Episode Transcript
Daniel Wrenne: Tim, my man. What's up dude?
Dr. Tim: Well, the usual stuff. It just, it never seems to change. And then at the same time seems like everything's changing all at once. So there you go.
Daniel Wrenne: Yeah.
Dr. Tim: That's what's up.
Daniel Wrenne: Well, I was expecting to also be with your lovely wife and she's unfortunately experiencing a migraine, so I understand her not being available.
Daniel Wrenne: But on the other hand, this should be kind of exciting because, one thing you'll learn about Tim is he's unfiltered. Which is great. And especially, I think with May not around, could get a little off the rails, which should be exciting, right?
Dr. Tim: Absolutely. all we need is the whiskey and Bong hit like Joe Rogan and we can really see where this goes, right?
Daniel Wrenne: Yeah. Well I know we got lots to talk about and I'm excited to dig into some of the challenges we're experiencing in the healthcare world and some of your experiences going through that. And going this entrepreneurship direction, which is, there's a lot of cool stuff out there in that world. But maybe before we jump into that, I would love it if you could give everyone a little bit of background on your story and how you got to where you are today.
Dr. Tim: Okay. So graduated from medical school in 1992, in Canada at the University of Saskatchewan up in the absolutely flat freezing cold prairies. where I grew up. That's where my family was from. Always loved skiing. Did a ton of traveling for that and windsurfing.
Dr. Tim: Loved all that outdoorsy stuff. I'd lived in Whistler in one of my gap years. And really wanted to live in the Northwest. Had a job offer in one of the small ski towns in Canada. And that all blew up because the Canadian government decided that you could only get a billing number to bill the government for your services if you had graduated from that provinces' medical school, or done a residency there.
Dr. Tim: So we're like, this is crazy. Meanwhile, somebody just randomly calls us from Oregon and says, "Hey, do you wanna come down to the United States?" And we're like, "Yeah, we'll do whatever. Like, we don't care." We have nothing encumbering, no kids at the time. I love the Columbia River Gorge. Had spent tons of summers there.
Dr. Tim: We're like, let's go. We're, an hour and a half from the coast. About an hour and a half from Bend. And a couple hours from the Gorge. So it was like perfect from a recreational perspective. It was small town medicine, which is what we wanted. So I did obstetrics in my family practice for 12 years.
Dr. Tim: We did death investigations. Worked in the ICU. Did hospital medicine, did absolutely the whole gamut and just learned a lot of medicine. And then switched over to urgent care about 10 years ago. Meanwhile, during this entire time I had been working for the insurance company side of the business that we worked for.
Dr. Tim: It ended up being about a billion dollar a year multi-specialty healthcare system with a bunch of rural hospitals. So I got a kind of an inside look on some of the administrative side, done that work as well. And then we just got entirely burned out on the corporate model.
Dr. Tim: And I'm mostly retired and I am working three quarter time at a small private clinic in the town that we live in, which has been really quite rewarding. And we're doing the podcast thing, which hopefully we can continue to grow that and make that a more soluble business, shall we say.
Dr. Tim: So that's the very small elevation, super short speech as far as where we came from and kind of where we are now.
Daniel Wrenne: Yeah. So the system of medicine, I know we talked at length about it was a big reason for pushing you guys this direction. I loved your analogy about the practice of medicine and dog poo tennis. Is that what you call it?
Dr. Tim: Oh, yes. That was a long time ago when I did that one.
Daniel Wrenne: I would love it if you could talk about playing dog poo tennis in the practice of medicine.
Dr. Tim: Okay, so take for instance, you are a highly trained tennis athlete. You know, you played in high school, you played when you were a kid and you just love playing tennis. and then the rules of the game continue to slowly change. So your passion and your skillset is you have a tennis ball, you have a tennis racket, regulation field, or court rather.
Dr. Tim: And then somebody just slowly starts to smear, like all the people in the surrounding area bring their dogs and their dogs start pooping on the tennis court So initially it's irritating. It's like you step in it once in a while and you're like, "This is ridiculous.", we gotta get a bigger fencer around here. We're gotta put locks on the door.
Dr. Tim: And then eventually the entire court is just smeared in a thin two and a half inch veneer of dog poop. So every time you go to run to hit the ball, you're sliding in it and then you're smacking the ball and it's like hitting you in the face.
Dr. Tim: And all that you're experiencing is essentially this bathing in dog poo. And that's exactly how I see what's happened in medicine. Like you take these very bright, highly trained people that really do want to care for people and they want to practice medicine. And then you start adding these encumbrances. And it happens very slowly until you realize there's way more dog poo about this than there is anything to do with tennis.
Dr. Tim: It is just a veneer of what, that sort of resembles tennis and has very little to do with the game that I was trained to play. And I see corporate medicine and maybe it's just cuz I'm older and jaded, but I see corporate medicine is that's where it is now. It healthcare isn't healthcare.
Dr. Tim: Don't go to a doctor for healthcare. Go to a gym for healthcare. You should go to a doctor for disease care. If you're sick, you should see a doctor. I have a tremendous friend who's a great mechanic. He works me in all the time, fixes what's wrong with my car, but I don't get 'em to teach my kids how to drive.
Dr. Tim: If you wanna learn how to drive your body, that's what gyms are for. That's what nutritionists are for. That's what reading books are for. That's not what doctors are for. But somehow we've made this thing healthcare and we wanna drive everything through this unbelievably expensive insurance system and somehow, and then have me be the purveyor of health for patients that don't care about their health.
Dr. Tim: Like as a primary care doctor, I can't imagine anything more frustrating. Because you're not solving any problems.
Daniel Wrenne: It's like playing tennis in a bunch of dog poop.
Dr. Tim: That's exactly what it's like.
Daniel Wrenne: But physicians seem to have a extremely high tolerance for playing in dog poop.
Dr. Tim: Well, I think that's a problem. I remember one time, I got in this confrontation with one of my colleagues. And I felt really bad and I asked my wife about it and she says, "Well, your problem wasn't that you got in a confrontation. Your problem was, is that your fuse is too long."
Dr. Tim: And if you would've dealt was that my fuses too long? If you would've not let things build up, then it never blows up. If you deal with, if you maintain it, you don't need a new engine if you change your oil every 5,000 miles.
Dr. Tim: I think that medical training really does warp people. Into putting up with a lot of stuff you'd never put up with normally. And I think it's good and bad, right? Because like the military, you gotta put up with stuff that's really, really difficult and you have to do it in a professional manner so you can maintain your skillset.
Dr. Tim: But at the same time, it makes a lot of people very driven by I think things that are unhelpful in really helping people, helping yourself, your family and bringing evolving the medical system into something that's mutually beneficial to provider and patient.
Daniel Wrenne: Yeah. And I think there's harm that happens not only, it's frustrating obviously to play in a game that's, you don't, nobody wants to play in a bunch of dog poop. But I think the other effect is that you come home, and you're grumpy. I mean, if you just got done playing tennis in a bunch of dog rap, you're gonna be like ticked off at the world.
Daniel Wrenne: And then you come home to your family and you're gonna be angry at them. Or even the patients, it's gonna be harder to provide care and it's gonna get in the way of doing what you kind of set out to do along the way. So there's all these like secondary effects I think, of just this system of healthcare that we're in.
Daniel Wrenne: I mean, maybe do physicians, is that top of mind with physicians? Are they thinking about these like secondary effects that happen?
Dr. Tim: Yeah. All the time. But it's ridiculous, right? Because you know, physician burnout is the big thing, right? One of the last big systems I work for they have a physician champion for burnout.
Dr. Tim: And so they put us all in a room and they're gonna talk about what they're rolling out for the system in the next two or three years, what their three year plan is and how all the doctors are gonna be part of this. And they start talking about burnout, and they sit there for five minutes teaching you how to do meditation by focusing on your breathing and your feet and the chair and all this.
Dr. Tim: And I'm like, okay, you don't understand. Okay, this isn't that I'm stressed out because I haven't been financially responsible, or I'm having a fight with my wife. This is a systemic cancer inside the entity, and you are the purveyors of the cancer, okay? So do you understand that is like, I got thrown in jail for a crime I didn't commit?
Dr. Tim: And they throw me in the cell with the most heinous offender. And as he's abusing me day and night, they put a picture of a beach in Hawaii and tell me just to imagine that I'm there. Yeah. I'm like, "No, no, no. I'm being assaulted. Maybe you can put me in another cell."
Dr. Tim: So the burnout thing is very egregious to me because it's like the discrepancies or the problems that we bring up in the healthcare system are somehow the pH the physician's fault because we're feeling this pain when in reality, I mean, I think that physicians have a tremendous amount to own. Because we gave our autonomy away to government regulators and gigantic insurance companies. I mean, we did that. We did that for financial security because we're not generally as a group, very savvy business people.
Dr. Tim: So we have to own that part. We have to own the part that we married the alcoholic. ' Cuz we did, I mean, I remember early in my career hearing these guys talk about cutbacks from Medicare or the federal government or whatever. And I'm like, "Well, we've just made ourselves drug addicts for public money."
Dr. Tim: That means that we're gonna be doing what they tell us to do. We're the ones that went to medical school. We're the ones that own the knowledge of how to treat patients. We're the ones that are the only people that can bill for services. You have to be a medical professional to bill for services, which then flows through the system.
Dr. Tim: You know, you have to be a physician or a nurse practitioner or a physician assistant or a physical therapist or somebody with medical training. And yet somehow we gave that unbelievable amount of power away to economic in interests so that they would pay us and we wouldn't have to worry about it.
Daniel Wrenne: Do you think most physicians agree that the healthcare system's all jacked up?
Dr. Tim: Well, of course, virtually everybody.
Daniel Wrenne: That seems to be the consensus. And Mike, you're saying there's a huge number of physicians and there's a collective huge, massive amount of power with that group. But yet, and I think if for instance, if somehow we could get all, everybody on board would just be in like, "Eh, let's go do a new system or whatever", like solve the problems, at least that would be a huge potential leap forward.
Daniel Wrenne: But right now everybody acknowledges the problem and nothing's changing. It's like they're just working within the problem and it doesn't seem like there's a lot of cooperation or banding together of like. And you would think that there would be, because of such, like the groups, there's a lot more power within in the group, right?
Dr. Tim: Well,
Dr. Tim: Right. But there's gonna be multiple solutions to this problem. And the last group practice I worked for, literally one of their practice locations had a picture of fauci up on the wall that said, in Fauci, "We trust". So, I'm a free market mostly libertarian guy. I mean, I can't count it teaming up with somebody with those kind of like, with that kind of just what I would call vacant zero thinking sort of attitude. And that's the problem. I mean, politically for physicians we're all over the map. You have very entrepreneurial people, which tend to be more conservative.
Dr. Tim: You have people that are absolutely staunchly socialists that the system should be a single payer and it should be the government that's the payer. So when you say team up and solve the problem, well, the solution to the problem is entirely different depending on kind of which one of these political factions you're in, right?
Dr. Tim: Yeah. So I mean, I sat down on a radio debate with somebody and said we don't have free market healthcare system. That's why it's expensive. And he thinks we do have a free market healthcare system and that's why it's expensive. And it should be 100% socialized. So we practiced in the same medical community and I sent him patients.
Dr. Tim: He was a great referral source. He was a good guy. So I see a couple different ways of solving this because the key isreally two things. Number one, it's decentralized power. So the power has to be away from federal regulators in gigantic business interests, which would be big pharma and big insurance. And well, and thirdly, the big healthcare entities.
Dr. Tim: So you have to decentralize power. That means small physician practices. Maybe a 100 maybe 5 depending on the community. And you're gonna have to have a free market side, which works I think, very, very well in primary care. Which would be things like direct patient care, direct primary care, some direct specialty care.
Dr. Tim: May and I interviewed a rheumatologist that does direct specialty care and is very successful at it. Loves it, works on his own terms, doesn't deal with insurance companies. Then the other thing that you have to do, and I think there's always gonna be a publicly funded side to this, and I think that they're probably, I think at least politically, there's no way we're ever gonna get away from that.
Dr. Tim: And maybe we shouldn't. Is you need physician unions. As much of a non-union guy as I am, if you want to decentralize power and put power back in the hands of doctors taking care of patients, there's a place for physician unions. And we actually did an interview on our show. It's the longest, the single longest BS free MD interview..
Daniel Wrenne: How long was it?
Dr. Tim: It's almost two hours is with, it might be over two hours. I can't remember. It was a while ago. So it was over a year ago. We drove May Crazy 'cuz this guy was just great. And again, politically we probably don't agree on a single thing, but it was very fascinating because how he got into union organizing for physicians was he's like, why am I gonna argue for money for rich people?
Dr. Tim: Like that just seems dumb. That was his thinking. And then he started interviewing doctors and they said, "No, we need our power back so we can take care of patients the way we think is right." And he said every single conversation he had with physicians interested in unions was all based on patient care, not on their financial interest.
Dr. Tim: And he said, I have to be part of this. And it was really, really interesting to listen to. And I don't think it's the solution, but I think it's a part of the solution of decentralizing power from these incredibly wealthy, powerful interests and putting it back in the hands where I think it's better served, at least for the patient, which is in the hands of the doctor where my boss ultimately my boss, should be the patient, not the insurance company.
Dr. Tim: And not the government.
Daniel Wrenne: Yeah, that's like you said earlier, direct primary care is the best, I think the best example of current system where the boss is the patient, because you've cut out all the middlemen and no insurance, no healthcare hospital system.
Daniel Wrenne: You're just like, patient pays provider. And provider provides service and patient pays as long as value is greater than costs. And it's pure and simple. And our families that we work with that are in that model love it. And they're not burning out or hating their work and it's the complete opposite.
Daniel Wrenne: But I think that's a very good example of like pure entrepreneurship. You know, you're not only are you starting a practice, you're starting like a non-traditional practice and you're kind of part of helping to solve the problem. I think there's even other flavors of entrepreneurship that even what you all are doing is like you're starting a podcast and you're kind of talking about some of these issues and trying to work through potential solutions to them.
Daniel Wrenne: My opinion, I'm curious to hear your thoughts on this. My opinion is that I think entrepreneurship is one of the best possible ways for physicians to have an impact on the problem. It gets them into this problem solving sort of situation as opposed to now in the current healthcare system, they know the problems, but there's no solutions.
Daniel Wrenne: That's unacceptable to talk about the solution. Things don't get solved. It just kind of stays how it is. And they're kind of a cog in the wheel. But when you start talking about like, I'm starting a business or I'm creating a new thing that nobody has, like you were saying, rheumatology direct care, right?
Daniel Wrenne: Is that what you said? You interviewed somebody on? That's super interesting to me. That's like a new thing. I didn't even know it existed. Yeah.
Dr. Tim: Michael Hugh, he has, I'm not sure if he takes, I think he's completely out of any insurance. Great guy, California. You can see him wherever he's licensed.
Dr. Tim: He's got licenses in a whole bunch of states and then it costs x for a new patient visit. It costs y for a follow-up visit. He can prescribe medications obviously 'cuz he's licensed in a bunch of states. It's the perfect kind of specialty practice for telemedicine.
Dr. Tim: And it really, but there's lots. I mean, like psychiatry, you could do that way. The coaching world has exploded. I mean, May and I kind of mock it because now everyone's a coach, right. And so, but at the same time we've kind of toyed with this concept of doctors are for sick people.
Dr. Tim: Like, I really believe Jesus was right when he says only sick people need a doctor. And it's really the key, this idea that you go to a doctor for health coaching is a very expensive solution for a relatively inexpensive problem. I love building cars. I have switched over to electric impact tools because they are just unbelievably great, very powerful. So if I take my new favorite Milwaukee fuel impact wrench that can almost turn the earth and use it as a hammer, I destroy the tool 'cuz it's not intended for that. A hammer is used as a hammer, that's what it's for.
Dr. Tim: And so talking to somebody about the fact that they should quit smoking or that they need to eat a certain diet and exercise a certain amount should not be done by somebody that spends at least 10, if not 14 years, to train as a physician, you want me to solve complex problems based on disease, not be a lifestyle coach.
Dr. Tim: I mean, otherwise I'll just get rid of my medical license and we're, I mean, May and I are considering this too. Just not having a license, not having any encumbrances of medicine, and then just being a lifestyle coach. I mean, I've done it for 30 years. I might as well just do it for cash and I can do it online and I can do it across the border. All my Canadian friends can do it.
Dr. Tim: And it just seems so silly. Like we're counseling, we're getting paid for metrics in primary care based on asking people how many beers they drink. I get it. Alcoholism's a real big problem, but you're burning resource of the brightest, most expensive resource you have.
Dr. Tim: There's other ways to do that. That's far more efficient and way less expansive.
Daniel Wrenne: Yeah, I think there's all these solutions though out there. And I think we could go on and on. I have ideas of possible solutions and ways to kind of, even an individual like you or someone listening could kind of start to make headway on solving some of these issues. Or maybe if you're younger, avoiding them as you go into practice. But it's kind of scary and goes against the grain of things. I think in training it's like this assumption that you're gonna go work for a system and do the thing and whatnot. And it's kind of scary to go against the grain of things.
Daniel Wrenne: But I think that is where it's at. That's where, when you're in a environment that's just jacked up toxic work environment and you continue working in that, that is gonna ruin you. You all, when we were talking before you talked about, the Bible verse from Matthew, which one was it about? Selling your soul.
Dr. Tim: Oh, it's was is it worth if man inherits entire earth and forfeits his soul. And the last corporate job that we had. We really recognize the fact that that is 100% the truth.
Dr. Tim: Like if you are trading your soul for money, it's never gonna be a fair trade. Right? And there's no amount of money that you can buy back your soul with. And I believe that's a 100% true. Like, it really is. And so you will turn to other soul crushing activities to try to blunt that reality.
Dr. Tim: Like whether it's drugs or alcohol or illegitimate relationships or all the soul and mind numbing things that we do to try to escape our realities. But it's scary. Like, I get it. I get it. Like we educate people. They graduate. You would know this more intimately than me being in the financial services side of things.
Dr. Tim: They graduate with $250 or $450,000 worth of debt. They could start their own business, which is gonna cost them more money. They can build up a practice which is gonna take time. So you're kind of mortgaging your future on a time, or you can just go sign up for a company and live like a resident for a few years and pay off your debts and et cetera, et cetera.
Dr. Tim: And maybe it's worth it for a while. But I mean, I've known lots of people that are stuck in jobs they hate purely because they got the payoffs from the government to go to a rural area to practice medicine and get their loans. Yeah. And it ties people into like 10 year contracts.
Dr. Tim: Don't sign a 10 year contract.
Daniel Wrenne: It's so long. it's 10 years. Nobody knows what they're gonna be doing in 2 years, much less 10 years.
Dr. Tim: Yeah. I mean, we were fortunate we stayed in a place and raised our kids and for three decades. But I mean, that is not the norm.
Dr. Tim: And I have no idea really, we have an idea where we wanna live. I have no idea where I'll be living in a year, which is, yeah. Awesome.
Daniel Wrenne: What would you tell say one of your children is starting in practice, or maybe before that, maybe they're in medical school and they're like, " Hey dad, what path should I take in this healthcare system? I wanna be a physician." What would you tell him?
Dr. Tim: Well, I would say just keep your eyes open and understand exactly what you're getting into. So there are advantages to being in a big system. Because there are, it's guaranteed income, you're not having to do the administrative load, you're not having to hire and fire people. But you have to live with all the choices that people that don't have your training or making for you.
Dr. Tim: So that's an issue. But if you own that and recognize it, you know, maybe you do it for a few years and then you start your own business. Or you start become, I think the guys that go straight into like I'm a primary care doctor, so direct primary care, I think they're very, very happy. And they're very deliberate in what they're doing.
Dr. Tim: But I also understand it's very difficult to do that. Based on the financial structure of medical training and trying to get paid back quickly. So I recognize that. But I would always have the biggest thing I would tell them, which is totally different than what we did, is I would be developing side gigs this second I started practice.
Dr. Tim: And recognizing that your value as a physician goes way beyond seeing patients. And that took me a really, really long time to recognize.
Daniel Wrenne: Can you talk about some examples of what that might look like? Okay.
Dr. Tim: So I started into the kind of insurance company, administrative side of my job quite early. I had worked for maybe 10 years, maybe not even. And I did it honestly because at that point I was riding a lot of dirt bikes and doing a lot of skydiving. And I wanted to be able to have a job I could do from a wheelchair. So I could read charts from a wheelchair. Yeah. So sounds kind of bleak, but there's disability insurance, but it's nice to continue working when you're 35 years old and screwed yourself up on a motorcycle.
Dr. Tim: So that part I kind of recognized, but it was still very narrow in medicine. What we've realized in just the last two and a half years of doing the podcast is there is a gazillion other things that you can do, that bring a tremendous amount of value to people. And honestly, once you build up a huge repertoire of experience, I think that there's, I mean, I don't know if it's just maybe I'm blind or arrogant or dumb, or I hope I'm correct, but like I've had this discussion yesterday with my wife and I just said, you know, I think what we can bring to the table of value now, communicating our experiences to people is far more valuable than we could contribute just seeing one patient at a time.
Dr. Tim: It's kind of bold, but I really believe that. And you have to have that sort of self-belief and medical training has a way of pounding out a lot of self-belief. There's a lot of that soul crushing. And I think one more thing, one more thing I'd say. I'd say in doctors for my entire career, and this goes back to the early 90s when things were very different than they are now.
Dr. Tim: Physicians, especially as the newer generation has come, are primarily driven emotionally by fear. And that's a really, really bad way to live your life. Do not be driven by fear. Fear that they're not gonna pay their debts off. Fear that they're gonna harm a patient. Fear that they're gonna get sued. Fear that they're not gonna fit in because they have different views on whatever it may be. Fear that they're gonna have a license issue. Like of all of this stuff and you cannot live like that.
Daniel Wrenne: Yeah, we interviewed, Jordan Grummet, Doc G a while back, and he's a hospice physician. I don't know if you know of him, but he had a ton of experienced people late stage of their life. And you know, one of the biggest regrets he saw was that they regretted not leaning into their fears and like facing them and basically like doing it anyway.
Daniel Wrenne: People just kind of get paralyzed by fear and then they get old and they're like, "Man, I wish I'd done X, Y, Z." It's not a good way to live and you end up regretting it.
Dr. Tim: Yeah. that's where we're living right now. We're like, you know, we're young and healthy enough that we can lean into what we think we should do now.
Dr. Tim: Most of our medical practice, and I'm speaking mostly for myself, was great. I mean, it was awesome. I was a small town guy, delivered tons of families, took care of families through the entire, exactly what I had I wanted to do. And then it got weird and we stayed a little bit too long. Like, I think a lot of people do that.
Dr. Tim: But we're now, I think we're trying to just sort of sell most of what we own and get the courage to just do what we really feel like we should do, which is try to communicate our hearts and our passions and interview some really, really cool people.
Daniel Wrenne: Jeff is asking about what is this story you told him about? Cleveland shocks.
Dr. Tim: Okay. Yeah, yeah. All right. So, we have an idea of percolating for another show we want to do where we drive across the country in a motor home and explore medical history. So there was a guy named Dr Beck, and he's the first person to successfully defibrillate anybody.
Dr. Tim: So he worked in Cleveland, I'm not sure if this predated the Cleveland Clinic or not. It was in like the late 1940s. And he was doing open heart procedure and the kid arrests. And so he's doing like internal cardiac massage, like he's literally has his hand on this guy's heart, this 14 year old pumping blood to his brain.
Dr. Tim: And he says to one of the assistants, go down to the lab across the street, and I got this thing made of like spoons and a big coil. And bring it back here. So they wheel this defibrillator in there and it literally is using like wooden spoons as the insulators. And some weird capacitance thing that he figured out by reading these studies from some guy I think in Sweden.
Dr. Tim: And he sparks this kid with this defibrillator. And nothing happens. He just, the second time the kid comes back to life, they finished the surgery and he lives like a normal lifespan as the first person. So you think of that, you think of the courage. Like you think in our healthcare system. Would anyone have the nerds to be able to get this thing he was working on in the basement of some lab to cardiovert somebody and say, I mean Cardioversion saved Damar Hamlin's life, two weeks ago.
Dr. Tim: That was it. That's crazy. That's where it came from. Isn't that nuts?
Daniel Wrenne: That is nuts. Yeah. I mean that's innovation and you gotta be courageous. And I think the healthcare system just drives that away. Like it's not a healthy, innovative system where you can come up with ideas like that at least. I can't think of examples of people doing that today, which is unfortunate.
Dr. Tim: Well, that's why the true innovations in healthcare is not gonna come from the healthcare system. It's gonna come from completely outside. You know, it's like if you look at what are the innovations in music production? It all came from the computer industry. It came com from somebody completely out 'cuz who would've ever thought of just using algorithms to interpret music and then edit it and all when they were using tape for a million years. So that's just the nature of innovation.
Daniel Wrenne: Yeah. So going back to your soul and losing your soul, and I think that's important point because I think people in the moment I don't think people are like, yeah, I'm losing my soul I think that's kind of a, there's a possibly a lack of awareness of maybe you being in conflict with your ethics or your values. And doing things that you don't think are right, but you're just doing it anyway and not really realizing it.
Daniel Wrenne: But I'm curious like, how do you know when you're in conflict there? How do you know if you're doing something that's basically gonna cause you to feel like you're losing your soul?
Dr. Tim: Well, I think it's really, really difficult. And I think it's especially difficult for people with a lot of training 'cuz you fall back on your training. And it's not introspective training necessarily.
Dr. Tim: And the other side of that is you can navel gaze so much that you're worthless to everybody. So there's a point that like life is painful and there's gonna be a certain amount of discomfort. But that discomfort should be like running a marathon where it's like, "Wow, that was really cool. I'm glad I did that."
Dr. Tim: And so I think you have to look at the things around you. So if you want to know what you care about, look at your bank account and for me, my garage, that'll tell you 99% of what you need to know. And I think that's the same thing with regards to these soul activities.
Dr. Tim: When was the last time you did something that made you feel really alive? That's the question I would ask.
Daniel Wrenne: That's such a good question.
Dr. Tim: Was it going for a run? Was it taking your kids to Disneyland? What was it? And then the next question is, what was it about that that did that for you?
Daniel Wrenne: So what was it for you? What was the last thing that you did it?
Dr. Tim: Well, there's it generally speaking, on a day-to-day basis, it's largely working out. I mean, I don't necessarily work out so much for vanity reasons. I work out for two reasons to not be completely insane, only partially.
Dr. Tim: And to be able to have enough athletic reserve to do the other activities that I like doing, like water skiing and downhill skiing and so forth. So there's that. And then when you think of other outside activities, I mean, I had the perfect life, not perfect, but when I was the most balanced as far as work and doing other stuff, my wife gave me Fridays. I had Fridays off.
Dr. Tim: And I would get up in the morning and I'd go water ski for an hour, hour and a half. Sometimes I'd ride motorcycles and then I'd go and do five skydives and I'd get home at five. Kids come home from school. I'm perfect. That was like, perfect. And..
Daniel Wrenne: And that's like very rewarding. You feel it's, I don't know if happy's even the right word, like joy. You feel like you're doing, living out your values and being the person you're meant to be.
Dr. Tim: Right, right. Because we've mentioned it several times on the podcast, this purification of the world. Where your job is supposed to, like you speak to the universe, the universe speaks back to you. And you get this perfect job with tons of money and all this balance.
Dr. Tim: Well, that's not life. I mean, that's just, I think that's just ridiculous. Because if that's the case, lots of people, as I say somewhat crassly. A lot of people have spoken to the universe and the universe said, "You're a dick." So sorry. But you know, it doesn't work out for everybody. So jobs are unpleasant, but they shouldn't be primarily unpleasant.
Dr. Tim: I mean, practicing medicine is a massive privilege and should be seen as a privilege, and it should be rewarded. It doesn't mean every day is rewarding or every patient encounter is rewarding. Of course it's not. But in the totality, it should be rewarding. You're giving your knowledge to people, you're helping people, you're being compensated fairly for it.
Dr. Tim: That's a rewarding job. When it's not rewarding anymore, it's because of other factors. And I've said this, I don't know how many times hard work does not burn a single person out. Meaningless work burns people out. What's burning out doctors is meaningless work. My friend that owns the business, I work art he works harder than he's ever worked in his life 'cuz he owns a business. But nothing he does is meaningless. It's incredibly taxing. It's not meaningless. Ticking a gazillion boxes so the insurance company is happy. Being on the phone to make sure that I can get a CT scan for my patient that I absolutely know needs the CT scan. That's meaningless labor.
Dr. Tim: And that burns people out. If you made that go away, people would be happy as heck working for gigantic.
Daniel Wrenne: Yeah. How often do you take a look at what's going on in your life and take an inventory almost of like, is the x, y, z thing, is that in good connection with my values and my purpose?
Daniel Wrenne: 'Cuz I think the challenge in healthcare really in anything is that you get in this auto pilot groove of just grinding it out and working a million hours and you don't have this introspective thought exercise of was I getting joy out of that? Is this in conflict of my values?
Daniel Wrenne: Am I living into the person I want to become? And it's almost like a muscle you gotta work out, right?
Dr. Tim: Yeah. Now I think about it almost every day because we're actually in a very challenging point of life, which is we're in a transition. We're in a transitionary period.
Dr. Tim: And so it's interesting talking to people that are younger than me that are kind of in the middle of raising families and whatnot. It's like, "Wow, that's really exciting." Well, it's kind of exciting, but it's really quite terrifying. Because, you save money, now you're spending it and you're earning less. And we're trying to develop this property that we have and then sell it, which is a huge challenge 'cuz there's always a million factors that you can't predict.
Dr. Tim: And I nailed it last night and I think that this is the key. I said to May, I'm like, why is this so distressing to us? Like we can solve these problems. It's not the end of the world. And it's because we're doctors and we're used to solving problems and having control over situations. And you get into a situation you don't have control in and it's unbelievably uncomfortable. And that's good discomfort. I think it's super duper healthy because that's working out that kind of discomfort where you just lean into it and you go, "Okay, well what's the next step?" And then you just do the next step.
Dr. Tim: So I think about my life inventory now, at least a couple times a month. If in more detail. And I talked to it with May a fair bit. And the other thing that's really, really important is you gotta have relationships completely outside of medicine where you can bounce some stuff off of people.
Daniel Wrenne: Like true relationships where you're actually vulnerable and you can speak truth and all.
Dr. Tim: Exactly, you know, I have one friend where we've had these kind of conversations for 20 years or so. And it was really cool because I texted him and I said, "You know, I think I finally realized that I'm actually more of a creative than I am anything else." And he said, "Dude, I've been telling you that for 20 years. Good thing you finally listened."
Daniel Wrenne: Yeah part of why my ski trip was so fun. First of all, I love skiing and I was telling you I got back at 8:30 this morning in the airport. I flew overnight, skied yesterday, flew overnight red eye. And then came back at 8. Drove in at 8 just to come to my first meeting.
Daniel Wrenne: It was, I love skiing and I love the experience of like nature combined with the athletic activity. And the challenge of it. I mean, all parts of skiing I love, but then on top of it, like this trip was a group of guys that have like super deep open, trusting conversation and we had a ton of like super great conversation and it just made it a fantastic. And it was only like three days, but it was an unbelievable trip because of all those factors.
Daniel Wrenne: And so I think of that as like an example of if I'm looking back at my time, 'cuz time is a big component. It's like, what do you use? Where do you spend your time? Where do you spend your resources? That's like a win. That's like doing what I need to do. But in other instances of my life, and I'm sure everybody has this, you look at it and you're like that's the complete opposite.
Daniel Wrenne: Like that's soul crushing. And there's probably a lot of stuff in the middle, but like just the act of taking that time to review a little bit, and it doesn't have to take hours and hours. How long does it take you to review your.. I mean, do you spend an hour a month?
Dr. Tim: Think, well, I think a lot of it is more not really unconscious, but it's more like I'll be out running or doing something and I'll be thinking about is this the right thing to do?
Dr. Tim: Or are we just completely insane. Like, should we just get normal jobs and work for 10 more years? And then we're like, "Nope. Can't do that." My wife's like, I'll work in Starbucks before I would ever feel like I felt before. Like I don't wanna sound too flippant about this stuff because I understand at the beginning of your career, it's different than at the end of your career.
Dr. Tim: At least it should be, hopefully it is. And so Joe Rogan talks about this reaching escape velocity where you can kind of be free to say and do whatever you want because if they take your job away, it doesn't matter. You don't need a job. Yeah. And we're not quite there yet, but we're closer.
Dr. Tim: But I can't imagine the stresses. When you have you bought the car and you bought the Tesla and you got $400,000 in debt, and you have to keep your foot to the floor 100% of the time. I think don't buy expensive stuff in your first 3-5 years of practice would be another piece of advice, which I didn't do.
Dr. Tim: I'm giving you advice of failures that we made..
Daniel Wrenne: Really failing forward.
Dr. Tim: Yeah. I mean that's a really, really important concept. Because you might not like it and there might be way more satisfying jobs for you inside medicine, seeing patients that are just outside of the more lucrative, gigantic system.
Dr. Tim: And I think you have to leave that door open. You should be happy most of the time. You should go on a trip. Here's another thing, you should go on a trip or if you're a tennis player and you play tennis every Thursday afternoon with one of your friends, that should make you feel good that you produce something at work and now you get to do this thing that you love.
Dr. Tim: If you're feel like that, you're mostly balanced. if you're into the second serve of your game and it's like, "Oh crap, I gotta go to work again tomorrow" then you got a problem. Or if the only activity you do is going to the bar, that's probably an issue too.
Dr. Tim: You should be like, "Man, you know, that was a super hard day to work today at the ER. I had two patients that were intubated and I managed them and I got 'em sent off to the specialist and I helped them.. And man, I don't want another day like that for another two years."
Dr. Tim: But wow. Was that cool that I got to do that? That's where you wanna live. Because you don't wanna live, you don't like having an easy life is dumb. You don't want an easy life. What it really, really comes down to. A lot of this is like spiritual or philosophical, however you wanna put it.
Dr. Tim: It's really meaning. And meaningless tasks especially that get in the way of really meaningful tasks. That is almost an impossible thing psychically for us to figure out. that's the problem.
Daniel Wrenne: Yeah. And I think there's a lot of people that don't feel like you were just describing about their work. They're just like, they come home and they go to the bar or they come home and they're playing tennis. And it's bogging them down and they're like, "ah, I gotta go do work, some work stuff.", or whatever. And it's definitely in causing problems. But I think there's a lot of paralysis around dealing with that.
Daniel Wrenne: And so this is where I think money can possibly be. There's a lot of factors, but, money a lot of times comes into play. And it goes back to, like we were talking about fear. Usually is the underlying issue is there's this fear of not making change, which could potentially cause financial instability.
Daniel Wrenne: And especially if you've kind of gotten used to this lifestyle with the high paying job. And so at that point it's like paralyzing almost to even consider a big change when you're in this chronic environment. But at the end of the day, like you have choices and I don't think money doesn't directly buy happiness.
Daniel Wrenne: Like you don't, a lot of people think that the money is the solution. They're like working through this train wreck job situation so that they can get enough money to go do something else. But that in itself doesn't solve the problem. I think. You don't have to be financially independent to say no to a terrible job.
Dr. Tim: Exactly. But you have to, I have this affliction, it's called old cars. And like I told May, I mean, the thing is why do I do the hobby? Because it makes me happy. I share it with my friends and I've done it since I was a teenager. But if I knew that I was gonna be 15 times more satisfied with my life by getting rid of that hobby, then you just get rid of it.
Dr. Tim: But most of us don't want to take the time to look at it and go, "Well, what if I got rid of this? Like, what if I took the 4,000 square foot house and lived in a 2000 square foot house. And moved to a slightly less affluent neighborhood and drove 10 year old cars?" If I did that and that freed up the cash to have a different job that I really was satisfied doing, why would that be bad?
Dr. Tim: Like, it's not bad. It's an absolute net benefit. And your kids don't care. They don't. They want to know that you're there. They want your time, and they eventually want to have relationships with other kids. Not everyone's kid is like my son, who when he was eight, said, "If you're not gonna take us to Disney World, why did you have kids?"
Daniel Wrenne: My gosh. Oh, wow.
Dr. Tim: Yeah. And that I was he is a genius though. He is an aerospace engineer. So something turned out all right so.
Daniel Wrenne: It did he was already thinking.
Dr. Tim: Yeah, yeah, way ahead. That was the same kid when we read the Bible verse about you can't serve God and money. He started weeping when he was like six. He's like, "I really like money."
Daniel Wrenne: Well, he most people don't go through that experience until they're like adults.
Dr. Tim: Yes. Exactly.
Daniel Wrenne: A very mature thought.
Dr. Tim: Yeah, it was. Well, he's always been sort of the old soul in that regard. So it's kind of interesting. So work-life balance doesn't exist.
Dr. Tim: You just try to get closer. And when you get it, you'll get it for two seconds, like walking in a tight rope and then you have to get it for another two seconds. But it can be pursued and it can be better. And medicine should be satisfying. We gave up way too much to do it to not be satisfied by trying to help other people and build something of benefit and reputation and all of these things we went into medicine in the first place for.
Daniel Wrenne: Last few minutes, I want to kind of shift gears a little bit and talk about like your experiences with following more of your purpose and like meaning and what we were talking about. And it seems like you're pretty well in tune with that. And I'm curious to kind of, here, like what does that look like now? Like how are you following through with that? And I know the podcast is such a great vehicle to help, it's one of the avenues to potentially use to do that, but maybe we could talk about that.
Dr. Tim: Yeah, so there's really two things for me personally.
Dr. Tim: One was, helping. One of our former residents establish a clinic in a town where we have a fair bit of, I guess I'd say political or at least reputation capital. Patients like us, they've seen us. I'd delivered tons of them. You know, I'd be delivering the kids I'd delivered now if I was still doing obstetrics.
Dr. Tim: So we did that and then we did something very interesting. We started hiring people, well within the guidelines of the law, but we didn't have vaccine mandates in our clinic. So when we started up in September of 2021, we could hire a whole bunch of people that wanted to opt out of that.
Dr. Tim: So that was easy. So it was real, quite easy to find good people, actually. And then we started treating Covid. We just said, we don't care if you're sick. We're just gonna treat you. So we managed to get our hands on a ton of monoclonal antibodies. The Oregon Health Authority was actually really generous with that.
Dr. Tim: We just asked, and they said yes. And we became kind of this startup defacto Covid treatment center. Treating people with EAU approved medications. Didn't have to go off the reservation on other stuff. Told people what nutraceuticals to take. And we treated about a 1,000 patients in a town of 10,000 people.
Daniel Wrenne: And that was fun. That was like, you're feeling good about work.
Dr. Tim: Right. I mean, we've talked about this. May and I have talked about this extensively. I mean, it's like this is a worldwide pandemic. This is my Normandy as a doctor. And I'm just gonna sit in the duck boat. No, this is when we're supposed to go out there and dodge bullets.
Daniel Wrenne: Yeah. Fun is probably not the right word. But it was satisfying. Doing good work. I mean, like hard work. Doing good work. Feeling good. Sleeping good at night.
Dr. Tim: Yes. So there was that. And then the whole entity of the podcast has just introduced us to people that have completely changed our outlook. Not so much on like our core principles of how we live, but have reinforced those and really taught us that there's other things that we can do that bring value. Because that's the hardest part now, is we're at the stage. We've done this for a couple years. We have a body of work. We have people that listen to us regularly.
Dr. Tim: We have people we're trying to get to listen to us. But you know, we're still on the stage where getting this to monetize it to essentially replace our income is, you know, that's the challenge. The business side, which we are not savvy at, is kind of where we're entering into now. And that's, you know, it's a little scary. But we're doctors, we got licenses.
Dr. Tim: You got a backup plan if things go horribly wrong. I could do locums for a couple years. I mean, the world won't end.
Daniel Wrenne: That's good. Scary though. That's like leaning into your fear of, and. But you kind of know deep down it's probably the right thing to do, but it's also a little scary.
Dr. Tim: Yeah, I think so. I mean, I am so convinced about a couple of ideas that we have for shows that we really have to just push. Like you do it, it's weird, but I learned this literally the first or second day I was an attending physician. Which is when you start something new, even if you're the most well trained guy in the entire world, when you're on the sharp end of the rope, you have to pretend that you're a doctor.
Dr. Tim: That's what it feels. You've got the credentials, you've got the training. They tell you that you can see patients on your own. But when you first start, you feel like you're pretending. And that's okay. So I'm just gonna pretend like I'm good at talking. But that's what it feels like.
Dr. Tim: And doctors are terrible for imposter syndrome because we've always been told, you gotta fit into this mold of doing what you're told or you're gonna kill people. And most of the time, that's absolutely correct. So, yeah, it's not a bad thing.
Daniel Wrenne: Yeah. Do you wish you had made some of these shifts earlier?
Dr. Tim: Yeah. 100%. You know, we bought our forever house when I was mid 30s, but we stayed in it forever. So that probably financially worked out. But I would've left corporate medicine way, way, way, way earlier. Like at least 10 years earlier. It would've been a bigger risk potentially, but at the same time now would've had 10 years of accruing, potentially a business. Potentially in a business with enough different arms of income that you have more passive income.
Dr. Tim: That's for sure. And you know, 45 would've been the perfect time to pull the rip cord and say, I have a whole bunch of training and I'm valuable. But you get lazy. Medicine after 15 years is not as challenging as it was. You know, when you're 5 years into it and you punch the clock and you know what, you're gonna get paid and it's easy to take nice vacations and as I would use in my biker terms, I should have "nutted up way earlier."
Daniel Wrenne: Yeah. Right. I mean, but it's a hard decision in the moment in.
Dr. Tim: And if it would've catastrophically failed, I might've told you that I made the right decision now.
Daniel Wrenne: I mean, but failing, that's the thing, it's not really taught in. A lot of these principles are not taught in medical training at all.
Daniel Wrenne: It's one of my favorite books is called Failing Forward John Maxwell. And it's just this basic entrepreneurship concept that like failing is a good thing and it's one step closer to where you want to go. And so the faster you can fail, the faster you get to this place of solid.
Dr. Tim: Yeah. And it's, you know, I heard another really interesting, I think it was Glenn Beck who's talking about this, who is LDS, and he talked about, he goes, how come so many Mormon men are successful at business?
Dr. Tim: And he said, it's because they know that No is just No, for one thing. It's not No for the rest of your life. So when you've knocked on a whole bunch of doors and 80 of them are No, and one is Yes, you realize all you need is one Yes. And in business that's absolutely true. You don't need to be successful at every business idea you have.
Dr. Tim: You have to be successful at one. And then make that more successful. And that's super, super powerful. And it's weird because, we've got to a place now, we've asked the weirdest people to for interviews and they say Yes. And some of them just ghost you. And we're like, well, whatever.
Dr. Tim: We don't care. It doesn't matter. Yeah. You ask, they say, No. It's no reflection on me.
Daniel Wrenne: Right. Yeah. That's a good spot to be. Yeah. So your podcast BS Free MD any other places people can find you or..
Dr. Tim: Yes, Instagram. We do a little bit on Facebook. Really no Twitter stuff, per se. Instagram, if you wanna see more of the wacky side.
Dr. Tim: Please follow us on Instagram. It's just @bsfreemd. You'll be able to find it really easily at Instagram. There's some very interesting videos on there.
Daniel Wrenne: Yeah, yeah, definitely check out the podcast too. They have a great podcast. I've listened to multiple episodes and I've shared them with multiple people because you have such, it's unfiltered, so it's hard to get, I mean, everybody's so careful about what they say, but you guys like speak truthfully. You know, you don't hold back stuff, which is really nice because you can get like the full story on things.
Daniel Wrenne: So that's what's great about y'all's podcast. And I would definitely check it out if y'all haven't checked it out already.
Dr. Tim: Yeah, we would absolutely appreciate that. And if any of you want have ideas or questions for guests, we have a website, bsfreemd.com. There's a portal there to email us and yeah, we're always open.
Dr. Tim: We've interviewed Todd Field Drax champion, who had all sorts of medical problems. Eddie Braun, who was a Hollywood stunt man that recreated evil Knievel's jump over Snake River Canyon, but actually succeeded. Peter McCullough a couple times. it's just been really, really fun.
Dr. Tim: And we've made a bunch of friends and we travel around now we go meet people just 'cuz we talk to him on a podcast.
Dr. Tim: Kind of wild.
Daniel Wrenne: Yeah, it's fun. Well Tim, I appreciate it. Tell May hopes she feels better and hopefully that migraine's short-lived and good luck with the surgery tomorrow too.
Dr. Tim: You bet.
Dr. Tim: Thank you so much. That was awesome.
Daniel Wrenne: Thanks Tim.
