Oregon couple uses social media sketches for healthcare education, advocacy

The U.S. healthcare system is notoriously complex — something as simple as a doctor’s visit has the potential to generate mysterious bills and endless calls to insurance companies. An Oregon couple is giving voice to those frustrations through comedy sketches on social media.

Dr. and Lady Glaucomflecken — otherwise known as Will and Kristin Flanary — began making TikTok videos during the COVID-19 pandemic. Will is an ophthalmologist and two-time cancer survivor. Kristin supported Will through those diagnoses and, more recently, provided 10 minutes of CPR after he suffered a sudden cardiac arrest in his sleep.

The couple has used their personal and professional experience to tackle topics such as private equity in healthcare, unrealistic expectations placed on medical students, and providers’ struggles to balance the needs of their patients with the requirements of insurance companies.

In addition to social media, the two host a podcast and create educational resources for clinicians and “co-survivors,” or people who support a loved one through a traumatic illness or medical crisis.

Will and Kristin Flanary join us to talk about healthcare advocacy and the role that humor can play in it.

Note: The following transcript was transcribed digitally and validated for accuracy, readability and formatting by an OPB volunteer.

Dave Miller: From the Gert Boyle Studio at OPB, this is Think Out Loud. I’m Dave Miller. The U.S. healthcare system is notoriously complex. A simple doctor’s visit can trigger mysterious bills and endless calls to insurance companies. An Oregon couple is giving voice to those frustrations through comedy sketches on social media. Dr. and Lady Glaucomflecken – otherwise known as Will and Kristin Flanary – began making TikTok videos during the COVID-19 pandemic. Will is an ophthalmologist and two-time cancer survivor. Kristin supported Will through those diagnoses and, more recently, provided 10 minutes of CPR after he suffered a sudden cardiac arrest in his sleep. The couple has used their professional and personal experiences to demystify the U.S. medical system and to advocate for patients and their providers. Kristin and Will Flanary join us now. It’s great to have both of you on Think Out Loud.

Will Flanary: Thank you.

Kristin Flanary: Thanks for having us.

Miller: Will, you had a background in comedy before you became a doctor. Did you know when you embarked on your medical career that you would still have some kind of hand in comedy?

W. Flanary: No, I did not initially. In fact, I got away from comedy for quite a while because I started doing stand up, dabbling in it as a high schooler, and went to med school and realized that I still needed it in my life. It was an outlet for me. It was a coping mechanism, and there’s just way too many things to make fun of in medicine.

Miller: What happened during the pandemic, early on in the pandemic, that led you to TikTok?

W. Flanary: Well, I’m in a private practice in the Portland area, and we had to shut everything down with lockdown, and there’s very limited uses for an ophthalmologist during a deadly respiratory pandemic. So I found myself with a lot of free time and I was already on Twitter making jokes here and there, and decided to try my hand at some video content. So I joined TikTok, which was growing in popularity right around that time.

Miller: Who did you think of as your audience at the beginning?

W. Flanary: My audience, I’ve always felt, was medical professionals. I was making it as a physician. I was making it for other physicians, but I realized pretty quickly that it was relatable to people outside of medicine as well.

Miller: Let’s have a listen to a TikTok that you put out in 2020:

Speaker 1: Hey, how was your weekend?

Speaker 2: Oh, it was awesome. I had a golden weekend. I got a lot of stuff done.

Speaker 1: Golden weekend, what does that mean?

Speaker 2: Oh, it just means I had the whole weekend off.

Speaker 1: Oh, OK, like a three-day weekend.

Speaker 2: Oh no, I worked on Friday, but I had Saturday and Sunday off.

Speaker 1: So you just had a weekend off.

Speaker 2: Yeah, but I had both days off, Saturday and Sunday.

Speaker 1: OK, that’s just a normal weekend off.

Speaker 2: Yeah, but it was a golden weekend, so I got to leave Friday afternoon. I didn’t have to come back to work ‘till Monday morning.

Speaker 1: And that’s exciting to you?

Speaker 2: Yeah, it’s two full days off.

Speaker 1: So you got a college degree… and then you went to med school for four years to get another degree.

Speaker 2: Yeah, that’s right.

Speaker 1: So after years of advanced education and training, you are now at the point where you’re just excited to have two consecutive days off?

Speaker 2: Yes.

Miller: That is a Dr. Glaucomflecken TikTok from 2020. Kristin, what kind of feedback do you all get from healthcare professionals?

K. Flanary: We hear from healthcare professionals all over the country and all over the world, actually, that a lot of these stereotypes that he kind of pokes fun at in medicine are pretty universal everywhere, and it just brings a lot of joy to people.

During the pandemic, for example, we still hear from people, even now, that his comedy got them through the pandemic as healthcare professionals because they had such an awful time at work. It was just such an awful time for everybody, they were seeing all of this death and horrible things. And then at the end of the day, they had something that they could turn on that helped them laugh about things related to their job. None of the death, obviously, but some of the lighter aspects of their job, and it helped them be able to just do it one more day.

Miller: I’m trying to remember back to those dark days in 2020, but I’m pretty sure that it was an ICU nurse who I know, who lives on the east coast, who sent me some of your videos back then. That was before I knew that you were Oregonians, that it came from the east coast and from somebody trained as an ICU nurse. Kristin, what are you doing behind the scenes to keep the Glaucomfleckin empire humming along?

K. Flanary: Well, he was, for a long time, just using one of our guest bedrooms and stealing props from our kids’ playroom and using them as costumes and acting out all these different characters. He is all of the characters, so he’s just in our room talking to himself and putting it on the internet. It was taking all this time and it was just silly, and I thought…

It just started blowing up, and I thought, if this is really going to take up so much of our lives, then we need to make it worthwhile for ourselves. So I actually started a business, Glaucomflecken LLC, and have been kind of leveraging some of the things that he’s doing as his hobby and turning it into entertainment and education and advocacy work behind the scenes.

Miller: Do you mind telling us, Kristin, your version of the early morning about six years ago when Will went into cardiac arrest?

K. Flanary: Yeah, it was about 4:45 or so in the morning, and I woke up to him making some really loud and strange sounds, that anyone in medicine would have known was agonal breathing, but I did not know what that was or what was happening. I saw that he was unresponsive. I tried to wake him up several times. The noises were really alarming. They had kind of an urgent quality to them so something was just very wrong. I called 911, and the dispatcher, Lisa Peterson, walked me through CPR.

I had no idea it was a heart issue. He has no history of heart issues, went to bed perfectly healthy, and she’s the one that really knew what to do. She just walked me through it and I did CPR for ten minutes. I had had a neck surgery a few months prior, so I was unable to move him from the bed, which is not ideal. You want as hard of a surface as you can underneath someone when you do CPR.

When the paramedics finally came in, they said that I was basically just jumping on him trying to get compressions that were effective enough. So, yeah, I did the CPR. They arrived. They shocked him five times, were able to get his heartbeat back, and then whisked him away to the nearest hospital.

Miller: Will, I mentioned that, in addition to your experience as a medical provider, you have a lot of experience as a recipient of medical care, two bouts of testicular cancer, and then this cardiac arrest. How has your experience as a patient shaped the way you view the system that you’re a part of?

W. Flanary: It certainly made me a little bit more cynical. You know, you experience the difficulties of the health care system as a physician. There’s so many things underneath the surface that our patients aren’t even aware of that go on behind the scenes. Challenges with getting services covered by insurance and prior authorizations, the list goes on and on.

It was mainly that cardiac arrest, because we had a lot of challenges with surprise billing and uncovered services, that really is what changed my social media content. It was around that time in 2020 that I started making all these videos about the U.S. healthcare system and it was because I had experienced it firsthand on the patient side. I saw what exactly we’re doing to patients in this healthcare system, and was able to start shedding light on the things that I honestly think can change, we can make better.

But in order to create change in the health care system, you’ve got to know what the problems are. And that’s one of the big challenges with the way healthcare runs in this country, it’s all convoluted and complicated and it’s hard for even me to navigate going through it as a patient, and I’m a physician. So you can imagine what it’s like for just the average person who doesn’t have that background. So I was starting to use that experience to just educate people on what these challenges are that we’re all facing. We just may not realize that’s what’s going on.

Miller: Let’s listen to another TikTok from this time. This is from 2020:

Speaker 1: Good afternoon, sir. How may I assist you today?

Speaker 2: Hi, you guys were refusing to pay the bills from my emergency hospitalization because my doctor was out of network.

Speaker 1: Yes, sir, that’s correct.

Speaker 2: But the hospital I was taken to by ambulance was in-network.

Speaker 1: Oh yes, sir, that’s correct.

Speaker 2: But the doctors that work inside the hospital were out of network?

Speaker 1: Well, some of them are in-network, but not yours.

Speaker 2: How do you decide which doctors are in-network?

Speaker 1: Well, they sign a contract allowing us to not pay them very much money.

Speaker 2: But not all doctors sign that contract.

Speaker 1: Correct, like your doctors, sir.

Speaker 2: But I didn’t choose my doctors. I had a cardiac arrest and woke up in the ICU three days later.

Speaker 1: Well, we do recommend patients call us prior to using any medical services. There’s a toll-free number on the back of your insurance card.

Miller: Kristin, whether it’s a global pandemic or, in this case, a cardiac arrest, together you are mining really dark experiences and finding some version of humor in them and then trying to make a broader societal point. What purpose does humor serve in your work?

K. Flanary: I think that, for one, it is a coping mechanism for us, for the viewers and listeners, but also, humor is a really effective Trojan horse for educating people. So it’s a really useful tool for advocacy for making change. As Will said, if people don’t understand how the system works or what’s going on behind closed doors, then it’s much, much harder to affect change.

But it’s a very boring and complicated topic, right? So, if you can make it fun and bring some levity to it, Will likes to say, we trick people into learning about it. And then once they’ve learned about it, you can really start pushing buttons to make things better.

Miller: And Will, what are those buttons that you want to push now? I mean, what are examples of the policy changes that you are, in your own way, advocating for?

W. Flanary: A big one is the vertical integration of our healthcare system and just the corporatization in general. You have a company like Optum, which is United Healthcare. Obviously, they’re an insurance company, but they also own pharmacies, pharmacy benefit managers. They’re in the hospitals and they’re the largest employer of physicians in this country. They’re owning every single step of the ladder which is driving up costs.

We’re working with Elizabeth Warren and Josh Hawley on a bipartisan bill to help break up big medicine, but also, on a more state level with Oregon, we’ve seen the benefit of legislation. We have a Corporate Practice of Medicine Bill that was just passed last year in the state, and it’s been used to fight back against the influx of private equity in Oregon – particularly recently with Eugene Emergency Physicians down in Eugene. I’d love to see that same blueprint applied to many other states, all the states, maybe even on a federal level.

Miller: Kristin, can you tell us about the curriculum that you’re developing for medical education?

K. Flanary: Yes. We really believe, based on our experience, in the effectiveness of using social media or just digital media in general, to educate people about things. We are really big advocates for having more healthcare professionals on social media giving evidence-based information to people, but in an accessible and even entertaining way, so that it can fight some of the…

There’s so much misinformation out there when it comes to health and wellness, so we do need people that are trustworthy and are using evidence-based information to be sharing what they know with the public. And we have on our team a PhD in curriculum and instruction, and she has been helping us create a curriculum for healthcare professionals or even for people working in the healthcare industry on the private side, to be able to create effective communication, in whatever form, for speaking to the general public; kind of translating their expert level knowledge into accessible language and formats that people want to hear about and consume.

W. Flanary: And most importantly, to do it ethically.

K. Flanary: That’s right.

W. Flanary: A big problem that I think healthcare professionals can run into is to say things or get led down a path that’s not ethical. So you want to maintain your ethical guardrails as a medical professional while also being able to give that high level evidence-based information.

K. Flanary: So we’ve taken what we’ve done over the past decade or so and really just put everything that we’ve learned into this curriculum and try to help them do that.

Miller: Will, as you’re talking about here, you’re using social media to reach people, and you’re aware of the deluge of other content that is not necessarily fact-based or evidence-based, but it’s all ending up in the same algorithmic soup. I mean, what do you see as the overall effects of social media on public health?

W. Flanary: I think it’s overall positive, we’re more interconnected than ever before, and social media is not going away, but it’s going to take a proactive approach to make sure we have accurate ethical voices. I don’t feel like we can, as medical professionals, really ignore social media. Not everybody has to create content, but there has to be enough good information put out there to counteract the voices that are not putting out accurate information.

I think social media can absolutely be good. It allows us to organize advocacy efforts and it allows us to shine light on harmful situations happening in small communities with regard to how the healthcare system runs, and things that anybody can do and have historically just been swept under the rug. We need social media. It’s an effective way to enact change, but it requires us to have a critical mass of people willing to put themselves out there and talk about these difficult challenges we face.

K. Flanary: And even for those who don’t want to do that publicly, there is such power in your own private social networks, just your Facebook friends, everybody that you know from college or whatever. There’s such power, because people trust other people that they know. So it doesn’t have to be everybody putting their face out on the internet. It can just be how to effectively communicate to the people in your life, both in person and online.

W. Flanary: It does help to wear costumes though. I will say that.

Miller: Kristin and Will, thanks very much.

Kristin and Will Flanary: Thank you.

Miller: Kristin and Will Flanary are the content creator duo behind Lady and Dr. Glaucomflecken. Will is also an ophthalmologist in the Portland area. They use social media to make humorous videos that demystify the U.S. medical system and advocate for patients and their providers.

“Think Out Loud®” broadcasts live at noon every day and rebroadcasts at 8 p.m.

If you’d like to comment on any of the topics in this show or suggest a topic of your own, please get in touch with us on Facebook, send an email to thinkoutloud@opb.org, or you can leave a voicemail for us at 503-293-1983.