From the Heart #4: A Day in the Life of a Family Doctor

Ever wonder what really happens behind the scenes in your family doctor's practice? In this raw, unfiltered episode, I open up about the everyday realities of primary care medicine that patients rarely get to see.

The morning starts in my surgical clinic with a challenging decision – accommodate an anxious young patient by performing procedures on both ingrown toenails instead of one, knowing it will delay every appointment afterward. This everyday scenario reveals a fundamental difference between medicine and other professions. While lawyers and accountants end appointments precisely on time, doctors constantly stretch themselves thin because we know the alternative for patients is often waiting months for the next available slot.

The most heartbreaking revelation comes when reviewing test results and seeing x-ray appointments scheduled for July 2026 – fifteen months away for patients with painful, potentially serious conditions. This isn't the fault of radiologists or technicians but reflects a healthcare system where resources haven't kept pace with demand. The frustration compounds when seeing patients repeatedly miss appointments without notice, wasting precious slots while others desperately wait for care.

These challenges explain why I've pivoted increasingly toward preventative medicine. So many conditions I treat daily – from vitamin deficiencies to chronic diseases – could be prevented or minimized through lifestyle interventions. When healthcare resources are this stretched, prevention becomes not just personal health insurance but a civic responsibility.

Next time you're frustrated by a delay in your doctor's office, remember there's likely someone before you who needed extra time, just as you might someday. We're all stakeholders in this shared healthcare system. What simple changes could you make today to protect both your health and our collective healthcare resources?

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Dr. Jules

Chapters

• 0:00 Section A

Transcript

Speaker 1: 0:00

Yo Plant-Based Buddies, welcome to a new segment of the show that I'm going to call From the Heart. Now, these bonus episodes are different no script, no plan, just me speaking openly and honestly about lessons and stories that come from real conversations, with real patience. It's raw and polished and honest, but packed with insights that matter. But packed with insights that matter. Most of the time, I simply open my phone camera, record a video and this is the audio of these conversations. So, if you're ready for something a little bit more spontaneous, this is from the heart, unplanned, unscripted, but straight to the point. Yo Lumbia's buddies, how about we do a video on a day in the life of a family doctor? This morning is my surgical clinic, meaning I'm removing lumps and bumps and ingrown toenails and doing minor skin procedures, just like Dr Pimple Popper. First case of the day very, very anxious young guy scheduled for an ingrown toenail, doesn't want to miss school, doesn't want to miss sports, so he wants to do both sides. He has both toes ingrown. He's only scheduled for half an hour. So what do we do? Is we decide to bite the bullet and take the time, delay and accommodate this person because he's extremely panicky and fearful of the procedure. He doesn't want to do it twice. His father insists that we do both procedures today. I accept because I'm a reasonable human being, but I do accept that we're going to take another extra 20, 30 minutes for the procedure and this delays everyone's appointment for the rest of the day. So the patient that I'm seeing at 11 is automatically pushed back a good half hour. Now, funny how doctors do that and it's become a part of our culture to be late.

Speaker 1: 2:24

When I started working, I needed to get incorporated. That means that, being a doctor, I operate as a small business, I have my expenses, my employees and I needed to get incorporated, which means that I needed a financial planner, I needed a fiscalist, an accountant and I needed a lawyer. Very quickly I noticed that, although I still had a million questions, if my appointment with my fiscalist was at 1, at 1.30, they were like okay, you need to leave now, our meeting is over. And I was like well, I still have a million questions. Then book another appointment because I have another client at 1.30.

Speaker 1: 3:03

And at the beginning of my career I remember being surprised, even maybe frustrated a little bit, because I'm like I'm giving all of myself to my clients, to my patients. I'm skipping breakfast, I'm not eating lunch, I'm working through my lunchtime, I'm often missing supper time, I'm working to the night. I'm doing my best. I volunteer a lot of hours as a doctor. Now that I have kids, I miss very important soccer games and anniversaries, all because I'm trying to accommodate my patients. But we seem like the only profession that actually does that. So if I get paid $40 for a patient, the $40 is whether I spend five minutes with them or an hour with them, right.

Speaker 1: 3:58

So whereas most other professionals, like lawyers and accountants, give you a half an hour appointment and most people respect that time, respect their time and leave once the appointment is done, I'm not sure why medicine is different. I think access is so difficult that for me it was easier doing that first case today, just doing both surgeries at once, because if I am to reschedule him, he's going to get an appointment in November and he's going to miss sports and he's going to miss school and I know and I recognize the hassle that I'm causing in his life. So instead I deflect that hassle onto myself. I'd much rather bear the weight of that extra 20, 30 minutes and give that bad news to all the rest of my patients throughout the day, make the rest of my clinic delayed to try to accommodate that one person. And welcome to being a doctor in New Brunswick. If I knew that I would have an extra appointment next week, maybe I'd be more inclined to have people respect my time. But the option is I can't really ask people to reschedule because my schedule is backed up and I think my next appointment is the first week of November with me. So sad, sad reality. Speaking of sad realities, I finished my clinic this morning and I decided to start looking at paperwork, and really every single day, unfortunately, we're used to it, so we've been desensitized and we normalize this, but every single day we get a stark reminder on how behind our healthcare system is.

Speaker 1: 5:55

On May 1st I ordered an x-ray for a patient that has a weird bump on her hand that we want to have looked at. I get the schedule, the date of her scheduled x-ray. She's scheduled on July 15th. It takes three months for me to get the x-ray date that I ordered in May, scheduled for July 15, 2026. 15 months after, another patient that has numbness, chronic tingling and pain in her right shoulder we suspect calcific tendonitis we order an x-ray. The x-ray was also ordered on May 1st. She gets her date yes, you guessed it July 15th at 3 pm, 2026. This is not doctor's fault. This is not the radiologist's fault or the x-ray technician's fault. They have access to vacation time too. They're short-staffed. Everyone is short-staffed when it comes to people's health.

Speaker 1: 7:19

People get very frustrated with wait times, get very frustrated with wait times. I'm not a politician, I can't legislate my way out of this one, but people need to understand that healthcare is a finite resource. So then, when I have this patient right here that has his third consecutive no-show for an ultrasound that is urgent and we need to do, I get frustrated a little bit. So third straight appointment that is missed without warning, without calling, without canceling. So the problem is that that spot goes unused, the 30-minute spot that that patient had to have an ultrasound done, where a technician takes images of the suspicious bump. It simply doesn't show up and doesn't call three times in a row.

Speaker 1: 8:19

And the problem is that sometimes people go through shit. Sometimes people get sick, people are sick in their family. They have great excuses on why they missed their test, but the problem is when it happens three times in a row to a patient that has one of the worst track records for not showing up to appointments with me. I get frustrated but I cannot say anything. I can't do anything If I just take this piece of paper and I throw it in the garbage and that bump ends up being something dangerous. I'm at fault because I didn't follow up.

Speaker 1: 9:03

So patients are absolutely able to be negligent with their health and to be cavalier with their health, but they're also able to sue their doctor if their doctor doesn't ensure proper follow-up after tests that have been missed three consecutive times. So now I have on the weekend to take time to call that patient and say hey, do you want us to schedule for a fourth time? Please show up to the next one. Resources are finite, people are missing appointments and we're not able to schedule them in time. Wait lists are getting longer. We all share our healthcare system but unfortunately we live in a very self-centered, selfish moment in history and just looking at the documents and tests that I have in front that he has a suspicion of renal cancer on his ultrasound. Now I have to call that patient that's been waiting for months to tell them that we have a suspicion of renal cancer and he's going to need a CT scan and a consultation with a urologist and then has to wait more. I don't like to complain when I don't have solutions, but that's one of the reasons that my practice has pivoted towards preventative medicine, lifestyle medicine, because a lot of the things that I see during the day are things that can be managed and when people get certain conditions, certain chronic conditions, often they could have been prevented with proper lifestyle medicine. Four other tests that I have in front of me. Just for fun, let's go through them.

Speaker 1: 11:29

So here we have severe deficiency in vitamin B12. Vitamin B12 is a vitamin that is absorbed by your stomach. People who take chronic anti-acid medication or medications like metformin, or who have a condition called pernicious anemia, may have deficiencies in vitamin B12 and should be supplementing. The thing is is that as we grow older, our stomach lining becomes less able to absorb B12. And a lot of people, even if they don't take EPIs, medication, metformin these can still have deficiencies in vitamin B12 and could possibly benefit from supplementing. People that don't have overt deficiency might want to consider taking a vitamin B12 supplement of 1,000 micrograms twice a week, knowing that if you do it twice a week, you will not be over-supplementing and any excess will be urinated, because vitamin B12 is a hydrosoluble vitamin, meaning it is soluble in water, meaning that we have the capacity of peeing it out if we take too much.

Speaker 1: 12:43

Second here severe iron deficiency. Iron deficiency is the most common mineral deficiency in the world, more common in women because they're menstruating and losing iron, but also common because people eat crap diets. Iron is not something that I would want to do mass recommendations of supplementation, because excess iron can be as dangerous as iron deficiency, depending on the cause. So it's something to talk with your doctor. The next blood test I have is severe deficiency of vitamin D.

Speaker 1: 13:23

More than 50-60% of people are deficient in vitamin d. Vitamin d is associated. First of all, vitamin d is actually a hormone and has hormonal impacts on top of vitamin impacts and cofactors, meaning that it helps activate other hormones in other enzymes, as on top of his function as a hormone. Um, a lot of people are deficient in vitamin d because we're not going outside anymore. On top of his function as a hormone, a lot of people are deficient in vitamin D because we're not going outside anymore and we're not really consuming foods that are rich in vitamin D, and so a lot of people would benefit. There are studies that show association between vitamin D and cancer. Vitamin D and immunity. Vitamin D and immune function If vitamin D and neurodegenerative disease like Alzheimer's. We should all optimize our vitamin D levels, either with lifestyle or with supplementation. Talk to your doctor about that.

Speaker 1: 14:24

The thing is that people take health for granted until health is not there anymore. There's this old saying you can have a million problems, but if you have a health problem, you only have one problem. I see patients where their only health problem is pain in their big toe, but that totally consumes their life because every single step of the day that's ruining their mood. Right? People who have chronic diseases have higher rates of depression and insomnia and mental health issues, because being sick is no fun right Now. I don't pretend that lifestyle medicine is going to repair your broken arm or cure cancer, but I think for people here who still have their health, do not take it for granted. I've been a patient myself in the healthcare system and every single day I see people that are waiting months for specialists or a year for an x-ray when you can't lift your arm right.

Speaker 1: 15:36

We all share this healthcare system. We need to use our resources judiciously. I would love patients to get a VIP blood test where we can check everything, but the problem is that then we have glitches where liver enzymes are high because you drank alcohol and you binge drank a case of beer this weekend and so my blood test is abnormal, but I can't be sure that it's the alcohol. What if I'm missing liver disease? So that leads to other tests and other ultrasounds, which then you wait three months, and it bogs the system. So I'd love, in a perfect world, to be able to test everyone.

Speaker 1: 16:14

That's not the reality. We live in in New Brunswick and I really want people to understand that right. When you miss a test, when you cancel an appointment, when you don't show up, when we over test, when we under test, when we undertest, when we under-test, when we under-prevent, when we under-screen, it all has downstream impacts on making our population sicker and on bogging our healthcare system, so we're not able to take care of people who need it. Look, new Brunswick has an amazing healthcare system and healthcare professionals that can see you very quickly if you are very sick. The problem is for people that have things that are just below that threshold of being dangerous. Things can be very, very painful without being life-threatening, and that's where patients are really stuck between a rock and a hard place, waiting months for tests and months for specialists. So take care of yourself. That helps us take care of your healthcare system so that when you or family members need it, we're able to help you quicker and help you gain your help back.

Speaker 1: 17:38

Cool Right on. You have an awesome weekend. Bon canceau des fous. Don't go overboard partying there. Okay, I'm watching. 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.