundamentally changed healthcare. And looking back, how has the profession changed? Because it totally turned medicine on its head, right? First of all, introducing telemedicine, which we could never do before.
Christy: So go into that a little bit for us.
Dr. Patrick Hadorn: Yeah, that's probably one of the biggest changes is like overnight in order to survive as a, as an organiza- well, uh, not just our organization, but across the board. I mean, um, you had these shutdowns. We had to switch to telemedicine and, and it was being done in, smaller, uh, ways prior to that.
Dr. Patrick Hadorn: But, you know, 100% virtual care for a little period of time there, and then even after that, that's kind of persisted. So that was a huge transition. I remember the first sort of video visit I did, it was-- I was nervous, you know? I was like, "Gosh, I've never done this." And the patient, you know, I didn't know how it was gonna go, and quickly we realized like, oh, this is actually like a viable way to do healthcare for certain And Christy, you know well, like you and I have done the vast majority of our care virtually over the past few years. Um, so that was big. And I think also, like, you know, there's been silver linings like that that have come out of it, but from a, from a maybe less positive standpoint is with COVID and the subsequent years, there was sort of a, uh, diminishing of the trust between, a lot of patients and healthcare providers.
Dr. Patrick Hadorn: you know, the, the vaccine issue and just in general, I think people, there's a lot of misinformation that came out of COVID, and so which again led to sort of a lot of downstream burnout and people leaving the profession and things like that. But, I think the biggest, probably the biggest change, yeah, was just in the delivery of care and realizing that this isn't, it doesn't have to be just a brick-and-mortar seeing your patient in the exam room situation.
Dr. Patrick Hadorn: And that was a positive, honestly.
Monica: Well, let's delve into the pandemic a little bit more because it, it affected everyone, uh, on-- in every aspect of their lives, and I was a public school teacher, and I cannot tell you how awful that was to try and teach virtually. But healthcare workers, uh, that was another level. So what, what would you like people to understand about that timeframe of being in healthcare during the pandemic?
Dr. Patrick Hadorn: Yeah, I think just that, healthcare providers, w- w- it was unknown territory for us too. We were all just trying to do our best. Uh, the, the amount of information and the, the pace of new information, new developments was, was, you know, it was like drinking from a fire hose. So we were trying to keep up. We were trying to do our best in a, in a brand new sort of un- unheard of type of scenario. I think the majority of people, kind of understand that, but there was just, you know, more pockets of people that where there was a lot of distrust. Um, you know, remember the early days of the pandemic, there was all this sort of outpouring of support for frontline workers and healthcare workers, and, that was really great.
Dr. Patrick Hadorn: But then you sort of saw as things went on over time, it was almost like it did a 180, and there were people that kinda saw a lot of healthcare as the bad guy, or, you started seeing people kinda going more to these sort of alternative practitioners and things like that. So I
Monica: Dr. YouTube
Dr. Patrick Hadorn: yeah, yeah, Dr.
Dr. Patrick Hadorn: Google, Dr. YouTube, ChatGPT, you name it. Yeah
Christy: And physician burnout has become a major concern, right? Because, uh, I just-- I-- To do research for this episode, I just looked, and there is a sharp decline in the number of people electing to go to medical school, whether that is because of the exorbitant cost or, you know, maybe it's a result of COVID.
Christy: We're not quite sure. But burnout is a major concern, and why are so many talented clinicians leaving the profession? And where is that gonna leave us when we have less doctors coming down the pipeline and more practitioners leaving?
Dr. Patrick Hadorn: Yeah, it's v- it's very concerning. even in our group, which we generally have been fortunate to have a lot of new applicants and clinician interviews over the years, even we're seeing a decline mainly in, interestingly, in kind of more in the physicians. I think there's still a pretty good pipeline of, what we call APCs, you know, nurse practitioners, PAs, it's, there's not that many physicians or, or, or residents that are going into, uh, primary care.
Dr. Patrick Hadorn: And as you mentioned, there's a lot that are leaving prematurely. We got people that are retiring in their 50s that were planning to work, you know, uh, uh, till 65 and I I think that's for a variety of reasons. I think, it has to do with the ins- increased documentation requirements, things like prior authorizations and insurance denials, and just all of the things that take away from that direct patient care that we went into it for.
Dr. Patrick Hadorn: I think there are-- I mean, that could be an entire podcast episode right there, but- ... I think the, the short answer is yeah, there's just, there's fewer people going into it, there's more leaving. And so, if we don't do something to sort of stem that loss, it's, we're, we're looking at a pretty bleak future for primary care.
Christy: Yeah
Monica: When you-- We're all in a fairly major met- metropolitan area, and what are you hearing about what's happening in rural areas?
Dr. Patrick Hadorn: Yeah, I mean, you know, just multiply what I just said by, you know, whatever factor. It's, it's, it's even worse. I think a lot of new grads are really hesitant to practice in rural settings because of the lack of support, which is not new for rural primary care. But I think that's kind of just been amplified, in recent years.
Dr. Patrick Hadorn: You know, you see a lot of, sort of a lot of the cuts that have come to funding that are affecting rural, hospitals. Hospitals are closing down, and there's lack of specialty care in rural areas, so these patients are having to drive hours sometimes or more to see, a diabetes specialist, for example.
Dr. Patrick Hadorn: And so these primary care doctors in the rural setting are having to manage things that they really weren't trained for and that again kind of just factors into the burnout. You, you know, they probably have to see more patients per day than, than, than I do in a suburban setting. and so it's just, it's not very enticing for, for a new clinician or, or a seasoned, clinician.
Dr. Patrick Hadorn: And there's a lot of great things about practicing rural medicine. I mean, I think you become even more a part of the community, and it's, very rewarding. I-- we had to do rural rotations in medical school, and I really liked that. But when, when the time came to decide, I was like, you know, I wanna go to a place where I have more support and, have more access and things to, to specialties, so
Christy: I just saw on MSNBC this weekend, they were talking about healthcare crisis. And in Iowa, people have to drive 200 miles to see an OBGYN because There are no OBGYNs in Iowa. Literally, people have to drive to the University of Iowa to deliver their babies. And for people with complicated pregnancies, I just can't even imagine having to manage that.
Christy: I mean, it just is really troubling to hear things like that
Dr. Patrick Hadorn: Yeah, I agree. mean, even in some places in Minnesota, I've, I've read, you know, there was, similar up north. I know there's places that are a couple hours from the nearest hospital. A lot of L&D, units, OB units have, have closed down in these smaller hospitals because they just can't afford to, to, keep it open.
Dr. Patrick Hadorn: It's unfortunate.
Monica: access to, to physical care is going to lead people even more to, as we mentioned, Dr. Google and Dr. YouTube and, and social media is pervasive. Like, people are going on social media to seek out medical advice. And what are you seeing about that in your patients and in your practice, the pervasiveness of informa- misinformation?
Dr. Patrick Hadorn: Yeah, that's a great question. I see it every day. Every day people come in and they, maybe they have a list of things that, uh, ChatGPT told them when they put in their symptoms or Dr. Google. and I think, I think it's great that we live in an age where we have that access to information, but the average person doesn't, have the training or, or the ability to sort through some of that and know what's misinformation versus, versus information.
Dr. Patrick Hadorn: And so, you know, what I try to do is go at it with an open mind. I never, you know, I know these people just want, they want what's best. they're-- I think of like a patie- a parent of a pediatric patient. they, they're worried about their kids. They come in with information that they saw on, on Google, and, what I try to do is I go through it with them.
Dr. Patrick Hadorn: You know, I don't dismiss them. I, say, "Oh, okay, well, this is interesting. Let's go through this." And sometimes, you know, people bring information that is, right on and is accurate and, and that's great. I think people should be advocates for their own healthcare. but again, the, the downside of that is when, you know, they're convinced they have cancer because of, uh, you know, an isolated lymph node on their neck and no amount of reassurance that I can try to give them is, is good enough.
Dr. Patrick Hadorn: And, you know, so, so that part is frustrating and, I just try to-- Yeah, I will say that that is definitely a source of frustration for all of us, not just in primary care, but in medicine in general. And I, I don't know the perfect solution, but I know that dismissing a patient because they come in with information is not the answer.
Dr. Patrick Hadorn: you gotta try to always put yourself in their shoes. And, you know, and I, we-- I, I do it myself, right? we're all guilty of it, right? We all use, uh, use AI these days, and I think it's, it's kind of the, the Wild West of medicine right now .
Monica: Okay, I have to jump in with a little aside, and this predates the internet, but when I was a little kid, my parents had encyclopedias on a bookshelf, and I had a lymph node under my arm that was swollen, and I'm paging through the encyclopedias, and I was convinced I had cancer. I was probably 12 years old.
Monica: So, you know, multiply that times, like you said, whatever factor with all the information available on the internet
Dr. Patrick Hadorn: Mm-hmm. Yeah, it's, it's certainly an added complexity to an already challenging job.
Christy: It gives people just enough information to be dangerous, right?
Monica: Exactly.
Christy: Um, so let's move on to vaccity-- vaccine hesitancy. Um, and that persisted long before the pandemic. all three of my kids are neurodivergent. Two of the three are on the autism spectrum. And I never once hesitated about vaccines. I do remember their pediatrician when they were young, when I asked him about it, said the reason that people are thinking that it's tied to the vaccines is because a lot of times the vaccines are being given at a time when the symptoms become
Christy: more prevalent and more easily identifiable. because a lot of times these kids are getting boosters when they're two or three years old, and that's really when you start noticing the neurodivergence stuff if the kids don't have developmental delays, right? So how do you approach conversations with patients who have concerns while maintaining trust?
Christy: Because with the Secretary of Health, all of the misinformation that's coming out of the Department of Health and Human Services right now, it is just, it's devastating because these kids are being left open to things like measles, and we're seeing a resurgence of tuberculosis and polio. And so how do you address that as a physician?
Dr. Patrick Hadorn: Yeah, um, carefully. Um, I think you try to, again, seek to understand. in my practice, I kinda have, I would say, two broad categories of, of parents that refuse vaccines. one is they've made up their mind from day one, and there's very little you can do, and they kinda get maybe a little defensive and, and angry if you even sort of bring the topic up.
Dr. Patrick Hadorn: And then the other, the other is more of a open-minded, they have questions, they're kind of, taking their time to decide, and maybe, maybe most of those in the second category will eventually get some or all of the vaccines, but they maybe wanna do an alternative schedule, or they just, you know, they wanna have that discussion.
Dr. Patrick Hadorn: And so, those categories, I mean, I s- I still see all of those, those children and, um, and parents. And so I try to periodically bring the discussion back up with those, parents in the first category, just to say, "Hey, you know, maybe the last time we discussed it was at the two-month well visit, and here we are at six months.
Dr. Patrick Hadorn: Still, feeling like you, you know, aren't interested in doing the vaccines, and why? And is there, you know, any questions you have?" And just try to keep that an open discussion, um, versus I, I, I have had colleagues over the years and, and, and, uh, attending physicians in, when I was in training, who just kind of have a blanket policy of, you know, "You can decide to refuse vaccines, and I can refuse to see you as a patient," and they just kick them out of the practice.
Dr. Patrick Hadorn: And, um, there's some people that are, that would say that that's the right approach. I, as pro-vaccine as I am, I, I still think these children need, they need to be cared for. They need a pediatrician, and, unfortunately, if I don't see them, right, they're likely to end up in a practice that is, you know, even more just kind of a, a, an echo chamber, 'cause those are out there.
Dr. Patrick Hadorn: We all know those practices where they, they kind of are, uh, on the other end of, of the science spectrum.
Christy: There are a couple of those in the Twin Cities where they're, the,
Dr. Patrick Hadorn: there's plenty of 'em.
Christy: yeah
Dr. Patrick Hadorn: Yeah. Yeah. So, so I think I-- for me, it's just about keeping an open mind, presenting the science, because the science on vaccine safety is... mean, they're one of the most studied, healthcare interventions in history. So we've got over a century of, of data, on their safety.
Dr. Patrick Hadorn: And as you mentioned, some of the, you know, the more recent stuff with the, health secretary, yes, it's been very, frustrating, and that's, that's putting it nicely. But what I have noticed, again, I try to see some silver linings in things, but is that the majority of my patients have come in saying, "You guys You guys are sticking with the previous schedule, right?
Dr. Patrick Hadorn: The previous vaccine schedule right here." And we are. Um, so we as an organization continue to follow the American Academy of Pediatrics. all of the big, physician organizations, the family practice, the pediatrics, internal medicine, OBGYN organizations, they all continue to support all of the previous CDC recommendations.
Dr. Patrick Hadorn: And so I think that's good to see these organizations led by physicians that are all banding together and saying, "Look, this is, this is anti-science. We're gonna continue to follow what the, what the science shows us." And, so I know it differs by practice. And even, even within the Twin Cities, as, as medical director, one of the things that I get to see is all the data on, well, Maple Grove's vaccination rates are this, and Elk River's are this, and Andover's.
Dr. Patrick Hadorn: You know, so our whole northwest region up here, we meet once a month with all the medical directors, and we go over things like, quality improvement and vaccine and all this kind of stuff. And so I get to see the different rates, and it's really interesting to see how different it is in, say, Wayzata versus Elk River versus Anoka.
Dr. Patrick Hadorn: You know what I mean? It's,
Christy: And you those words and we can in our minds know exactly what the
Christy: vaccination rate is gonna be based on those cities?
Dr. Patrick Hadorn: I realize I'm talking to a wider audience, but yes, even within any area, you're gonna see that. Even as you get 20 minutes out into kind of a little more rural, you're gonna see, uh, a lot of times those vaccine rates drop things like that, so
Christy: How does it feel to feel like you've been hung out to dry by the administration? I mean, I just cannot even imagine the years that you've spent putting into your education. We've got a Health and Human Services secretary who has no medical background whatsoever. He cherry-picks... He, he'll read one study.
Christy: He'll cherry-pick information from it, He'll pick studies that aren't even peer-reviewed. And for people who don't understand that, a peer-reviewed study is something that not only has been written, but peers in that area of specialty have read it, have reviewed it, and have quoted it in their own work because it's valid information.
Christy: So how does it feel just to be hung out to dry? I just can't even imagine what it must feel like.
Dr. Patrick Hadorn: It's, I mean, it's demoralizing. It's, it's very unnerving. I think we in our profession never thought there would come a day where we were at such odds with, our own policymakers, our own government like that. And, and honestly the rest of the world, the World Health Organization, you know what I mean?
Dr. Patrick Hadorn: It's, uh, I, you know, I think we're all just kind of doing the best we can until, fingers crossed, this is, uh, o- over,
Christy: Sooner rather than later, hopefully
Dr. Patrick Hadorn: yeah, this hope that like, you know, better minds will prevail and we'll kinda get back to leading the world in terms of our health guidance and our, you know, basic things like vaccine guidance, which again, you never thought would be under such attack.
Christy: Right
Monica: Well, and in this era of misinformation and disinformation, and as Christy pointed out, the Secretary of Health and Human Services having no medical expertise, how do you guide people, like for our listeners trying to make informed decisions, what are some practical ways to identify credible medical information?
Dr. Patrick Hadorn: Yeah, great question. I, I try to guide people to trusted resources. we use a lot of... Mayo Clinic, for example, is a, is a trusted resource that I guide people to a lot. Cleveland Clinic, uh, the World Health Organization. The problem with that is that, people still, when they Google something, they have to do that extra legwork to kind of determine that.
Dr. Patrick Hadorn: And I think some people, you know, that's not something that the average person might-- They think, "Oh, I Googled it. This is what I saw. This must be right." Or, or increasingly people are relying on social media, which again can be good or bad. But, um, as we all, as we all know, it's a bit of an echo chamber there too.
Dr. Patrick Hadorn: And so, I think I just, I try to guide them to the sources that I would look up. I, uh, you know, like I said, American Academy of Pediatrics, uh, the American College of Physicians, that's our internal medicine organization. But when we-- like when I am looking up from an AI perspective, when I am looking up, data or looking up studies, there's a great site called Open Evidence now.
Dr. Patrick Hadorn: It's mainly created for healthcare professionals, but it's open to the public too. And that is really good at like sorting through, like you said, randomized controlled peer-reviewed studies and things like that. So it gives you-- it's, it's probably the most trusted medical version similar to something like ChatGPT or Copilot
Christy: Well, we'll make sure to put those links in the show notes for people to have. And since you brought up AI, we were gonna talk about that a little bit later in the show, but I think it makes sense to talk about it right now. So why don't you explain a little bit on how AI has impacted practice, both from a physician's perspective and also in frontward public-facing with patients?
Dr. Patrick Hadorn: Mm-hmm. Well, from a physician and patient perspective, It's really kind of, I mean, we're witnessing it revolutionizing our practices already. I'll give you a few examples. One is we now use it, there's something called ambient dictation, which I'm sure, most people are familiar with, but that's where if you'd gone into a doctor's appointment in the past few months, uh, you probably have had your physician or your, provider get consent to use, you know, ambient dictation, which is basically it listens, it helps transcribe and turn the visit into a nice succinct note, and it takes away some of that time that we previously had to spend typing away.
Dr. Patrick Hadorn: It also cuts down the time that we have to spend after work in cases like mine, where I like to get out of there quickly so I can get home and see the kids. So I probably spend an hour less per day, honestly, because of that. It's also been... And that, and that's just more of a practical kind of administrative use of it, and we're also seeing it become more and more, sort of mixed in with, clinical decision-making, and it's still kind of in its infancy with that.
Dr. Patrick Hadorn: I think we're still, figuring out how best to use that and what, you know, what, what's the right way to use that ethically. But, uh, yeah, I mean, even now, if I were to type in, you know, I have a two-year-old with a fever and swollen lymph nodes, what are the, what are the some of the things I should be considering?
Dr. Patrick Hadorn: You know, it'll give you a list of things, and again, it's not making that decision for you or telling you exactly what to order, but it's, but it's reminding you of some things that you may not have considered when you have to keep a, a million different things in your brain every day. Um, so I think we're seeing it really revolutionize care in that way.
Dr. Patrick Hadorn: From a patient standpoint, similar, I mean, I think as I touched on earlier, patients are, patients are putting their symptoms into ChatGPT. They're, they're-- It's spitting out, uh, who knows what. I mean, some of those might be a, a likely diagnosis, but, but oftentimes, you know, the C word, cancer, is gonna be on there somewhere, so people are coming in kinda worried and freaking out that they have the worst thing on that list of potential diagnoses.
Dr. Patrick Hadorn: And so that's where I think there's always gonna be that need to interpret those findings and have that expertise, because I can look at that right away and put it into context with lab findings or imaging findings and say, " Oh, no, this isn't cancer. This is XYZ." So that's, that's just from more of a clinical sort of symptom-based, but then you're seeing it used with, some online applications like MyChart, which everybody's familiar with, right?
Dr. Patrick Hadorn: We-- A lot of the big organizations use the same Epic system, uh, which has MyChart. So, AI is being used with that. Gosh, the list goes on and
Christy: used by insurance companies to make decisions about covering treatments. So let's talk about that elephant in the room
Dr. Patrick Hadorn: there's, there's the dark side. Yes, that is probably the number one sort of, uh, bane of my existence in my practice. Uh, yeah, we're getting insurance denials left and right, and this isn't one specific insurance company.
Dr. Patrick Hadorn: It's, it, it's, it's really across the board. but yeah, they're-- you're seeing a lot of where previously, let's say I ordered an MRI and I might get a denial and have to submit a prior authorization because they say, "Well, you shouldn't have gone straight to an MRI of the shoulder. We need to see an X-ray first."
Dr. Patrick Hadorn: Well, me as the clinician knows that an X-ray would not have been helpful in this situation, so that's why uh, jumped to doing a more advanced imaging. Well, you know, that used to be something where in the worst-case scenario, we would have to do what's called a peer-to-peer, right? So I might have to pick up the phone during my busy day and call this, uh, this utilization review physician with fill-in-the-blank insurance company.
Dr. Patrick Hadorn: And the majority of the time when you talk to the human on the other end, they'd say, "Okay, that makes sense. We'll approve it." And yes, that process is frustrating, but at least there was a human involved. Now it's like, you know, I can't tell you how many times there's a denial and it gets to the point where we submit an appeal letter and you can tell that this is all AI-driven, and it gets denied and there's nothing you can do.
Dr. Patrick Hadorn: Either you tell the patient, "Well, this isn't gonna be paid for. Your options are, you know, we can pay out of pocket, we can try an alternative test that's inferior." It's very frustrating because I, as their clinician, know what's best for, uh, whatever the scenario is and, and yet there's this middleman, this constant elephant in the room, as you said, that's, that's, uh...
Dr. Patrick Hadorn: And, and now we have to talk, we have to talk about it, and that's not something that I went into medicine for. I didn't go into medicine to have discussions about insurance during your 30-minute physical or discussions about, "Well, I'm gonna prescribe this GLP-1 for you, but, just so you know, it's gonna get denied.
Dr. Patrick Hadorn: We're gonna have to go through a prior authorization process, which we'll do. We have, we have an entire team now that works these things," which gets
Christy: I had to go through that process with you, and I remember my prior authorization remember got held up for two months because they were backed up with GLP
Dr. Patrick Hadorn: I do remember that.
Christy: Yeah. Yeah
Dr. Patrick Hadorn: we've, we've literally hired extra people just to work on prior authorizations. so that again, that's just, is this really saving anybody any money? Well, no, it's, it's not. It's adding to the cost of care
Monica: this'll be the elephant in the room for quite a while going forward as the world figures out how to navigate a world of AI. But as you look over the next decade, what's giving you hope about the future of medicine?
Dr. Patrick Hadorn: Yeah, I think that if used correctly, and I'm not gonna claim to know exactly what that looks like, but I think if used correctly, AI has a ton of potential. I don't think there's any use in, in, in fighting it because it's here and it's not going away, and players involved with this need to find out how to use it appropriately.
Dr. Patrick Hadorn: But I think it gives me hope for things like, you know, the big obvious ones are cancer treatment. I think it's, I think we're gonna see more and more uses in oncology where you can see treatments tailored to a specific individual, as opposed to kind of the old, let's throw these broad, uh, chemotherapy drugs at it that are gonna kill the cancer, but they're also gonna wreak havoc on your, your healthy tissue and, and cause, all kinds of downstream side effects.
Dr. Patrick Hadorn: I think you're gonna see a lot of targeted therapies that are, gonna be coming out for diseases that we thought were, just kind of insurmountable, right? I mean, I think you're gonna see things like pancreatic cancer in coming years be, be more treatable and, and increase survival for things like that and, and maybe rare diseases too, because AI, when you think of it, it has the entire database and the entire world at its fingertips and, and no human mind can, can compete with that.
Dr. Patrick Hadorn: So, I think it has a ton of potential in that world. and I think even within primary care, if we use it correctly, if we use it, with the patient and, and not, you know, look at it as, as this enemy, I think it has, uh, great potential. I'm excited about it. I, I'm also weary of just, like the things I mentioned, I think more and more people have a trust issue and they feel like, "Well, I can get my answers online," and they kinda come in wanting sort of a la carte, "Well, it said you should order this test, this test, and this test."
Dr. Patrick Hadorn: And if I don't, as their doctor, order those tests, well, you know what? We get scored. We get these patient experience scores all... You know what I mean? So there's all these different factors in there, and so I think we have to find a way from the public-facing side to better educate people on how to use AI and, and how to work with their, uh, healthcare professional, as opposed to seeing us as simply, you know, someone to, you know, order what they, what they want.
Christy: Yeah. And Dr. Hadorn, you've walked through some pretty difficult years with me the past few years. and you have seen what happens when patients have a physician who believes in them, listens, and refuses to give up. Because I, I'm not gonna lie, I'm a complicated case. There are probably plenty of times where...
Christy: I, I've heard that, when you're a doctor, If you hear hoof beats, you shouldn't look for horses, you should look for zebras, right? Is that a, is that a thing?
Dr. Patrick Hadorn: Yeah, that is a thing. Yeah, that's-- We, uh, we often talk about, use that analogy of, of the zebra, right? 'Cause it's-
Christy: Well, I've been a zebra for you, and it's taken a long time for you to really-- and, and my other, the other members of my healthcare team to really come to figuring out what's wrong with me and then coming up with a treatment plan going forward. And for me, it's not a matter of curing what I have.
Christy: Unfortunately, it's chronic, and it's gonna be managing that over time. So I see you once a month on a, a regular basis to touch, touch base, see how I'm doing. And what does it mean when we talk about the relationship between a primary care doctor and someone living with ch-chronic illness? How does that relationship grow, and why is that trust so important both for the doctor and for the patient?
Christy: Because there has to be a, a trust both ways, correct?
Dr. Patrick Hadorn: Correct. Yeah, trust is, is what it's built on. and it's-- This is why having that sort of stable long-term relationship with the, the same provider ideally is so important. it's why I went into primary care. It's why I still practice primary care despite a lot of these challenges we talked about.
Dr. Patrick Hadorn: Because when I have a patient like yourself who we've spent years kind of building that relationship and, and that trust, that's really-- I mean, that, that's something special. And it's not so much that, oh, I've spent years learning about your complex illness and, and it took us all these years to find the zebra.
Dr. Patrick Hadorn: It's more about the, uh, it's more about that, uh, how do I put it? I just, I think it's that bond that you have, with,
Christy: For sure
Dr. Patrick Hadorn: with a patient when know your family, I know on any given month when I talk to you, I can tell within, within a minute of the call, I can tell, all right, is she, is she having a, bad week?
Dr. Patrick Hadorn: Are we having a lot of migraines? Are we having... You know, I can kinda tell and I can look back at my notes. I can look back at my notes for the past however many years and reference that and and see, see the longitudinal progression over time. And so that, that doesn't happen overnight. And I think, when you have doctors and providers that are kind of in and out of the system where they're leaving early or, you know, that, it's really hard to replace that.
Dr. Patrick Hadorn: I mean, it's hard, you see when a doctor retires, and we had a doctor retire from our practice a few years ago. You know, he was, he was retiring at a normal age, but he, uh, when he left, a lot of his patients had to, you know, be, kinda be split up amongst the, uh, those of us that were left. And, and what you just heard over and over from his patients was just how much like he felt like part of their family.
Dr. Patrick Hadorn: They, uh, you know, they knew that they could confide in him anything. There w- there wasn't anything too big or too small. He, you know, he would ask them how their son's wedding was. You know, he knew their pets' names. You know, all that kind of stuff, it, it, it really matters, and it's primary care is unique in, in that we, we're the only sort of part of medicine that has that.
Dr. Patrick Hadorn: You know, you think about, know, cardiology, maybe you have a cardiologist that you see once a year, but at some point, typically, you sort of graduate from, uh, from specialty care if things are stable over years. Or maybe you see them long-term, but it's not quite the same as seeing them two, three, 12 times a year, um, like you do with your primary care doctor.
Christy: Yeah. And it's not uncommon if I'm having a televisit with you that Tom will pop in or one of my kids will pop in and say, "Hey, Dr. Hadorn, how are you doing?" So
Dr. Patrick Hadorn: It's always nice to see them.
Christy: So, before we let you go, if there's one message you'd like every listener to remember about today's conversation, what would that be?
Christy: And I wanna say that we did not get to talk to- about mental health today 'cause we're running out of time. I'm hoping you'll agree to come back so that we can talk, have a whole episode on mental health. So I'm gonna put you on the spot for
Dr. Patrick Hadorn: Yeah, not, not a problem. Yes, and I agree. I would love to have more discussion, 'cause that's such a huge part of my practice, any, any primary care practice these days. But I think a, a message, a takeaway would just be to, you know, trust your, trust your, your primary care doctor.
Dr. Patrick Hadorn: Remember that we're, you know, we're on your side and that we have your best interest at heart. And I think, come to us for-- be-before seeking out outside, information or if it, or if it seems too good to be true, it probably is. you know, that, that's what we're in it for.
Dr. Patrick Hadorn: And so I think I love what I do. I wouldn't trade it for the world, uh, but it's challenging, and the thing that keeps me coming back are those relationships. So I think just, reminding people that every, every one of us is a patient at some point. I'm a patient. I have a primary care doctor and, and so it's, uh...
Dr. Patrick Hadorn: Just trust us, and it goes both ways.
Monica: I hope our listeners have found as much value in this conversation as I have in it, and I think we could sit and, and talk for another hour about mental health and, and about more about AI and the future of, of healthcare and the need for universal healthcare in our country. So thank you for everything that you've provided today
Christy: Yeah, we definitely need to have you back. And I, I just, I cannot say this enough. Everyone needs a doctor like you. I, I'm serious. I, I talk about you all the time to Monica and she, you know,
Monica: She does.
Christy: Yeah, I do.
Dr. Patrick Hadorn: very kind
Christy: yeah, well, but it's the truth. I mean, I, I've had to trust you in some pretty low periods of my life at, at times where I've been emotionally vulnerable and frustrated and hopeless, and you've just kind of been a rock to kinda like get me through this and get my family through this, not just me, because my family's had to deal with what's happened to me over the past few years too.
Christy: So, um, I really hope that people can find someone like you in their community that they can go to and who provides for them what you have given me and my family. So I just wanna say thank you
Dr. Patrick Hadorn: Well, you're welcome, and thank you for the kind words. And you are the reason I, why I do what I do, and I appreciate you guys having me on, and hopefully we can continue the conversation
Christy: Yeah, we are definitely coming back, so
Dr. Patrick Hadorn: good.
Monica: like that, yeah
Dr. Patrick Hadorn: Sounds like an invite.
Monica: It, it is.
Dr. Patrick Hadorn: All right. Thank you, guys
Monica: Thank you. And to our listeners, if you're finding meaning in the stories we're sharing, if something moves you, challenges you, makes you see the world a little differently, please like, comment, and share. It helps more than you know
Christy: And follow us everywhere at the Politics Chicks on Substack Threads, Blue Sky, Instagram, TikTok, and Facebook
Monica: Thanks for being a part of our community, and keep shining your light so we can find each other in the dark
Christy: And remember, we're stronger together. Thank you, Dr. Hadorn, and I'll see you on Wednesday. We have an appointment on Wednesday. Bye-bye