The Dr. Jules Plant-Based Podcast

Behind the White Coat: What Your Doctor Wishes You Knew

• Dr. Jules Cormier (MD) • Season 2 • Episode 96

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What really happens after your doctor closes the exam room door? How do physicians feel when they can't give you the time you deserve? The healthcare system has trained us to focus on symptoms, tests, and diagnoses, but we rarely discuss the human experiences on both sides of medicine.

Drawing from nearly two decades in healthcare, I'm pulling back the curtain to reveal what doctors wish every patient understood about their reality. The truth might surprise you: physicians carry your stories home, cry over difficult cases, and often work while sicker than the patients they're treating. Behind the professional demeanor lies deep caring that extends far beyond the brief medical encounter.

The modern healthcare system places impossible demands on both doctors and patients. With specialists facing hundreds of new consultation requests monthly while already working at capacity, the math simply doesn't add up. Most physicians work 50-60 hour weeks with months-long waitlists, yet still face criticism for seeming rushed during appointments. This episode explains why canceling a clinic creates cascading problems that follow a doctor for months, and why your physician might choose to work through illness rather than reschedule patients who've waited months for care.

Beyond time constraints, we explore the power of lifestyle medicine, the uncertainty inherent in medical practice, and the need for collaborative healthcare models. I've witnessed patients reverse chronic conditions through consistent lifestyle changes, but guiding these transformations requires time that our current system rarely allows. The future likely involves integrated teams of specialists working together to support patients holistically.

Whether you're frustrated with your healthcare experience or simply curious about what happens behind the scenes, this episode offers perspective that could transform your next medical visit. Want to help create a better system? Start by understanding the realities your healthcare providers face every day.

Go check out my website for tons of free resources on how to transition towards a healthier diet and lifestyle.

You can download my free plant-based recipes eBook and a ton of other free resources by visiting the Digital Downloads tab of my website at https://www.plantbaseddrjules.com/shop

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Peace, love, plants!
Dr. Jules

Speaker 1:

Hey everyone, welcome to Season 2 of the Dr Jules Plant-Based Podcast, where we discuss everything from plant-based nutrition to the main pillars of lifestyle medicine. Hello everyone, and welcome back to another episode of my podcast. Today we're going to be doing something a little different. Instead of talking about lifestyle medicine or diving into the science of nutrition, I wanted to talk about the top things that I wish that every patient knew about their own doctor. Now, after almost 20 years in medicine, one thing has become very clear to me, and that's the fact that we talk a lot about symptoms, we talk a lot about lab tests and prescriptions and about patients and diseases and diagnoses, but we do not talk about the human experience of being a patient, and even less about the human experience of being a patient, and even less about the human experience of being a doctor. So today I wanted to lift the curtain and share a few things that I truly wish that every patient would understand about their doctor, and consider this an homage to my colleagues, to my friends, to my mentors, my teachers, and also to my students and to my patients. Now, the first thing that I want my patients to know, or that I want all of the general public to know is that doctors care deeply. I once had a patient with advanced cancer who made the brave decision to stop their treatments, and I did support and respect their choice. But I still went home that night with a heavy heart and I kept thinking about his children, the courage he showed and the silence that then filled the room when we said goodbye. I knew that he was going home to have palliative care and I assumed that the next time I would hear from him was from one of his family members telling me that they've passed. Now, doctors see you at your most vulnerable and even when we're quiet or distracted or we seem to rush, we often still carry your stories with us at home. And, yes, we do cry too. Over the last 20 years I've broken down maybe a handful of times in the room with my patients. Typically it happens when children are involved or when someone's story just strikes a chord and reminds me of the upbringing that I've had.

Speaker 1:

Now, with time and with bad news every single day, doctors do tend to be desensitized to bad news. To be desensitized to bad news meaning that when you work day in, day out inside of negative energy and suffering and pain sometimes someone's pain, although the center of their own lives is just one of the 30 patients we're going to be seeing that day and we are likely going to see someone who's in worse shape than you and although discomfort and suffering is relative someone's 10 out of 10 discomfort may be someone else's 6 out of 10 pain right Now. The other thing that is important to recognize is that doctors don't have all the answers. We have guidelines that are based in great data and systematic reviews and meta-analyses and randomized controlled trials, but these studies often give us answers about populations or about averages, but you're not an average. You are you and your experience is determined by your genetics and your background and your life experience and your desires and how it impacts your life on a daily basis and regardless if you have children or not or work or not. All of these things come play a role in how we manage your symptom right. Medicine isn't always a straight path and there are times when we're basically doing our best to navigate uncertainty. We use the best available evidence and then we combine that with our years of experience to try to guide us, because most people do not fit inside of our guidelines, and that's the art of medicine it's knowing what the patient wants, knowing what the guidelines say, seeing the impact in your life and obviously, the personal experience and professional experience of that doctor you're seeing during that day will absolutely help determine what the treatment will be.

Speaker 1:

Now I remember a young woman who came in. She had persistent fatigue but all of her tests were normal. We did blood work, we did x-rays, we did sleep apnea testing, we did cognitive testing. We made sure that she wasn't having a bout of depression or anxiety or ADHD. After months of investigation, she asked me Do you believe me? Do you think I'm lying? And I told her yeah, I do believe you, but because, even if the answer is not obvious right now, her story matters. We're always trying, we're trying to listen, trying to learn and trying to never give up on you. And I always tell my students we're not detectives, we're not the police. We believe what patients tell us to be their experience and we try to see maybe they're misinterpreting their symptoms or maybe they're biased in their own research that they've done. But that's why they come to see us To have someone neutral and unbiased give an expert opinion based on thousands of hours of clinical training and years of clinical experience.

Speaker 1:

Now, the other thing that I would want my patients to know is that doctors wish that we had more time with you. Now we've had 10-minute appointments where I've had to explain a new diagnosis, discuss medication and treatment, counsel on lifestyle habits and then answer a grocery list of questions, all of this knowing that there are a dozen more patients waiting in the waiting room to be seen. Now. Do we want to feel rushed or to rush you? No, never. We became doctors to connect and to guide and to help and to educate, but the reality is we often leave our clinics feeling like we've let someone down, not because we didn't care, but because we simply do not have enough time to show that we do. We have a caseload that is sometimes backed for months, and the more time we spend with you, the more time others wait for their appointments. Others wait for their appointments. Now.

Speaker 1:

When I was hired as a doctor, I was told that I was going to be offering not only service to a patient, but service to a community of patients, and what that means is that if I have a thousand patients and a three-month wait and my appointments are booked every 15 to 20 minutes, and I, tomorrow, decide that I want to spend half an hour with everyone. I want to help patients stop smoking and exercise more and sleep better, and I want to advocate for lifestyle medicine, and so I'm going to extend my appointments to 30 minutes instead of 15 to 20,. Well, that means I'll be seeing about 30 to 40% less patients Instead of seeing 20 patients in a day. That might go down to 12. And if that happens, well, that's six to eight more patients that do not get seen on a daily basis, more patients that do not get seen on a daily basis, and the implications for our healthcare system would be dramatic. I mean, my waitlist would probably balloon to five, six months. Doctors would start accepting less patients in their clientele and exponentially more people would be without doctors or would be waiting months to access one. Now, tomorrow, if you call my clinic and you ask to have specifically an appointment with me in person, you're waiting months for that appointment.

Speaker 1:

Now, could I work at the office every single day, 8 to 6 pm? I could, but I'd be very unhappy doing that, because the reason I like my job is that medicine can be practiced in many different ways. I'm teaching on Monday mornings and then seeing patients in the afternoon Tuesday, I'm teaching again and then doing skin surgery. On the afternoons of Tuesday, wednesday, thursday, friday mornings I do surgery again. I teach at a university, I give courses at my clinic, I advocate for lifestyle medicine. I do a whole bunch of different things. I have my colleagues doing the diabetes clinics and others that are on committees. One of my colleagues is the current president of the New Brunswick Medical Association. Some deliver babies, some do ER shifts.

Speaker 1:

The reality is is that doctors are not always sitting at the office seeing patients like you're at the drive-thru right Now. There are simply not enough doctors for the amount of people who need to see one, and that's why we need to collaborate with other disciplines and other healthcare professionals like physiotherapists, dieticians and psychologists, in order to offer the best care possible. But I understand that, after 20 years of building a relationship with the patient and their family and knowing the name of their pets and what they do for a living and where they vacationed over the last year, I understand that some of my patients would rather get their nutrition counseling from me than from having to see a new dietitian, for example. From having to see a new dietitian, for example, because my recommendations will not only be evidence-based, but they'll be adapted to the patient's needs, because we've built that relationship over years and years and we've built that trust and confidence.

Speaker 1:

Now there are simply too many patients, not enough doctors and not enough time in a day. I probably work 50 to 60 hours on average per week and still have many months of wait time before having an available appointment. Now one specialist recently told me that he had over 500 new consultation requests per month. He already works inhumane hours at full speed trying to see maybe 50 to 60% of these patients waiting on his wait list. Then one of the patients that he saw one of my patients said yeah, I didn't like him. He seemed very rushed. Now this story happened a few days after that colleague of mine admitted to how guilty he already felt having to work so fast and not spending more time for preventative counseling. That's probably why a lot of specialists come to Moncton or come to New Brunswick and end up leaving again simply because the workload is too much.

Speaker 1:

Now I can imagine some patients saying well, doctors, you kind of know what you were getting yourself into when you decided to go into medicine. Most of us go into medicine knowing we're going to be studying for over a decade and we're going to have thousands of hours of training and a very, very hard work. We know that our profession is not easy and practicing medicine will come with the long hours and working on holidays and having minimal vacation. We know that, working on holidays and having minimal vacation, we know that. But what we kind of didn't recognize is and I can just speak for myself is how frustrating it can feel to go home knowing and wanting to have done better. Now I remember seeing 30 patients in an afternoon at the walk-in clinics and I recall feeling like there there's so much more that could have been done, not only to treat and diagnose, but more to prevent right things that I could do so that you do not need to come to the clinic next time. Information that I can counsel you on why you could have waited another 24 to 48 hours before consulting with your child, because there's a 95% chance that the ailment they have would have disappeared within that time frame.

Speaker 1:

This investment on the front end will help on the back end by decluttering clinics and having people maybe be a little bit more patient, a little less worried and maybe not even needing that that appointment in the first place. Now, when someone is, that's not the best time to scream swimming instructions. You simply want to throw them a lifeline. And when the house is on fire, it's very hard to find time to figure out how to keep the fire from starting in the first place. And this concept applies perfectly to medicine. We are so busy putting out fires that we simply have no time trying to prevent them.

Speaker 1:

Now, the fourth thing that I want all of my patients to know is that lifestyle change is powerful, not optional, and it can be very frustrating waiting months to see your doctor just to have them talk about your diet and sleep and movement, when you just wanted a quick fix. But I always bring these things up because I've seen them change lives. Plague. Our schedules would respond to some type of lifestyle intervention that acts on your nutrition, your exercise, your movement, your sleep, your social connections, your stress management strategies. Now I've seen patients reverse their type 2 diabetes by changing what they eat, and I've seen depression go away through consistent movement and better sleep, and I've watched people remove their blood pressure medication simply because they've changed their lifestyle. Now lifestyle medicine isn't just something we mention at the end of the visit. It should be the starting point. It's powerful, it's personal, but it takes time, and it takes time that we often don't have inside of a medical visit. Now, the other thing that I'd like my patients to know about doctors in general is that we're human too. We make mistakes, we get tired, we carry stress, guilt and grief, just like you Now.

Speaker 1:

One morning, I was about 10 minutes late to clinic after being up most of the night with a fever. I'm pretty sure that I had strep throat, so I made sure to wash my hands and wear a mask. Now the best thing I could have done is simply stay home. Right, but staying home meant that I needed to cancel my clinic, and canceling 30 patients that have been waiting months for an appointment means that I need to figure out where to reschedule them Now. Unless you want to come see me Saturday night at 10 pm, there's no space in my schedule for 30 patients, so these patients would need to simply be either put at the back of my list or be seen early in the morning, late at night or during my lunch hours.

Speaker 1:

Now that's why a lot of doctors rather not take vacation or not take a day off and not call in sick, because it simply makes our life more complicated than working tired or working while ill. That night where I got to work a few minutes late because of a fever, I tried to push through the day but my mind was not even there and a patient was frustrated with the weight and the fact that I was working slow that day, and understandably so. But in that moment I wish I could have said please be patient with me, I'm doing my best, I'm not feeling well. It's more complicated for me canceling your appointment than simply trying to work while I'm feeling like crap. Doctors aren't machines, but we're people who chose this path because we wanted to help and because we love the science of medicine. But sometimes we need a little grace too, and I've worked many days, lots of days, where I was sicker than the patient that I was seeing and I was sicker than the patient who was asking me for a medical note to have some time off work for a scratchy throat while I was swallowing razor blades. Now I never like to rant or to vent without offering possible solutions, and the main problem is that there are simply not enough doctors for the amount of patients that need to be seen.

Speaker 1:

Our population is aging. The rates of chronic diseases that are directly or indirectly linked to the lifestyle we live and the choices we make is growing exponentially. Science has evolved. Pharmacology and medicines are evolving. Imaging technologies are exponentially getting more advanced than when I started working, and now artificial intelligence will enter the picture. So obviously the landscape of practicing medicine has evolved dramatically over the last 20 years, but medical training hasn't right. Doctors absolutely need to get more training in the things that are coming up, including using lifestyle medicine interventions to help people get their life back. Doctors are not just prescribers, they're now coaches. Prescribers, they're now coaches and they need to learn how to intervene in the four or five minute window that they have with their patients to discuss lifestyle medicine. They also need to accept that it's okay to collaborate, and patients need to understand this too.

Speaker 1:

Working with dieticians and working with physiotherapists and working with massage therapists and other holistic practitioners that practice evidence-based medicine is absolutely important and incredibly, incredibly useful. I mean having a team of people that work around you and that all see your problem from a different angle will obviously provide the best outcomes. But the thing is is that with the insurance companies and the way things are organized, just physically, it's inconvenient for patients to drive down one side of town for their physio and then the other side of town for their dietician and the other side of town for their doctor. Imagine everything being in-house. Imagine a clinic where you could see the nurse, the doctor and the dietician back-to-back, and imagine that then you would have a cheerleader in your corner, a coach or a coordinator, a care coordinator that's calling you and texting you and making sure everything is okay and that you're getting your steps in and you're drinking your water. Now I think this is the future of healthcare and I don't think doctors need to be involved in every single facet of preventative practice and preventative medicine. I really honestly think that if a patient is surrounded by a team of people, that will lessen the burden on doctors.

Speaker 1:

Practice in medicine is difficult. I mean, I love my job but I find is difficult. I mean, I love my job but I find it difficult, and I have difficult days where I feel that I'm not doing enough and I'm working against the system that's working against me. It's such a weird concept. Now, if you felt this frustration as a patient, I don't blame you. And if you felt like modern healthcare wasn't providing you the answers that you needed and you needed to seek answers elsewhere, in either alternative medicine or alternative practitioners. I understand, and that's why my goal has always been to try to marry these two things together Evidence-based, holistic alternative medicines.

Speaker 1:

There has to be a way of having them integrated into the modern medical system. It doesn't need to be one or the other, it can absolutely be both, just as long as these alternative treatments are based in good quality evidence. Now I understand that supplements or cupping or acupuncture will likely never be studied with a billion dollar budget in huge randomized placebo-controlled trials where the study lasts for a year and involves thousands of patients. I mean, these companies simply don't have the budget that big pharma has to produce these high-level, high-quality studies. But we can absolutely still look through the BS and find good quality science to support some of these alternative measures that could help patients get healthier right Now.

Speaker 1:

One of my colleagues once told me when I was a student no one gets put on a timer when they come see their doctor. Some patients will require five minutes and you give them five minutes, and some people will require 25 minutes, and these patients, you give them 25 minutes. You try to thank the next patient that was waiting. You thank them for their courage and patience and explain to them that some people simply may need more time right, but if you're one of these patients that are listening to this podcast right now, you're likely someone who already understands that lifestyle interventions are the key that will likely save our whole healthcare system. So to you, who already practices lifestyle medicine in your daily life, who moves, who eats well, who manages stress, who connects with people they love, who lives with purpose and passion, to you, thank you. Purpose and passion To you, thank you. You're one of the main reasons that our healthcare system hasn't completely been overwhelmed, and you're the reason that I love my job. Going through success with patients is infinitely more validating than the weight that we carry through bad news. Having patients that stop smoking or reverse their diabetes or reduce their blood pressure pills that's extremely reinforcing for me and it makes me want to coach and help a million other people do the same. Now I've seen it happen so many times that people turn their lives around and get their lives back that I want everyone to feel the power that that can have. I felt it for myself when I reversed my chronic diseases, and I hope everyone has a chance to do it too, right on Cool.

Speaker 1:

Thanks so much for being here. Thanks so much for listening to this episode. Let me know what you think. Do you feel heard? Do you often feel misunderstood by the modern healthcare system? I can almost guarantee you that the problem isn't your doctor. It's the system that we work in and we're forced to adapt to. But we're trying to change that. We're going to start with one clinic at a time and one doctor at a time and hopefully this can trickle down and be a part of the culture that we have in New Brunswick Healthcare. Right on, you have an amazing day. We'll see you at the next episode. Peace, hey, everyone. Go check out my website plantbaseddoctorjulescom to find free downloadable resources and remember that you can find me on Facebook and Instagram at Dr Jules Cormier, and on YouTube at Plant Based Dr Jules.

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Dr. Jules Cormier

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