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A movement founded by doctors, for doctors, dedicated to empowering medical professionals to reclaim control over healthcare decisions and advocating for their fair share of the industry's resources.
00:00:04:00 - 00:00:27:04
Justin Nabity
This is the Doc Nation podcast. We are a movement founded by doctors for doctors dedicated to empowering medical professional to reclaim control over health care decisions and advocating for their fair share of the industry's resources. Please note the views expressed are those of Doc Nation and not necessarily those of our Guest or Reference Health centers.
00:00:27:06 - 00:00:46:00
Reid Lancaster
Hi everyone. We have Jon Nichol on with us today for our podcast. We're going to try to keep these podcast to about 15 to 20 minutes. We're not really good with time frame, but we're going to try to be as good as we can. We want you to join these podcasts or look at Doc Nation podcast and say, hey, I got a 15, 20 minute drive.
00:00:46:02 - 00:01:05:22
Reid Lancaster
These guys aren't going to labor on forever. So thanks for joining, Jon. Jon is, just getting off shift. Just jumped out of the car and jumped into, his seat behind the screen. So thanks, Jon. We appreciate you. Jon's been a signature member with us for, over a year now. And we're doing some really, really cool things with Jon.
00:01:05:24 - 00:01:22:00
Reid Lancaster
We have some really fun ideas. Doing a couple things right now and introduced him to some to some cool people here just recently. And so I'm excited about those things. But we're not going to discuss those things today. So without further ado, Justin, you can, jump in with, the questions.
00:01:22:02 - 00:01:26:18
Justin Nabity
Yeah. Jon, tell us about how you got into medicine and what your role is today.
00:01:26:20 - 00:01:42:10
Dr. Jon Nichol
So originally when I think about, you know, my very first experience with medicine, it was doing CPR on a patient. I was, like, 18 years old or something, and a Dairy Queen. And somebody runs in and says, help. Does anybody know CPR?
00:01:42:12 - 00:01:43:06
Justin Nabity
Oh, wow.
00:01:43:08 - 00:01:52:23
Dr. Jon Nichol
I did I did my BLS training, you know, had some, CPR class and Boy Scouts or something, and went over and did CPR for a minute.
00:01:52:23 - 00:02:16:15
Dr. Jon Nichol
And it was the wildest rush I've ever had in my life. I mean, took me and, like, changed me in so many ways. And it was, like, okay, now I have to really think about this. And so from that moment on, I started down the path of, okay, I think I want to do this. Took a first aid class, took an EMT class, got a job as an EMT in an emergency department.
00:02:16:17 - 00:02:31:06
Dr. Jon Nichol
Loved it. Loved the people. I mean, it's it's a family in the hospital a lot of times. And, that led me into my medical school. And, here I am. That's how I think
00:02:31:08 - 00:02:50:17
Reid Lancaster
Jon, we’ve been working with you for over a year. And I guess we didn't ask that question. That's an awesome question. I just wanted to say, for the listeners real quick, it's cool. That's the whole thing about, providers is it's a heart posture thing. It's never a money focus. It's how do we serve other people? I got full body chills thinking about your experience at Dairy Queen.
00:02:50:22 - 00:02:57:07
Reid Lancaster
This isn't a guy who just sits on the couch. This guy is preparing for a 100 mile race. 100 mile
00:02:57:08 - 00:02:58:09
Justin Nabity
Actually no, no,more than that.
00:02:58:14 - 00:02:59:23
Reid Lancaster
What is it?
00:03:00:00 - 00:03:10:01
Dr. Jon Nichol
So I always preparing for different races. My next race is 50 miles, then maybe a 100 mile race, and then in May, a 250 mile race, 250.
00:03:10:03 - 00:03:16:06
Reid Lancaster
So when he says it's the greatest rush of his life helping that person in Dairy Queen, that's saying something is my point.
00:03:16:08 - 00:03:19:04
Justin Nabity
Yeah, And then tell us...
00:03:19:04 - 00:03:31:10
Dr. Anthony Giuffrida
I htink you said it when you said Reid, people don't get into medicine for the money. It's usually a story like that wanting to help people, wanting to do more. It's really a calling. So Jon, thank you for sharing that story, that's pretty amazing.
00:03:31:12 - 00:03:36:07
Dr. Jon Nichol
Yeah. It was, it was crazy. And, I mean, I remember it like it was yesterday.
00:03:36:07 - 00:03:36:23
Dr. Jon Nichol
It was.
00:03:37:00 - 00:03:37:06
Dr. Anthony Giuffrida
Yeah.
00:03:37:11 - 00:03:40:13
Dr. Jon Nichol
Very influential for me.
00:03:40:15 - 00:03:41:09
Justin Nabity
And then tell us about.
00:03:41:09 - 00:03:43:12
Justin Nabity
Your role today.
00:03:43:14 - 00:04:06:23
Dr. Jon Nichol
So currently I'm practicing as an emergency physician in Salt Lake City, Utah. I work strictly nights, so. And I actually kind of like that some people don't understand that, but that's why I just got off the shift right now is, worked overnight last night and working in the emergency department. I mean, it's always crazy. It's always something.
00:04:06:23 - 00:04:35:09
Dr. Jon Nichol
It's, I mean, I had a patient last night just start yelling at everybody, so you never know what you're going to. You're going to see and and, deal with. And a lot of times we're dealing with complex medical situations. But in the emergency department, a lot of times we get to deal with social situations, and we always see mental health patients and we always, you know, try and do what's best for the patient and getting them to the best care that's possible.
00:04:35:09 - 00:05:09:19
Dr. Jon Nichol
And and often I'm I'm in the role of helping people navigate the very complex health care world health insurance. Yeah. Physician's offices inpatient, outpatient. What what treatment is needed next. And, the, emergency department, we're often considered the jack of all trades, but master of none and I wear that with a badge of honor. I can talk to any consultant about their job, and I can talk to them about the most exciting parts of their job, because that's the parts that I usually deal with.
00:05:09:19 - 00:05:22:20
Dr. Jon Nichol
And I, I love it. It's, it's a profession like nothing else. And I tell staff and everybody, we have the weirdest job in the world, and we have the best job in the world because we get to do some amazing things.
00:05:22:21 - 00:05:24:00
Dr. Jon Nichol
00:05:24:02 - 00:05:25:16
Justin Nabity
That's really cool.
00:05:25:18 - 00:05:30:13
Justin Nabity
Yeah. So how long you been doing it now?
00:05:30:15 - 00:05:33:03
Dr. Jon Nichol
I graduated medical school, 2016.
00:05:33:05 - 00:05:36:16
Dr. Jon Nichol
Graduated residency 2019. So my fifth year
00:05:36:18 - 00:05:37:02
Justin Nabity
5th year okay
00:05:37:02 - 00:05:39:24
Dr. Jon Nichol
just just started my sixth year out of residency.
00:05:39:24 - 00:05:42:04
Justin Nabity
Okay. What are you seeing.
00:05:42:08 - 00:05:46:11
Justin Nabity
As you've been doing this for that long? What's happening in healthcare from your perspective.
00:05:46:11 - 00:05:48:15
Justin Nabity
In terms of how it.
00:05:48:17 - 00:05:51:00
Justin Nabity
Affects you, supports you, how patient care is.
00:05:51:00 - 00:05:54:09
Justin Nabity
Happening, like what are you seeing? Things are going in a good direction.
00:05:54:11 - 00:06:00:22
Justin Nabity
Like going in a bad direction, like what's your overall take on it and what do you how do you assess it?
00:06:00:24 - 00:06:35:15
Dr. Jon Nichol
I think I'm a pretty unique situation. I'm not unique to myself, but the five year mark out of residency seems to be kind of an interesting spot where I feel like I have, you know, enough experience and education and understanding of the system and where I am to know I'm comfortable. I know the system well enough to navigate everything and and I've also been through some of the changes and the recent changes, and I can I can see the the outlook.
00:06:35:17 - 00:07:08:04
Dr. Jon Nichol
And I mean, it's hard to say that it's good. I think there are a lot of people that want to do good within the system, but ultimately it's crumbling around us and we're trying to put the pieces back together while it's falling apart. It's not just building the ship as we sail. It's build and repair the ship as we sail through choppy waters like it's hard to it's hard to put into words.
00:07:08:04 - 00:07:32:19
Dr. Jon Nichol
Sometimes it's just because it is so chaotic and it's hard to imagine what it either should be or even could be. And there's often what I think is there just has to be a better way, because the way that we're going right now is towards complete failure.
00:07:32:21 - 00:07:38:13
Justin Nabity
What? Tell us about that. Like, why do you say that? Like, can you give us an example of something that you're seing
00:07:38:15 - 00:07:45:03
Dr. Jon Nichol
it's just a system that's not built to treat patients like humans.
00:07:45:05 - 00:08:08:14
Dr. Jon Nichol
They're they're treated and it's it's a complex system. And health is complex. And health care is complex. But it's it's really not built in a way that is driven towards the health of people and helping people live a healthy life.
00:08:08:16 - 00:08:13:21
Justin Nabity
If it's not for that, then then what is it? What is it directing people toward?
00:08:13:23 - 00:08:34:07
Dr. Jon Nichol
Well, it's it's ultimately it's directing all the majority of patients towards a, a system of chronic health that leads to payments to a broad kind of spectrum of corporations. Basically
00:08:34:07 - 00:08:35:13
Justin Nabity
Got it
00:08:35:15 - 00:08:52:01
Dr. Jon Nichol
so you have and it just gets more and more complex. You have hospital corporations, you have pharmaceutical corporations, you have health insurance corporations. And all of them are trying to get a piece.
00:08:52:03 - 00:09:19:10
Dr. Jon Nichol
And the one piece that I think about the most, being a physician, is the physicians. And how without physicians, there is nothing. And if you take you could take nurses out of the out of the out of the equation completely. Okay. We can we can figure something out there with within the, the hospital system and ordering and, and getting things done.
00:09:19:12 - 00:09:51:18
Dr. Jon Nichol
You could take respiratory therapists out. You could take physical therapists out and the system would still work. But ultimately, if you take physicians out of this system, it's done. It all falls on the physician. And then within as a physician, to me, it all falls on my individual interactions with patients one on one. And within that one on one moment, I'm trying to create a connection and a relationship with somebody.
00:09:51:20 - 00:10:09:17
Dr. Jon Nichol
But there are 20 other people on that periphery. They're all trying to get a piece of that. I'm trying to create a connection with the patient about their health, and everybody's trying to connect, create a connection with that patient and their wallet. And that's it's just fundamentally wrong.
00:10:09:19 - 00:10:10:15
Justin Nabity
Jeesh.
00:10:10:17 - 00:10:13:15
Reid Lancaster
That was well, put. oh yeah.
00:10:13:17 - 00:10:17:16
Dr. Anthony Giuffrida
So and I have a follow up question to that and as a physician as well.
00:10:17:18 - 00:10:37:02
Dr. Anthony Giuffrida
Do you think. And I might be leading the witness here. Do you think the physician being that center point of medicine, which I agree with you with, I always make the analogy that they're like the player in the football game, you can't have the game without the player. Do you think the physician has how much power compared to the other 20 people in the room?
00:10:37:04 - 00:10:44:01
Dr. Anthony Giuffrida
Does a physician have in decision making ability, or in the day to day life of even their themselves and their patient?
00:10:44:03 - 00:11:16:04
Dr. Jon Nichol
Well, I think that's been whittled away so carefully and slowly over time that I think a lot of physicians don't see where they don't have that anymore. And I think it was all brought if I think back in, in the short history of medicine, that I can either have a hand, had myself or know of from other people and older physicians, everything kind of got outsourced as this way to make the physician's life better.
00:11:16:04 - 00:11:42:15
Dr. Jon Nichol
Oh, we'll do this for you and it'll make your life better. And what we have had happen through that is we've kind of sold off our control along the way with the the auspice and the ideal of your life is, you know, pretty crazy as a physician. And you work crazy hours and are on call or all these things, but somebody came from the side and said, I can make your life easier.
00:11:42:15 - 00:12:01:19
Dr. Jon Nichol
And we all said, yeah, sure. I love that idea. And we did it too many times, so we've lost control of every step along the way. We've lost control of billing in a lot of ways. That's outsourced to a coding and billing company. And honestly, I don't even know what's billed under my name most of the time.
00:12:01:19 - 00:12:03:19
Dr. Anthony Giuffrida
And it's not taught anymore.
00:12:03:21 - 00:12:25:05
Dr. Jon Nichol
No, no, no, it's not correct. 100%. And that's, that's such a problem that I see. And so, yeah, that that loss of control from, from the physicians, if we're going to be the quarterback of this team, but we don't know the play that we're running. Right. It it doesn't make sense.
00:12:25:07 - 00:12:29:09
Dr. Anthony Giuffrida
Do you see a fix for this or any ideas for a fix.
00:12:29:11 - 00:12:54:16
Dr. Jon Nichol
So yeah I think about that all the time. I, I think physicians from, from my perspective on what I would like to see happen and it doesn't fix everything, but I think physicians need to be in control of hospitals. I think that's a very big step. We've we lost control of hospitals as physicians. We let that get taken from us.
00:12:54:18 - 00:13:22:23
Dr. Jon Nichol
I don't remember the bill, but there there are there are some legislative things that happened along the way where physicians used to own and operate hospitals. And I think there were some bad actors within that that kind of gave us all a bad name. And there was some, you know, some shady business there. But, physicians can no longer own hospitals in certain states, from what I understand.
00:13:23:00 - 00:13:24:21
Dr. Anthony Giuffrida
In the whole country.
00:13:25:00 - 00:13:50:08
Dr. Jon Nichol
Yeah in the whole country, you can't own a hospital. And. Yeah, so there's problems there. But without owning the hospital, I think we need to be in the leadership of hospitals. I get emails and and and notifications and everything from CEOs of hospitals who are telling me in their polite way how to do my job.
00:13:50:10 - 00:14:19:07
Dr. Jon Nichol
They have no medical training. They have no understanding of what it's like to work at 3 a.m. in the emergency department with a patient having a crisis or yelling at everybody or dying, and I'm there trying to save them. I'm the only one there. They don't. They don't understand that. They don't understand what any of that is like, what the training was like going through years of residency, working all of those hours.
00:14:19:09 - 00:14:39:24
Dr. Jon Nichol
And, and then they come to me and say, oh, hey, you're late on this chart. That needs to be done. Two days ago and sure. Yep. I should probably be a little bit more on top of my charts and getting them done on time, but I don't. I don't want you to tell me to do that. I need to know that for myself.
00:14:39:24 - 00:15:00:21
Dr. Jon Nichol
And I do know that for myself. But they come from that perspective and tell me that means so little to me. If it were another physician to come to me and say, hey, we need we all need to get our charts done on time. Sure, I totally understand that, but I have, I don't want to say it that way.
00:15:00:22 - 00:15:04:19
Dr. Jon Nichol
I was going to say I have very low respect for all hospital CEOs.
00:15:04:21 - 00:15:05:19
Dr. Anthony Giuffrida
Well, well, I think
00:15:05:19 - 00:15:06:06
Dr. Jon Nichol
I don't
00:15:06:06 - 00:15:21:20
Dr. Anthony Giuffrida
I get that, but we're not I think you don't have enough respect for the hospital CEOs is you have more respect for the people that have gone to what I call the fraternity of medical school residency. And you'd like to see one of those people in charge overseeing what's going on with the physicians.
00:15:21:22 - 00:15:23:09
Dr. Anthony Giuffrida
I think we all would.
00:15:23:11 - 00:15:30:00
Dr. Jon Nichol
Yeah, I think that's a key. I don't know that that necessarily solves the problem, but
00:15:30:02 - 00:15:31:17
Justin Nabity
It’s big step forward
00:15:31:19 - 00:15:36:14
Dr. Jon Nichol
it would be and I think for physicians well-being, I think it would make a huge difference.
00:15:36:16 - 00:16:08:20
Reid Lancaster
Okay. Think about if you if you think about every single professional sport and you look at the amount of coaches who, have never played the sport themselves, you will see that that number is close to zero. Yeah, yeah. Health care today, administration is 95% business people and 5% medical professionals. That is absolutely insane. And if that number can be flip flopped in some fashion, and I'm not even saying flip it to 95 five the other way, I'm saying something like 5050,
00:16:08:22 - 00:16:09:19
Justin Nabity
Let's go there.
00:16:09:21 - 00:16:34:00
Reid Lancaster
5050 would be a gigantic change. And so, Jon, you said something that I think is really, really, really important where maybe patients would be like, well, that doctor won't take the advice of someone who is doing their job. No, no, no. Here's the thing. It's this is how I think about it. It's like a guy who just got done, guy or gal who just got done, fighting a battle in a different country, a war, a war.
00:16:34:02 - 00:16:55:20
Reid Lancaster
And they have a very difficult time talking to anybody else about it besides the people they were in the war with. That is exactly what you're saying. That's the only thing that you're saying. And there's just a level of understanding that people who don't go to war won't ever understand what it's like to go to war. So it's a waste of my time to talk to them about it.
00:16:55:22 - 00:17:13:08
Reid Lancaster
And, and we have to respect that, the reverence for that alone, right there has been lost. And so that the main rub now is you have all these other corporations getting in between you and the patient. And that's why health care is money.
00:17:13:10 - 00:17:17:06
Justin Nabity
20 tentacles coming in on each patient, like, come on.
00:17:17:06 - 00:17:22:13
Dr. Anthony Giuffrida
Yeah I think, I think Jon, you made some really good points and said them extremely well.
00:17:22:13 - 00:17:24:21
Dr. Anthony Giuffrida
And honestly in 15.
00:17:24:21 - 00:17:52:10
Dr. Anthony Giuffrida
Minutes here you've you've described the problem and even even we know what the fixes are. Let let the physicians have more control. Not all control. We don't want all control. But let us have more control of the patient's outcomes. The day to day life of the physicians, what goes on in the hospital. And you still have the CFO there who's a business guy to make sure we don't go off the rails with money, spending and all that, but make it make it more of a collaboration instead of our up down approach.
00:17:52:12 - 00:18:16:06
Reid Lancaster
I'll end with this. You know who should be most excited about that focus and that direction? The patient. Not the physician. Not even the physician, the patient. Now the doctor who's going to come save my life is thinking about me and me alone. That's it. What would health care be like if that was it. Jon Nichol fantastic 15 to 20 minutes man.
00:18:16:07 - 00:18:30:13
Reid Lancaster
Thank you so much. We appreciate your time. You literally just got done with the night shift and jumped on. And these are the kind of people at Doc Nation. We here have a reverence for you and a respect for you. Go get some sleep man. Don't go. Run. Don't go. Train 15.
00:18:30:15 - 00:18:31:04
Reid Lancaster
Miles.
00:18:31:06 - 00:18:32:08
Reid Lancaster
Go get some rest.
00:18:32:10 - 00:18:33:00
Reid Lancaster
Thank you so much.
00:18:33:02 - 00:18:34:03
Dr. Jon Nichol
Not now. Maybe later.
00:18:34:05 - 00:18:34:13
Justin Nabity
All right.
00:18:34:14 - 00:18:35:20
Dr. Anthony Giuffrida
Thank you. John.
00:18:35:22 - 00:18:36:06
Reid Lancaster
Have a great
00:18:36:06 - 00:18:36:20
Reid Lancaster
night, Jon
00:18:37:01 - 00:18:38:18
Reid Lancaster
Thanks, buddy. Bye bye.
00:18:38:20 - 00:18:41:11
Dr. Jon Nichol
Later.
00:18:41:13 - 00:18:58:08
Justin Nabity
This has been the Doc Nation podcast. If you like what you heard, be sure to subscribe, rate and leave us a review on Apple Podcasts, Spotify, or wherever you are listening to us. Your feedback really helps us reach more listeners like you. We'd also love to hear your thoughts and any topics you'd like us to cover in future episodes.
00:18:58:14 - 00:19:06:17
Justin Nabity
Don't forget to follow us on Facebook, Instagram, and LinkedIn for updates, behind the scenes content, and join the conversation. Thanks for listening and.