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How Standardized Patients Work · Stuff You Should Know

0:00
Speaker 1: Hey, everybody, it's us Josh and Chuck, and we want
0:03
Speaker 1: you to know we are coming somewhere near you. We're
0:06
Speaker 1: sure if you live in North America this year, that's right,
0:10
Speaker 1: We're going on tour, and uh, why don't we just
0:12
Speaker 1: rattle through these dates? Okay? Uh? Toronto August eight at
0:16
Speaker 1: the Dan and Fourth Music Hall, Chicago August nine, the
0:19
Speaker 1: next day at Harris Theater. Then we are taking some
0:22
Speaker 1: time off to recover after that two day grind. We're
0:25
Speaker 1: eating Vancouver the Vogue Theater September twenty six, followed by Minneapolis.
0:30
Speaker 1: We're gonna be at the Pantageous Theater again on September
0:34
Speaker 1: that is correct, yep. And then Austin Chuck on October
0:37
Speaker 1: tenth of the Paramount Theater, Yes, and very special show
0:42
Speaker 1: and Lawrence Kansas at Liberty Hall on October eleven, yep.
0:45
Speaker 1: And then we're gonna do a three night stand October
0:48
Speaker 1: two at the Bellhouse in Brooklyn, New York. And then Chuck,
0:53
Speaker 1: take it home. Uh, well take it home literally, because
0:56
Speaker 1: we are finishing up November four right here in Atlanta
0:59
Speaker 1: at the Bucket Theater and this is a very special
1:02
Speaker 1: benefit show. Uh, and all the Proceeds will be going
1:05
Speaker 1: to Lifeline Animal Project of Atlanta and the National Down
1:09
Speaker 1: Syndrome Society YEP. And for more information in DWO buy tickets,
1:13
Speaker 1: just go to s Y s K live dot com.
1:17
Speaker 1: Welcome to stuff you should know. I'm from House Stuff
1:20
Speaker 1: Works dot com. Hey, welcome to the podcast. Blame is
1:30
Speaker 1: Josh Clark, and I'm proud to introduce my partner co
1:34
Speaker 1: hosting Crime, one of those two Mr Charles W. Chuck
1:39
Speaker 1: Wayne Chuck Tran Bryant Chuck Tran yep. And this week, Chuck,
1:45
Speaker 1: we have a very special guest producer filling out the seats.
1:49
Speaker 1: Right is the rump of Noel around. Yeah, Jerry's she's
1:56
Speaker 1: at the beach because she needs a vacation. I'm good, guys. Yeah,
2:02
Speaker 1: Jerry's romping at the beach with her wife and her
2:05
Speaker 1: daughter and a bunch of friends. And you know, I
2:09
Speaker 1: think that sounds lovely. Well, yeah, the beach rocks. Even
2:17
Speaker 1: Miley Cyrus likes the beach. Now, I don't get it.
2:20
Speaker 1: She's got this new single out about how her boyfriend
2:23
Speaker 1: introduced her to the beach. Is pretty sweet song. Actually,
2:25
Speaker 1: you know this stuff? I just I my my wife
2:29
Speaker 1: produces me to think sometimes each otherwise would never ever
2:33
Speaker 1: have come across like, I can pick on you for that,
2:35
Speaker 1: but I would never pick on you me for that.
2:37
Speaker 1: You know, what, are you a monster? You know? Pick
2:40
Speaker 1: on a man's wife? Right? So, yeah, it is a cute, cute,
2:44
Speaker 1: sweet song. Though I can I can give it a
2:47
Speaker 1: hearty endorsement. Emily has her little secrets to from even me.
2:50
Speaker 1: She's she singing this song the other day that was
2:52
Speaker 1: on some TV show. I was like, how do you
2:55
Speaker 1: know this? I've never heard the song, and she said, no,
2:59
Speaker 1: you know it's a song. I know what song. I
3:01
Speaker 1: don't even know what it was. It was just some
3:03
Speaker 1: kind of bubblegum poppy thing you don't and that's kind
3:06
Speaker 1: of not her. But you never you never know, you know,
3:09
Speaker 1: I might have a fromer boyfriend, s Todd Todd Hodds
3:16
Speaker 1: into bubblegum pop. He's a jerk, he's got frosted tips
3:19
Speaker 1: on his hair, he's got a severe embre. So which
3:26
Speaker 1: one are we doing? We're gonna do standardized patients and um,
3:30
Speaker 1: it's funny. The the thought occurred to me to go
3:33
Speaker 1: through this entire episode without mentioning sein felt at all,
3:37
Speaker 1: just to make people really angry. Man. We would have
3:40
Speaker 1: gotten so many emails though. But that's kind of like
3:43
Speaker 1: you can't not mention the very famous Seinfeld episode where
3:48
Speaker 1: Kramer and uh, who's the other guy, Mickey? Oh? Yeah,
3:53
Speaker 1: I forgot Mickey was one too. Was that his name? Yeah,
3:55
Speaker 1: it's his friend who was a little person. Yeah, and
3:58
Speaker 1: they they were. I think Mickey got him into it,
4:01
Speaker 1: and they were they were And I didn't even know
4:03
Speaker 1: they were called standardized patients. I doubt if they said
4:05
Speaker 1: that on the episode. I don't remember what they called them.
4:08
Speaker 1: They surely they call them something. Well, they have a
4:12
Speaker 1: few names, simulated patients, standardized patients, care actors. Well, there,
4:17
Speaker 1: those are. Some of those are different. They're they're generally
4:19
Speaker 1: the under the umbrella of say like a simulized or
4:23
Speaker 1: stand simulated patient, but they're slightly there's little nuances there
4:27
Speaker 1: that that make the whole thing revolting, lee fascinating. Programmed
4:32
Speaker 1: patients and that what the first guy called it. Yeah. Man,
4:34
Speaker 1: if that's not like a brain doctor's name for it,
4:37
Speaker 1: then I don't know what. Uh, well, should we start there. Yeah,
4:42
Speaker 1: let's go back to that guy, a doctor named Howard Barrow.
4:45
Speaker 1: He worked out at USC Ego Trojans and he was
4:48
Speaker 1: teaching back in the early sixties, late fifties, I believe,
4:53
Speaker 1: and apparently at the time, Chuck, they would just teach
4:56
Speaker 1: you everything and then say, okay, you've graduated, your going
5:00
Speaker 1: goodbye to practice medicine. Good luck with a live human exactly,
5:04
Speaker 1: you've never encountered one throughout your entire training, but you're
5:09
Speaker 1: a doctor now, so we we wash our hands of you. Right.
5:13
Speaker 1: And so this guy was teaching neurology and realized, like
5:18
Speaker 1: I think he had a friend who had come to
5:21
Speaker 1: to start like observing his graduates in a clinical setting,
5:26
Speaker 1: but like after they graduated and we're practicing doctors and
5:29
Speaker 1: we were like whoa, well, whoa, you guys are doing
5:31
Speaker 1: this all wrong. Who taught you this? And like you did?
5:36
Speaker 1: And uh, He's like, all right, well, we gotta do
5:38
Speaker 1: something different. So that doctor figured out that he could
5:41
Speaker 1: sit down and go through basically observe a doctor doing
5:46
Speaker 1: an entire patient history and exam and everything. But each
5:50
Speaker 1: one took like two to three hours, and they're like,
5:52
Speaker 1: there's gotta be a better way to do this. So
5:55
Speaker 1: Barrows was it was his idea, and his idea alone.
5:59
Speaker 1: Right from what I understand I saw, I came across
6:02
Speaker 1: another doctor, a woman pediatrician, woman named Paula's Stillman, who
6:09
Speaker 1: came up with this idea also seemingly independently in the
6:12
Speaker 1: early seventies. Um, because it didn't catch on big time
6:16
Speaker 1: in the eighties. So I think she am Barrow are
6:19
Speaker 1: kind of like the earliest practitioners of this thing. Well,
6:22
Speaker 1: it wasn't a big hit at first, Like people kind
6:25
Speaker 1: of made fun of them, uh. I know in this
6:27
Speaker 1: one article you found they there were newspaper articles, one
6:31
Speaker 1: in the l A Herald Examiner that had a headline
6:33
Speaker 1: that said Hollywood invades USC Medical School. Uh. In in
6:38
Speaker 1: the San Francisco Chronicle, of all places, they said scantily
6:41
Speaker 1: clad models were making life a little more interesting for
6:45
Speaker 1: the USC medical students, which is really I mean, I
6:49
Speaker 1: guess it's a sign of the times, but really kind
6:52
Speaker 1: of a crappy way too. You know, they made it
6:55
Speaker 1: sound like it was some titilating sexual thing, right, because
6:59
Speaker 1: you know, they had these people that are really doing
7:03
Speaker 1: what you know, what I learned was a super valuable service. Well, yeah,
7:07
Speaker 1: for sure, I think they were just trying to sex
7:10
Speaker 1: it up for the paper. You know what I mean,
7:13
Speaker 1: they're reading audience because they were like Zodiac Killer coming soon,
7:16
Speaker 1: what's that stay tuned? But he wasn't around yet, so
7:21
Speaker 1: they had to do something. So they were just trying
7:23
Speaker 1: to take something that was actually, yeah, a valuable service
7:25
Speaker 1: and pretty straightforward and again sex it up a little bit,
7:30
Speaker 1: but it actually it kept it from catching on for
7:33
Speaker 1: a while, at least at first. It wasn't until I
7:35
Speaker 1: think the mid eighties that Barrow was able to like
7:38
Speaker 1: get it to start to become adopted throughout the the
7:43
Speaker 1: the medical universe and the United States at least. Yeah,
7:46
Speaker 1: and you know what, we've done that thing again. Yeah,
7:49
Speaker 1: I know where we haven't said what it is yet.
7:53
Speaker 1: You had to have seen Seinfeld and know how to
7:56
Speaker 1: read between the lines of our conversation. Yeah. So a
7:59
Speaker 1: simulated patient or a standardized patient is um Sometimes you're
8:03
Speaker 1: an actor. Sometimes they have no acting experience. Sometimes it
8:07
Speaker 1: we'll get to who these people are, but they're generally
8:10
Speaker 1: people looking to make a buck, who are who fit
8:12
Speaker 1: the profile and of being a fake patient to a
8:18
Speaker 1: medical student so they can get a real practical human
8:22
Speaker 1: to human experience in medical school exactly because there's a
8:28
Speaker 1: big difference between book learning in real life, right, and
8:32
Speaker 1: if you're a doctor, a huge, huge part of your UM,
8:37
Speaker 1: your job, especially UM non surgical doctrine is conversing with
8:44
Speaker 1: a human being patient and and on the one hand,
8:49
Speaker 1: treating them as a human being, not a set of symptoms.
8:52
Speaker 1: That's a big one. But then also um, getting out
8:56
Speaker 1: of them what's wrong with them so that you can
8:59
Speaker 1: diagnose them. Yeah, that's I thought this was all sort
9:03
Speaker 1: of just about bedside manner and like being you know,
9:06
Speaker 1: because it's a big part of the job. You know,
9:08
Speaker 1: you want a doctor. If you've ever had a doctor
9:11
Speaker 1: that had a poor bedside manner, you know what I'm
9:13
Speaker 1: talking about. UM, If you haven't, then you might take
9:16
Speaker 1: it for granted that everyone's like that, but that's not
9:18
Speaker 1: the case. But the second part of that I didn't
9:20
Speaker 1: really think about. But um. The director of the Standardized
9:23
Speaker 1: Patient Program at University of Pittsburgh School of Medicine, Valerie Former,
9:28
Speaker 1: who they don't know if they interviewed her for this
9:30
Speaker 1: or if she was just they pulled some quotes, but
9:33
Speaker 1: I never really thought about it. She said, communication is
9:35
Speaker 1: at the root of proper diagnosis, patient safety, and patient
9:39
Speaker 1: satisfaction and miscommunication can lead to medical error, so they
9:42
Speaker 1: have to A big part of the job is drawing
9:45
Speaker 1: out of the patient what the heck is wrong with them,
9:47
Speaker 1: because they can examin until the cows come home, but
9:50
Speaker 1: they need words, right, So like, yeah, patient who comes
9:54
Speaker 1: into the doctor's officer, that e er isn't gonna be like, um,
9:57
Speaker 1: I have an abscess on my right kid. Need that
10:00
Speaker 1: needs to be treated or else I'm gonna die of
10:03
Speaker 1: sepsis in the next twelve hours. Is my my my
10:06
Speaker 1: side hurts, That's what you get. So you have to
10:09
Speaker 1: ask more questions and know what questions to ask. So yeah,
10:12
Speaker 1: it's it's diagnosis, learning how to diagnose from talking to
10:15
Speaker 1: people in drawing info out of them. But that bedside
10:18
Speaker 1: manner that's not to be overlooked, Like that's a big
10:21
Speaker 1: part of it because you know, if if people start
10:24
Speaker 1: to think every doctor I've ever interacted with treated me
10:28
Speaker 1: like I was just a bag of organs and bones,
10:30
Speaker 1: which we couldn't couldn't sure, and couldn't care. But you're
10:33
Speaker 1: not supposed to to let on that every like we
10:37
Speaker 1: all have to pretend in this big grand manner, right exactly,
10:41
Speaker 1: And but it will keep you from going to the doctor.
10:44
Speaker 1: And if you stop going to the doctor, and then
10:46
Speaker 1: health problems can can start to accumulate, and it's all
10:49
Speaker 1: the doctor's fault for being a sociopathic jerk. Well yeah,
10:53
Speaker 1: but you also you know in that um which one
10:56
Speaker 1: were we talking about doctors being too empathetic? The empathy one?
11:01
Speaker 1: Oh yeah, okay, there you have it. You didn't want
11:04
Speaker 1: to dr fell to pieces. No, you you need to
11:06
Speaker 1: learn to walk that fine line between being too clinical
11:09
Speaker 1: and too much of an EmPATH to where the patient
11:13
Speaker 1: feels eddies and taking care of but you feel confident
11:16
Speaker 1: and they're not like breaking down and crying because they
11:20
Speaker 1: have to tell you that you may be dying. Let's say. Yeah,
11:23
Speaker 1: but the the lady from the University of Pittsburgh who
11:26
Speaker 1: was interviewed in this article points out that there was
11:29
Speaker 1: she she remembered at least one medical student who did
11:32
Speaker 1: break down because of an interaction with a simulated patient
11:37
Speaker 1: or standardized patient. UM and that that that that's the
11:42
Speaker 1: point of a similizer or simulated or standardized patient is
11:46
Speaker 1: so that you can go ahead and break down like
11:48
Speaker 1: that and get it out UM In in a basically
11:52
Speaker 1: a classroom setting, so that when you encounter this in
11:55
Speaker 1: the real world, you'll have already gone through that. Yeah,
11:58
Speaker 1: and um, we'll get into the nuts and bolts of
12:01
Speaker 1: it in a bit. But um, if you're wondering if
12:05
Speaker 1: you want to go do this, if you have to,
12:07
Speaker 1: like you know, get a prostate exam. Um, you don't
12:11
Speaker 1: have to, but if you're if you're open to that
12:13
Speaker 1: kind of your intention, you can sign up for a
12:17
Speaker 1: more intense uh and I imagine those are the ones
12:20
Speaker 1: that pay a little bit better. But you can go
12:23
Speaker 1: in and volunteer for a prostate exam or or or
12:25
Speaker 1: breast exam or anything that involves something a little more
12:30
Speaker 1: uh um invasive. Yeah, but you're not gonna get cut
12:34
Speaker 1: or you're not gonna get a needled or anything like that.
12:37
Speaker 1: They're not going to practice that kind of stuff on you. Right.
12:40
Speaker 1: I was reading the f a Q on the University
12:42
Speaker 1: of Pittsburgh site about their um simulated patients, and they
12:46
Speaker 1: point out that patients simulated patients will not be given drugs. Yeah,
12:51
Speaker 1: then that can inject you with like a cocktail of
12:53
Speaker 1: antipsychotics and stimulation, and this may be a good way
12:57
Speaker 1: to score, right, But it's on you, is the simulated
13:01
Speaker 1: patient to um to act as if you're um going
13:06
Speaker 1: through a psychotic break right there. Yeah, potentially so that
13:09
Speaker 1: the doctor can learn how to deal with that kind
13:11
Speaker 1: of thing. That's probably one of the more dramatic examples.
13:14
Speaker 1: I think a lot of them are a lot more pedestrian,
13:17
Speaker 1: but that is definitely in the mix as well. Well.
13:20
Speaker 1: Even though you're as we'll see, it's you sort of, Um,
13:24
Speaker 1: it's not scripted. You do have to be an improviser
13:27
Speaker 1: of sorts, but you're supposed to stick to kind of
13:30
Speaker 1: I don't think you're supposed to throw them any just
13:32
Speaker 1: curveballs that you think of in the moment, uh, which
13:36
Speaker 1: is what I would want to do, which is probably
13:38
Speaker 1: I would not be a good sp That's what Kramer did. Yeah,
13:42
Speaker 1: he he could have made it into like a real
13:44
Speaker 1: acting gig, right right. And they say that actors can
13:48
Speaker 1: be good at this, but it's not acting, like they
13:52
Speaker 1: point out that, Um, there's no you're not searching for
13:56
Speaker 1: moments of drama. You're not there to entertain. You know,
14:00
Speaker 1: they're playing. You're not playing to the audience. So yeah,
14:04
Speaker 1: it could be helpful to learn, say, um, I don't know.
14:07
Speaker 1: Would it be character acting or method acting in this one?
14:10
Speaker 1: Mm hmmm, probably method acting. So it would be useful
14:14
Speaker 1: to learn some nuts and bolts of of that, just
14:17
Speaker 1: practice and rehearse that type of acting. But you're not gonna, like,
14:22
Speaker 1: you're not gonna go get your big break or something
14:24
Speaker 1: doing this. That's not the point of it. Now. I
14:26
Speaker 1: think I would, Uh, I would try and fart a
14:29
Speaker 1: lot or something, just something very subtle. That'd be your
14:33
Speaker 1: your trademark because yeah, that would be in the in
14:37
Speaker 1: the in the lounge. Afterward they'd all be like, did
14:39
Speaker 1: you get the kind I think he was farting? Right?
14:43
Speaker 1: Was that on purpose? Or that'd be your standardized patient card.
14:47
Speaker 1: It's say, Charles W. Chuck Bryant ask about my trademark
14:51
Speaker 1: arts on command? Uh, all right, that was dumb. So
14:54
Speaker 1: we should take a break. Yeah, so I can get
14:56
Speaker 1: it together. Okay, So Chuck, let's get down into the
15:21
Speaker 1: nuts and bolts. So the nitty gritty a little bit, right.
15:23
Speaker 1: So I said earlier that all of this kind of
15:26
Speaker 1: falls under the umbrella of a standardized or a simulated
15:31
Speaker 1: patient um and then underneath that umbrella, which we've kind
15:36
Speaker 1: of been using interchangeably, but really shouldn't UM. Is the
15:39
Speaker 1: standardized patient is largely what we're talking about, and I
15:43
Speaker 1: think synonymous with the standardized patient and is the programmed patient.
15:48
Speaker 1: That first UM the first term that George Barrow used
15:52
Speaker 1: for right. And the reason that it's called standardized or
15:55
Speaker 1: programmed is because it's like you said, there isn't a script,
15:58
Speaker 1: like you don't memorize the script of the doctor says
16:00
Speaker 1: this and then you say that, but you do have
16:03
Speaker 1: like a You are given a specific set of criteria
16:07
Speaker 1: and it can be really detailed as well, and you're
16:10
Speaker 1: expected to stick to that role, that character. You take
16:14
Speaker 1: on a character, and your character is sick, your character
16:17
Speaker 1: as a backstory, there's um certain things that your character
16:20
Speaker 1: is capable of doing and incapable of doing because of
16:24
Speaker 1: the medical condition, maybe because of a prior medical history. UM.
16:29
Speaker 1: And then you go in there and you remain in
16:33
Speaker 1: this character and you do it virtually the same way
16:37
Speaker 1: as close to the same as possible for student doctor
16:41
Speaker 1: after student doctor actor student doctor usually up to about
16:45
Speaker 1: ten in a day, and they each student doctor is
16:49
Speaker 1: supposed to get the same experience from you. And the
16:52
Speaker 1: reason why they wanted that standard is because they're being
16:54
Speaker 1: graded on this, they're being tested on this. It's it's
16:57
Speaker 1: um the closest thing to sign a typically reproducible that's
17:02
Speaker 1: something as objective as bedside manner could be made into.
17:06
Speaker 1: That's the point of standardized patients specifically. Yeah, and you've
17:10
Speaker 1: um the case that you've gotten. It's either uh, something
17:13
Speaker 1: that's just made up, like hey, we need somebody that
17:16
Speaker 1: has an uh maybe a rupture dependix or whatever. That's
17:20
Speaker 1: kind of a run run of the meal, uh meal,
17:23
Speaker 1: run of the breakfast, run of the mill situation. But
17:28
Speaker 1: sometimes it's an actual case, like a real case UM
17:33
Speaker 1: that they base it on, Like someone has actually experienced this,
17:37
Speaker 1: it's been recorded, and they have this case study and
17:40
Speaker 1: they want the doctor to go through this very specific thing, uh,
17:43
Speaker 1: and in that case they want to really replicate that
17:46
Speaker 1: right down to like the age, gender, and ethnicity of
17:51
Speaker 1: that actual patient that had that actual case to begin with,
17:54
Speaker 1: right exactly. I think George Barrow, the guy who came
17:57
Speaker 1: up with us in the sixties, he based his first
18:00
Speaker 1: UM standardized patient on an actual case that he handled
18:03
Speaker 1: because he knew exactly how it presented, UM, exactly what
18:07
Speaker 1: the medical history was so and it was something that
18:10
Speaker 1: he felt could be reproduced pretty easily again and again. UM.
18:14
Speaker 1: And there's this really interesting essay that was running The Believer,
18:18
Speaker 1: but I think it made it into a collection UM
18:21
Speaker 1: in the Writer's book by a writer named Leslie Jamison,
18:26
Speaker 1: and the name of the essay is the Empathy Exams.
18:29
Speaker 1: It's about her UM experience as a standardized patient. It's
18:34
Speaker 1: really really interesting just how she's really investigating the character
18:39
Speaker 1: that she's given. Like, I think her her main characters
18:43
Speaker 1: Scott more than one UM, but her main winner, the
18:46
Speaker 1: one that she seems most attached to, her brother like
18:49
Speaker 1: drowned in after tailgating at a football game and then
18:53
Speaker 1: jumping into a river and he drowned years back, and Um,
18:57
Speaker 1: she's like still green being over the loss of her
19:01
Speaker 1: brother and it's led to seizures, but she doesn't even
19:07
Speaker 1: she the character doesn't know that these seizures are basically
19:10
Speaker 1: coming out of grief. So it's for the doctors to
19:14
Speaker 1: suss out. And that's just one of at least a
19:17
Speaker 1: couple um it's standardized patients that she's played. But it's
19:20
Speaker 1: really interesting. It's a great, great essay. Well, yeah, in
19:23
Speaker 1: them in this article that you dug up. It said
19:26
Speaker 1: that one of the there are a lot of reasons
19:28
Speaker 1: someone might want to do this, but one of them
19:30
Speaker 1: can certainly be that they had like a family member
19:33
Speaker 1: that died of a certain disease or maybe was misdiagnosed
19:37
Speaker 1: st even so they feel like this is like something
19:40
Speaker 1: they can do to kind of help out, uh that
19:43
Speaker 1: kind of research or whatever, you know, right, I ran
19:45
Speaker 1: across though, that one of the pitfalls of UM standardized
19:49
Speaker 1: patients is that the people who do it, they can
19:52
Speaker 1: have a hidden agenda sometimes and it may be as
19:55
Speaker 1: benign as yet, my brother was misdiagnosed, and I want
19:58
Speaker 1: to make sure that doesn't happen to anybody else or UM,
20:02
Speaker 1: it can be some I ran across in this comment
20:05
Speaker 1: section on a biomedical blog about some doctors, said that
20:10
Speaker 1: while he was in training, he came across a standardized
20:12
Speaker 1: patient who was sure to list all of the herbal
20:15
Speaker 1: medications that she was taking right then and then she
20:19
Speaker 1: later said that it was because she wanted to make
20:21
Speaker 1: sure that these medical students were made aware of alternative
20:24
Speaker 1: medicine as well, So she had like a specific hidden
20:28
Speaker 1: agenda that she wanted to get across to these med
20:31
Speaker 1: students without going to the trouble of going to med
20:34
Speaker 1: school herself and becoming a doctor teacher. We just kind
20:37
Speaker 1: of came in under the radar basically, and apparently they
20:41
Speaker 1: try to root people like that out because it's not
20:43
Speaker 1: the point of the whole thing. But it's kind of
20:45
Speaker 1: funny how they slipped in there. Sometimes. Yeah, and you know,
20:50
Speaker 1: you're in character unless you're doing and we'll talk about
20:53
Speaker 1: this later, but that one thing that you found and
20:56
Speaker 1: sent me is that seemed like a little bit of
20:58
Speaker 1: a different process where they might have a really specific
21:01
Speaker 1: goal in mind where you kind of do almost like
21:05
Speaker 1: play acting back and forth with the student doctor. But generally, uh,
21:10
Speaker 1: they're trying to diagnose you. So you walk in the
21:13
Speaker 1: room and you're in character. So if you've got kidney
21:17
Speaker 1: pain or bad back or a limp or whatever, then
21:21
Speaker 1: you don't walk in and say all right, let's get
21:22
Speaker 1: started and then go oh like they try to make
21:25
Speaker 1: it as real as possible. You walk in there in
21:27
Speaker 1: character with you know, holding your side or or whatever
21:31
Speaker 1: your ailment is. You don't you know, run your face
21:35
Speaker 1: over your hand over your face over smiling, like frowning
21:39
Speaker 1: to get in character. No, you don't do that. No,
21:41
Speaker 1: And apparently I've seen that if standardized patients really good,
21:46
Speaker 1: they'll be basically indistinguishable from some of the patients that
21:49
Speaker 1: the the doctor will eventually run into and their clinical practice. Right, Yeah,
21:54
Speaker 1: I mean it's it's tough, man, because you have to
21:57
Speaker 1: I mean, if you're not an actor, you might be
22:00
Speaker 1: have a talent you didn't know you had if you're
22:01
Speaker 1: good at this, because you have to memorize and internalize
22:06
Speaker 1: and study all this stuff, because you have to be
22:10
Speaker 1: just as real as someone who is experiencing something, and
22:13
Speaker 1: like that's that's the best. Like you, you would be
22:17
Speaker 1: the best actor if you literally become that person that
22:20
Speaker 1: you're playing. And that's kind of what you have to
22:22
Speaker 1: do for this, right you know what I'm saying, Like
22:25
Speaker 1: these people, if they are an actors, they might want
22:27
Speaker 1: to look into it, sure if they're good at it. Yeah,
22:31
Speaker 1: So let's talk about that. So acting is not being
22:34
Speaker 1: an actor is not a prerequisite for this, right, Um.
22:37
Speaker 1: But you could be an actor and be good at it.
22:39
Speaker 1: You could be an actor and become very quickly frustrated
22:41
Speaker 1: by the whole thing because it's not acting necessarily it's
22:44
Speaker 1: very specific type of acting, right, it's literally medical acting.
22:48
Speaker 1: But just that's not enough. You need to apparently be
22:53
Speaker 1: ceaselessly upbeat, endlessly upbeat. And the reason why is because
22:58
Speaker 1: you're going through this thing, say up to ten times
23:01
Speaker 1: in a row. And these things last, from what I saw,
23:04
Speaker 1: about forty five minutes. So you're doing this for forty
23:07
Speaker 1: five minutes, half an hour or two an hour in
23:10
Speaker 1: the in the waiting room beforehand exactly filling out forms. Yeah,
23:14
Speaker 1: because you gotta get angry before you go in there.
23:16
Speaker 1: Some guys like coughing along up next to you and
23:18
Speaker 1: it's like, oh, I'm no continued, just um. It drives
23:22
Speaker 1: me crazy when people are like, I'm not contagious. It's
23:24
Speaker 1: like you don't know, you have no idea whether you're
23:27
Speaker 1: contagious or not. Um. But so you have to do
23:31
Speaker 1: this maybe ten times in a row. It's about forty
23:34
Speaker 1: five minutes per from what I saw, and that that
23:37
Speaker 1: tenth one needs to be as great a performance as
23:39
Speaker 1: that first one because those are two different medical students.
23:43
Speaker 1: There's ten different medical students seeing you, and each one
23:46
Speaker 1: needs to get your best because, as far as they're concerned,
23:50
Speaker 1: this is their training. They're not looking at your day,
23:54
Speaker 1: you know, like, oh, I'm one of ten. It's this
23:56
Speaker 1: is my this is my big, my big test, or
23:58
Speaker 1: my big training. So you need to give each one
24:01
Speaker 1: you're you're you're all in that sense, you have to
24:04
Speaker 1: have a lot of energy, a lot of spunk, a
24:06
Speaker 1: lot of positivity. Um. And then you also have to
24:08
Speaker 1: be very comfortable dealing with medical professionals, which is not
24:14
Speaker 1: necessarily always the easiest bunch to deal with from what
24:17
Speaker 1: I understand. Well, no, I mean if you have a
24:19
Speaker 1: phobia of doctors, then this is not the gig for you. Sure,
24:23
Speaker 1: And I think if you are easily crushed by pushy,
24:27
Speaker 1: um arrogant people, it might not be the best gig
24:30
Speaker 1: for you either. But doctors can beat ted arrogant sometimes.
24:35
Speaker 1: I mean we all saw Malice. I don't think I
24:39
Speaker 1: saw that. Yeah you did. When Alec Baldwin is like,
24:42
Speaker 1: do I have a God complex? I don't have a
24:44
Speaker 1: God complex. I am God. I just thought that was
24:48
Speaker 1: Alec Baldwin, like probably what you tweeted it, right? Uh, No,
24:55
Speaker 1: I never did see that. Actually I remember the movie though, Um, yeah,
24:59
Speaker 1: it was good eighties of late eighties movie. But but yeah,
25:02
Speaker 1: So you can't just be like a wilting flower when
25:04
Speaker 1: a med student gets all mad or pushy or whatever.
25:07
Speaker 1: And you also have to be the type who could
25:10
Speaker 1: conceivably take charge and can take control if if a
25:14
Speaker 1: med student is doing that and UM kind of maybe
25:18
Speaker 1: guide them back a little bit toward where they should be,
25:21
Speaker 1: or at the very least being willing to give them
25:23
Speaker 1: feedback to their face about how they just royally screwed
25:27
Speaker 1: this whole thing up because they're over aggressive or because
25:30
Speaker 1: they were um under assertive. Who knows you, I think
25:34
Speaker 1: you run into all of that stuff, and you have
25:36
Speaker 1: to be prepared to do this. So that brings up
25:38
Speaker 1: another point too. You have to have a really good
25:41
Speaker 1: memory because it depending on who you ask. A lot
25:45
Speaker 1: of the um simulated patients will also be required to
25:49
Speaker 1: give feedback. Some of them, I got the impression have
25:53
Speaker 1: something to do with like the scoring or grading process
25:56
Speaker 1: as well. So you have to be in care. So
26:00
Speaker 1: you have to have your character's history, symptoms, everything memorized.
26:05
Speaker 1: You have to stay in character. You have to um
26:09
Speaker 1: respond to the doctor's questioning, and then you have to
26:13
Speaker 1: um be paying attention to all the stuff the doctors
26:16
Speaker 1: should be asking all the stuff the doctor is failing
26:19
Speaker 1: to ask, and um, the doctor's just behavior in general,
26:23
Speaker 1: so that you can give accurate feedback afterward, and then
26:26
Speaker 1: you have to do it ten times in a row
26:27
Speaker 1: in a day. Yeah, and this this serves a very
26:30
Speaker 1: specific need, um beyond the obvious that uh, well, there's
26:36
Speaker 1: a few things and then and they're all somewhat obvious,
26:39
Speaker 1: but it bears going over um an experience of of
26:43
Speaker 1: medical students. You don't want them practicing on a real
26:46
Speaker 1: sick person because they if they mess up, that's not good.
26:50
Speaker 1: So having almost like a live uh recessa annie on
26:55
Speaker 1: your hands is good. I had a live or says
27:00
Speaker 1: that any my mom used to bring those homes she
27:02
Speaker 1: used to teach CPR. What would you do with them?
27:06
Speaker 1: I tried to teach and then I learned to kiss.
27:09
Speaker 1: I knew something weird went on. I tried to learn
27:13
Speaker 1: CPR here that I think I've learned it like four
27:15
Speaker 1: or five times in my life. I keep keep forgetting it.
27:18
Speaker 1: So the one thing I do remember is you want
27:20
Speaker 1: to do it to the You want to press the um.
27:25
Speaker 1: Why is it called where you do where you give
27:27
Speaker 1: chess compressions to the beat of staying alive. And then apparently, um,
27:34
Speaker 1: you don't give breathing aid, like you don't pinch their
27:37
Speaker 1: nose and breathe into their mouth for a couple of reasons. One,
27:41
Speaker 1: you're exhaling carbon dioxide directly into their lungs, so that's stupid.
27:45
Speaker 1: And then too, they don't really have a way to
27:47
Speaker 1: expel it. So now they apparently, from what I understand,
27:50
Speaker 1: they just recommend chess compressions until um paramedics arrive. Is
27:56
Speaker 1: that the latest accurate? I don't know. I should probably
27:59
Speaker 1: look at up before we publish this. Yeah, we should
28:02
Speaker 1: say too that we're not trained medical professionals. Now we're
28:04
Speaker 1: not even trained medical actors. And you are now taking
28:08
Speaker 1: life saving advice from a guy who learned to kiss
28:10
Speaker 1: from a lifeless Uh, synthetic. She wasn't lifeless when I
28:15
Speaker 1: was kissing. She went her little curly wigs fun on
28:21
Speaker 1: her head. Uh. All right. So the first thing is inexperience.
28:25
Speaker 1: You don't want a medical student to be messing up
28:27
Speaker 1: on real people. UM. Number two is availability. Uh, they
28:31
Speaker 1: have to teach, they have to run the gamut of
28:33
Speaker 1: medical issues, and you just can't count on having real
28:37
Speaker 1: you know, being able to source real patients with that
28:40
Speaker 1: specific problem. So it's really easy just to teach someone
28:43
Speaker 1: to act like that. Uh. And finally, a real patient,
28:47
Speaker 1: uh isn't supposed to provide feedback constructive feedback for their doctor.
28:53
Speaker 1: I suppose they could. Yeah, even if they could, though
28:55
Speaker 1: they're not necessarily like they're going to be like, again,
28:57
Speaker 1: my kidneys absessed them in a lot of pain, don't
29:00
Speaker 1: really care about your medical career. Just fixed me. Yeah,
29:02
Speaker 1: you can you call seen at the end of this thing.
29:05
Speaker 1: And then they go all right, now, let's like you said,
29:08
Speaker 1: let's talk about it. I'm really not in pain, so
29:11
Speaker 1: I'm fine to have this conversation. Sure, whereas the patient
29:14
Speaker 1: would be like, I'm I gotta go urinate blood real quick.
29:16
Speaker 1: I'll be right back green, I'll give you feedback doctor.
29:20
Speaker 1: So that's a standardized patients right. Yeah, but there's there's
29:24
Speaker 1: plenty of other kinds. Let's take a um, let's take
29:26
Speaker 1: a break, and then we'll come back and talk about those. Okay,
29:51
Speaker 1: one thing before we move on to that I think
29:54
Speaker 1: we mentioned yet, is that, um, speaking of recessa Annie,
29:58
Speaker 1: they have these really expense of surgical dummies. Now they
30:03
Speaker 1: think they actually they call them robots. Uh, and this
30:06
Speaker 1: is how surgeons practice now, um grand to a hundred grand.
30:11
Speaker 1: And I looked them up. These things are amazing and
30:14
Speaker 1: life like. Uh. They breathe and have pulses, and some
30:18
Speaker 1: of them bleed. They know how to love. Some of
30:21
Speaker 1: them give birth birth obviously, but uh, I kind of
30:27
Speaker 1: did wonder, like, how do surgeons even practice these days?
30:29
Speaker 1: I know they probably cut on cadavers in in med school,
30:35
Speaker 1: but that you can only get so far. We've come
30:39
Speaker 1: a long way from the days where med students were
30:41
Speaker 1: forced to rob graves. Now we've got hundred thousand dollars
30:46
Speaker 1: cadillacts of robots ready for surgery. Yeah. I mean they
30:50
Speaker 1: look like I mean, some of them don't have if
30:52
Speaker 1: they don't need it. They don't have legs and arms,
30:55
Speaker 1: but they cover that up just to make it a
30:57
Speaker 1: little more realistic. But they have cuts. And this one
31:01
Speaker 1: dude I saw had like kind of a five o'clock
31:03
Speaker 1: shadow beard. Um. It was creepy and awesome that they
31:08
Speaker 1: have this stuff that's so lifelike. Oh man. So I
31:11
Speaker 1: was on Twitter the other day shout out Twitter, um,
31:15
Speaker 1: and Atlas Obscura had this um tweet where they were
31:19
Speaker 1: They had a picture of this. It was a decapitated
31:22
Speaker 1: serial killer whose head was pickled in a jar from
31:27
Speaker 1: I think a teaching hospital and I believe Portugal, possibly Spain.
31:31
Speaker 1: I think it was Portugal. It was Portugal, is like
31:33
Speaker 1: first serial killer and um, they had his head pickled
31:37
Speaker 1: and it was from eighteen forty when he was executed.
31:40
Speaker 1: And man, it looks like he was from the seventies maybe,
31:44
Speaker 1: like it's just so I mean, lifelike. Still it was
31:48
Speaker 1: completely undegraded and just creepy. And his eyes are wide open,
31:53
Speaker 1: just kind of like his mouth is a little slack,
31:54
Speaker 1: but he looks like he could be thinking about something
31:57
Speaker 1: rather than being headless. Well that's where the old race from.
32:00
Speaker 1: A pickled head never loses its looks right. There's a
32:04
Speaker 1: T shirt all right. So if you're a recruiter, uh,
32:08
Speaker 1: let's say at the University of Pittsburgh, UM, and you're
32:11
Speaker 1: trying to find these people and source them, you're gonna
32:14
Speaker 1: be very picky, um because it's a it's a big deal.
32:19
Speaker 1: It's it's not like a fly by night job like
32:22
Speaker 1: this is something that medical students take very seriously. Uh,
32:28
Speaker 1: you have to be intuitive. Um, like you said, you
32:31
Speaker 1: had to weed through people that you might think have
32:33
Speaker 1: some other sort of weird motive. Uh, but you know
32:38
Speaker 1: you're gonna have to weed through a lot of people
32:40
Speaker 1: because you know, this is also the kind of thing
32:42
Speaker 1: where you can make twenty hour so, um, you also
32:47
Speaker 1: want to I mean, obviously people want to get paid,
32:49
Speaker 1: but their motives have to be more than just money,
32:53
Speaker 1: I think. Well, yeah, I mean it's it's tricky too
32:56
Speaker 1: because you you um expect you know how I caliber
33:00
Speaker 1: of commitment and and um skill from your your pay
33:05
Speaker 1: your teachers or your special standardized patients, right, yeah, and
33:09
Speaker 1: they're very highly trained and there's a lot of like
33:13
Speaker 1: um ongoing education that happens. Um. But at the same time, yeah,
33:19
Speaker 1: you're paid handsomely if you look at it per hour,
33:22
Speaker 1: but if you look at it over the course of
33:23
Speaker 1: a month even you're probably not even gonna be able
33:26
Speaker 1: to make rent off of this. No, it's it's a
33:28
Speaker 1: part time gig if if that. But um, you know
33:32
Speaker 1: you have to be a good listener as well as
33:34
Speaker 1: all the things we mentioned like memorization and be a
33:36
Speaker 1: decent actor. You have to be able to take direction. Well,
33:39
Speaker 1: you have to be flexible if they change something up
33:42
Speaker 1: on you. Um, like if it says in here, if
33:46
Speaker 1: the simulation isn't achieving them is our goal. They you know,
33:49
Speaker 1: they may come in between sessions and say, hey, listen,
33:53
Speaker 1: I think we had the wrong approach here, So can
33:54
Speaker 1: you can you do it this way right? Act better?
33:58
Speaker 1: I think that was Christopher Walkin said that was the
34:01
Speaker 1: only direction there was, really do it better? Yeah, but
34:07
Speaker 1: I love that guy. Yeah, don't we all so? UM?
34:12
Speaker 1: And you know, it's it's probably something you get into
34:15
Speaker 1: if you have a desire to help people, if you
34:20
Speaker 1: just have a zeal for interesting jobs, you know, yeah,
34:25
Speaker 1: maybe if you have an interest in medicine or psychology
34:28
Speaker 1: or being an educator like you're you're kind of you
34:31
Speaker 1: are an educator in some ways. And if in fact,
34:33
Speaker 1: I think some of them call them, uh educators like
34:37
Speaker 1: medical educators. Yeah, there's a UM national association, a national
34:41
Speaker 1: group called the Association of Standardized Patient Educators UM, and
34:47
Speaker 1: I think they have like ongoing education and core curriculum
34:52
Speaker 1: and UM. It's it's pretty interesting to see just how
34:55
Speaker 1: how much training you can get in this. And I
34:58
Speaker 1: imagine if you're really good and really highly trained you
35:02
Speaker 1: you you're not going to be some part time, you know,
35:06
Speaker 1: adjunct employee of a local medical school. You could conceivably
35:12
Speaker 1: go around the country or possibly the world, especially if
35:15
Speaker 1: you have a specialty. Sure, you know. One of the
35:19
Speaker 1: downsides of this is that, uh, and this is kind
35:22
Speaker 1: of a shame, but there there is no like controlled,
35:25
Speaker 1: randomized trial that can actually prove the effectiveness. But by
35:31
Speaker 1: all accounts across the board, everyone says this is super
35:34
Speaker 1: important and highly highly effective as support students. It just
35:40
Speaker 1: can't prove it. Yeah, that drives them crazy. Probably. So
35:46
Speaker 1: so you've got you've got standardized patients one of the
35:50
Speaker 1: other ones you touched on. That's worth diving into a
35:52
Speaker 1: little more. Care actors, right, yeah, these are they fall
35:58
Speaker 1: under that same umbrella of umulated patient. But these guys
36:01
Speaker 1: are um Whereas like a standardized patient is really going
36:06
Speaker 1: to help a you know, second or third year medical
36:11
Speaker 1: um student who has no clinical experience whatsoever and is
36:16
Speaker 1: learning the very basics of like physical exams or bedtimee
36:19
Speaker 1: men or and all that stuff. A care acter is
36:22
Speaker 1: is much more useful for somebody who's already in practice
36:25
Speaker 1: and has a lot of experience, which just wants to
36:28
Speaker 1: get better at it right, So like a care actor
36:32
Speaker 1: will basically be there to add lib a little bit
36:37
Speaker 1: based on whatever the doctor wants to work on, Say
36:40
Speaker 1: the doctor wants to work on empathy. Rather than go
36:43
Speaker 1: through the whole history and the whole patient encounter from
36:46
Speaker 1: beginning to end, they're going to focus on that one
36:49
Speaker 1: part of the patient and patient doctor interaction and they're
36:54
Speaker 1: gonna do it over and over again. There's an ability
36:57
Speaker 1: rather than having to start at the beginning and this
37:00
Speaker 1: at the end, you can stop and try something over
37:02
Speaker 1: again if you didn't like it or you want to
37:04
Speaker 1: repeat it. Um. Like I said, there's a lot of
37:06
Speaker 1: ad libbing, and um, the doctor can say, okay, I
37:11
Speaker 1: want to We're gonna do a patient who has um
37:16
Speaker 1: psychosis and is in the midst of a psychotic break
37:20
Speaker 1: and it's on a scale of one to tenants and eleven,
37:23
Speaker 1: and I need to be empathetic, so let's try and
37:28
Speaker 1: then they're they're gonna go from there and they can
37:30
Speaker 1: just kind of switch it up as need be. Yeah,
37:32
Speaker 1: And I think this is really cool because the doctor
37:34
Speaker 1: can get as specific as they want. They can say, like,
37:38
Speaker 1: you know what, I feel like I have a pretty
37:39
Speaker 1: good bedside manner, but I have a really hard time
37:42
Speaker 1: dealing with patients when they get angry at me. UM.
37:45
Speaker 1: So they'll say, all right, let's let's dial up an exercise. Yeah,
37:48
Speaker 1: they're like, oh, you want something anger exactly you asked
37:51
Speaker 1: for it, and they'll bring someone in there, or like
37:53
Speaker 1: you said, if someone was if the doctor was like, hey,
37:57
Speaker 1: I do pretty well even with UM patients to have
38:02
Speaker 1: like a psychotic episode, but maybe not right in the
38:05
Speaker 1: middle of a psychotic episode. I've had some real trouble there.
38:09
Speaker 1: So they again, they come in there and like you said,
38:12
Speaker 1: this is different. They're not surprised on what they're gonna get.
38:15
Speaker 1: This is just a very specific training method. Yeah, or
38:19
Speaker 1: the doctors like, I'm fine with kids unless they turn
38:23
Speaker 1: their eyelids inside out, and then I can't. I just
38:27
Speaker 1: completely lose it so cold you ever do that? But
38:29
Speaker 1: now I wasn't one of those either. I can roll
38:32
Speaker 1: my tongue perfectly and wi a my ears. Yeah, I
38:35
Speaker 1: can do those things too. I can't turn my tongue
38:37
Speaker 1: into like a clover club though, you know that kids
38:41
Speaker 1: who could do that, Yeah, I can do that. I
38:43
Speaker 1: can't do that. I don't know I didn't know you
38:44
Speaker 1: could do that. Yeah, I hadn't pulled that one out
38:47
Speaker 1: in a while though. No, you got to. But the
38:49
Speaker 1: islet's saying, that's just there's no reason you do that
38:52
Speaker 1: unless you're you know, you're not gonna impress ross and
38:57
Speaker 1: you're not going anywhere in life if you're one up
39:00
Speaker 1: to the girls in class with your eyelids turned inside out.
39:04
Speaker 1: There's no way to woo a girl. Young guys, young boys,
39:07
Speaker 1: if you're listening to this, don't don't don't don't do that.
39:10
Speaker 1: You know what you do Be nice to girls and
39:13
Speaker 1: listen to them, and trust me on that. I'm still
39:17
Speaker 1: learning that one. Are we all as we grow Now?
39:22
Speaker 1: I'm always nice, but I could always work on the listening. Sure, man,
39:26
Speaker 1: Uh was personal. That was good advice, Chuck. You know
39:32
Speaker 1: if you start out like a if you start a
39:34
Speaker 1: fifth or sixth grade boy out on the right track
39:36
Speaker 1: like that, yeah, it canna be good humans. I feel
39:41
Speaker 1: like girls are inherently good. Sure you don't see girls
39:44
Speaker 1: running around with their eyelids turned inside out. Never, not
39:48
Speaker 1: even wonder woman would do that. Uh, that's true. What else?
39:56
Speaker 1: So you got standardized patients care actors and then there's UM.
40:01
Speaker 1: I ran across another one called unannounced standardized Patients. I'm
40:06
Speaker 1: not kidding. They they're basically you know what a secret
40:09
Speaker 1: shopper is. Yes, they are highly trained standardized patients who
40:13
Speaker 1: are secret shoppers at hospitals and doctors offices and stuff
40:16
Speaker 1: like that to go in from beginning to end to
40:19
Speaker 1: rate the experience from the patient's eyes. Yeah. That's yeah,
40:23
Speaker 1: that's scary. Yeah yeah. But it's cool though that any
40:26
Speaker 1: hospital would do this because you know, it's it shows
40:30
Speaker 1: um a bit of a dedication to customer service, yeah,
40:34
Speaker 1: which I think that people forget that. You know, when
40:36
Speaker 1: you go in for medical care, you're the customer. You
40:40
Speaker 1: should be treated well. Like we demand to be treated
40:43
Speaker 1: well from cable providers, from car dealers, from grocery stores,
40:48
Speaker 1: from everybody. But we just go into a hospital like
40:52
Speaker 1: complete supplicants, like please don't murder me, you know. And
40:57
Speaker 1: and if if you demand to be treat did like
41:00
Speaker 1: a a good a customer, well then well then they
41:06
Speaker 1: do kill you. It's a conundrum. They're like, oh, I
41:12
Speaker 1: guess somebody shouldn't have mouthed off, and then the pillow
41:15
Speaker 1: goes over the faith you sent that one cool article
41:19
Speaker 1: UM of the doctor Uh what was he? What do
41:24
Speaker 1: you call himself? The MUDA that the guy who basically
41:29
Speaker 1: has recruited medical professionals that are self uh not actors,
41:36
Speaker 1: but you know, well they're they're medical actors. That did.
41:39
Speaker 1: Dude wasn't even a doctor, he was just a he
41:41
Speaker 1: was a doctor. No, he was a freelance UM like
41:45
Speaker 1: teaching actor or or UM teaching patient, right, and he
41:51
Speaker 1: got really good at it and he specialized UM in
41:56
Speaker 1: male eurogenital exams, right, so prostrate exam, testicular exam. And
42:01
Speaker 1: this guy would travel the country UM doing this and
42:05
Speaker 1: he set up shop actually in Atlanta, a company called
42:09
Speaker 1: UM Clinical Skills USA, right, and recruited other people. And
42:14
Speaker 1: these people are they just go around the country allowing
42:20
Speaker 1: medical students to give them rectal exams, breast exams, UM,
42:25
Speaker 1: vaginal exam, cervical exams, UM, so that they can these
42:29
Speaker 1: students can practice on a live person, but more than
42:33
Speaker 1: just a live person because in this articles articles by
42:36
Speaker 1: UM Elizabeth Coles and I think evocative, Well, these medical
42:40
Speaker 1: models use their own bodies as teaching tools and it's
42:42
Speaker 1: really great. But she makes mention that apparently medical schools
42:47
Speaker 1: to train um MED students on gynecological exams. Back in
42:52
Speaker 1: the day, they would hire prostitutes. Did not know that.
42:56
Speaker 1: I didn't know that either. I thought these people, though,
42:58
Speaker 1: had medical background, because are training them as well, aren't they? Yes?
43:03
Speaker 1: A little to the left, little to the right, right
43:05
Speaker 1: there it is, Yes, So these people are trained in
43:09
Speaker 1: the exam. They're not medical professionals. UM one's a one
43:13
Speaker 1: one that they interview is a real estate agent or no,
43:16
Speaker 1: an insurance agent. One guy's retired from that GM plant,
43:19
Speaker 1: which I suspect probably the one in Doraville. Um. No,
43:23
Speaker 1: they're just they they know what the exam is supposed
43:25
Speaker 1: to be like, and then they've subjected themselves to the
43:29
Speaker 1: exam so many times that they know the right way
43:32
Speaker 1: to do it so well that they can teach med
43:35
Speaker 1: students how to do it. But this is still under
43:37
Speaker 1: the supervision of trained professionals, right. I have the impression that,
43:44
Speaker 1: like the the the med school teacher who brings these
43:49
Speaker 1: people in says, listen to what this person has to say.
43:53
Speaker 1: They're the trained professionals. All right, Wow, that's interesting. Yeah,
43:56
Speaker 1: So this one guy who's UM a male eurogenetic an
44:00
Speaker 1: auld teaching associate that they interview, um, Mike Manning. He
44:05
Speaker 1: said that he he estimates his head somewhere around four
44:09
Speaker 1: thousand prostate exams man in nine years. Wow. So yes,
44:16
Speaker 1: that guy probably knows more about how to yeah, yeah,
44:20
Speaker 1: give a prostate exam than anybody in the world. Well.
44:23
Speaker 1: I saw the one picture, um of the guy like,
44:26
Speaker 1: you know, bent over the table. Uh, and it's from
44:30
Speaker 1: you know, his front and then the doctor student doctor
44:35
Speaker 1: behind him, and he's kind of looking back like you know,
44:38
Speaker 1: that's that's it. That's correct. Yeah, I think that was
44:41
Speaker 1: the guy. I think that was Mike Manning or Mark Manning. Yeah,
44:45
Speaker 1: isn't it interesting? Yeah? I mean what a I don't
44:48
Speaker 1: want to call it weird, but what a just what
44:50
Speaker 1: a fascinating thing too to have a knack for and
44:55
Speaker 1: and not mind and just be like yeah four thousand times,
44:59
Speaker 1: so do it. Yeah, it's pretty pretty interesting that these
45:04
Speaker 1: the people who all work for him too, um are
45:08
Speaker 1: are They've kind of become a bit of a family.
45:11
Speaker 1: I love that they like go to bars and go
45:13
Speaker 1: to dinner and hang out. Yeah, they do. Um. One
45:16
Speaker 1: of the one of them as uh, she's actually she
45:19
Speaker 1: would be considered a gynecological Teaching Associated g t A
45:23
Speaker 1: rather than m u t A. Her name is Katie Patterson,
45:27
Speaker 1: but like she travels the country teaching med students how
45:30
Speaker 1: to correctly insert a speculum um. I mean, like these
45:34
Speaker 1: people are literally donating their body to science. But while
45:38
Speaker 1: there's still a lot, I mean it's amazing. And yeah,
45:41
Speaker 1: they're getting paid, but I mean they're not getting paid
45:43
Speaker 1: enormous amounts of money. They're getting paid something between thirty
45:46
Speaker 1: five and fifty bucks per student per day. So say
45:49
Speaker 1: you have ten ten students, you make ficks in a day.
45:53
Speaker 1: It's not bad at all, But you're only working thirty
45:56
Speaker 1: days out of out of the year. Maybe maybe fifty
46:00
Speaker 1: doesn't add up too much. So clearly these people are
46:02
Speaker 1: driven by by much more um benevolent thing than than
46:07
Speaker 1: moneyless their hearts. You know, yeah you got anything else,
46:13
Speaker 1: I got nothing else? Son, turn out better than I thought, Chuck. Yeah,
46:16
Speaker 1: I think if you um, maybe if you're out there
46:19
Speaker 1: and you all this sounds like, hey, I could probably
46:23
Speaker 1: do that. And I have a desire to help people learn,
46:26
Speaker 1: and I don't mind being you know, poked and prodded,
46:29
Speaker 1: and I want to make a few bucks. Look into it.
46:32
Speaker 1: We should reiterate that the people who are the male
46:35
Speaker 1: eurogenital teaching Associates and the ladies who are the gynecological
46:39
Speaker 1: teaching associates, they're very specific. And yes, you could say
46:45
Speaker 1: I want to sign up for rectal exams and they'd say,
46:47
Speaker 1: come on in, we need rectal exam volunteers. Bad. But um,
46:52
Speaker 1: just becoming a simulated patient of some sort. You could
46:57
Speaker 1: say I never want to do rectal exams. I just
46:59
Speaker 1: want to do you know, bedside man or something like that,
47:02
Speaker 1: and they would they would probably just stick to that,
47:04
Speaker 1: you know. Yeah, they're not going to force you to
47:06
Speaker 1: ever do anything that you're not comfortable with. And again, regretfully,
47:10
Speaker 1: they don't give you any drugs. But if you do
47:14
Speaker 1: want that kind of thing, Yeah, if you are interested,
47:17
Speaker 1: check out your local mid school. They probably have some
47:19
Speaker 1: sort of program. Or again, go to the Association of
47:22
Speaker 1: Standardized Patient Educators. Bring in if you're an actor, beach
47:27
Speaker 1: waiting tables. Yeah, and in the meantime, you can type
47:31
Speaker 1: standardized patients into the search bart how stuff works dot com.
47:34
Speaker 1: And since I said search bar, it's time for a listener. Uh,
47:42
Speaker 1: I'm gonna call this uh South Africa and Canadian All right,
47:48
Speaker 1: does pique your interest? Yeah, but I know what this
47:51
Speaker 1: one's about. Hey, guys, never really had a reason to
47:53
Speaker 1: get into contact into now since you announced your tour
47:57
Speaker 1: up to Canada, and that fired my cylinders into action.
48:01
Speaker 1: Listen to you, guys for a couple of years, probably
48:02
Speaker 1: from early to fifteen to been listening forever. I was
48:09
Speaker 1: then living in South Africa. At nineteen, fresh out of
48:12
Speaker 1: high school, I made the daring decision to leave my
48:14
Speaker 1: family and friends try and make something of myself. I
48:17
Speaker 1: have Canadian citizenship as well, due to my father being
48:20
Speaker 1: born in Toronto or Toronto Toronto, so I landed there
48:25
Speaker 1: in Toronto early last year and made my way a
48:27
Speaker 1: little east and then a lot west to Vancouver, where
48:31
Speaker 1: I would be seeing you in September of this year.
48:34
Speaker 1: The point is being away from family and friends is
48:36
Speaker 1: brutal at a nine hour time difference, and brutal turns
48:39
Speaker 1: to lethal. I often feel lonely or anxious of the future.
48:42
Speaker 1: And when this happens, stuff you should know, and the
48:44
Speaker 1: three of you, lovely people make it not seem so bad,
48:47
Speaker 1: as it feels like there's someone right here with me
48:49
Speaker 1: chatting casually about some neato topic it is. So I
48:52
Speaker 1: just want to say thank you for making this move
48:54
Speaker 1: tolerable when it feels sometimes not so great. Who's that
49:00
Speaker 1: that is? K H? And I don't know if k
49:05
Speaker 1: E y A is Yeah, ka ka Kaya? I don't
49:11
Speaker 1: know how Kaya identifies on the gender spectrum. Well, who cares? Right?
49:17
Speaker 1: That's right, k H. They age sounds for how are you?
49:20
Speaker 1: I just want to use the right pronoun, you know
49:22
Speaker 1: what I'm saying? Sure, So what's that one? Is it sis? Sis?
49:27
Speaker 1: Gender like gender neutral? I'm not sure about they. I
49:33
Speaker 1: think they is like making a big, a big push
49:35
Speaker 1: right now? Well, a nice email from thy Yeah, thanks
49:39
Speaker 1: a lot, Kaya, that's pretty awesome. Congratulations for striking out
49:43
Speaker 1: on your own. It's pretty amazing. And thanks for coming
49:46
Speaker 1: to our show in Vancouver, and even more than that,
49:49
Speaker 1: thanks for giving us a reason to plug our show
49:51
Speaker 1: in Vancouver and the rest of our tour where people
49:54
Speaker 1: can get tickets at s y s K live dot
49:56
Speaker 1: com and right all right, Well, if you want to
49:59
Speaker 1: get in touch with us, like KAA did, you can
50:01
Speaker 1: tweet to us at s Y s K podcast. You
50:03
Speaker 1: can join us on Facebook dot com slash stuff as
50:06
Speaker 1: you know, you can send us an email to Stuff
50:08
Speaker 1: Podcasts at how stuff Works dot com, and, as always,
50:12
Speaker 1: join us at our home on the web, Stuff you
50:14
Speaker 1: Should Know dot com. For more on this and thousands
50:20
Speaker 1: of other topics, is it how stuff Works dot com.