Glauc Talk: Can Free Medical School Fix the Primary Care Crisis?

It's just the two of us this week, which means we bounce between Star Wars, ageism in medicine, Mark Cuban's healthcare policy ideas, and the spleen. Kristin sent me a video about the Bajau people of Southeast Asia, a group of divers from Indonesia and the Philippines who have genetically evolved spleens that are 50% larger than average, which they use as an oxygen reservoir to dive 70 meters and hold their breath for up to 13 minutes, and look, I'm not saying I was wrong about the spleen, but I'm being forced to acknowledge it might have one useful function. We also talk about the 72-year-old medical school graduate who is now heading into a family medicine residency and the baffling ageist backlash she received from people who apparently think someone "stole a spot", in family medicine, where programs regularly can't fill their positions. She earned it, full stop. We get into Mark Cuban's argument that free medical school tied to service requirements could help fix the primary care shortage, I think he's closer to right than I initially gave him credit for, but the downstream problems are thornier than they look, and the direct primary care model, which makes a lot of happy doctors but probably has a selection bias problem. We also go deep on spleen physiology because Kristin is my heckler and this is the bit now: splenic lacerations, splenules, Howell-Jolly bodies in the blood post-splenectomy, and why losing your spleen means you really, genuinely need to be vaccinated against pneumococcus, meningococcus, and Haemophilus influenzae type b. Also, I had mono in college, did not follow the no-contact-sports instructions, and I only survived because Kristin wasn't around yet to enforce anything. She has since made up for lost time. Takeaways: The Bajau people of Southeast Asia have genetically evolved larger spleens. A 72-year-old woman earning her medical degree and entering family medicine isn't taking anyone's spot Free medical school tied to service requirements is a more interesting idea than pure loan forgiveness Losing your spleen significantly raises your infection risk from encapsulated bacteria Direct primary care attracts genuinely enthusiastic physicians, but that may partly reflect selection bias — To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! knockknockhi@human-content.com Can’t get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! –⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ http://www.patreon.com/glaucomflecken⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Also, be sure to check out the newsletter: https://glaucomflecken.com/glauc-to-me/ If you are interested in buying a book from one of our guests, check them all out here: https://www.amazon.com/shop/dr.glaucomflecken If you want more information on models I use: Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact. For more information go to Anatomy Warehouse DOT com. Link: https://anatomywarehouse.com/?aff=14 Plus for 15% off use code: Glaucomflecken15 -- A friendly reminder from the G’s and Tarsus: If you want to learn more about Demodex Blepharitis, making an appointment with your eye doctor for an eyelid exam can help you know for sure. Visit ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠http://www.EyelidCheck.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for more information. Produced by⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Human Content⁠⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices