A doctor who spent 25 years in practice tried to get a real answer from his own cardiologist and could not. Jeffrey Junig, a psychiatrist and addiction medicine specialist who recently retired, lays out what happened after his lifesaving surgery: an aneurysm he learned about in passing, a beta blocker request answered with "I'm not comfortable" through a nurse, and an online pharmacy that approved a prescription in 10 minutes for $20 with no health questions asked.

⏱️ Chapters:
0:00 Introduction
0:30 From anesthesia to psychiatry to retirement
1:52 The aneurysm nobody told him about
3:13 Why he ordered his own beta blocker online
4:50 The Rip Van Winkle moment
5:08 What 25 years of medicine taught him is missing
5:51 The lack of pharmacy nobody talks about
8:17 What he wishes had happened instead
9:14 Why "I'm not comfortable" is not an answer
10:41 What it would take to fix this
11:53 People remember how you made them feel
12:27 Take home messages

About this episode:
Jeffrey Junig is a psychiatrist and addiction medicine specialist who trained as an MD-PhD, practiced anesthesia for a decade, and ran his own psychiatry and Suboxone practice for 20 years before retiring a few months ago. He shares what happened after a 12-hour lifesaving surgery for CTEPH and a follow-up cardiology visit where a new doctor mentioned, in passing, that he had a thoracic aortic aneurysm nobody had told him about. When Junig asked for a beta blocker through the patient app, the answer that came back twice through a nurse was "he's not comfortable," with no further explanation. He pushed for a month, got metoprolol at the lowest dose, developed cold hands, researched nebivolol on his own, and after another month of pushing got 1.25 milligrams. Lying in bed feeling his heart pound and unable to wait six months for his next visit, he ordered five milligrams from an online pharmacy, paid 20 dollars for a 10-minute remote approval, and received the medication in the mail with no questions asked about his health. He argues the gap is not clinical competence, it is the disappearance of the three-minute conversation that used to be standard, and he leaves the audience with a clear message about why the connection is the reward and what physicians lose when their practice becomes throughput.

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