#1698 Dr. Beachgem
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Dr. Beachgem (@Beachgem10) is a board-certified pediatric emergency medicine physician and a massive, trusted voice on TikTok, Facebook, and Instagram. She translates real ER experience into simple, actionable advice for parents—helping families decide what’s normal, what’s urgent, and what to do next.
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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner (0:0) As the holidays approach, I wanna say welcome and thank all of my good friends for coming back to the Juice Box podcast over and over again. (0:18) I guess I have to be careful about what I say on the Internet because a couple of weeks ago, I said, I'd like to see doctor Beach Jim on the podcast, and here she is. (0:29) You all went and told her on TikTok, Instagram, Facebook, YouTube, everywhere you could find her. (0:34) You tagged her. (0:35) You tagged me, and you said we'd love to hear you on the juice box podcast.
Scott Benner (0:38) And you guys did it. (0:39) You're the producer of the podcast today. (0:41) You got us doctor Beach Jem, and she is every bit as amazing as you think she is. (0:47) She's known all over the Internet as doctor Beach Jem or doctor Beach Jem ten and is a board certified pediatric emergency medicine physician. (0:56) She's a wife and a mom.
Scott Benner (0:57) I had such a fantastic time making this recording with her that after we got done recording, I asked if she would be interested in coming back and putting together a series with me about how type ones could have better success in the emergency room. (1:10) And guess what? (1:11) She is so lovely. (1:13) She said yes. (1:14) So you'll see doctor Beach Gem back on the podcast in 2026, maybe for a number of episodes.
Scott Benner (1:19) If you're here today because you're a big fan of doctor Beach Gem and you have no idea who I am, my name is Scott. (1:25) I make this podcast, the Juice Box podcast. (1:27) It's eleven years old. (1:28) We have 1,700 episodes. (1:30) An episode goes up every day.
Scott Benner (1:31) Most of them are conversations with people who live with type one diabetes or love somebody who does, some people with type two, and a lot of other autoimmune issues, Hashimoto's, celiac, stuff like that. (1:44) If you like to hear people sit down and really openly and honestly talk about their life with their condition, I think you'll really like this podcast. (1:53) It's not super serious. (1:54) It's not super jokey. (1:56) It is entertaining, and I think you'll love it.
Scott Benner (1:59) Subscribe and follow. (2:00) Give us a shot, and at the very least, you'll get more doctor beach gem in the future. (2:04) And please don't forget that nothing you hear on the juice box podcast should be considered advice, medical or otherwise. (2:09) Always consult a physician before making any changes to your health care plan or becoming bold with insulin. (2:21) The episode you're about to listen to is sponsored by Tandem Moby, the impressively small insulin pump.
Scott Benner (2:26) Tandem Moby features Tandem's newest algorithm, Control IQ Plus technology. (2:31) It's designed for greater discretion, more freedom, and improved time and range. (2:36) Learn more and get started today at tandemdiabetes.com/juicebox. (2:41) Today's episode is also sponsored by US Med. (2:45) Usmed.com/juicebox or call (888) 721-1514.
Scott Benner (2:52) You can get your diabetes testing supplies the same way we do from US Med. (2:57) The podcast is also sponsored today by the Eversense three sixty five, the one year wear CGM. (3:04) That's one insertion a year. (3:06) That's it. (3:07) And here's a little bonus for you.
Scott Benner (3:09) How about there's no limit on how many friends and family you can share your data with with the Eversense Now app? (3:14) No limits. (3:16) Eversense. (3:17) So you're being recorded already, just so you know.
Dr. Beachgem (3:21) Awesome.
Scott Benner (3:21) But so okay. (3:23) It's not and there's no video. (3:24) If you wanna pick your nose, it's cool with me. (3:27) No one's ever gonna know. (3:28) Although, I get Priorities.
Scott Benner (3:29) Priorities. (3:29) People are like, you should do a screenshot so you can do the social media. (3:32) I'm like, I'm not good at social media. (3:33) I'm gonna just hope that she enjoyed herself and posts about it. (3:37) Yep.
Scott Benner (3:37) It's like, I I'm not gonna be good at cajoling people. (3:40) We'll just jump right in. (3:41) How do you want me to refer to you? (3:43) What do I call you?
Dr. Beachgem (3:44) Doctor Beach or doctor Beach Jem.
Scott Benner (3:45) Doctor Beach or doctor Beach Jem. (3:47) Okay. (3:47) You can call me Scott.
Dr. Beachgem (3:48) Jem is Meg backwards, my maiden name was Meg Beach. (3:51) So Beach Jem is Meg Beach. (3:53) It's a play on my name, which, again, I'm not allowed to use, but that's yeah.
Scott Benner (3:57) People have got it figured out pretty well.
Dr. Beachgem (3:59) A little bit. (3:59) There's a couple people that are like, I'm on to you.
Scott Benner (4:02) I just figured that you loved the beach when I saw it.
Dr. Beachgem (4:05) And I live in Florida. (4:05) Like, it makes sense.
Scott Benner (4:07) People are confused and want me to ask you why you live in Florida, but you wear Bills gear.
Dr. Beachgem (4:12) So I did training in Buffalo. (4:14) So I spent three years. (4:15) We my husband and I packed up everything we owned. (4:18) We sold our house. (4:19) We bought two new cars that had four wheel drive, and we moved to Buffalo.
Dr. Beachgem (4:22) We didn't know a soul with our two tiny babies. (4:25) We lived there for three years. (4:26) It's I don't know. (4:27) The people who don't know Buffalo is an incredible community. (4:30) Very, very, like, welcoming and supportive.
Dr. Beachgem (4:33) And, yeah, there's snow, but, like, the people, the festivals, everything is just amazing.
Scott Benner (4:38) That's good to hear. (4:38) My daughter's friend just graduated from college, and she got her first job in Buffalo, and she's leaving in a couple of weeks.
Dr. Beachgem (4:43) She's gonna have a blast.
Scott Benner (4:44) Awesome. (4:45) I'm gonna tell her that because I think she's worried. (4:46) I think she just thought snow.
Dr. Beachgem (4:48) Yeah. (4:48) There's there is snow. (4:49) Mhmm. (4:50) If you live north of downtown, it's actually you don't get as much lake effect as, like, just south of downtown.
Scott Benner (4:55) I'll tell her that. (4:56) Yeah. (4:56) That's good advice. (4:57) Okay. (4:57) So you went to school there.
Scott Benner (4:58) Did you go to undergrad, med school? (5:02) What did you do there?
Dr. Beachgem (5:03) I did my fellowship training. (5:04) So my pediatric emergency medicine fellowship after my general pediatric residency. (5:09) I spent a lot of time in school.
Scott Benner (5:11) Did you start out thinking, like, you'd be a pediatrician in an office and then kind of expand, or did you always have this as a path?
Dr. Beachgem (5:19) You know, I wasn't sure. (5:21) There were three things that I was interested in. (5:23) I liked pediatric emergency medicine, pediatric ICU, and pediatric endocrinology because when I was in med school, I did this summer camp just outside of Tallahassee for kids that have diabetes. (5:35) And it's a one week summer camp, and they bring med students and people who are a little bit more savvy with medicine so that we're doing blood sugar checks and that kind of stuff in the middle of the night in these kids and can alert camp staff if there is something awry. (5:49) So I fell in love with die like, as much as you can, fall in love with diabetes and the management while I was still in medical school.
Scott Benner (5:56) So a lot of doctors tell me that they they make their students go to diabetes camp to really get a feeling for what happened to you? (6:03) Can you tell me, like, what you didn't know that you left understanding?
Dr. Beachgem (6:07) I think, like, the glucose is still fuel. (6:11) You still need the sugar. (6:12) Even though sugar is, like, kind of the enemy, like, we wanna keep it manageable, it is still fuel. (6:17) And so when kids come into camp, one of the first things that they do is they adjust everyone's regimens. (6:22) Like, they go rogue because the kids are gonna be much more physically active than normal.
Dr. Beachgem (6:26) Mhmm. (6:27) And so we need to make sure that they have a little bit more of that fuel accessible for what they're doing. (6:33) And we actually had a kid have a really kinda scary low at one point. (6:37) And so just to see that, like, this is what parents are worried about when they tend to want their kid's blood sugar a little on the higher side and doctors want it a little on the lower side, but this is the scary part that doctors don't always get to see that parents get worried about.
Scott Benner (6:50) Okay. (6:50) So the reason I'm super interested to have you here is because I want your perspective, but I do first want to understand, like, you know, a little bit about you and how you got to where you are. (6:59) Can we start with why you're famous? (7:01) Like, how did that begin?
Dr. Beachgem (7:03) Yeah. (7:04) It's a great question. (7:05) I because
Scott Benner (7:06) you are. (7:06) Because but I I told you before we started recording, my wife has been cajoling me for two years to try to ask you on the podcast. (7:13) I now watch you online. (7:15) And then I was telling doctor Beacham this story before we started recording, but she did a diabetes awareness video that a lot of people who listened to me must have seen, and then I kind of sicced them on her. (7:25) I was like, hey.
Scott Benner (7:26) I'd love to get her on the podcast. (7:27) Can you go tell her? (7:28) And then they tagged you a lot and me. (7:30) Appreciate you not thinking we were crazy and coming on. (7:32) Like, no one doesn't know who you are who has social media.
Scott Benner (7:36) But did you set out for that to happen? (7:38) Because it doesn't feel that way.
Dr. Beachgem (7:39) No. (7:40) I this was an accident. (7:41) A kind of a happy accident, but this was never my intention at all. (7:45) I started making content during the pandemic. (7:48) I think everyone had a million activities.
Dr. Beachgem (7:50) Life is busy. (7:50) I had four kids, and then all of a sudden, all that's gone.
Scott Benner (7:53) Yeah.
Dr. Beachgem (7:54) I go to work, I come home, and I look at everyone. (7:56) So I downloaded TikTok, and then I started creating videos that kind of broke down science a little bit, you know, talked did some myth busting, discussed some of the misinformation, and talked about real science based stuff. (8:08) Mhmm. (8:09) And I guess I did it in a way that was authentic and accessible, and so people really were drawn to that, I guess.
Scott Benner (8:17) Do you find yourself thinking about that? (8:18) Because this is not a thing a lot of people didn't try. (8:21) I don't wanna get, like, down a wormhole that's only for you and I, but I don't understand why my thing's popular and other people tried it and it didn't work. (8:28) It's hard to pull out far enough macro enough to see yourself like that. (8:32) Do you have any feelings?
Dr. Beachgem (8:34) I a 100 a 100% agree. (8:35) I don't really know why that social media kind of chose me because I there's so many people that come out. (8:42) There's and I have a bunch of colleagues who do very similar stuff that I do, but don't have the same degree of following. (8:49) And arguably, they're smarter than me, most of them. (8:52) You know?
Dr. Beachgem (8:52) But I think that one of the things that I do is I do share a little bit more of, like, my personal life and my flaws and my messy house. (9:01) And I think getting to know someone, you trust them more. (9:05) Yeah. (9:05) They know that I've got the ADHD and that my house is messy. (9:08) And I get anxious when I do public speaking.
Dr. Beachgem (9:10) And they say, now she's gonna talk to me about this, but I can trust her because I know that she's a real human. (9:14) Yeah. (9:15) And I think that letting people in a little bit keeps them here.
Scott Benner (9:18) I said something on a recording that isn't out yet that I still can't believe I even admitted about myself. (9:23) I always think, like, maybe I'll just message the editor and be like, take that out. (9:26) I don't think I should have said that. (9:28) Even the, just two days ago, I was recording with a lady, and she was talking about her antibodies for type one. (9:34) And she goes, there's three.
Scott Benner (9:35) And I went, I think there's five. (9:37) And there is five, by the way. (9:38) I was right, but I wasn't sure. (9:40) And I've been doing this a really, really long time. (9:42) And it does give you a moment where you're like, am I not the right person to have this, whatever this is?
Scott Benner (9:47) You know what I mean? (9:48) Like, I what do they talk about? (9:49) Imposter don't feel don't feel that way. (9:52) I just I'm worried that I'm not doing as well as I could be sometimes for people. (9:56) I don't if that makes sense or not.
Scott Benner (9:57) But, anyway, it seems to be going okay. (9:58) So, okay. (9:59) You did not do this on purpose. (10:00) You started making videos No. (10:01) People like you.
Scott Benner (10:02) And then when does it occur to you that you're a slave to the machine now? (10:07) Because at some point, you have to make content. (10:09) Right?
Dr. Beachgem (10:10) Yeah. (10:10) I do feel like I kind of have to make content. (10:12) There is a certain degree of pressure there. (10:14) But at the same time, I don't really feel like a slave to the machine because it's still something that I really enjoy. (10:20) I really enjoy making the content, deciding on what to talk about that day.
Dr. Beachgem (10:24) Like, this is still something that is my coping mechanism for what I deal with, what I consider the real world at my real job. (10:30) Mhmm. (10:31) This is still something that I really enjoy, so it doesn't really feel like work. (10:34) You mentioned before we got on that you work seven days a week. (10:37) And I was like, oh, I guess I also work seven days a week on this, but I I just don't look at it like that because it's still something that's really fun.
Scott Benner (10:43) Yeah. (10:44) It doesn't feel that way to me, but it's true. (10:46) And, actually, like, we're just gonna get up and exist in this house again tomorrow. (11:06) I might as well do something, you know? (11:07) That's really interesting.
Scott Benner (11:08) Okay. (11:09) So I would also tell you that when I first started doing this, there was a person who told me, well, you won't be able to do it long because you'll run out of topics. (11:17) And I have found that to be the most untrue thing that anyone has ever said to me. (11:21) Yeah. (11:21) I think that there is a way to continue to help people and be thoughtful about it infinity, just just to keep going.
Scott Benner (11:28) Like, there's so many things to talk about that people don't understand or have context for. (11:33) My question is, what do you see that you talk about that really helps people that you didn't believe? (11:39) Like, you just thought, oh, I'll just talk about this today, then you realized how impactful it was.
Dr. Beachgem (11:43) You know, probably honestly, some of the diabetes stuff that I've talked about, like, that I diagnosed a friend's child with DKA in Carline, and I tell that story every year. (11:54) Throughout the year, I get tons and tons of comments still on those videos, and then people sending me messages like, Hey, I knew what to look for. (12:03) I was able to get my child or a friend's child early diagnosed. (12:06) They didn't go into DKA because, you know, we knew the symptoms ahead of time. (12:10) So some of that content, I feel like, has been among the more impactful stuff that I've done.
Scott Benner (12:15) You might not know this, but type one diabetes is one of the best represented disease states as a community online. (12:21) It has been like that since I started blogging in 2007. (12:25) And, you know, it's interesting because back in the day, like, I'd have people come to me and say, we'd really like to start a community for type two. (12:32) There's so many more people with type two, but they don't seem as interested as being in a community. (12:36) And then and do you realize, like, there's something about type one that makes people they can't hide it.
Scott Benner (12:43) Right? (12:43) You can't ignore it, and you need support. (12:46) I didn't realize even when I started doing this, this will maybe make you laugh. (12:49) When I started making the podcast, I actually just thought I would take my most popular blog posts and read them into the podcast because I knew they helped people. (12:57) I didn't realize it was gonna go like this.
Scott Benner (12:58) And people were like, Nick, like, please don't do that. (13:01) I pivoted a little bit. (13:02) But as I started growing, I kept thinking all I was doing was sharing tools. (13:06) And then when I started seeing the tools I think tools and foundation are really important. (13:11) I think the confidence to make decisions about setting changes is a huge thing for type ones.
Scott Benner (13:17) But community and support from people who understand I don't wanna sound silly because maybe I maybe I feel old, but I didn't realize that was a big deal. (13:26) And now I see it as, like, half of it. (13:28) Yeah. (13:29) You know? (13:29) So maybe that's one of the reasons why you're seeing back from people with type one because they are engaged because they need to be.
Scott Benner (13:35) And I think when you talk about it, they're like, oh, there's somebody who's outside of diabetes a little bit who's willing to, like, talk about this. (13:41) It must just be exciting to hear somebody speak about it thoughtfully. (13:44) Yeah. (13:45) Yeah. (13:46) So now we understand how you got here.
Scott Benner (13:48) Now I'm gonna ask you my difficult question.
Dr. Beachgem (13:50) Oh, boy.
Scott Benner (13:52) I hate the word advocate for myself. (13:54) I hate to think that you like, here's how I think about it. (13:57) When I go to the to get tires on my car, I don't go, hey. (14:01) Get me four new tires. (14:03) Let me watch and make sure you pick the right ones.
Scott Benner (14:05) Let me watch and make sure you put them on the right way. (14:07) Did you balance them? (14:07) Did you fill them up with air? (14:08) Did you tighten the lug nuts? (14:09) I gotta advocate for myself to make sure you do your job right.
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Dr. Beachgem (16:40) Oh, you know, health care is tough. (16:42) Mhmm. (16:42) And health care is not your car. (16:44) It's not as easy as putting tires on something. (16:47) You know, disease states are complicated, people make them individual.
Dr. Beachgem (16:52) I work in emergency medicine so my job is looking for emergencies. (16:57) I may say to someone, I don't know what this is, but this isn't something that's going to kill you tonight and this is the plan for follow-up. (17:06) It can be complicated because, you know, what's your insurance status? (17:10) What can you guys get approved as an outpatient? (17:12) There's so much more that goes into decision making in health care than just let's throw some tires on.
Scott Benner (17:18) Mhmm.
Dr. Beachgem (17:18) So, you know, I have to think, is this person doesn't have an emergency going to be able to get this test done? (17:25) Can they get into their pediatrician? (17:27) Can they get into this test done as an outpatient? (17:30) And so I think when we talk about the decisions that we have to make, it's just so it's not even three-dimensional. (17:37) It's four dimensional.
Dr. Beachgem (17:38) And I think there are a million different ways to approach conditions and decisions. (17:44) And I think when we're advocating, we're trying to bring everyone to the table to the same table.
Scott Benner (17:50) Okay.
Dr. Beachgem (17:51) Because a lot of times and and granted, there are great providers out there and not so great providers out there, but I'm sitting at my emergency medicine table, and they're sitting at their parent table. (18:00) And we need to be sitting at the same table, and I don't understand their insurance and their, you know, transportation and all of this other stuff. (18:06) And so I think advocating is really trying to get us all on the same table so that we're understanding all of the same things.
Scott Benner (18:12) Okay.
Dr. Beachgem (18:12) I don't wanna defend the not great decisions that happen out there, but I think some of the decisions that are made in medicine are decent decisions, just not made for the right person.
Scott Benner (18:21) And is it different for people with type one because they often have such a deeper understanding of their illness than other people do? (18:29) Right? (18:29) So when you say something that smells a little wrong in the ER for me, I'm like, oh, that ain't right. (18:34) And then, like, suddenly there's a a chasm there. (18:37) Like, oh, we're gonna take your pump off.
Scott Benner (18:38) You're like, dude, don't do that. (18:39) Yeah. (18:40) Or, you know, when somebody finger sticks you every hour when you're wearing a CGM and you think, like, you're just doing this so you can charge me for the finger stick? (18:46) Like, what is happening right now? (18:47) And, like so I ask you the question.
Scott Benner (18:49) It's a bit of a trick question because Mhmm. (18:51) People feel all the time like medicine doesn't understand diabetes. (18:56) But I've been doing this for so long, and I've spoken to so many different doctors that I think it's kind of a, like, a multipronged problem. (19:03) Like, you are you said and you said something I feel like. (19:05) Like, you as the patient, you're the variable because you don't know, am I on the ball?
Scott Benner (19:10) Do I not understand this at all? (19:11) Like, where's my diabetes understanding? (19:13) Like, so you have to treat us all like we don't know what we're doing because that is probably what you see most frequently. (19:18) Right? (19:19) People with higher a one c's who aren't quite sure about how to do what they're doing.
Scott Benner (19:23) And then there's your level of education, your level of experience, like, how tired are you? (19:27) Are you fighting with your husband? (19:29) All this is happening at the same time. (19:31) And then there's the insurance piece. (19:33) So can I even run this test?
Scott Benner (19:35) Am I right to say that, like, there's basically a checklist and if you don't meet everything, then there's a test you can't run even if you wanted to?
Dr. Beachgem (19:42) Not necessarily a check list in all situations. (19:44) Okay. (19:45) Especially, again, I'm in I'm in the emergency department. (19:47) I have relative free rein as long as I can justify it.
Scott Benner (19:51) Got it. (19:51) Okay.
Dr. Beachgem (19:52) So I can't order, you know, a random outpatient send out test that has nothing to do with your visit today. (19:57) Mhmm. (19:57) But I can order an a one c if we're concerned about x, y, and z, and it makes sense with your visit. (20:04) I do have more leeway than a lot of outpatient providers, which is cool, which is really cool.
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Dr. Beachgem (21:16) Yep. (21:17) Like, if I can justify it with the visit today, like, we could probably make it happen. (21:22) But I think one of the things that gets complicated is that, like you said, there are a lot of situations where people have higher A1Cs, maybe not managing quite as well for whatever reason. (21:34) And so we have all of these protocols and checklists that we have for new onset diabetes or maybe hyperglycemia. (21:41) And so we click these check boxes for orders, and now it's saying everybody that comes in with hyperglycemia is going to get a blood sugar every hour.
Dr. Beachgem (21:51) And what if your CGM is not working? (21:53) So I think that we are in this super cautious over here phase where you're like, I got out my CGM, we're good. (21:59) My blood sugar is 10 points different than it was an hour ago, but we have to function in this more conservative space, and we use these protocols to do that. (22:09) And it's nice because we can override these protocols in certain situations, but a lot of times the default setting is gonna be going by these protocols.
Scott Benner (22:16) Okay. (22:16) People also want me to ask you, how can it be possible that when a kid comes into a pediatrician's office with flu like symptoms that a finger stick is part of the diagnostic? (22:25) Because that's usually where people are misdiagn like, could be diagnosed and and aren't. (22:30) Right? (22:30) Is that what like, is that a money thing?
Scott Benner (22:33) Like, like, it's such a strange idea that it's not just part of it.
Dr. Beachgem (22:37) I don't know if it's as much as a money thing as a resource thing because you have to make sure that that blood sugar meter every day has to be like you have to check it to make sure that it's working. (22:47) I forget what the thing's You have to calibrate it every day, so you have to have the person to do it, and then if it's not done, you have to calibrate it. (22:54) That takes time. (22:54) That takes you know, your nurse that's busy that you guys have 40 appointments today, and instead of doing this, now she's calibrating and then checking her blood sugar, which takes time. (23:03) So I think it's more of a resource thing.
Dr. Beachgem (23:05) I will say that's one of the more commonly missed things is gastro or flu like illness and it's actually new onset or DKA. (23:14) We do our best to check blood sugars frequently in the ER, but it is something that could easily be missed. (23:21) I would say in the ER, that's all we see all day long, and so it goes back to the resources. (23:26) We calibrate every day anyway because we check enough of them, but that's probably the biggest barrier I would say is doing it.
Scott Benner (23:32) So I often I sit around and I think sometimes doctors' jobs are really unfair. (23:38) Right? (23:38) Like, you expect them to like, first of you go to if you really were gonna go to medical school and come out with a complete understanding, you'd have to go to medical school for a hundred years. (23:46) Mhmm. (23:46) Right?
Scott Benner (23:46) Like, so you get a little bit of everything, and then you're left to just remember, oh, did I hear a thing one time about that, or have I ever had this experiences? (23:54) There's times when I think when you come into an ER, should just be talking and an AI should be listening to you. (24:00) And then it should say, here are the possibilities in case you miss something, and then layer the human side on top of it because that is what we're asking you to do. (24:08) And there's there's no way you're gonna be able to do that. (24:10) Like, even the sharpest, brightest, most focused person isn't gonna have access to everything they've ever encountered in the world, every thought and every teaching, and they might have missed one.
Scott Benner (24:20) And so I mean, your job must feel like rooting around in the closet without a flashlight in the dark. (24:26) Right? (24:26) Like, is that am I getting close?
Dr. Beachgem (24:28) Yeah. (24:29) The saying that we have is you're walking through a minefield in clown shoes because it's four years. (24:34) And in that four years, you're supposed to learn, everything that you need to have to go start practicing, and then you've got three to six years of residency where you're supposed to learn everything else. (24:44) I can tell I learned a lot during that time, but I certainly didn't learn everything that there is to know, especially when there's getting into these really rare genetic conditions and stuff like that. (24:53) It is hard, and we have to be perfect a 100% of the time or else somebody's life could be in danger.
Dr. Beachgem (24:59) As a human, being right a 100% of the time is just it's impossible. (25:03) I will a 100% agree that I think that bringing things in like AI, to help us not miss things and to help give us ideas. (25:12) I think that we're gonna see all types of new things coming onto the horizon and hopefully not missing things
Scott Benner (25:17) Yeah.
Dr. Beachgem (25:18) To say like check a blood sugar. (25:19) Do this. (25:20) I feel like my other response was a little more defensive. (25:23) I am all about checking a blood sugar in literally anyone I can order it on.
Scott Benner (25:28) Right.
Dr. Beachgem (25:29) In a kid that's vomiting, I'm asking the questions. (25:31) How are they drinking? (25:32) How are they peeing? (25:33) You know, some screening things in addition as well. (25:35) But it's not an easy job, and it's a it's a heavy lift sometimes.
Scott Benner (25:38) Yeah. (25:39) It's interesting that you said you felt like you might be being defensive. (25:42) I pay attention to your content, and I know that you're having some sort of a medical issue. (25:47) I'm sorry to say this with discharge from your breast. (25:49) Right?
Dr. Beachgem (25:49) Yes.
Scott Benner (25:50) And I watched a couple of videos where it was interesting because, like, what you do professionally as a doctor, what you do professionally on social media, like, social media, you know that, like, people go to the hospital and have outcomes that aren't great and that they could be But yet, when you it was you personally, you were like, I have a good doctor and I'm gonna listen to what they say even if I don't agree with what's happening. (26:11) And I was like, well, that was such an interesting separation for me because you're a doctor and you know what it feels like to be your doctor. (26:19) Can you untwine all that for me? (26:21) Because you know what I'm talking about. (26:22) Right?
Dr. Beachgem (26:22) I do.
Scott Benner (26:23) Okay.
Dr. Beachgem (26:23) So I I had an experience where I was supposed to have a test performed and I didn't have a great experience having that test performed. (26:30) They actually weren't able to do it. (26:31) It felt to me that they were being kind of condescending and, you know, I'm not dumb. (26:36) I have an OBGYN who I trust because of other things that I can't really talk about, but I I trust her.
Scott Benner (26:42) Right.
Dr. Beachgem (26:42) She knows the system and she's she knows the stuff. (26:45) And so if she tells me, hey. (26:47) You need to do this test, like, I trust her. (26:49) It's not the answer that I wanna hear, but I will go and do it. (26:52) And she recommended that I see a specialist and in the end we're going to end up skipping the test and move right towards surgery, which is kind of what the evidence based stuff shows.
Dr. Beachgem (27:01) And I'm a big fan of evidence. (27:02) You've probably seen that in my videos. (27:03) Show me the evidence and we'll follow it. (27:06) So I know as a patient, there are things that I don't wanna do because it's uncomfortable or unpleasant, or I don't wanna go back into that situation again. (27:14) But I do trust my doctor and what she says, especially when she can provide me with the evidence to back it up.
Scott Benner (27:18) So how do you make that leap when you know I'm just guessing, but you've made mistakes as a doctor. (27:23) Right? (27:24) So when you're sitting there sick, having this problem that people are like, I don't see. (27:28) Like, I heard you say this one thing that you went in for a test, they couldn't produce the result to prove what you were seeing. (27:34) Then I think you went out into the the waiting room and, like, were having it and you kinda ran back in.
Scott Benner (27:39) You were like, it's happening now. (27:40) And they're like, don't worry. (27:41) We'll look another day. (27:42) Like, when you know you've been wrong before, how do you still say I'm gonna trust the process when you've seen the process be wrong and now you're the one who's in jeopardy?
Dr. Beachgem (27:52) Yeah. (27:52) So I was trusting my doctor who ordered the test. (27:56) Not necessarily I and I had some frustration with that situation.
Scott Benner (28:00) Mhmm.
Dr. Beachgem (28:00) And I know based on lots of things that that facility actually does really good work. (28:05) And I I go back to we're all human and we all have bad days sometimes. (28:09) Using your word, I I had to advocate for myself in the next step, and I usually don't advocate for myself. (28:15) I'm actually really bad at that for lots of reasons. (28:17) That's
Scott Benner (28:17) interesting. (28:18) Okay.
Dr. Beachgem (28:18) But I did that day, I I stepped back out and I said, look. (28:22) Here's my symptom, and they said, no. (28:24) Thank you. (28:24) I go back to the doctor that I trust, and and I she called me the next day and said, you know, what do we think about next steps? (28:31) And we talked we had a really great talk about it.
Dr. Beachgem (28:33) We kind of went over, you know, the next plan. (28:36) But I I think it's it's hard because I wanna trust my medical colleagues. (28:40) Like, this is a system that I work in. (28:42) This is these are my people, and it is maybe more disappointing for me than for others. (28:47) I'm not sure about that, but it feels more disappointing to me because, like, these are the people this is me.
Dr. Beachgem (28:52) And, like, when I'm disappointing myself, that's hard. (28:54) So I feel like like, if they're gonna do anything, like like, let's fight for the same team, and it's just, you know, sometimes it all falls apart.
Scott Benner (29:02) I just found it kinda fascinating because, like, you don't have white coat. (29:05) Right? (29:05) You that doesn't happen to you. (29:06) You don't
Dr. Beachgem (29:06) No.
Scott Benner (29:07) Know. (29:07) Right. (29:07) So you have other reasons. (29:08) So you're a people pleaser or something like that.
Dr. Beachgem (29:11) Yeah.
Scott Benner (29:11) Gotcha. (29:12) Okay. (29:12) Okay.
Dr. Beachgem (29:12) I don't wanna go against the grain. (29:14) Right? (29:15) Because this is my team. (29:16) So, like, we should all be in it together and doing the same thing. (29:18) So I don't wanna go against the grain.
Scott Benner (29:20) See, that's what I was wondering. (29:21) Like, if you're not, like, a wide receiver on television, like, not wanting to say something bad about the offensive line. (29:26) Like right. (29:27) Yeah. (29:27) Yeah.
Scott Benner (29:27) Because why? (29:29) Because you have a respect for them or because you believe that you could be in their position quite easily in another situation?
Dr. Beachgem (29:36) Probably. (29:37) Yeah. (29:38) Probably that.
Scott Benner (29:38) There's a lack of confidence underneath all of it. (29:42) So it's interesting because I think people see doctor I think doctors, teachers, and cops, right, get, like, a pass because you're brought up. (29:49) Like, be kind to the police officer, listen to your teacher, listen to your doctor. (29:53) And most of your life, that works. (29:55) And then usually, even if you get sick, it works right.
Scott Benner (29:58) I say all the time, like, break your arm. (29:59) Go somewhere. (30:00) Right away. (30:00) Like, I I've had my shoulder repaired. (30:02) I've had my ankle repaired.
Scott Benner (30:03) Like, there are things medicine is awesome at. (30:06) And then when you get into type one diabetes, it very quickly becomes, how strange is it that endocrinologists all over this country will get you in a corner and go, hey, listen. (30:18) You should go listen to the Juice Box podcast. (30:20) Do you know what I mean? (30:21) Like, how strange that is?
Scott Benner (30:22) The endo is like, you know what your best bet would be here? (30:26) Go do this, like, because I can't help you as much as you want to be helped. (30:31) I can't figure that part out for my life. (30:33) Like, I can't figure that like, how am I a better resource than your nurse practitioner?
Dr. Beachgem (30:38) Oh, I think part of it is going back to the resource. (30:41) You know, time is one of the biggest resources that we have in medicine. (30:45) And the way that insurance reimbursement goes, we have to see a certain number of patients to keep the lights on.
Scott Benner (30:52) Yeah.
Dr. Beachgem (30:52) And when you look at medicine and the way that doctor's salaries are going up, there's a lot of other people that are going up way faster than doctor's salaries. (30:59) Like, we're not really keeping up with keeping up with that. (31:01) I mean, we're doing okay. (31:02) No no complaints. (31:03) But The resource is the time because we've got to get in and get out and see the patients.
Dr. Beachgem (31:06) And so we tend to refer to resources that are going to be supportive resources, are going to be educational resources, that are going be giving great life tips. (31:15) I think that finding community is also important where you can share, and community that's gonna be giving good information is vital.
Scott Benner (31:22) Yeah. (31:23) I have such a great idea that nobody takes seriously because I I think they don't know how to bill it. (31:27) But Mhmm. (31:27) I think that instead of coming in and having a an appointment once every four every three or four months, right, and for fifteen minutes, I think a huge group of people should come to an auditorium three or four times a year and have a group experience. (31:44) Because I've gone and spoken at events where people come in, don't know what they're doing, and an hour later, they're better off.
Scott Benner (31:52) And then six months later, they send me a note. (31:53) Oh my god. (31:54) My a one c went down two points because of that thing you said. (31:56) Right? (31:56) Which is a wonderful feeling, but, like, we should find a way to do that for people.
Scott Benner (32:01) I know that that's Yeah. (32:01) Not the system. (32:02) But, like, if fifteen minutes isn't enough, then give them more time. (32:06) And who cares, like, in the end, like, my opinion is, like, who cares? (32:11) Like, just bill it the same way, but give them different tools.
Scott Benner (32:14) Like right? (32:14) Like, you could do that a few times. (32:16) I could give that talk every day. (32:18) Like right? (32:18) Like and and so could other people.
Scott Benner (32:20) And I I also think it would help the physicians at some point too because so much about type one is timing and amount. (32:25) Doctor. (32:26) Beecham, I tell people all the time, I'm like, if I if you pushed me off a cliff and said, teach people about diabetes as you were falling, I'd say, it's all timing and amount. (32:33) Like, just use the right amount of insulin at the right time. (32:35) It'll all be okay.
Scott Benner (32:36) And there's obviously more to it than that, but that really is that's the seed of the idea. (32:41) And then you have to understand how food impacts your blood sugar, how your blood sugar impacts your food, about activity. (32:47) Like, there's other stuff obviously to layer on. (32:50) But every time you look at one of those layers, the truth of it is at its distilled end, it's timing and amount. (32:57) Very few people are told to pre bolus their meals.
Scott Benner (33:00) Very few people are told that fat and protein impacts their blood sugar later. (33:04) Like, really simple things that have such a huge impact. (33:08) What I ended up saying at some point on the podcast is that you will leave your doctor with what I consider to be don't die advice. (33:14) Like, it's enough to keep you alive, not really enough to keep you healthy. (33:19) And to your point, you need more time to absorb all that.
Scott Benner (33:23) So you're telling me that what doctors need is they need to get paid by the download the way I do. (33:28) And I wonder how to fix that. (33:29) And I and I don't know because I can step back and look at it like big picture in the world and go, like, this is how insurance works. (33:35) We're not gonna fix any of this. (33:37) This is bigger than all of us.
Scott Benner (33:38) Right? (33:39) And then I can also look at people's lives one at a time when I interview them and see the incredible impact it has on them just to not be told that. (33:47) Like, as you have a million stories, I will tell you one. (33:51) Alright. (33:51) So I'm put in touch with a person who has type one diabetes and a lot of kids.
Scott Benner (33:56) She's got, like, six or seven kids, and she's in her mid forties. (34:00) And she's online looking for help. (34:02) Nobody can help her. (34:03) Somebody points her to me. (34:04) She sends me a message, and I'm just like, just call me.
Scott Benner (34:07) She gets on the phone. (34:09) I give her the talk, basically. (34:11) And the next day, I get a text back from her. (34:13) She wants to know if she can call me back. (34:15) I get on the phone, and she's angry.
Scott Benner (34:17) Not at me, I realize. (34:19) And she's like, my blood sugar was so stable overnight. (34:22) She's like, it was, like, 90 all night long. (34:25) I slept. (34:26) I feel so much better.
Scott Benner (34:28) Why didn't anyone tell me this? (34:31) That was what she was angry about. (34:32) She was angry about lost time. (34:34) And then she started talking about she has complications, and someone could have just told me this thirty years ago. (34:41) And, like, the desperation in her voice about, like, not knowing where her health was going to go, the recognition that she had lost time to a struggle that she did not need to be involved in was heartbreaking.
Scott Benner (34:52) It sticks with me to this day, you know. (34:54) I don't know. (34:54) Like, I want there to be a better way. (34:57) I don't think there is. (34:58) And but if that's the case, then how do we make it so that where people with type one or type two touch doctors, there's more understanding?
Scott Benner (35:10) Because if you ask a type one what they're most scared of, it's going to the ER or being admitted to the hospital. (35:17) So I kind of would like to shift into that now, and and I'd like you to help me help them have a better experience when they if they end up in the hospital.
Dr. Beachgem (35:25) Yeah. (35:26) That's tough. (35:26) I think especially for pediatrics, go to a pediatric facility. (35:32) The way that DKA and type one diabetes is managed in adult facilities or community hospitals is quite different than a pediatric facility. (35:42) I'll be honest, we manage a little bit of type two, a little bit of insulin resistance, but we manage so much type one.
Dr. Beachgem (35:50) I feel very comfortable with type one management and I, as much as I can, defer to the family's kind of expertise about their kid in that situation. (35:59) And and you can tell pretty quickly talking to a parent. (36:02) I could almost guess their a one c after that first discussion
Scott Benner (36:05) Mhmm.
Dr. Beachgem (36:06) With the family and kind of the way that they're managing things at home. (36:09) I think it's really important to stay on top of things as much as possible. (36:13) We do a lot of protocols. (36:15) We'll ask you to remove the pump if we are in DKA just because we're trying to you know, we're gonna end up putting on an insulin drip and stuff like that, so it helps manage a little bit more cleanly so we know how much insulin is going in. (36:27) But these times can be very tough and I do think it is really important to be at bedside and ask when they're checking the blood sugar, and what was it, and how much insulin are you giving?
Dr. Beachgem (36:37) Because, obviously, those are it's pretty big deal making sure that they're getting what they need to get.
Scott Benner (36:43) Yeah. (36:43) It's interesting to hear you talk about it because I trust you, and I know you're smart, and I know you understand this, and your answer still seems a little like, I don't know. (36:51) And I appreciate that, by the way, that you're not bullshitting me. (36:53) Like, I really do appreciate that. (36:55) My daughter has a friend who ended up in she had ketones.
Scott Benner (36:58) She got sick. (36:59) She got ketones, and she couldn't get them to go away. (37:02) She got panicked. (37:02) She went to the hospital, and then she called me 34 later, and she was exhausted. (37:07) And I was like, what's going on?
Scott Benner (37:08) She goes, I just I shouldn't have gone to the hospital. (37:11) She said it did not take long for me to realize that I knew more about this than they did, and I don't know a ton about it. (37:17) Like, she's a young girl. (37:18) Like, she's still understanding her diabetes. (37:20) You know?
Scott Benner (37:21) I asked, like, different questions. (37:22) She said they kept my blood sugar really high. (37:24) They wouldn't, like, give me insulin for food. (37:27) Like, they she's like, they kept bringing me things that were, like, really heavy in carbs to eat and then not giving me insulin for it. (37:33) And as my blood sugar got higher, I felt sicker.
Scott Benner (37:36) I was trying to, like she's trying to convalesce from some sort of an infection with a high blood sugar, which I'm not wrong. (37:42) Right? (37:42) That makes that more difficult.
Dr. Beachgem (37:44) Mhmm.
Scott Benner (37:44) So what happens in that situation? (37:46) She's there. (37:47) Is it what you said earlier? (37:49) Like, you come into the emergency room. (37:50) If it's not killing you, then I'm not focused on it.
Scott Benner (37:52) So in the hospital, if it's not the thing you're there for, is it background then?
Dr. Beachgem (37:57) No. (37:57) I I
Scott Benner (37:59) because it shouldn't be. (38:00) You're
Dr. Beachgem (38:00) No. (38:00) It shouldn't. (38:01) It shouldn't be. (38:01) Right. (38:02) And I think that my ER DKA and my ER type one diabetes with a viral illness pathways in my head are very different.
Scott Benner (38:10) Okay.
Dr. Beachgem (38:10) In which case, like, I know I'm gonna give you a fluid bolus, and I know that's gonna bring down your blood sugar automatically. (38:17) I might not wanna treat, you know, the couple sips of Gatorade that you just took. (38:21) I might wanna let you roll a little higher because I know your blood sugar is gonna come down with fluids. (38:26) Mhmm. (38:26) And I'll be honest, I may not verbalize that as well to a family.
Dr. Beachgem (38:31) I'm I may just, like, give the bolus and, like, hey. (38:33) We'll check blood sugar again in sixty minutes and see where we're at, then we can make some plans. (38:38) I may not verbalize always my thought process behind that. (38:41) And maybe I need to get better at that, and especially with families that are, like, really on top of their stuff. (38:46) They know it, and they're starting to get anxious as they see that CGM creeping up a little bit.
Scott Benner (38:50) Yeah.
Dr. Beachgem (38:50) And again, DKA management for me, it took different different pathway.
Scott Benner (38:55) Is there another side to this? (38:56) Would ignorance be bliss for me? (38:58) Would you get me through my hospital experience better if I shut up and didn't have opinions? (39:02) And then I could go home and get my blood sugar back down again, or is that not the right answer either?
Dr. Beachgem (39:07) I don't know. (39:08) I don't think that's the right answer either because I you know, sitting on the floor with a high blood sugar, like, you getting DKA in the hospital is not good for anyone. (39:16) Right? (39:17) So I think we need to be managing it, and I think sometimes there could be some oversight potentially. (39:22) I know my people in my hospital are again, we're following protocols.
Dr. Beachgem (39:26) We're checking blood sugars at these certain intervals because we wanna avoid all of that happening. (39:31) And I think, again, finding a facility that knows what they're doing, so a pediatric facility, and ask what their protocol is. (39:37) Like, can print it out and hand it to you, and I can say this is our protocol. (39:40) This is what we're gonna be following while you're an inpatient. (39:42) We're gonna be doing insulin this like this.
Dr. Beachgem (39:45) We're gonna be doing blood sugars like this. (39:47) So I I think it's reasonable to ask, you know, could you show me your protocol for, you know, patients that are admitted with diabetes and a gastroenteritis? (39:55) Okay. (39:55) Show me what you're gonna be doing. (39:56) Show me that protocol.
Dr. Beachgem (39:57) And then if they're not following it, you can hold them accountable there.
Scott Benner (39:59) So expectations should be that you're gonna be a part hopefully, they'll allow you to be, but you should be a part of the process if you wanted to go
Dr. Beachgem (40:05) more smoothly. (40:06) Okay. (40:06) Really, medicine should really be a partnership between the patient and family and the providers, the nurses, the doctors, the RTs, whoever's taking care of them.
Scott Benner (40:13) No matter what. (40:14) So would it surprise you to know that mothers who are nurses who end up with kids with type one often seem the most confused to me when I'm talking to them. (40:24) Why would that be? (40:25) Because it used to freak me out. (40:27) But you know what stopped freaking me out?
Scott Benner (40:28) When a a Hopkins brain surgeon contacted me privately and asked me to explain to him how to take care of his kid. (40:35) That's when I was like, oh, okay. (40:37) And here's my last little piece. (40:38) One of my daughter's best friends is in nursing school right now. (40:41) She's probably three or almost four years down.
Scott Benner (40:43) I think she's almost done with her first four years, her undergrad. (40:45) Right? (40:46) And she came to me a few months ago, and she's obviously grown up with Arden. (40:51) And so, you know, has a a a pretty tight understanding of what's going on. (40:54) And she said, Scott, we just went over diabetes in class.
Scott Benner (40:57) And I said, yeah. (40:58) And she goes, and I sat there, all I thought was, wait. (41:01) Is that all you're gonna teach us? (41:02) Because that would that's not enough to keep Arden alive. (41:05) And then she said she had a stark moment where she thought, what else did I now believe that I have full understanding of that I don't have an understanding of?
Scott Benner (41:13) It was, like, a real interesting moment for her. (41:15) So, anyway, I I'm not asking you say anything bad about the nursing profession. (41:19) I'm wondering, like, what happens between because when you're in the hospital, like, I I don't wanna say who, but I know somebody who was just in the hospital who tried to advocate for their diabetes. (41:28) The nurse was like, I know better than you. (41:30) Like, shut up, basically.
Scott Benner (41:32) And it that was not the case. (41:34) So Yeah. (41:34) Like but she really believed it. (41:37) Does that all make sense?
Dr. Beachgem (41:38) Yeah. (41:39) And, again, diabetes type one diabetes, I think, again and you know this traditionally looked at as a pediatric disease, and those kids do grow up and become adults, which is awesome. (41:49) So I think that there are people that can manage type one diabetes well, but I think as kids are growing up and you're seeing this more in the adult population, a lot of the people that are taking care of the adults are thinking about type two diabetes management and not necessarily having that stronger experience with the type one where you need the insulin, you need to be monitoring the ketones, you need to be getting insulin, you need to be carb counting, you need to be monitoring what you're eating, your nutrition. (42:21) It's complicated. (42:22) And I think the thing about coming in as parent without medical knowledge or a medical background, you're coming in like, I just need to learn it all.
Dr. Beachgem (42:31) Mhmm. (42:31) I need to learn it all. (42:32) I'm gonna start at the beginning, and I'm just gonna learn as much as I can possibly learn. (42:36) Or I think sometimes us as medical professionals, can go, I know a little bit about that. (42:41) Let's just go with this.
Dr. Beachgem (42:42) Let's see what we can do, or maybe we nitpick what we can learn about this or that. (42:47) So we have this baseline knowledge that sometimes we rely too heavily on, but I think if you had a nurse that had more specific, like one of my floor nurses manages type one diabetes all the time. (42:59) And I think that if you if one of their kids ended up with it, I think they would probably feel more comfortable managing it.
Scott Benner (43:05) Yeah. (43:05) I also wanna point out that I've also heard countless conversations and and stories from people who had fantastic doctors and fantastic nurses. (43:13) Right? (43:13) Like, it's not I'm not trying to say that everybody is lost. (43:16) I always say it's interesting because when you get a doctor, you don't know which one you're getting.
Scott Benner (43:20) Yeah. (43:20) And you're gonna believe them no matter what. (43:22) What if I got the one that doesn't know? (43:24) And what if I got the that's what made made me think about with your situation earlier too. (43:28) Like, you don't always know who you're getting.
Scott Benner (43:30) And then there's Yeah. (43:31) There can be ego involved too. (43:32) And I don't mean, like, in a, like, a god complex way. (43:35) I mean, like, I went to undergrad. (43:37) I went to school.
Scott Benner (43:38) I did this. (43:38) I did all that. (43:39) I got a guy now telling me what to do. (43:41) Like, you know what I mean? (43:42) Like, he's he's sitting in a room being like, no.
Scott Benner (43:44) You don't understand. (43:44) Like, I don't understand. (43:46) I mean, imagine me. (43:47) I'm a podcaster. (43:48) Like right?
Scott Benner (43:49) So imagine if I was in a room going, no. (43:51) I think this is what you should do. (43:53) I can see where that could be difficult too. (43:55) Plus, there's a ton of pressure and stress. (43:57) I mean, I can't imagine being a doctor, to be perfectly honest with you.
Scott Benner (44:00) Like, it must feel like your hair's on fire all the time. (44:04) No?
Dr. Beachgem (44:05) You know, we have days I can't imagine doing anything other than this. (44:08) This is what I was I was made to do. (44:10) And so, you know, to me doing air conditioning seems really stressful. (44:14) Mhmm. (44:15) But doing this feels very natural.
Dr. Beachgem (44:16) But there are days that I, you know, I second guess my decisions or, you know, I go to bed thinking about that one patient. (44:23) You know, did we do the right thing? (44:24) You know, did I did I do this right or, you know, wonder how they're doing, you know, now kind of thing. (44:29) Like, we second guess ourselves a lot.
Scott Benner (44:31) What do you think it is about your personality that lends itself to the job?
Dr. Beachgem (44:35) I have no idea.
Scott Benner (44:36) No. (44:36) It just works for you.
Dr. Beachgem (44:37) It just does. (44:38) It's the ADHD, and it's the seeking adrenaline and wanting to help people. (44:43) But I I don't know. (44:44) Yeah. (44:44) It's just it's just we're all made to do something, and I think I just found what I was made to do.
Scott Benner (44:50) When you put yourself out there online because I've gone through this. (44:54) I imagine you have too. (44:55) Right? (44:55) Like, at some point, somebody says, oh, you're busy telling me what to do, but look at you. (45:00) I'm sitting in front of you today, two and a half years removed from starting GLPs.
Scott Benner (45:05) I'm seventy pounds lighter than I was. (45:08) And there were times where I didn't put myself on video because I thought, know my stuff is rock solid about type one, but I don't want somebody to look at me and go, oh, there's an overweight guy trying to tell me about my health. (45:19) Right? (45:20) Like, I actually had that feeling. (45:21) I was like, I shouldn't probably do that.
Scott Benner (45:22) Right? (45:23) Have you had any experience with the people being shitty to you? (45:27) How do you deal with that? (45:29) And does it slow you down at all with the things you talk about?
Dr. Beachgem (45:33) Yeah. (45:34) You know, emergency medicine and the lifestyle for emergency medicine does not lend itself well to physical health. (45:40) The late nights, early mornings, eating on the go, not necessarily the healthiest food. (45:47) I'm sitting a couple pounds heavier than I would like, especially with the hurricanes and all the moves and stuff like that. (45:52) I do get comments occasionally like, Oh, look at this fat person telling me you know, to be healthy.
Dr. Beachgem (45:58) And for the most part, I'm not really talking about, you know, weight loss and nutrition. (46:01) I'm talking about ways to keep your kid from getting in a ebike crash.
Scott Benner (46:05) Right.
Dr. Beachgem (46:06) And realistically, people don't get to choose their provider in the emergency department. (46:10) Like you said, you kinda get stuck with whoever walks into the room. (46:13) There might not be an alternative. (46:15) I might be the only one there. (46:16) People tend not to, in real practice, say, like, hey.
Dr. Beachgem (46:19) I'd like another doctor that could is there somebody skinnier that could come in and see me? (46:23) No. (46:23) I mean,
Scott Benner (46:23) it's obviously on are people that directly horrible?
Dr. Beachgem (46:27) Yeah. (46:27) Online, are. (46:28) You know, and it's social media. (46:29) Like, everyone has an opinion. (46:31) And I I have like I said earlier, I have really good social media boundaries, and I do a lot of, like, just delete and block.
Dr. Beachgem (46:37) Like, I don't need someone Yeah. (46:39) Like that in my comment section for my own mental health and sanity.
Scott Benner (46:43) Good for you. (46:44) I brought it up because my wife is very impressed with how you manage that. (46:47) That she said to me, she's like, I really like the way she takes care of that. (46:50) And I was like, okay. (46:51) Yeah.
Scott Benner (46:51) Well, I'll bring it
Dr. Beachgem (46:52) to house. (46:52) I try to eat pretty healthy and I do work out and exercise, so I and I'm strong. (46:57) Like, I could bench press some I can bench press some stuff. (47:00) Yeah. (47:01) But, I'm like I'm like one forty.
Dr. Beachgem (47:03) I could bench press. (47:03) I'm doing alright. (47:04) Yeah. (47:04) Good. (47:05) You know?
Scott Benner (47:06) I well, listen. (47:06) I hear you. (47:07) I sit still a lot. (47:08) And also, in truth, I do not eat much differently today than I did two and a half years ago. (47:13) I am a pretty much a fan of the idea that there might be some metabolic help that's coming from GLP ones for some people because it hasn't really changed a lot about I mean, it's true.
Scott Benner (47:23) You're not hungry ever. (47:25) Like, you know, like, I ate breakfast this morning because I know I needed to. (47:28) So I'm not saying that it isn't benefiting me in that way, but I had an instant, like, an a very instant impact from I lost 14 pounds, like, the first five days.
Dr. Beachgem (47:38) Wow.
Scott Benner (47:38) Yeah. (47:39) It was crazy. (47:40) I used to be anemic. (47:41) Like, I had to get iron infusions three times a year. (47:44) I don't have to do that anymore.
Scott Benner (47:46) So I don't know if maybe I'm just digesting my food better now or I'm holding on to it long enough to extract it. (47:51) I don't even care. (47:52) I've never been in a situation before where was like, actually don't care. (47:55) I just I'm happy it's working. (47:56) So I've seen it with other type ones too.
Scott Benner (47:59) I've seen it with type twos. (48:00) I know plenty of type twos who've lost weight, a one c, like, their variability is better, everything. (48:05) But more and more type ones are getting a hold of it now. (48:08) And it really is interesting to see their insulin needs sometimes go down 30%. (48:13) And their spikes get lesser, and I'm like, wow.
Scott Benner (48:16) I wonder where this is all going. (48:17) Like, it seems like so new. (48:20) But I would imagine the only probably the only intersection you have with is probably the people who don't do well with it. (48:25) Right? (48:25) Because in the ER, you're just coming in because what?
Scott Benner (48:28) Have gastroparesis from it or low motility or something. (48:30) Right?
Dr. Beachgem (48:30) Pancreatitis, vomiting, dehydration, chronic abdominal pain, gastritis. (48:35) But, you know, in pediatrics, I think Wegovy has been approved for 12 and older, but for, like, just obesity and not diabetes. (48:43) Mhmm. (48:44) So there's we've only seen a handful in the pediatric population so far, and I don't really treat adults when I can manage it. (48:51) But I think we are going to see more and more of the kids that have the type one and type two diabetes on these medications and the kids that are struggling with obesity on these medications to avoid the longer term complications.
Dr. Beachgem (49:05) The research that's coming out about the GLP-1s is really cool. (49:08) I mean, some of these conditions that you wouldn't even think are related. (49:12) I saw something the other day on pseudotumor cerebri, which is extra CSF fluid that's produced creating pressure, and it can create, you know, injury to the eyes and really bad headaches. (49:22) They're seeing improvements on GLP ones. (49:24) Just some really cool stuff coming down the line with these medications.
Scott Benner (49:27) Yeah. (49:27) I would have kissed the Gila monster twenty years ago if I knew about this, I'll tell you. (49:31) Ladies with PCOS getting pregnant out of nowhere Wow. (49:34) That's crazy. (49:35) Right?
Scott Benner (49:35) My wife swears that it helps with inflammation so much so that she thinks that, her perimenopause was easier because of it. (49:42) You know, I've seen people say that it's lessened, impacts of long COVID. (49:46) Oh, that's something I wanted to ask you about. (49:48) That's real. (49:48) Right?
Scott Benner (49:49) Long COVID? (49:50) Yeah. (49:51) Okay. (49:51) Alright. (49:52) So if I told you please don't disconnect.
Scott Benner (49:56) If I told you that, I don't know, eight months ago, I was listening to a podcast and I randomly heard some guy say, like, nicotine helps with long COVID, and I didn't really register it. (50:05) Right? (50:05) And then two months ago, I had a lady on the podcast, and she said just kind of offhandedly, I've had long COVID for a while, but it's really getting better. (50:13) And I just said, oh, what did you do? (50:15) Because my wife has it, suffers with it pretty badly.
Scott Benner (50:17) She said I did a twenty one day nicotine patch protocol. (50:21) And I was like, googled that, And there was a website, and I was like, well, this doesn't look like it was made by a serial killer. (50:26) So I read it, and I said to my wife, I'm like, I don't think a nicotine patch is gonna hurt you one way or the other. (50:32) Right? (50:32) Like, so she was in the middle of a bad flare to real foggy.
Scott Benner (50:36) She couldn't get rest and everything. (50:38) And my you don't know my wife, but this was not a thing she was up for. (50:41) Right? (50:41) Like, she and I just I caught her in a day where she was so bad off. (50:44) I'm like, look.
Scott Benner (50:45) I'm just gonna stick this on you. (50:47) Then I was like, and we'll stick another one on in twenty four hours. (50:50) And about seven days later, goes, hey. (50:52) You know, I feel better. (50:53) And fourteen days later, she's like, telling other people about it.
Scott Benner (50:56) Now, teach them, I don't know how how long you've been married, but I've been married thirty years. (51:00) My wife doesn't run around saying nice things about me out of hand. (51:03) So she's now telling other people, I think Scott saved me with this nicotine patch thing. (51:07) Now when I know that's happening, I know something's really going on. (51:10) Okay?
Scott Benner (51:10) And now it's been a month later and she's a different person.
Dr. Beachgem (51:14) Oh.
Scott Benner (51:14) Something about, like, receptors that nicotine sticks to I don't even again, I can't believe I'm saying this. (51:21) Don't care. (51:22) Like, she's so much better off, and she's not using the patches anymore.
Dr. Beachgem (51:25) That's pretty crazy. (51:26) Nicotine is interesting. (51:28) Mhmm. (51:28) There's a couple different disease processes that nicotine influences in a positive way. (51:33) And, again, no, not to encourage people to go out smoke or use at any but there are it it is something that works in your body and and can do certain things.
Dr. Beachgem (51:43) And I I think it deserves continued research, especially with things like that when we're seeing positive effects.
Scott Benner (51:50) Okay. (51:50) How willing are you to talk about, like, what's happened over the past ten years about people's concepts about vaccines? (51:58) Are you comfortable talking about that?
Dr. Beachgem (52:00) Yes. (52:00) I can't get too controversial.
Scott Benner (52:02) I don't want you to get controversial. (52:03) I want you to tell me your opinion.
Dr. Beachgem (52:04) I think that we have tremendous evidence for at least the childhood vaccines and influenza vaccines that they are low risk, extremely effective, and I think we're already starting to see the impact of decreased vaccine uptake.
Scott Benner (52:22) Yeah. (52:22) You think the population is getting sicker in ways that it doesn't need to be?
Dr. Beachgem (52:26) I mean, we're about to lose our measles elimination status because we've had, you know, a pretty significant measles outbreak since I don't think we've had this many measles cases since 1992. (52:36) I believe we've had three deaths this year from measles, one in an adult, two in previously healthy kids, all unvaccinated, unfortunately. (52:44) We've seen polio in wastewater in up in New York. (52:47) I think that we should have a level of concern that some of these, like, really bad things are gonna come back.
Scott Benner (52:54) How frequently do you find yourself talking to a patient where you think, oh, gosh. (52:59) They've been radicalized by some sort of online thing, they have a belief that is completely just bull Do you find yourself standing in front of people who you're like, oh my god. (53:08) I can't believe I have to explain this to you, but here we go?
Dr. Beachgem (53:11) Yeah. (53:12) So, you know, online all the time.
Scott Benner (53:15) Oh, sure. (53:15) Sure.
Dr. Beachgem (53:16) All the time. (53:16) In my practice, about two to three in ten kids under two years old are not vaccinated. (53:22) The younger kids, it's it's between seventy five and eighty percent are vaccinated. (53:26) Mhmm. (53:27) But when kids are not vaccinated in under three years of age, there are increased risks for bacteria in the bloodstream, something called epiglottitis, which is an airway blockage, meningitis.
Dr. Beachgem (53:37) And so I have to talk about the risks and potentially an increased workup because they have these additional risk factors or at least don't have the protective factors of vaccines. (53:46) And I try not to ask why they are not vaccinated. (53:51) I really just wanna present it in a nonjudgmental way because the most important thing is creating that partnership that they're willing to trust me. (53:58) And if I start
Scott Benner (53:59) Sure.
Dr. Beachgem (53:59) Asking too many of those questions, I don't wanna alienate them. (54:02) I wanna be able to really have that discussion about, these are the things I'm concerned about. (54:05) This is what I like to do, and this is why. (54:07) Yeah. (54:08) I try to limit anything that could be interpreted as judgment.
Scott Benner (54:12) Right. (54:12) I appreciate you being willing to talk about it. (54:15) Can you please take me back to the day that you got really famous online and somebody had to have pulled you into an office at your job and went, hey. (54:21) What the hell are you doing? (54:22) Did that not happen?
Scott Benner (54:24) I mean, did. (54:24) Right? (54:24) Yeah.
Dr. Beachgem (54:26) Yeah. (54:26) So, you know, I started making content. (54:28) It it was kind of in the 2020, and I had a video actually about vitamin k deficiency bleeding, so a baby that hadn't received vitamin k Mhmm. (54:37) At birth. (54:38) And I presented, like, a Google article.
Dr. Beachgem (54:40) Like, I googled an article. (54:42) So it was a research paper, and I I put it up. (54:45) Someone told my job that I had used a patient picture and a patient case, which I, again, I'd used. (54:52) You could clearly see the Google. (54:54) And so that's kind of that was my job's introduction to, I'm putting stuff online now.
Dr. Beachgem (54:59) And I obviously, like, they were like, You know what? (55:01) Don't you're good. (55:02) Obviously, be careful. (55:03) But I've had many a discussion with HR and vice presidents of things. (55:08) Again, open communication, partnership, they're fine with me doing what I do as long as we have certain boundaries and obviously protecting patient privacy and stuff like that.
Dr. Beachgem (55:18) So we have some rules and boundaries in place. (55:20) I'm very appreciative that they're letting me do all of this.
Scott Benner (55:23) Yeah.
Dr. Beachgem (55:23) And they I think, you know, they appreciate me putting, you know, evidence based information out widely.
Scott Benner (55:29) I was gonna say it's gotta be good for them too. (55:31) Right? (55:32) Maybe you're really well liked.
Dr. Beachgem (55:34) Yeah. (55:34) You know, I don't know.
Scott Benner (55:36) You don't know?
Dr. Beachgem (55:37) Like, you know, because I think any anything you do on social media, there's gonna be someone that is upset. (55:41) Like, even if you just say, like, have a great day, there's gonna be someone that's like, I don't wanna have a great day. (55:49) I think that a hospital that really is focused on taking care of kids in the best way possible, and all of a sudden you've got someone on social media and it's like, focus is really trying to do this and you're over here, you know, making these little videos. (56:03) I I think that they're they are really supportive, but I I think that, you know, they're really focused on their mission of trying to help kids.
Scott Benner (56:09) Do you have people that hate listen or hate watch you?
Dr. Beachgem (56:12) All the time. (56:13) Yeah. (56:13) Of course.
Scott Benner (56:13) I I have a small band of, people who I think maybe are unwell who, enjoy listening to me, but don't seem to like me or anything that I say. (56:22) Yeah. (56:22) I always explain to them when they're listening, your downloads sell to the advertisers just like everybody else's, so thank you very much. (56:29) What about being, like, this person online? (56:33) Is there anything about it you don't like?
Dr. Beachgem (56:36) No. (56:36) No? (56:36) I I the negativity that comes with it sometimes, I think that gets a little frustrating. (56:41) But my main goal of, like, I wanna educate people. (56:44) You know, I wanna use this as a coping mechanism to avoid burnout at work.
Dr. Beachgem (56:48) Like, I think it's functioning well in those aspects. (56:50) So
Scott Benner (56:51) Good. (56:51) That's awesome. (56:52) I I I'm glad to hear that. (56:53) I don't have a lot of downside to what I do either. (56:55) I just I was wondering if there was, like, how's the business y side of it?
Scott Benner (56:59) Like, you have like, obviously, you guys listening reached out to doctor Beach Jem and she she gave up and and and messaged me, like, so thank you. (57:07) At the same time, like, then you passed me off to, like, a management company or something like that. (57:11) Like, the day you did that, were you like, oh my god. (57:13) I have a management company? (57:14) Like, that's gotta be crazy.
Scott Benner (57:16) Right? (57:16) No?
Dr. Beachgem (57:17) Yeah. (57:17) Yeah. (57:17) I am really bad at answering emails as it turns out. (57:22) Mhmm. (57:22) And so when I was doing brand deals and they were trying to do, like, onboarding stuff and I had to answer emails to get paid, like, I I wasn't doing well with that just because I wanna focus on the the good stuff.
Dr. Beachgem (57:31) And so I hired a management team or I kind of was approached By somebody. (57:36) That encouraged me to find a management team. (57:38) I am absolutely in love with the the group that I have. (57:41) Lanea is amazing. (57:42) They really just help get everything organized and on board, and she kind of knows when I'm awake and when I'm sleeping and can just make things happen when it needs to happen.
Scott Benner (57:51) No kidding. (57:52) I don't have anything like that. (57:53) Like, so but there's something that sounds incredibly attractive about it. (57:57) I don't I don't wanna ask you this question because I feel like I'm gonna ask you, do you make enough money that that makes sense financially? (58:02) But I don't wanna ask you that.
Scott Benner (58:03) Like, so
Dr. Beachgem (58:04) I think the thing that most influencers or creators will tell you about a management company is that they will sift through the deals and find the ones that work for you. (58:12) They will also go out and find deals if that's something you're interested in.
Scott Benner (58:17) Mhmm.
Dr. Beachgem (58:18) And most of the time, they will ask for more money from whatever brand deal you're gonna be working with enough that it more than covers their portion of it.
Scott Benner (58:27) Are you saying I'm not charging enough? (58:29) Okay.
Dr. Beachgem (58:29) It could be. (58:29) And
Scott Benner (58:30) Alright. (58:30) No.
Dr. Beachgem (58:30) A lot of times, we undervalue ourselves. (58:32) Like, we talked about this. (58:33) Like, we're Yeah. (58:34) We're in it to educate. (58:35) We're in it to talk to people and and help people be better be their better selves.
Scott Benner (58:40) Mhmm.
Dr. Beachgem (58:40) And so we undervalue ourselves, kind of as it is, and I never would have thought, you know, this brand deal would have brought in, you know, near what it did. (58:50) Yeah. (58:50) But I have someone who believes in me that said, you know, this is what you're worth.
Scott Benner (58:54) Is there ever been a moment where you wondered if you're gonna keep practicing? (58:59) No. (58:59) It's not gotten that. (59:00) And you love it too much to stop doing that anyway is what I'm hearing. (59:03) Yeah.
Scott Benner (59:03) Yeah.
Dr. Beachgem (59:03) And if I stopped, I think I would have a hard time restarting just because you can lose skills. (59:08) So I this is not something that I would change.
Scott Benner (59:11) Oh, so you do see this as something that could possibly flare out, the social media thing?
Dr. Beachgem (59:15) Everyone asks my five year plan, and there is no plan. (59:18) I'm just, you know, one day at a time, and whatever happens happens. (59:21) And if I can work for another fifteen years and keep doing it, we'll keep doing it.
Scott Benner (59:26) Yeah. (59:27) You you would probably connect much with the idea that every year, I think this is the last year I'm making the podcast. (59:32) Anybody who works with me on a professional side, I'm like, well, I mean, obviously, it'll be over after this year. (59:37) And then, you know, we'll all go on our way. (59:38) And they're like, why do you think that?
Scott Benner (59:39) I'm like, well, I mean, because this is ridiculous. (59:42) That's why. (59:43) Like, it's not a real thing. (59:45) I keep thinking I'm just gonna end up being, a really popular Walmart reader. (59:49) Because unlike you, I can't fall back on being a doctor when I think it was bad.
Scott Benner (59:52) Like, I'm a I was a stay at home dad who became a popular podcaster. (59:57) Like, I don't have a there's nowhere for me to go exactly. (1:00:00) I I don't it's funny you said the same thing that I always think is that I don't have even the life skills I had before this, I don't even think they're transferrable to now. (1:00:08) And I don't know that I really remember what I was doing before that, actually. (1:00:12) It's really interesting.
Scott Benner (1:00:13) Your family at all. (1:00:14) Do your kids I heard you say you have kids. (1:00:16) Kids or your husband, do they mind any of this, or they're good with it?
Dr. Beachgem (1:00:19) They don't seem to mind very much. (1:00:21) I think I've been doing it so long. (1:00:23) They've just gotten kind of accustomed to it, and it's been kind of slow growth. (1:00:26) Like, it hasn't just jumped very quickly. (1:00:28) It's really just kind of been a slow growth over time.
Scott Benner (1:00:30) Mhmm.
Dr. Beachgem (1:00:31) You know, I think we've created some, like, safety things for them, like, when we're out in public. (1:00:35) I get approached quite often by people that just wanna say hi or selfie, but, you know, there have been times where they've been more interested in the kids, and so we've had to create good boundaries there. (1:00:46) The kids, I don't think it registers as much for them
Scott Benner (1:00:49) Yeah.
Dr. Beachgem (1:00:50) You know, what this actually
Scott Benner (1:00:51) is. (1:00:51) I have to tell you the coolest part about you besides the fact that you're incredibly normal and yet lovely to speak to and knowledgeable is that you don't have any of that, like, influencer vibe. (1:01:01) Like, I've never felt that once from you. (1:01:03) I've never felt like you've turned the camera on and willed yourself to be excited. (1:01:06) Do you know what I mean?
Scott Benner (1:01:08) Like, everybody. (1:01:09) Like, you know, like, that kind of thing or, like or ask one of those leading, like, social media questions that, like, they they know the algorithm. (1:01:15) You don't think about any of that, do you?
Dr. Beachgem (1:01:17) I do try to, you know, sometimes bring a hook.
Scott Benner (1:01:20) Okay.
Dr. Beachgem (1:01:20) Like, a little something to bring it in, and maybe it's, like, the top of the screen or the bottom of the screen because I want you to hear what I have to say. (1:01:27) Like, I think what I have to say is important, but I try not to do the, like, the cringey hooks as much as I can. (1:01:33) Yeah. (1:01:33) Like, I made a Christmas one yesterday where I very quickly said something that would catch someone's attention, and I'll avoid saying it out loud at this point. (1:01:41) But you can go see that Christmas video if you wanna find that out.
Scott Benner (1:01:45) Follow and subscribe. (1:01:46) I
Dr. Beachgem (1:01:48) I just I I don't know if there's kids listening, and so I just
Scott Benner (1:01:51) Oh. (1:01:51) Oh, no. (1:01:52) I saw that one. (1:01:53) That one's awesome. (1:01:53) Yeah.
Scott Benner (1:01:54) And there might be kids listening. (1:01:55) Yeah. (1:01:56) It's so funny you said that because the way you did it with the visual, I thought that's what everyone wants to know from an ER doctor. (1:02:02) What have you found in people's butts? (1:02:04) And you have to go home and tell people.
Scott Benner (1:02:06) Right? (1:02:06) I mean, you keep their details out of it. (1:02:07) You don't not go home and say to your husband, I found a Christmas tree candle and how would you not?
Dr. Beachgem (1:02:12) Yeah. (1:02:12) You know, people always ask, like, what's the most interesting case you've ever seen? (1:02:16) And they actually don't wanna hear about the most interesting case. (1:02:18) They wanna hear about the butt stuff. (1:02:20) Yeah.
Dr. Beachgem (1:02:22) And, you know, I don't know. (1:02:23) Maybe, like, the first couple cases that I saw, you know, like, someone put something somewhere up. (1:02:28) But at this point, like, working in pediatrics, like, we see it pretty commonly and Wait.
Scott Benner (1:02:32) Kids put stuff in their butts?
Dr. Beachgem (1:02:34) Yeah. (1:02:34) And I see up to the age of about 21, and so some of our teenagers or some of our young adults.
Scott Benner (1:02:38) Gotcha.
Dr. Beachgem (1:02:39) I don't know how to say this in a way. (1:02:41) You know, I think it's important to talk to kids about their bodies. (1:02:44) Mhmm. (1:02:44) And sometimes kids experiment with their bodies in in ways that we wouldn't necessarily expect, and kids are way, way more honest than adults are about that situation. (1:02:54) Like
Scott Benner (1:02:55) Yeah.
Dr. Beachgem (1:02:55) They'll tell you, you know, what happened and, you know, they're kinda like, yeah. (1:02:58) Okay.
Scott Benner (1:02:58) Uh-huh. (1:02:59) Well, listen. (1:03:00) I I think it's when people are honest and and communicate well, I think everything seems to go better. (1:03:05) Did you enjoy doing this with me? (1:03:06) Was this okay for you?
Dr. Beachgem (1:03:07) Did. (1:03:07) I did. (1:03:08) This was good.
Scott Benner (1:03:08) This was good. (1:03:09) I will thank you very much for doing this and ask you just to hold on one second for me. (1:03:13) But please, first, before you go, tell people how to find you. (1:03:16) Mean, I don't think they need my help, but are you everywhere? (1:03:19) Or
Dr. Beachgem (1:03:19) I'm on TikTok at Beach Gem 10 and YouTube, Facebook, and Instagram at doctor period beach gem ten, or just Google beach gem, and you could probably find me.
Scott Benner (1:03:28) Wow. (1:03:29) That's awesome. (1:03:29) Alright. (1:03:30) Well, doctor Beach Gem, thank you so much for doing this. (1:03:32) I really do appreciate your time.
Dr. Beachgem (1:03:34) Appreciate your time as well. (1:03:35) Thank you.
Scott Benner (1:03:41) Thank you so much for listening. (1:03:43) I hope you enjoyed my conversation with doctor Beach Jam. (1:03:45) Don't forget, she'll be back soon, so subscribe and follow not to miss any of that. (1:03:49) And in the meantime, if you have type one diabetes or you know somebody who does, please don't forget to suggest this podcast to them. (1:03:56) If they need management help, we have the bold beginnings series, the diabetes pro tip series, and much more.
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