The Podcast by KevinMD

"The idea was to try working in Rome for a year and see how it went. This sensible American plan collapsed under the weight of Italian bureaucracy. Luckily I didn't investigate every angle before starting off; if I had known the true lay of the land I might not have kept going after that Italian medical license like a donkey after his carrot. I'd have taken a job in some clinic in the Bronx, where I'd be seeing four patients an hour to this day. Instead, I made those steps you can't retrace: gave up my three-bedroom apartment on the Upper West Side with views of the Empire State Building and the Tri- borough Bridge, and sold my Dodge Challenger convertible to a pinky-ringed Turkish importer-exporter who planned to strip it down to the skeleton of an Oriental low-rider. Months beforehand I started focusing my Manhattanite efficiency on getting registered in Italy, my Italian husband leading me by the hand through the wilderness of Old World red tape. The first step was "getting my documents together," an Italian ritual repeated before every encounter with officialdom. Sticking to a list kindly provided by the Italian Consulate, I collected my birth certificate, passport, high school diploma, college diploma, college transcript, medical school diploma, medical school transcript, certificates of internship and residency, National Board Examination certificates, American Board of Internal Medicine test results, and specialization diploma. Then I got them transfigured into Italian by the one person in New York authorized by the Italian Consulate to crown his translation with an imprimatur. We judiciously gave him a set of our own translations as crib notes, tailored by my husband to match the Rome medical school curriculum." Susan Levenstein is an internal medicine physician and author of Dottoressa: An American Doctor in Rome. She shares her story and discusses her KevinMD article, "An American doctor in Rome." (https://www.kevinmd.com/blog/2019/09/an-american-doctor-in-rome.html)

"I have no doubt, given my extensive experience in health care and being a Black woman in America, that we as health care professionals have made the same mistakes as Chris Harrison with our patients. Instead of listening to and validating our patients' concerns, we make excuses for ourselves or the people who have caused the injustice that our patients are experiencing. Effectively we delegitimize or invalidate their concerns, and we exacerbate their pain due to the experience. In some ways, our role as clinicians, combined with the reason for them seeking health care, magnifies and even eclipses the pain from the original experience causing an even more damaging effect. Whether or not we believe their experience is real or perceived is irrelevant. We are no authority to know the difference, and when a patient is in our care, it is our responsibility to place their needs first. As health care professionals, we should strive to validate our patients' feelings and offer comfort whether or not we agree about the etiology. Resist the urge to justify or defend the perceived abusers. I believe that this could potentially improve our relationship with our patients and improve their care and, as a bonus, make us more empathetic to the other people in our lives." Monique Rainford is an obstetrician-gynecologist. She shares her story and discusses her KevinMD article, "When it comes to bias, doctors need to do their homework." (https://www.kevinmd.com/blog/2021/07/when-it-comes-to-bias-doctors-need-to-do-their-homework.html)

"We have a chance to take a meaningful step in fighting burnout and mental health issues in the health care profession. We have lost too many valued and vibrant health care professionals due to an illness that is treatable but stigmatized – including the devastating loss of Dr. Lorna Breen. The Dr. Lorna Breen Health Care Provider Protection Act will leave a lasting legacy for bettering our health care community, taking the first step in addressing this horrible crisis. Endorsement of the Lorna Breen Act is not limited to medical students, other health care workers, students, and hospitals have a stake." Corey Feist is co-founder, Dr. Lorna Breen Heroes Foundation. He shares his story and discusses the KevinMD article, "A step forward: a way to advance the mental health of health care professionals." (https://www.kevinmd.com/blog/2021/05/a-step-forward-a-way-to-advance-the-mental-health-of-health-care-professionals.html)

"Five years into my practice as an academic allergist/immunologist, my perceptions continue to evolve. Though once primarily informed by my mentors' wisdom, I continue incorporating my experiences as both physician and autoimmune patient to guide my practice. Though we all know medicine isn't like it used to be, nostalgia is bittersweet. In its wake, the real question remains: how are we going to respond to ongoing changes and fight for the health of our patients and our colleagues? From the loss of autonomy with the advent of managed care and corporate takeovers, we find ourselves practicing under increased pressure from all sides. Less time and resources to help sicker patients. Answering not only to our patients' needs but those of insurance companies and other interested parties whose motives are less than altruistic." Kara Wada is an allergist-immunologist. She shares her story and discusses her KevinMD article, "Burnout and bias? Or medical gaslighting?" (https://www.kevinmd.com/blog/2021/07/burnout-and-bias-or-medical-gaslighting.html)

"It is no wonder that in 2020, a Doximity physician compensation report revealed there were no specialties in medicine in which women earned the same or more than men. We can all agree that many things could account for this, including structural barriers and lack of diversity or mentorship. It may also include factors such as women not maximizing billing knowledge, not knowing how to negotiate, not asking for the same or more of what is offered and just not thinking about what they really want. Instead as women, we think of others first, or what others expect of us. Yes, we know we want the job or the position. But is that position truly, truly, taking you towards your true purpose? Becoming chief of department, manager or CEO, are remarkable goals and should be pursued. But are the pursuits authentic to what you consciously found your purpose is? It is not about what your family thought you should achieve, but about doing something that truly takes you and continues to propel you on your true-life purpose. If you have not thought about it, then I challenge you to find introspection. Find consciousness and think about your true purpose. Continue to follow its path to experience joy so it will not leave you with regret when you look back. Find your purpose. Ask yourself, 'What do I really want in life?' And do it today." Diana Londoño is a urologist and can be reached at her self-titled site, Dr. Diana Londono, and on Twitter @DianaLondonoMD. She shares her story and discusses her KevinMD article, "What do you really want in life?" (https://www.kevinmd.com/blog/2021/08/what-do-you-really-want-in-life.html)

"The problem with health care isn't 'fixing' the system. The problem is continuing to ensure that profits can be made and millions can be employed while better health care outcomes and experiences are achieved. We won't find the solution to that problem by embracing the solutions offered by either the right or the left. We need to leave the past behind and start again, building a new health care system that better meets our needs. We have to build from the ground up, starting with a new foundation. I can't wish away the political realities that stand in the way of such fundamental reform. But given all that's at stake, I'm unwilling to accept anything less than this goal. Hopefully, you agree." Jeb Dunkelberger is a health care executive and author of Rich & Dying: An Insider Calls Bullsh*t on America's Healthcare Economy. He shares his story and discusses his KevinMD article, "Our health care system may be failing, but it isn't broken." (https://www.kevinmd.com/blog/2021/06/our-health-care-system-may-be-failing-but-it-isnt-broken.html)

"Fifteen minutes for a checkup or urgent problem, thirty minutes for a physical. In the tiny gasps of time in between: Refilling scripts, checking labs, and signing medical supply orders and insurance authorization requests. Maybe lunch. Maybe a chance to get to the restroom if I am lucky. Clicking, always clicking away on my EMR, hoping to finish my notes. Maybe typing notes while holding on a phone call (why do patients call with a question about a medicine, but they leave the vial upstairs and have to retrieve it while you wait?), while trying to cram a few bites of lunch, while wondering if I will get out of there in time to get the blasted Valentine's napkins before picking up the kids from their after-school program. I take a deep breath." Melissa Schiffman is an internal medicine physician. She shares her story and discusses her KevinMD article, "Primary care: I love the variety and the intimacy of the problems that are placed before me." (https://www.kevinmd.com/blog/2021/08/primary-care-i-love-the-variety-and-the-intimacy-of-the-problems-that-are-placed-before-me.html)

"When we hear skepticism, our first instinct may be to end the conversation. After all, why spend our time trying to convince someone who has made up their mind? Our second instinct may be to counter the person's position without pausing to hear more about their perspective. Unfortunately, trying to force someone into getting the vaccine often results in defensiveness and anger." Alicia DiGiammarino is a health educator. She shares her story and discusses her KevinMD article, "Try this new technique when talking to vaccine skeptics." (https://www.kevinmd.com/blog/2021/08/try-this-new-technique-when-talking-to-vaccine-skeptics.html)

"The pandemic has demonstrated the value of online platforms, especially in health care – but equitable access has not matched this growth. Sadly, many Americans cannot reap the benefits of connectivity. State and federal funding sources are required to enable digital health equity. Moreover, there should be a focus on measuring/creating standards of care in digital health equity. Public financing and public infrastructure (broadband) will be essential to coordinate organizations and defragmenting care. Now is our moment to create a new and better health care system that emerges from the dark days of COVID-19." Joshua W. Elder is an emergency physician. He shares his story and discusses the KevinMD article, "Digital health equity is an emerging gap in health." (https://www.kevinmd.com/blog/2021/06/digital-health-equity-is-an-emerging-gap-in-health.html)

"As we enter a year and a half into a worldwide pandemic, many of us working in health care are fatigued, over-worked, and burned out on compassion. Burnout has been so widespread that the CDC published guidelines on how to cope with the stresses of the job as COVID-19 cases persist. As the Delta variant continues to spread and individuals remain unvaccinated despite the data, health care workers find themselves attempting to care for their patients and simultaneously try and care for themselves. This episode outlines some myths about the "softer side" of health care and focuses on compassion and rapport building— exploring the ways in which providing patient-centered care for those who seek our help not only improves clinical outcomes but can also help improve ourselves." Katherine Buaron is a community nurse consultant, Rush University. She shares her story and discusses her KevinMD article, "5 myths about compassion and patient rapport building in health care." (https://www.kevinmd.com/blog/2021/09/5-myths-about-compassion-and-patient-rapport-building-in-health-care.html) This episode is sponsored by the Rush University Series at The Podcast by KevinMD. (https://www.rushu.rush.edu/)