The Podcast by KevinMD

"As a practicing surgeon for 30 years in the super-specialized field of otology, neurotology and skull base surgery, I have been privy to some of the most disturbing realities of surgical care. Often, these realities are bleaker than most people expect. One thing physicians, and the general population, need to be more aware of is the very real racial disparity in surgical care. Are the outcomes for Black and Hispanic patients truly different than white patients when it comes to surgery? The answer is an astounding yes. Are the differences related to other factors such as socioeconomic class, insurance status, gender, income, extent of disease at presentation or other comorbidities? Even when controlling for many of these factors, racial disparities in the delivery of surgical care persist." Sanjay Prasad is a surgeon and founder, SurgiQuality. He shares his story and discusses his KevinMD article, "The bleak reality of racial disparity in surgical care." (https://www.kevinmd.com/blog/2021/08/the-bleak-reality-of-racial-disparity-in-surgical-care.html)

"The same question could be asked about the joy and meaning in medicine. Where does it dwell? And the answer may be the same. It dwells wherever we choose to let joy and meaning in medicine into our physician-healer lives. As I look back upon my career, it saddens me to know that those doors to my dwelling were closed shut so often. For so often, I had not a clue as to where lay the key to unlock them. For so many years, this encounter would have been chalked up to another annoying, unfathomable "little old lady dizziness syndrome." But, on that day, in that encounter, I was graced to have those doors opened by an 86-year-old, dizzy, square dancing roller skater. I hope the doors of that dwelling never close again." Scott Abramson is a neurologist who blogs at Doctor Wisdom. He shares his story and discusses his KevinMD article, "Where does the joy and meaning in medicine dwell?" (https://www.kevinmd.com/blog/2021/07/where-does-the-the-joy-and-meaning-in-medicine-dwell.html)

"I am a proud science-trained medical doctor and concerned mother. I am not going to remain silent when the biggest tragedies are yet to hit earth yet. Like seriously, I do not want to become like the dinosaurs. History wasn't too kind to them. Just saying. Scientists say the worst is yet to come if America doesn't listen. What do scientists know anyway? You might disagree with my words, but If you want to get angry, write many insults, and be in denial, go ahead. I am a mother bear, and I do bite, as it's called self-defense. To all my fellow scientists and torchbearers of the truth, I salute you. Let us not stop speaking the truth until real change happens." Tomi Mitchell is a family physician. She shares her story and discusses her KevinMD article, "Who needs scientists? It's not like we listen to them anyway." (https://www.kevinmd.com/blog/2021/08/who-needs-scientists-its-not-like-we-listen-to-them-anyway.html)

"This is where we are: Hospitalizations rising, new variants that are more infectious, and many people believing that this is all a hoax, or that millions of people have conspired together to make injections that harm people rather than helping them. Patients leaving AMA and dying because there's no trust anymore. This is where we should be: People recognizing that we don't like wearing masks or getting shots but maybe we should in order to get things under control, people trusting that health care workers are really working toward the best interest of everyone, health care workers optimistic because they see progress. How do we get from here to there?" Steve Burgess is a hospitalist and creator, Hospital Medicine Seminars, where he teaches CME focused on updates for those who practice hospital medicine. He shares his story and discusses his KevinMD article, "Dying after leaving AMA." (https://www.kevinmd.com/blog/2021/08/dying-after-leaving-ama.html)

"What can we control? Our behavior and our responses to circumstances. Focusing on what is in our power to control and putting all our energy and efforts in the right places and for the right reasons seems to be a step in the right direction to make positive changes and avoid burnout. Now, imagine not only surviving medicine but also enjoying it, using it as an opportunity for personal growth and development, as a catalyst that transforms challenges into amazing outcomes. Close your eyes and remember why you decided to be a doctor. How did you feel the first time using your white coat, hearing the ticking of a heart, saving a life? It's time to recover the power. It's time to reassume the responsibility, the privilege and the joy of being a physician. Be healthy, be happy — and keep helping people and saving lives!" Miriam Zylberglait Lisigurski is an internal medicine physician. Yudith Furman is a psychotherapist. They share their stories and discuss their KevinMD article, "Take back the power and joy of being a doctor." (https://www.kevinmd.com/blog/2021/08/take-back-the-power-and-joy-of-being-a-doctor.html)

"Some may say that we all come into this world with our own luck, and if we end up having to endure a disability, then other people in society should not be held financially responsible. To that I say, do we not have a moral imperative to ensure that we create a society that we would be proud to live in? Humankind has only come so far on the basis of cooperation, trust, and looking after each other. We can't just abdicate our responsibilities in the face of selfishness, or because it feels easier. United we stand, divided we fall. I would hope that if one day you find yourself a victim of fate, someone extends a hand to you in your time of need. Because we're all healthy—only until we're not." Shreya Kumar is a medical student. She shares her story and discusses her KevinMD article, "Eradicate the disability tax, before it's too late." (https://www.kevinmd.com/blog/2021/08/eradicate-the-disability-tax-before-its-too-late.html)

"Attending physicians struggling with a mental health issue should consider contacting a counselor first, rather than a department head or employer resource. A counselor can assess the mental health issue, offer treatment recommendations, and provide therapy that meets the physician's needs – all while protecting that person's privacy. Mental health providers are legally obligated to maintain confidentiality except under the most narrow of circumstances. Despite the concerns that licensing boards and employers have about the risk to patients or impairment, there is little evidence that simply having a mental health issue, or receiving treatment for one, imperils patients. We have abundant evidence, however, that avoidance of treatment imperils physicians. Many physicians have successfully undergone counseling while continuing to work without ever notifying their employer or department, imperiling patient care, or incurring licensing consequences. Until changes occur that mitigate the causes of burnout, depression, anxiety, and substance use disorders among physicians, our priority must be increasing access to and engagement in treatment. Physician-specialized private counseling practices are one way to accomplish that." Vickie Mulkerin is a family physician and owner, White Coat Counseling, LLC. She shares her story and discusses her KevinMD article, "Why physician-specialized private counseling practices are important." (https://www.kevinmd.com/blog/2021/08/why-physician-specialized-private-counseling-practices-are-important.html)

"I called my wife of 31 days, anxious and dazed. I told her that the pace I was on was crushing me. I told her I had done seven admits since 5 p.m. and taken floor calls, too. It was not yet midnight. I told her I don't know if I can do this job. But I soldiered on. It was the first of July. I picked up my first chart of the shift and began to walk to see the patient. Felt some apprehension. I looked at the chart and noticed the name printed in the box for the attending physician. The name was mine. I felt awe. I felt pride. I felt fear." Duane Corsi is an emergency physician. He shares his story and discusses his KevinMD article, "An emergency medicine life." (https://www.kevinmd.com/blog/2021/07/an-emergency-medicine-life.html)

"Chiefs, remember, one of those interns is going to fill your shoes in a few years. They may model you in that role, so you want to raise them well! As a former chief resident, I have lots of pearls for those entering residency. However, what I will tell you now is different from what I would have told you then. I have since learned that there are possibilities to create the results that we want and not just follow the path we are told to take. Recently, a former intern of mine — who went on to be a chief resident and subsequently a program director — tweeted that he received advice from another chief: "If you are unhappy in residency, you need to adjust your expectations." He pondered that this suggestion was a mixed bag. Can you see both sides? Residents, who is responsible for your happiness? Is it the institution, the program, the program director, the chief resident — or you?" Marion McCrary is an internal medicine physician and can be reached at Marion McCrary Wellness. She shares her story and discusses her KevinMD article, "A word of advice from one chief resident to another." (https://www.kevinmd.com/blog/2021/07/a-word-of-advice-from-one-chief-resident-to-another.html)

"In January of 1991, at twenty-two months old, Nick had another heart catheterization. Andy and I had started thinking about the next stage of surgery to finish the heart repair. Just before Nick was discharged, I discussed it briefly with Dr. Kanter. 'Tell me when you would like to do the surgery,' he said. 'Never, if it's up to me.' We were in no hurry for Nick to go into the OR again. The older Nick grew, the more difficult it became to agree to procedures. At least this operation would be one of the planned surgeries. By now, heart surgeons were doing an additional repair, completing the surgery in two stages instead of one. The positive side was that at least we would be taking a step forward. Andy and I wanted the surgery date to be sooner rather than later, but we still had questions. I asked Dr. Kanter to call me. He and I discussed the pros and cons of the repair. There was a pause in the conversation, and then Dr. Kanter asked, 'Susan, are you sitting down?'" Susan May is a writer and author of Nick's New Heart: 30 Years and Counting. She shares her story and discusses her KevinMD article, "The story of a heart transplant in a 1-year-old, as told by his mother." (https://www.kevinmd.com/blog/2021/05/the-story-of-a-heart-transplant-in-a-1-year-old-as-told-by-his-mother.html)