EP 122: Knock Knock, Hi with the Glaucomfleckens | Will and Kristin Flanary
This week, Bon talks about redesigning medicine with Will and Kristin Flanary (aka the Glaucomfleckens)!
Knock Knock, Hi! Is a podcast and YouTube series hosted by Will and Kristin Flanary (aka the Glaucomfleckens). I had the chance to join this famous duo on their show and chat about redesigning medicine. We talk about why fax machines are still a thing, how I can die happy if we figure out how to eliminate hallway beds from ever being a thing, And how Dr. Glaucomflecken really just nailed his emergency medicine character. ICYMI we are rebroadcasting that interview for you this week on Design Lab. If you want to see the video of the episode or listen to the full episode of Knock Knock, we’ll share links in the show notes.
Episode mentions and links:
Knock Knock, Hi with the Glaucomfleckens!
Video of the episode via YouTube
"Why do hospitals still use fax machines? Jefferson's Bon Ku has no answers for medical comedian" - Via The Philadelphia Inquirer’s Tom Avril
Follow Dr. Glaucomflecken: Twitter | Facebook | LinkedIn | Instagram | YouTube | TikTok
Follow Lady Glaucomflecken: Twitter | Facebook | LinkedIn | Instagram
Episode Reflection:
Obviously, we are HUGE fans of the Glaucomfleckens. Will’s brand of comedy is so well done and hilarious that it has transcended the boundaries of the niche world of healthcare and has entered the pop culture zeitgeist. With this massive exposure and platform, they continue to raise awareness around the trials and tribulations of people who work in healthcare. The topics covered include everything from clinician burnout to systemic injustices in the healthcare industry to life as a medical student. Of course, as an Emergency Medicine Pharmacist, my favorite characters are Emergency Medicine and Pharmacy. This skit about Hospital Pharmacy Phone Calls is spot on and especially triggering for us pharmacists. I would say some of the most powerful skits though are the ones about the US insurance system as Will makes light of how bafflingly complex it is to navigate because “if it made sense, it wouldn’t be US healthcare.” He even goes so far as to throw in a Cheesecake Factory menu reference in his latest video about Choosing a Health Insurance Plan.
The Glaucomfleckens’ latest multimedia endeavor, their Podcast “Knock Knock, Hi!” brings both Will and Kristin together to chat with a new guest each week. So far they have had some fantastic clinician guests on the show and I can’t wait to see what they do with this platform to give a voice to people who can bring human-centered stories of patients, caregivers, and other “survivors” of the injustices many face in our healthcare system. Lady G has an especially powerful perspective being a co-survivor of sudden cardiac arrest, after having famously saved Dr. G’s life she reflected, “my perfectly healthy husband had a sudden cardiac arrest in his sleep. I fought back death for ten long minutes with no weapons but my hands and phone.” Be sure to check out this recent interview with Kristin from NAEMSP where she covers the topic of co-survivorship.
I seriously doubt it, but if any of our listeners out there have never heard of Dr. Glaucomflecken before today, here is a great playlist of his greatest hits to get you going. Enjoy!
Written by Rob Pugliese
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Hello? Hello. I'm Bon Ku the host of Design Lab. It's a podcast that explores the intersection of design and health. We have a special show for you today. It's actually a rebroadcast of an episode of Knock Knock, Hi with the Glaucomfleckens.
It was such an honor to be a guest on their show. I spoke with Will and Kristin Flanary we had so much fun talking about fax machines and design fails in healthcare. You can find them on Twitter, Instagram and Tik Tok. They are witty, funny and cool people. The Philadelphia Inquirer, which is the main newspaper of my city actually published an article of me being on the podcast. So that speaks to the reach that they have.
My producer Rob Pugliese has a great idea for us to engage with you our listening audience. Go to our website designlabpod.com. There you can submit your favorite design fail in healthcare. I talk about one in the podcast with Will and Kristin. Then we'll pick our favorite design fail and share them with the entire listening audience.
Okay. Now, here is my conversation with Will and Kristin Flanary on the rebroadcast of Knock Knock, Hi with the Glaucomfleckens.
Interview
Will Flanary: So we have Dr. Bon Ku. Bon Ku is the director of the Health Design Lab at Thomas Jefferson University and an emergency physician. And we are so excited.
This was a fascinating conversation.
Kristin Flanary: Yes. He talks all about healthcare design and why, people in medicine should care about design. Yeah. And, and how it can help.
Will Flanary: That's great. So let's get to it. Here is Dr. Bon Ku.
All right. We are here with Dr. Bon Ku. thank you so much for joining us. I know Kristen in particular. Mm-hmm. Uh, she introduced me to you. Very excited, and she's very excited, for us to talk with you this morning.
Bon Ku: I'm way more excited. This is going to be my claim to fame because all are famous in the emergency medicine world.
Uh oh.
Kristin Flanary: But for much more ridiculous reasons than you.
Will Flanary: So, yeah, I mean, do you, do you actually ride a bike?
Bon Ku: I do. I, I'm a big mountain biker infer, so all these memes that, that you have, I,
Kristin Flanary: and he's drinking a diet Coke. Did you see that? Oh,
Will Flanary: yeah. I did not see that. Oh, there you go. I love it when my stereotype fits perfectly with a specialty.
Bon Ku: 100% fit the mold musty. It's embarrassing.
Will Flanary: Uh, in fact, one, one time I was at a, a conference totally unrelated to emergency medicine, and, uh, I just ran into an emergency physician while I was there, who was on his way to go kite surfing. And it was just, uh, just classic emergency medicine. Doctor, , what are the things that you do that are, would be considered dangerous to anybody?
any normal individual?
Bon Ku: Well, sometimes after I work a night shift, I've been up all night. I get into my car that already has my surfboard in it, and I drive an hour to the beach to go surfing. And then sometimes I'm so tired, I just pull off on the side of the road at a random rest stop and sleep in my car for like 20 minutes and then like I surf all day.
So you're, yeah. So you're,
Kristin Flanary: you'd rather surf than sleep after. Yes. A shift.
Will Flanary: Exactly. Well, it's always, it is you're like up all night working very hard and then decide to go out into the ocean. Yeah.
Kristin Flanary: Or get in a car and drive it.
Will Flanary: Yeah. I mean, there's several, there's several things there
Bon Ku: I would not recommend it.
It's, but I, I gotta get my surf in.
Will Flanary: How often are you doing night shifts?
Bon Ku: I do a couple of night shifts a week. Okay
Kristin Flanary: and so, this is not infrequent.
Bon Ku: Yeah. No, no. It's very, very frequently. But I have a system set up. I've been doing it since residency. Okay. I used to like, uh, surf, in New York City of all places, uh,
Will Flanary: really?
Bon Ku: In Queens. Yeah. So I used to, and back then it was like 12 hour night shifts. I don't even work eight hours now, so that's not a big deal. I would work
Kristin Flanary: surfing in the Hudson River or what? Yeah,
Bon Ku: surfing. It's Far Rockaway Queens is actually a big surfing community in New York City. Out of all places you actually take a subway to surf.
Will Flanary: Oh, interesting. Yeah,
Kristin Flanary: you gotta get your board on the little subway train. And
Bon Ku: I had a car, so they made it a little bit more convenient.
Will Flanary: so I gotta ask, how, how does someone. I'm always fascinated by origin stories and how people get into the things that they're involved in. And so for you, you know, obviously you know, as an emergency physician you started, seeing that there, this, this health design, uh, we're gonna be talking a lot about this and so I'd number one wanna know like, how on earth did you get into this type of work?
But also like, what is it exactly help our listeners Yeah. Understand this?
Bon Ku: Well, one is I've always wanted to apply creativity in medicine, but was really frustrating cuz there was no avenue to be able to do that. And I feel like creativity is a skill that can be taught and creativity is important even in a quote, non-creative field like medicine.
Cuz you know, I think creativity helps us to solve complex problems. And I had this opportunity in, um, the medical school where I'm at in Philadelphia to teach. Design to medical students, a human-centered design or design thinking. And that was a way for us to tap into our creativity as medical students, as physicians, and to put on a mindset of thinking like a designer, to be able to apply the principles and methods of design to healthcare.
So it's not just about when people think about design, they think, well, you're just kind of making the aesthetics of a product or an object better. But it's a lot more than that. It's really applying empathy, applying skills of prototyping, of really being able to tap into our innate creativity as humans and but in the healthcare space.
Kristin Flanary: so two questions. One, you know, why. Do that. Why is that important? And two, how does design thinking differ from scientific thinking that maybe most people in medicine, or at least the stereotype of medicine, might be more familiar
Bon Ku: with. Yeah, yeah. great question. I, I get this a lot and, and I feel like, you know, I'm not saying do abandon the scientific method.
You know, I, I'm a researcher, I have a lab but I feel like we could blend the scientific mindset with the creative mindset and, you know, many of the problems in healthcare aren't black and white solutions, right? There's a lot of ambiguity in the healthcare space. You know, there's multiple drugs or treatments we could give for, a specific disease.
And a lot of times there's not a clear cut answer to that. Sometimes there is. Right. If you have a tumor that needs to be excised, yeah, that needs to go away. But so many of the problems are ambiguous, and I think design can help us get to a better solution by helping us embrace that, ambiguity. Hmm.
Kristin Flanary: This is very cool. What, what do you think that The biggest barriers to good design in the healthcare system are right now. Because to me it seems like it's, you know, horri horribly designed. Yeah. As an end user, right. I'm not, a participant in, creating any medicine, , or providing any medicine.
But I do, you know, show up and go to the doctor. You
Bon Ku: save his life right there. Oh my
Will Flanary: God. Actually a little, they got a little bit of that.
Kristin Flanary: Well, not in any licensed capacity, let's put it that way. but I've seen some pretty, pretty bad examples. Like, when I did CPR on him and I came to the, , hospital, it was at like the height of the Covid pandemic.
And so I wasn't allowed in, except as an end of life case. So ultimately I did get to come in. but I didn't get to see him. I didn't get to be with him. And where they put me was this little exam like, Not exam room, a waiting area for, patients. After they would gown up, they would be waiting for scans and it was in radiology.
And when I go around speaking, I always like to ask doctors if they know why that's a problem and they never, they never think of why that's a problem. So I'm curious if you might know from a design perspective.
Bon Ku: I think design excels at making experiences Beautiful. And most of our experience in healthcare aren't beautiful.
They're these crummy experiences of Yeah, I've had the worst day of my life. And then mm-hmm. They put you into the worst place in the hospital, it looks like, you know, you're at the, um, DMV getting your driver's license. It's just like just a terrible experience. And we don't think about the end user.
We don't think about how we might design a better experience for patients, family members, caregivers. Yeah. Uh, like, and there's
Kristin Flanary: a functional component too. Of the design.
Bon Ku: what do you mean functional component?
Kristin Flanary: Well, in radiology, the walls are lined with lead. Mm. Yeah. Yeah. So I'm in there all alone, isolated, and then they just cut off my cell phone signal.
Oh. So they cut me off from the outside world all for just, you know, bad design, bad forethought, whatever. Yeah. so yeah. So I'm curious, you know, that's
Will Flanary: definitely pandemic. We're really kind of flying by the seat of our pants.
Kristin Flanary: Yeah. I like to think it was that. Who knows? Um, maybe
Bon Ku: a little bit of both things haven't changed since the pandemic i, in our experiences in hospitals and clinics.
Right. Yeah.
Kristin Flanary: Yeah. So anyway, that was an example, that I've seen in my own life. So I'm curious why is it that way? What are the barriers to making things better?
Bon Ku: I feel like as in, in healthcare, we don't appreciate the value of design. I think. So much of what we do in healthcare, you know, we're putting out fires, all the time.
Mm-hmm. And, in design there's a saying of a form follows function. You know, the chairs that we're sitting on, they look that way because they're supposed to hold us up in, in the air when we sit, so we don't fall down. And my buddy Brendan Carr, who's emergency physician, says in healthcare form, follows finance.
Yeah. And the incentives are so perverse in healthcare and because of the way that our system has been intentionally designed leads to poor experiences. So you can think about, you know, the financing of healthcare, the way we pay for healthcare, these policies, impact our experience as patients, providers, and clinicians.
Will Flanary: So there's two things we can do. Then we can. Going forward, we can have more of a form follows function type of thing. But then how do we, we gotta figure out a way to fix , the problems though that are already in place.
Kristin Flanary: Yeah. You can't just, completely eliminate the finance piece of it, but how do we add in maybe a third component?
Yeah.
Bon Ku: Yeah. I mean, but you know, when we think of the financing of healthcare, that was someone design the financing of it. You know, decades ago that Yeah. Are, , the way we pay for healthcare is through insurance. Through
Will Flanary: Who was that guy? I just wanna talk to him.
Bon Ku: I think it was like in Texas, maybe a lot.
Of course it was
Will Flanary: ago. Look at it. Okay. Go back in time and, you know, do a couple things and how that is a stern conversation, a stern talking to person,
Kristin Flanary: stern talking to you.
Bon Ku: And in other countries they haven't designed it that way. Right. And just because we experienced this, have experienced this for decades, we don't realize Yeah.
At some point, somewhere, some body, some entity, some, uh policy was created. And we have a system that was perfectly designed to give us our experience of it right now. Right,
Will Flanary: right. Perfectly designed to, make us all miserable, uh, to sell and, and financially devastate people. Yeah. That's, that's, uh, so you are going back.
You, you're a med student. and that's when you started getting into this idea of design and, and wanting to combine creativity.
Bon Ku: No, I, you gave me way too much credit.
Will Flanary: Oh, it was, it was later.
Bon Ku: Yeah. much later. But I have always been, I, I was fascinated about design, but didn't really know what it was.
I never formally studied, design. I was a classical studies major in college, so I'm this weird guy who studied ancient Greek and Latin. Nice. And, like I actually didn't want to go to med school at, one point because I, um,
Will Flanary: what were you gonna do instead?
Bon Ku: I don't know. Some, that's probably why I went to medical school.
Kristin Flanary: You already knew all the words, so you were one step ahead of everybody else.
Will Flanary: That's true.
Bon Ku: My parents would disown me. They're, they're from immigrants from South Korea and they say, Hey, we came to this country so you could go to an Ivy League school and become a doctor. Literally. So I've been brainwashed, so there you go.
It would've been cause chaos in the, in our universe if, I had not followed a path of medicine
Will Flanary: gotcha.
Bon Ku: And. Yeah. So I've always been, you know, I geeked out about the design, like industrial design, the design of products, of how architects design buildings, and have always been kind of fascinated by this process.
and I thought, you know, why don't we do this in healthcare? Because I believe that design can bridge technology and patience. Like we have the technology, but there's so many times there's this mismatch where we feel like something's missing there. Right. And, and I, I think the bar is so low for us and the healthcare both from the clinician side, and the patient side for us to make these experiences that we have beautiful, to bring humanity into our experiences.
And, and what you have said about the pandemic of, of separating patients from their loved ones should never, ever happen again. That was the most.
Will Flanary: Mm-hmm.
Bon Ku: That was the hardest thing I think I've experienced as a physician in, in my career. It was, it was inhumane. Yeah. And if my loved one, you know, if my wife or my mom ended up in the hospital and was dying, I mean, you would have to get the security and police from me not going into that room.
Like I would literally barge in. I was like, I don't care if I get covid. I don't care if you arrest me. You are not going to separate me from my loved one.
Kristin Flanary: Yeah. Yeah. It was, it was rough. And there are a lot of people out there in that situation that are they dealing with the aftermath of being separated in these
Bon Ku: horrible circumstances.
So, so many stories. And, you know, I've had experiences of telling family members that their loved one was dying on the phone. it was just, it's, yeah. So, you know,
Kristin Flanary: that's brutal.
Bon Ku: How, you know, going into, you know, thinking about our next crisis, how can we make hospitals safer? for patients, their family members.
So this doesn't ever happen again. How can we design hospitals with more ventilation? How can we ensure supply chain so, this inhumanity will never happen again.
Will Flanary: So now you're the director of the health design lab at, Thomas Jefferson University. congratulations, by the way.
That sounds very impressive. I mean, I think being a physician is enough. Like you didn't have to go and do like a whole nother like really impressive thing. But g Good on you. can you give us like a concrete example of like something you tackled from a design standpoint that you saw?
Bon Ku: Yeah. You know, one is, I have these 3D printers in the back of me here that I see those. Yeah. So we were starting to, we look at a lot of different emerging technologies, so desktop 3D printing, and bought some printers, uh, years ago and thought, you know, what can we do with this in the healthcare space?
You know, can, you know, what are the applications of this technology? So we started doing some research, working with our surgical colleagues in the beginning and, and said, Hey, can we use this as another data point for surgical planning? So, complex surgeries, you know, working with our head and neck cancer surgeons around, mandibular reconstruction and thought, Hey, can we print out the mandible from a CAT scan?
And do some surgical planning. So one technique was, bending a titanium plate, in the, or in real time to stabilize your, uh, mandible, your, jaw. And we thought, Hey, why don't we print these out first? pre-end these plates so we don't have to do it in real. So the surgeons don't have to do it in real time in the or, you know, sterilize them and see if we can match it.
And so save some time. So that's like one practical example of, of we have this technology, how can we, think about human-centered design and apply it into real problems in the healthcare space. So that problem was, you know, decreasing or timing and complex surgery. So we've done a lot of research, um, around that.
Will Flanary: you are in one of the best places for finding out where those problems are. Right. The emergency department, there's probably so many design things. You're, you got like roaming around your head and, um, oh, yeah, yeah, yeah. Do you have like a holy grail of, of design you're trying to, you're trying to unlock.
Bon Ku: You know, one is Yeah. The holy grail is how do we keep patients from being in hallways Yes. When they're boarded in the hospital. So , if I could prevent, boarding in emergency rooms, I feel like I could die. And that, that would be like, it'd be better than winning a Nobel Prize because I think it's the most inhumane thing to do.
Right. When you are, when you go to the er, it's probably the worst moment of your life. Mm-hmm. And then we go, okay, well we're so busy. Uh, you waited 10 hours and then we're gonna put you in a hallway bed. And you're gonna wait maybe 2, 3, 4 hours a day, two days to get upstairs to your admitted bed. I mean, that is, inhumane.
That happens. And I go, how come this doesn't happen anywhere else in the hospital? Like imagine going into the ICU. And having aborted patient like in the hallway on a ventilator in an I C U or, think about maybe other industries of if you hop on a flight and go, Hey, I was assigned a seat but then they're like, oh no, we don't have a seat for you. But you could be in the aisle for this entire, like eight hour flight, landing flight, a
Will Flanary: little overhead bend space we could, could go into, could slip into.
Bon Ku: And, that is a great, design challenge of, you know, how do we prevent boarding?
And I think a lot of people will go, well, we just need bigger emergency rooms, right. Because to, we could have more beds. Well, I mean, I don't think that is the answer. I think it's a lot of the policies that we have that prevent a patient from going upstairs from the discharge processes to a human capital of, of, we have nurses.
And other clinicians, you know, leaving healthcare in droves. And so when there's a shortage of hospital beds, I, I don't like that term cause I think there's, like, really the problem is a shortage of nurses and other, frontline workers.
Will Flanary: The, what do they call it? The great resignation.
Yeah. Everybody, everybody's leaving
Bon Ku: Oh, a hundred percent. And how can we, how can we redesign the experience , of a nurse or a clinician working in a system to be a great, great experience? I mean, love the, humanity I see in so many of my coworkers. You know, we really, at the end of the day wanna take care of patients.
But then when we treat, uh, healthcare workers, put them in the most stressful situations, like, don't give them the resources that they need. It's gonna lead to burnout. And it's really frustrating cause I visit a lot of like, tech companies and I go and. I go, this space is a beautiful, there's like light here, there's places to decompress, there's like free food and kombucha on tap.
And I see my residents like stealing Turkey sandwiches from, from the patient trays cuz they're no food. I'm like, , we need to give some compassion to our, our healthcare workers who are in the most stressful situations.
Kristin Flanary: Yeah. And I think, I'm assuming that some pushback to that might be, well that doesn't increase the bottom line, right?
That's if form follows finance, where's the finance in that? But I think that that's maybe a, a shortsighted way of thinking about that problem. Because if you can retain your healthcare workers, if you have less turnover, if people are, able to treat patients better, right? Then the patients are happier, the patients get better faster.
I mean, all of that. Would affect the bottom line. Yeah.
Bon Ku: and burnt out. Nurses and physicians are gonna give burnt out care.
Kristin Flanary: Right.
Bon Ku: to me it's a simpler formula. Like yes, it's gonna be some short-term pain, but, it's going to be, have better long-term impact upon the delivery of care.
Will Flanary: can you 3D print a solution to this? Is this how, how close are you?
Bon Ku: Well, you know, it is a complex problem that needs a different mindset. Yeah. Uh, you know, like how can we give it a different lens? You know, a great part of design is, , questioning a problem from multiple different angles. And I think in healthcare we assume that we know the answers all the time, but, how do we pause, , take a step back, and how do we think about a better future state?
I think designers are so optimistic and they have to be, they have to think of how something like a product or service or space is gonna look like in the future, and to create a path to get there. And I don't think we do that in healthcare. You know, we don't think about, Hey, how are we gonna create a better system in 10 years from now and 15 years from now?
Because we're so busy, literally putting out fires every, every day in our jobs. Mm-hmm.
Kristin Flanary: Right. Yeah. What do you say to people who, you know, the idealism sounds great, the optimism sounds great, but there's the practicality of in the realism of the situation. So how do we balance those things?
Bon Ku: other countries are doing it, you know, that, , I was just reading these stats of, we, here in the us out of all the high income nations, like we have the worst health outcomes. We experience, uh, worse, uh, health outcomes. The, we have the, I think the lowest life expectancy at birth, the highest maternal and infant mortality rates.
, you know, the highest death rates for like treatable conditions. Mm. And we are the richest country in the world. So other nations have figured this out. And, and this is, you know, nations like, like New Zealand and a lot of European nations and South Korea from where my parents are from, and they figured it out.
So it's not a technology or a financing issue. Like we have the finances, we have the technology, and I, I really believe it's, that we designed these policies, , incorrectly. You know, we have not put the human, , at the center.
Will Flanary: Let's take a quick break and we're gonna come back with, uh, Dr. Bonk.
All right. We are back with Dr. Bonk now. Dr. Ku, we, we've, established that you're, , you wear two hats. You got this designed that you got the emergency medicine thing, and that emergency medicine provides you with a lot of interesting, experiences. And I know that you, yourself have had an experience as a patient, and kind of a really exemplifies how sometimes bad doctors are as patients.
Would you care to share with us this,
Bon Ku: okay, this is, this is embarrassing. It happened a while ago. I, as we said before, I'm addicted to surfing, and one time I was surfing and I don't know what happened. I think the board hit me in the head pretty violently, and I was in the lineup and in the ocean, and I'm, and I'm thinking, How long have I been out here in the ocean?
And I was like, thinking what happened this morning? Like how did I even get here? And I paddle up to another surfer near me and I said, yo, dude, how long have I been here? And he says, I think you should probably get out of the water. So I get outta water. I call my buddy who's another emergency room doctor and who I surf with.
And I said, Hey, ed, did we surf together or did I call you this morning? He's like, yeah, dude, like you called me. He was like, we had a whole conversation this morning. I was asking about the waves and he said, don't drive home. You should like, just check into a local emergency room down there.
Wow. And I'm like, dude, I was like, I am driving home. I'm not gonna go to my local, like local hospital. Ugh. Like otherwise I felt fine. I just, I had retrograde amnesia. I couldn't remember what
Kristin Flanary: happened earlier. I'm starting to think your driver's license should be revoked.
Bon Ku: So I go home and I like, I feel fine, and then I have to work an overnight shift later that day and my wife goes, you are not working.
You need to go and seek medical treatment. You might have like a bleed. I'm like, I don't have a bleed, I don't have a headache. And that's fine. That's, that's why I
Will Flanary: said, fine. Yeah. That's
Bon Ku: my favorite line. I'm just like a terrible patient. I don't have a doctor and she just four. She drives me to the hospital before my shift and my colleague takes care of me and she ends up getting a CAT scan of my head and my neck to look for like a dissection or maybe one of my arteries that caused me, yeah.
To like have some amnesia from the head trauma. And then I get this freaking report that says there might be a bleed there in my neck or something like that. Or maybe abnormal. Oh yeah. Anatomy. So I call one of my trauma surgeons and I go, yo, can you just like take a look at this skin because I gotta work tonight.
And Oh my God. And he's like, he's like, I just think it's like just, I don't think it's a bleed. Doesn't look like a bleed. Just probably it's fine. One of your vessels, you have some abnormal anatomy there, vascular anomaly or something. And he just said, yeah. And he said, why don't you just put on a cervical collar and just, you know, come.
Just, we'll, we'll see you in the morning. I was like, fine. So I put on a cervical collar and worked my entire shift with that. I couldn't, like, I had to turn like this. My patient were like, are you okay? Yeah, that would
Kristin Flanary: be a little nerve wracking to see your doctor
Bon Ku: and ended up show up like that. Ended up, I was fine.
I saw a neurosurgery resident. Later. Later
Will Flanary: you my shift have to work at all costs. Yeah, I do. There's no
Bon Ku: way. Oh my gosh, what am I, am I gonna call you? People call out. Like, because if, if I call out to a shift, then I have to call a colleague to work. And I was like, I'm not gonna do that of, oh my goodness.
Something silly of some head trauma and some just some silly head
Kristin Flanary: just can't remember anything and I'm gonna go treat patients and have their lives in my hands. It's, it was retrograde. Ask someone
Will Flanary: else to come in. It was retrograde amnesia. I
Bon Ku: was asymptomatic. I didn't have a headache, no nausea, vomiting.
It was fine.
Kristin Flanary: You people are infuriating. She, she always gets down. I have had own up with this for, I don't know, too long ago. It's
Bon Ku: terrible.
Will Flanary: Yeah. When, you know, when I, I had my cancer diagnosis. I tried to continue working and, and, uh, and
Kristin Flanary: I, yeah, like he left, the ultrasound room where we got the diagnosis.
I was like on the phone
Will Flanary: and went to work. Oh my gosh. I tried to ended up having to, to leave because it was, Too much emotionally to, to bear, but no, like I told you, it would be that, that's just another example of why doctors are terrible patients. We don't know how to take care of ourselves.
Bon Ku: It's so, it's so bad.
I, I would not do that again. I was like younger back then. I'm older now. So
Will Flanary: talk about a design flaw in the way we all think Yeah. About our own health. so I, I prepared something here. this is just kind of off the top of my head for the most part. I came up with some healthcare design fails, like in my own mind.
Yeah. Like, these are failures of healthcare. and I thought we could just like, talk about 'em. Yeah. And maybe we could, maybe, you know, how to fix them.
Bon Ku: I'm, I'm ex I'm excited about this. This is one of my favorite, topics. Healthcare design fails. Well, yeah,
Will Flanary: absolutely. And if you have, there's so many to
Kristin Flanary: choose from
Will Flanary: and if this triggers some, healthcare design fails that you know of, please uh, feel free to chime in here.
All right. The first one is probably something that you've actually encountered in your job. I know I have, , eye drop bottles and super glue bottles look almost identical. Uh oh. Can you imagine how this could be a problem? Yeah. What do you think, Kristen? What do you think happens? People put super glue in their eye.
People put super glue. Have you ever seen a super glued eyelid chef of you? I, is this real?
Bon Ku: Yes. What? Goodness. You. I have not seen that
Will Flanary: yet. Oh, yeah, yeah. Yeah. It, probably, I, hear about it probably once or twice a year. And so, um, I'm, we're in a big metro area, so you know, we're gonna get, more of, everything.
But, , yes, people think they mistake , the super glue for their eyedrops because like gorilla glue, it can, some, some of them come in little bottles that have like a twist cap. You know, obviously like sometimes people that use eyedrops they can't see as well. And so, you know, some reason they have the, the eyedrops and the super glue, like on the table, like together or in a drawer together.
And then sure enough, they super
Bon Ku: glue their eyelid shut. Yeah.
Kristin Flanary: What? So you just can't open your eyes? What happens? Yeah. So do
Will Flanary: you rip your cornea off? Well, actually, you know, I guess I, your eyeballs come out, I can tell you how to treat this. Um, actually people think that it's the eyelid that gets glued to the eyeball, but actually what happens is the eyelashes get glued to the skin of the lower eyelid.
Mm-hmm. So, so actually what you can do is just cut the eyelashes off. And then the patient should be able to open their eye. Hmm.
Kristin Flanary: Okay. Not as horrific as that is conditioning.
Will Flanary: So it's fairly, I mean, it is horrific for the patient because they think the worst, obviously, that they're going blind. But then when you can fix it, it's great.
But anyway, that's, uh, healthcare design. Like
Bon Ku: what? Yeah, like designers have a, have a responsibility, uh, ma making, making some of these products. So remember that there was like that TikTok challenge of people, like kids eating like laundry detergent. Oh, the Tide pods. The Tide pods. The Tide pods.
And. Why would a designer ever design something to look like candy? It looks just like candy. Yes. Like why would, even bright colors. Yeah. Yeah. Bright colors. Like about that size. It looks like something that you would want Yeah. To eat and consume, like it should never have been designed that way. And, and things.
One of my favorite slides that I use, in a lot of talks, I had to retire it because I use it so much, but I get so many laughs from the audience is that we have. Two thermometers in our trauma bay, an oral thermometer and a rectal thermometer. Oh no. And if you look at it straight on, you cannot tell which one is a oral thermometer.
Which one is a rectal thermometer? So, oh no. Our nurses did a hack of, of, we have with a marker go rectal oral, because the only way you could tell is a a dot on top of the probe itself, red or blue. I'm like, oh, you should make those things very different because in, in an emergent situation when we're working, , like in a hospital, you're just gonna go quickly for a thermometer and no one wants a rectal probe in their mouth.
Will Flanary: Oh boy. No, no. I would say, I would say not Nobody wants that. So that reminds me of That's a good
Bon Ku: example. Crazy glue and,
Will Flanary: uh, yep. Uh, crazy glue and eyedrops. Uh, rectal and oral thermometers. Uh, different things should should look differe. Yeah. Yes. Look differently. Feel
Bon Ku: differently. Sound
Will Flanary: differently.
Exactly. Alright, here's one. can we design a better way for patients to sleep in the hospital?
Bon Ku: Oh, I think about this so much yet. So we've, we did some exploratory research on this with sound that. There are way too many alarms in a hospital. Needless alarms, you know, so you could, like, how can you design, an ecosystem of alarms where, the devices speak to each other?
Because currently medical manufacturers of these devices, they could put any freaking alarm they want on a device, but there's no system that orchestrates all of these sounds. Mm-hmm. And then also, you know, why do we need a, a 2:00 AM blood draw on a patient, or 2:00 AM vital signs, like, can we eliminate that and prioritize sleep for, for patients?
So I think there are so many ways where we can minimize, sleep disruptions or design, redesign, the way that we take care of patients overnight. Mm-hmm. Redesign the, alarms that we have for in the hospital or even the rooms themselves.
Will Flanary: Yeah, the rooms. Yeah. You know, like why? I don't know if we still have, I'm sure we still have lots of hospitals that have like two patients to a room, but that should probably not be a
Bon Ku: thing.
Yeah. I don't know. But it, still happens.
Kristin Flanary: Yeah. Yeah. And even little things like just make it a little more comfortable and, and nice looking in there. Right. So you can relax and, and sleep. It's, or have
Will Flanary: have windows that can, you can crack open and get a little
Kristin Flanary: Yeah. Little air, fresh air or something.
Yeah. Fresh
Bon Ku: air. I mean, I wish I had that during the pandemic. Right? Because you, not all of our rooms, were a negative pressure rooms and, , because of the way hospitals are designed, they're hermetically sealed and Right. I sometimes I wish I was like, I wish I had an open window and I quit a fan in there that I could buy a target cause mm-hmm.
I would feel protected. Right. So, I have a, a buddy who's an architect, Michael Murphy, and he talks about, you know, How can we design hospitals themselves to have p p e? We think of, hmm, what would that look like? The PPE of, of buildings, of ventilating them. But instead we we just think of the humans in those buildings say, Hey, we could put p p E on them.
Mm-hmm. Right. That's a good point.
Will Flanary: All right. How about, um, can we design away fax machines? Is it, you mentioned fax machines earlier. is there a, do you perceive a world in the future where we do not rely on fax machines?
Kristin Flanary: Yeah. I feel like the rest of the world, the rest of the industry have figured this out.
So what's the problem?
Bon Ku: Yeah. I don't know. I mean, it, it is,
Will Flanary: You're the director of the health design lab. If you can't figure this out, no one can, nobody can figure this out.
Bon Ku: Okay. One, this proves my point that we don't have a technology problem, right? we have a design problem, right? Yeah. The, we have the technology to send secure, patient information over.
Over many other mediums besides a fax machine, but we still use fax machines routinely. So the system has been designed to keep these, archaic 1980s technology. And I think it's funny cuz our medical students nowadays, the first time they've seen a fax machine is their third year clerkships, uh, in the hospital.
So like, they literally don't know how to use a technology cuz this is the first time they've encountered. They're like, what is this? You know, they're, I'm like, man, I am old. Like, these kids do not know what a fax machine is. So,
Will Flanary: I
Bon Ku: don't think
Will Flanary: it's ever gonna happen. I don't know. Nor are fax
Kristin Flanary: machines any more secure than encrypted data.
I mean, the paper just sits there on the other end. You have no idea who's gonna see that.
Will Flanary: I don't know. I mean, that, that's, that was the argument for fax machines for a long time, was that it was like HIPAA compliant. Like, so
Kristin Flanary: you can, how though, like there's, the paper just sits, there's anyone can go by and
Will Flanary: read it.
It does, it does just sit at the fax machine. So it's, I think theres limit, it's, it's still super
Bon Ku: cheap, uh, to have, and that's, it's a real cheap, secure way of, of sending information. But it infuriates me, like I, my daughter had to get, , a c l repair. she tore it and, and then at one point they were like, yeah, can you fax over some information?
Like, are you kidding me? Faxing over Information.
Kristin Flanary: My favorite is when sometimes my, you know, healthcare institutions where I receive healthcare will ask me to fax something and I'm like, no, no, I can't. Like from your house. How would I even do that? Yeah, your residential, like maybe the public library might still have
Will Flanary: one.
Let
Bon Ku: me find a fax machine. Oh, I thought it was a moral argument. It's like, no, I refuse to. It's cause you don't have a fax machine. Oh, it's the principles who matter.
Kristin Flanary: Who does, who can do that anymore?
Will Flanary: All right, I got a couple more. can we design a better slit lamp?
Bon Ku: Oh, yes. I mean, they're so hard to use.
Like I, yes, did few weeks of ophthalmology as a, , emergency medicine resident, and so, you know, I, I put some time in to learn it, but Good for you. It is, yeah. It's big and cumbersome. You
Will Flanary: know, you need need. Yeah, exactly. For those of you who don't know what a slit lamp is, it's a, a machine on wheels that basically it's a microscope that allows you to look at the front and the back of the eye, with, uh, fine detail.
Kristin Flanary: It's the thing when you're a patient and you go to the eye doctor and it's the one or two. One or two, no, no, no, no.
Will Flanary: It's the four optic. It's the big thing that sit on that's not, no, that's not the thing. No, I had
Kristin Flanary: all this time I thought that was No, the slit slit lamp.
Will Flanary: The slit lamp is the look at that slit lamp's, the bright light.
That they shine in your eye. The thing that you hate so much, they hate dial at your eyes and they shine a bright light. The, the thing you're talking
Kristin Flanary: about, you still have that thing on your face when they do that, right?
Will Flanary: No, not necessarily. You gotta put your
Bon Ku: chin on that thing there. That
Will Flanary: thing. That thing.
Okay. Well I, I think you're maybe thinking about maybe you're combining, maybe we should combine the two into one device. I don't know. I
Kristin Flanary: don't think we might be onto something here anyway, from the patient perspective. That seems like the same thing.
Will Flanary: It looks like a, a medieval torture device.
It really does. Yeah.
Kristin Flanary: It feels like one too. It, I'm, I, yes, it does.
Will Flanary: It. I'm sure it does. and it doesn't, you wouldn't numb. You've never had an eye exam. A lot of body. It's true. Okay. You're calling me, me out here? Yes. It, it is true. I don't wear glasses. I never have. And I, I had one.
Kristin Flanary: You still get an exam?
That's what you tell me. You're right. Doctors are the
Will Flanary: worst patients. Oh, doctor, what're the worst. Keep coming back to that. Anyway, we need a new, a different type of slit lamp one that like, also, depending on your body type, it doesn't fit a lot of people. and so it's just all around, needs and,
Bon Ku: and I think we need a, we need to design a slit lamp for non ophthalmologists because I don't need all those bells and whistles.
I just need to look for like exactly a corneal abrasion. Right. And I. and I'm like, there's so many dials to get it perfectly. I like, I I don't need to do that. And slit lamp
Kristin Flanary: for dummies. Yes. Business idea for the day. Like me, like
Bon Ku: I need a slit lamp design for me. I'll tell you,
Will Flanary: this is a, people listening have probably heard this already, but, this is what I always tell emergency physicians, like if it's been a while since you've sat down at the slit lamp and you, you're trying to remember what everything works just to the patient.
You say, who messed with this thing? And it's gonna, it's gonna buy you a little time to try to figure it out. I, I'm
Bon Ku: totally going to like, write, write that down. That that's a, I have all these scripts for patients that, that I use, so I'm like, I gotta remember
Will Flanary: that one. Yeah. Okay. I have one more, one more.
Design fail. Um, how do we design nicer cardiologists? can we do something about this? What do you mean?
Bon Ku: I think the cardiologists in my hospital are. A lot of them are nice. Oh, you
Will Flanary: have to say that. Okay. They're, they're gonna be listening to this. I'm so glad you have nice ones. No, I'm hard on the cardiologist.
I had like one or two of the difficult experiences as a med student that might've ended up with me crying. uh, know, I think overall probably they're nicer than I imagined. But, um, you know, maybe we could just cut out the, asking about details on an e kg. I, maybe that's, oh yeah.
I dunno. I, you know,
Bon Ku: and I think that it's a, it's a funny question, but it is a serious question too. Like, how can we redesign medical education and, and how can we how can we design behaviors. Right in medicine. How could we redesign those behaviors? You know, if I, when I was a medical student, you know, when I, I had a surgeon throw surgical instruments in a room and yell at me and say, Hey, maybe you shouldn't, I was thinking about going into surgery, but it was like, well, maybe you should go into pediatrics instead.
I'm like, what? That is so mean. What Pediatrics is a great feel. And like that is a, like, it's so insulting. So I think, medical schools are doing a better job of designing behaviors and modeling, , out there, but I think we can, we can do better. That
Will Flanary: sounds like a difficult, a difficult endeavor to be
Kristin Flanary: redesigned behavior.
I love, I would some co-design in medical education too. Yeah. From patients and families and physicians. Right. Like, how can we design this whole system to work better for the people? I think it's, BJ Miller has that great quote about healthcare systems are designed for diseases, not people. Mm-hmm. Which is to say they're badly designed.
Yeah. So, I wanna see people have input into, what can be better. And then we start just teaching people to do those
Bon Ku: things. You're speaking like a true designer, Kristen. I think Stanford Medical School has a co-design process, in their admissions. I think they actually have, like, patients from the community participate in interviewing medical students.
Oh. So that's, that's one way. Cause that's gonna be their patients. Yeah. And then a patient may go, Hey, this, undergrad or This applicant has no social skills or no emotional intelligence. Interesting. Maybe, maybe you should not accept him. Oh,
Will Flanary: that's an interesting idea.
Kristin Flanary: Yeah. I could talk all day about
Will Flanary: this stuff.
Well, let's, let's take a break and then, uh, we're gonna come back with a couple of stories from a very special person. Oh. Oh, right. And uh, and so we'll be right back with Dr. Bon Ku.
All right, we are back. We're gonna take a look at, uh, a couple of. Special stories from Kristen's dad? Yes. Or more? Am I actually more your grandfather? My
Kristin Flanary: grandfather. Yeah. Through your dad. Exactly. My dad sent these in to our email address, which I thought was really cute.
Bon Ku: That is cool.
Will Flanary: And, and your grandfather, was an, obstetrician.
Yep. And he actually designed something very special. He designed what's called the Mighty Vac, which is a, you'll have to help me. I think it's a, like a plastic disposable, it's a vacuum. Vacuum
Kristin Flanary: extractor. Vacuum extractor. It's a certain kind of vacuum, like the vacuum extractor as a device, existed, but it was like made of steel and it was really, you know, a not a great experience for the, doctor or the baby.
And they came out with a big, you know, cone on their head and that freaked the bombs out. And it just, all around, it was doing the bare minimum but wasn't doing a great job. And so, My grandfather always used to tell the story of he was sitting in a sauna one day and where
Will Flanary: all the best meetings happen
Kristin Flanary: and uh, there was another guy in there and he would say, you know, you gotta talk about something while you're sitting there naked.
So, I. They just start making small t about what they do. And it turns out he was a plastics manufacturer and one thing led to another and, and they came up with a new design for the vacuum extractor that involved, a certain kind of plastic. And anyway, he patented that and, and that's the mighty vac and it's still in use today.
So I thought these stories are particularly appropriate for this episode with you Bon Ku.
Bon Ku: Oh, that, that's so cool. I love like where inspiration comes from can, comes a sauna. It can from make it a sauna. Right. Some of my best moments are in the shower when I'm, that's on my devices. I, my, my brain can just like, go down different pathways.
Yeah.
Kristin Flanary: I'm with you. You completely unrelated things together and something magical comes out of it. But, you know, I,
Bon Ku: I encourage, like a lot of us, to look at outside healthcare for inspiration. Yeah. You know, design is called this, like, there's a term for this called like analogous inspiration of looking at another, industry.
For some, inspiration. So, you know, like a lot of us in healthcare airlines, you know, we get a lot of inspiration for them and kind of like pilots, how they use simulation and, you know, why can't we teach simulation to, doctors instead of having them take multiple choice question tests every 10 years to get recertified, but maybe they should have as rigorous, , processes like pilots due to get, maintain their certification.
Kristin Flanary: Or even just cross-disciplinary within medicine. You guys are so siloed that it just doesn't. You know, allow for these moments of creativity to,
Bon Ku: yeah. I don't think I've talked to an ophthalmologist in 10 years. Yeah, that's right.
Will Flanary: Doesn't surprise me whatsoever. Anyway.
Bon Ku: A radiologist, I never see them anymore. I, we used to have reading rooms. I loved going back and to the reading room and talking with the human.
Now it just like over chat in the electronic health record.
Kristin Flanary: Yeah.
Will Flanary: You think you haven't talked to certain doctors. When was the last time I talked to anybody outside of my own field? I don't know.
Kristin Flanary: Just this podcast.
Will Flanary: This, yeah. Exactly. All right, so these are a couple of stories from, Kristen's grandfather.
So, and your dad sent us these. So it says, Kristen, your grandfather enjoyed telling the story of a mischievous patient of his who became bored lying in bed in the hospital, recovering from surgery. The nurse brought him his lunch and a small plastic bottle for a urine sample that he was, was to fill at his leisure.
After he finished his lunch, which included apple juice, he then surreptitiously poured his apple juice into the sample bottle and waited patiently for the nurse to return. As she asked for the bottle, he started to hand it to her and then abruptly stopped just short of handing it to her. Held it up to the light and said, hold on a sec.
This looks a little cloudy. Let me run, run that through again. And then started, and then, and then to the startled dismay of the nurse, quickly chugged it down.
Kristin Flanary: That's great. Gotta give that another pass through the kidneys. Okay. You gotta
Bon Ku: give that another pass'. Take that out a little more. That was a good one.
I have not seen that. That's
Will Flanary: a great one. That was a difference. That's a good, that's, that'd still be a pretty solid prank on your, on your nurse. I'm sure that would, that would throw people for a loop. Okay. The second one. He also told the story of a high school boy who worked part-time in the afternoons at a small filling station garage in a tiny rural community nearby.
The boy came to him complaining that he was having difficulty urinating your father, examined him and quickly became suspicious. Something was up after quite some interrogating. The boy confessed. He had grown bored the day before and found some small ball bearings lying around and thought it would be a cool idea to shove them up his penis and shoot them out.
Shoot them out while peeing. That was the goal. Oh my gosh. To shoot them out. I'm sure you have probably encountered your fair share of things in orifices. Um, were they where they they should not be where they should not be
Bon Ku: all, all the time. And you know, I used like.
Kristin Flanary: Why do people do this?
Bon Ku: I don't know. And like, you know, there's like crazy x-ray findings and all this stuff and you know, people sticking foreign bodies up the rectum and urethra Yeah. And swallowing stuff and, and you know, as I grow older, I go, I started asking patients like, why did you do this? And you know, I had one patient keeps on swallowing objects and he is like, you know what I like, I'm just like, depressed doctor, and this is my way of, of dealing with the stress and depression.
I'm like, yeah. I mean, yeah. It's like, it's sad, you know? Cause this guy has to go to the operating room and,
Will Flanary: I'm sure you probably get a lot of different reasons, a lot of interesting conversations come from. Yeah. I mean those
Bon Ku: types of encount. Yeah. We have the best, uh, stories to tell.
A cocktail parties mean. It's kinda one reason I went to do specialty. I've heard a lot of them. Yeah.
Will Flanary: Alright, you can send us your stories. Knock knock high human content.com. , Dr. Baku, thank you so much for joining us. Before you go, , let us know, what's going on in your life, uh, what you want people to know about.
Yeah.
Bon Ku: We have a great book on called, oh my gosh, you have it
Will Flanary: called. We have the book. Of course. We have the book. It's a wonderful
Bon Ku: book. It's called, uh, health Design Thinking. It's co-written by a famous designer named Ellen Lupton, and she did the second edition, during the pandemic. And we use examples of creativity during the pandemic.
So if this, Intersection of design and healthcare is interesting to you. check it out. And I have a podcast called Design Lab, where we explore this in depth. So we have like architects on industrial designers, physicians, other folks, and we just like take a deep dive into the intersectionality between design and health.
Very cool. Not
Will Flanary: only is it a great book on design, but the book itself is designed very well. I It is. It's very pretty. It's very pretty to write that.
Bon Ku: It is, it is. Yeah. Yeah. Uh, Jenny Tobias did all the illustrations. It's like, graphing paper here, like a EKG machine. And it's, that's awesome. It's, it's, it's a beautifully designed
Will Flanary: book.
Check it out. Health design thinking. Bon Ku, thank you so much. Uh, it's, it's really been a pleasure talking to you.
Bon Ku: This was a dream. I'm gonna be so famous in emergency medicine now. Like you, you both are legends. Like, I'm going be like, I'm gonna impress people in my specialty, so thank you. All right.
Good talking to
Will Flanary: you. Take care.
We are your host, will and Kristen Flannery, also known as the Glaucomfleckens. Special thanks to our guest today, Dr. Bon Ku and our executive producers are Will Flanary Kristin Flanary Aaron Corny, Rob Goldman, Ashanti Brook, our editor and engineer Jason Portizo our music is by Omer Ben-Zvi to learn about knock knock, hi's program disclaimer and ethics policy, submission verification, and licensing terms and HIPAA release terms.
You can go to glaucomflecken.com or reach out to us at knockknockhi@human-content.com with any questions, concerns, or other medical jokes who I did it. Knock Knock, Hi is a Human Content
END Interview. Add Bon's Outro Here.
Bon Ku: Don't forget to support Design Lab. Subscribe to our podcast, go to our website. Submit your favorite design fail. Sign up for our newsletter and leave us a review on apple podcasts and give us five stars.
Design lab is produced by Rob Pugliese editing by Fernando Queiroz. Our theme music was created by Emmanuel Houston and the cover designed by Eden Lew. And special thanks to Will and Kristin and Flannery for having me on their podcast Knock Knock, Hi with the Glaucomfleckens. See you next week.
