The Podcast by KevinMD

"I bring this to your attention because, in 1971, I took an oath to impart precept, oral instruction, and all other instruction to all indentured pupils who have taken the Healer's Oath. Having done so, if it strikes you that, during the aforementioned trial, an opportunity was missed, only to be rectified by the Court of Special Appeals, then I leave you with this admonition. When you are a defendant in a malpractice suit, and you believe you are in the right, be relentless and use everything at your disposal to expose the opposing expert as a miscreant. Had defendants in this suit been so disposed, likely, the outcome would have been different." Editor's note: This show refers to the Abeline paradox, which is when "a group of people collectively decide on a course of action that is counter to the preferences of many or all of the individuals in the group." Howard Smith is an obstetrics-gynecology physician. He shares his story and discusses his KevinMD article, "A counterintuitive strategy when you are sued for medical malpractice." (https://www.kevinmd.com/blog/2021/07/a-counterintuitive-strategy-when-you-are-sued-for-medical-malpractice.html)

"The first step to hospital recovery is the collection and analysis of data. Organizations that effectively leverage data to optimize surgery can see rapid, quantifiable, and sustained improvements in metrics that directly link to operational efficiency and associated financial benefits. The current situation presents a unique opportunity for hospitals to implement new tools to recalibrate how surgical services are evaluated, delivered, and experienced by the patient and provider. Doing this now will accelerate resolving the backlog, better positioning the organization to handle the day-to-day schedule moving forward with unprecedented confidence and clarity. Heading down the path now to leverage historical and current data will enable health care organizations to create a robust, data-driven, surgical management plan to overcome the backlog created by the pandemic. A data-first strategy will also allow hospitals to better prepare for future disasters and re-establish a solid revenue stream sooner. Who knows? They may even grow market share." Michael Woods is a health care executive. He shares his story and discusses his KevinMD article, "Surgical volumes are still down. A data-first strategy is the key to recovery." (https://www.kevinmd.com/blog/2021/06/surgical-volumes-are-still-down-a-data-first-strategy-is-the-key-to-recovery.html)

"The dramatic uptick in mental distress, trauma, and substance use since last year has driven a corresponding rise in the use of virtual mental health therapy and psychiatric care, helping us, as a society, more effectively grapple with the fallout from the pandemic. According to one study, more than half of the people who used telehealth in May 2020 used it for a mental health concern. Virtual care has the added benefit of increased privacy and access to care for people who have difficulty getting to in-person care or end up on a waitlist for weeks to see a provider. Virtual care reduces the time commitment for therapy since it doesn't require a commute. Overall, it's a method that provides patients with more control over how they access mental health care. Providing treatment to those in need is no small task, but with new digital tools and more accepting attitudes, the hope is that those struggling with suicidal thoughts and other mental health challenges will feel supported and optimistic." Erik Vanderlip is a psychiatry and family medicine physician. He shares his story and discusses his KevinMD article, "Suicide is never the answer, especially during the COVID-19 pandemic." (https://www.kevinmd.com/blog/2021/05/suicide-is-never-the-answer-especially-during-the-covid-19-pandemic.html)

"When I teach medical students who rotate with me at my clinic, I ask them to write about the single most negative and single most positive emotional experiences they have had in their 3 to 4 years of training thus far. Commonly, I see fear as a negative emotion and pride in self-worth as the positive. When we break it down, their fear often stems from not knowing if they did a good enough job working up a tough case. The students talk about facts, etiologies, treatment plans, and what could have been done better clinically. Interestingly, their positive emotion of self-worth is often described as the patient thanking them or even hugging them after they shared stories and bonded that they both like wake surfing, went to the same Metallica concert, exchanged jokes or photos of their same breed of dog or that the patient reminded them of their grandparent and they just sat and talked about their families. After describing the case, students usually do not mention disease, workup, or treatment with me this time. In fact, very little medical terminology is used when I ask why this experience was so positive, and the words I do hear are usually centered on how they felt bonded with the patient after learning something they have in common. What beauty lies in this space when doctor and patient connect." Erika Visser Aragona is a family physician. She shares her story and discusses her KevinMD article, "Can doctors have personalities?" (https://www.kevinmd.com/blog/2021/08/can-doctors-have-personalities.html)

"Just as Simone Biles has her detractors, there will always be physicians unable to empathize with their mentally ill colleagues, believing psychological struggles are a constant state of being human. But if taking care of oneself means temporarily leaving the workforce to receive professional treatment, then so be it. Physicians are beginning to feel empowered to protect themselves. Their acts of self-care can be seen as the first step in protecting and preserving mental health. Being mentally tough for practicing medicine is no different than being mentally tough for competing for a gold medal. In either case, it does not mean sacrificing your sanity. It's time medical schools and institutions were on board with this notion." Arthur Lazarus is a psychiatrist. He shares his story and discusses his KevinMD article, "If Simone Biles were a doctor she would be vilified, not praised." (https://www.kevinmd.com/blog/2021/07/if-simone-biles-were-a-doctor-she-would-be-vilified-not-praised.html) Read his story mentioned on the show: "The Most Memorable Patient I Never Saw." (https://alphaomegaalpha.org/pharos/PDFs/2014-3-Lazarus.pdf)

"According to AAMC, the median debt for medical students in 2019 was $200,000. Unfortunately, fundraising for scholarships was difficult for many organizations due to the pandemic despite more students seeking out scholarships. Luckily, more anonymous generous donors have helped the next generations of physicians in recent years, but what happens if you are not as lucky to go to one of those tuition-free schools? Frankly, your options are limited. You can invest, work, apply for scholarships. While I am not an expert in the first two, I would consider myself knowledgeable on the last topic. I started undergraduate with only 25 percent of my tuition covered. Medical school offered me nothing. As a third-year medical student, I fully self-funded my undergraduate tuition and am steadily working towards funding my medical tuition through just scholarships. I wanted to share with you some tips on decreasing your debt." Trisha Chau is a medical student. She shares her story and discusses her KevinMD article, "8 scholarship tips for medical school." (https://www.kevinmd.com/blog/2021/07/8-scholarship-tips-for-medical-school.html)

"Our country is facing a voting crisis with multiple layers: chronically low overall voter participation, even lower voter participation among physicians and — to add insult to injury — an increasing number of laws that make voting more difficult, especially for those with chronic health conditions. Voter registration in health care settings can be part of the solution to all these problems — problems that threaten the health of a democratic society. Through these civic health conversations, both physicians and patients will increase their awareness and be empowered to raise their voices by voting. It is time for the clinic be a place for civic health as well as physical health." This episode mentions the non-partisan organization, Vot-ER (https://vot-er.org/), which integrates voter registration into the health care delivery system. Rio Barrere-Cain is a medical student. She shares her story and discusses her KevinMD article, "Doctors: You can increase voting in the U.S." (https://www.kevinmd.com/blog/2021/06/doctors-you-can-increase-voting-in-the-u-s.html)

"Currently working in a COVID ICU in a tertiary center in Kathmandu, I have experienced how difficult it is for the health system to manage the patient load. A month ago, ICU beds were fully occupied, ventilator alarms would set off time and again, indicating low flow as the hospitals faced shortages of oxygen supplies, emergency rooms were over-occupied, and patients waited in queues to receive oxygen or just to be checked up by a doctor. At such a desperate time, telemedicine is a noble initiative. I thank my patients who taught me more than just mere medical knowledge and my dedicated fellow volunteer doctors who teamed up in this project to help the nation in these dire times." Astha Prasai is a physician in Nepal. She shares her story and discusses her KevinMD article, "Telemedicine in Nepal during COVID-19." (https://www.kevinmd.com/blog/2021/07/telemedicine-in-nepal-during-covid-19.html)

"Until recently, voice changes from menopause and aging have been almost unmentionable. If a woman talked about her challenges, especially if she was a professional singer, it could have meant decreased opportunities and even the end of her career. Most women have stayed silent, coping as best as they can, assuming that they have to deal with their baffling voice issues by themselves. But that is not the case. Millions of women around the world are on the same path, and we no longer need to walk that path alone. Working together gives us a better understanding of the vocal issues women might face and how to minimize them. So how exactly do menopause and the changing hormonal landscape that women experience impact the voice? Estrogen is a major player, vocally speaking." Nancy Bos is a vocologist and co-author of the book Singing Through Change: Women's Voices in Midlife, Menopause, and Beyond. She shares her story and discusses the KevinMD article, "Menopause changes women's singing voices." (https://www.kevinmd.com/blog/2021/07/menopause-changes-womens-singing-voices.html)

"A rough career transition in 2019 followed by the pandemic highlighted how I was still financially tethered to my job — after 10 years of practicing as a subspecialty trained radiologist, saving, maxing out my retirement accounts, and investing in the stock market and in real estate. Looking around, I saw other physicians in a similar predicament. After years dedicated to rigorous training, we were still trapped by "golden handcuffs." High income was not necessarily translating to high net worth or financial freedom. It didn't seem fair or necessary. There had to be a smarter way to financial freedom — without having to live on a shoestring budget or work more shifts. I poured time and money into educating myself — really understood my financial independence numbers, learned the impact of asset allocation and taxes on my retirement nest egg, and put strategies and systems in place to optimize returns." Param Baladandapani is a radiologist and can be reached at GenerationalwealthMD. She shares her story and discusses her KevinMD article, "How doctors think about financial independence is dead wrong." (https://www.kevinmd.com/blog/2021/07/how-doctors-think-about-financial-independence-is-dead-wrong.html)