The Podcast by KevinMD

"Despite forces not within our control, namely the thoughts and actions of others, headway has been made in my local practice area: the decline in mortality, the advances in clinical knowledge about the pathophysiology, more efficient testing, more PPE, an uprooting and great revealing of the need for prioritization of health care worker wellness, the impact of stress and isolation on health, the magnification of health care disparities, racism, and sexism, an opportunity for the interweaving connection of humanity for some, along with the stark divisiveness that continues to exist. But we get to choose how this pandemic plays out for us. I choose extreme caution, gratitude for this opportunity for temporary seclusion, an opportunity to recharge while reconnecting. I wait in the uncertainty." Ni-Cheng Liang is a pulmonary physician and founder, the Mindful Healthcare Collective. She shares her story and discusses her KevinMD article, "A physician waits in uncertainty." (https://www.kevinmd.com/blog/2020/11/a-physician-waits-in-uncertainty.html)

"At the start of the pandemic when hospitals were overrun, testing and PPE were scarce, and unknowns about COVID-19 transmission abound, such restrictions were reasonable, perhaps even essential. But we have made progress since then; most hospitals test most if not all admitted patients for COVID-19; most Americans own a mask, and hospitals are able to provide to those without one. We must still take reasonable precautions. Allowing only one visitor at bedside, placing restrictions on movement of visitors throughout the hospital, and ensuring they practice social distancing from other hospital staff. With this, we can maintain patient and staff safety but also prioritize a part of care that is currently being undervalued. And as hospitals and cities across the country continue to try and get a handle on the pandemic, we must also continually re-examine what aspects of care we determine to be essential and must preserve in some way. And we must realize that family at the bedside is part of that essential care our patients need to heal." Taimur Safder is a cardiology fellow. He shares his story and discusses his KevinMD article, "It's time to end draconian hospital visitation policies during COVID-19." (https://www.kevinmd.com/blog/2021/02/its-time-to-end-draconian-hospital-visitation-policies-during-covid-19.html)

"A scientific achievement can never have success on its own unless if it has acceptance in the social context by the masses. I think that the concerns brought forward by the vaccine-doubters cannot be dismissed as ignorance, and it is hard to convince people. As a physician, it is not uncommon that I see a patient become indecisive and anxious about various treatment decisions facing them. I don't shy away from asking them to put their faith in me as their physician at moments like this. There is a simple strategy that makes the decision-making relatively easier, and that is to think of each patient as your own family member and recommend to them what you would want done if they were your own mother or grandfather. When presented this way, it usually goes very well with the patient, and a bond of trust is built, which ends up in successful care for the patient. I would say the same thing to a vaccine-doubter. If I am being vaccinated myself as a health care worker and if I agree to vaccinate my children, please trust me that you should do the same." Farhan S. Imran is a hematology-oncology physician. He shares his story and discusses his KevinMD article, "What this physician says to vaccine-doubters." (https://www.kevinmd.com/blog/2020/12/what-this-physician-says-to-vaccine-doubters.html)

"The rapid change-over to telemedicine in March of 2020 brought predictable challenges to health care at large and substance use disorder treatment in particular: patients without the skill set to navigate HIPAA-compliant apps, phones with too little smarts to handle video conferencing, lack of connectivity in rural and economically depressed areas. But telemedicine brought unexpected benefits: the no-show rate plummeted. Patients were more empowered by their own motivation to engage in care than limited by bus schedules' vagaries. Suboptimal face-to-face interactions among individuals in the throes of addiction (otherwise known as "mayhem in the parking lot") ceased immediately. Most of all, telemedicine mitigates the stigma associated with substance use treatment." Julie Craig is an addiction medicine specialist. She shares her story and discusses her KevinMD article, "Telemedicine reduces the stigma in substance use disorder patients." (https://www.kevinmd.com/blog/2020/12/telemedicine-reduces-the-stigma-in-substance-use-disorder-patients.html)

"While behavioral health integration (BHI) has been a long-standing conversation in collaborative care or health's team-based approach, it hasn't always been clearly defined and rarely means more than referring a patient in need to a specialist. The biggest shift over the past twenty years has simply been recognizing just how vital behavioral health is to overall wellness. To effectively and efficiently achieve true BHI, we must engage people in the digital age we currently live in. This modernization begins with innovative technology at its core to drive connected care." Chris Molaro is a health care entrepreneur and CEO, Neuroflow. He shares his story and discusses his KevinMD article, "Pandemic or not, we're failing patients when it comes to behavioral health." (https://www.kevinmd.com/blog/2020/11/pandemic-or-not-were-failing-patients-when-it-comes-to-behavioral-health.html)

"When we think about holistic medicine, many assume that it requires human-to-human touch points and, therefore, doesn't lend itself well to technology and innovations such as artificial intelligence. In fact, holistic medicine and whole-person care advocates often view technology as manufactured or impersonal and therefore dismiss its utility for health care. This is because there is a perception that health care tech values the human experience only for the purpose of developing better widgets or to refine machine learning algorithms. As a result, it can be difficult to envision high-tech holistic medicine that is supported by a whole-person care model. Nevertheless, I see a future where both technology and holistic medicine can complement each other for the advancement of whole-person care." Trisha Swift is a health care executive. She shares her story and discusses her KevinMD article, "The future of whole-person care: high-tech holistic medicine." (https://www.kevinmd.com/blog/2020/08/the-future-of-whole-person-care-high-tech-holistic-medicine.html)

"I would encourage you to see amazing women on social media for who they are in the future. Maybe figure out where they have been and what they are working toward. Maybe even figure out how ways to help each other solve the problems this country faces. Instead of looking at someone's appearance, listen to their story. You got unlucky with me; you can't intimidate someone who has lived through the war. I'm hoping that you choose to go in a more professional direction with the next woman you message because of these words. We are not transactions. We are intelligent, determined, passionate, and persistent people. It's far better to be our ally than our foe." Kellie Lease Stecher is an obstetrician-gynecologist. She shares her story and discusses her KevinMD article, "When a colleague asks you for nude photos." (https://www.kevinmd.com/blog/2021/01/when-a-colleague-asks-you-for-nude-photos.html)

"Yearly physicals are usually afforded a longer time than regular visits. If I can use most of that time focusing the discussion on what a healthy life means to each of my patients and what they need to achieve it, I feel that I've accomplished more than doing palpation, range of motion, and auscultation. Discussing medications and finding opportunities for de-prescribing, and discussing annual routine labs' futility is also an equally important and welcome part of my yearly rituals. As our population ages and we are faced with more chronic diseases, our goal is to maximize our patients' abilities to function, relate to family and community, and live a life of purpose. Expanding the visit to discuss health status, strengths, weaknesses, and goals is a good time investment in achieving healthier people and enriching our relationship with patients. For my part, it also adds joy and purpose to my life." Alina Urriola is a family physician. She shares her story and discusses her KevinMD article, "What are your health goals for the coming year?" (https://www.kevinmd.com/blog/2021/01/what-are-your-health-goals-for-the-coming-year.html)

"For a vaccination campaign to be highly effective, we need to be open to having difficult conversations with people who disagree with our perspective. If we don't, the result will be a polarization of philosophical ideas and not an unbiased and unemotional assessment of the data where maybe we can meet in the middle. As we share our pictures and experiences regarding getting our vaccines, let's try to admit what we know and, more importantly, what we don't know. Let's not speak down to those who have questions. And let's not be afraid to say that maybe we are a little afraid ourselves of some of these unknowns but that we are willing to take the potential risk of getting a vaccine because over the past then months, there are a few more knowns about the actual virus that scare us even more. Happy conscientious and kind posting." Alicia Billington is a plastic surgeon. She shares her story and discusses her KevinMD article, "The COVID vaccine selfie: The caption matters as much as the picture." (https://www.kevinmd.com/blog/2020/12/the-covid-vaccine-selfie-the-caption-matters-as-much-as-the-picture.html)

"In addition to being a pediatrician, I am Jewish and the granddaughter of a sole Holocaust survivor. My grandfather's family perished in Auschwitz, a concentration camp in Poland. My grandfather alone escaped, skiing through the night, to his safety and ultimate survival. The request from my hospital, the presidential debate, and the seeming dismissal of parentless children reminds me of a quote from Elie Wiesel, a Nobel Prize-winning writer, and Holocaust survivor. "What hurts the victim most is not the cruelty of the oppressor, but the silence of the bystander." I will not tone it down. I will not be silent. I believe a medical institution that is dedicated to the well-being of all people would not ask me to do otherwise." Ariana Witkin is a pediatrician. She shares her story and discusses her KevinMD article, "Why politics has a place in medicine." (https://www.kevinmd.com/blog/2020/10/why-politics-has-a-place-in-medicine.html)