The Podcast by KevinMD

"There is a unique non-clinical consulting opportunity any physician can learn to do full-time, as part of your existing practice, or in lieu of retiring. I'm Dr. Armin Feldman, and I'm a full-time medical-legal consultant in legal cases. A little over 13 years ago, I started and now, through the years, have been refining a new subspecialty of forensic medicine. I've trained over 1,600 physicians to do this consulting work. When doctors and lawyers think about lawyers hiring doctors, they only think of one thing: Hiring doctors to be expert witnesses. It's important to know, you won't act as a medical expert, and you won't participate in medical malpractice cases. There is a big difference between a medical-legal consultant and a medical expert witness in legal matters. In fact, they are two completely different things." Armin Feldman is a medical consultant to attorneys. He shares his story and discusses his KevinMD article, "An introduction to medical-legal consulting." (https://www.kevinmd.com/blog/2020/12/an-introduction-to-medical-legal-consulting.html)

"Children cannot afford to wait, especially our youngest learners who have difficulty engaging on a screen. We need to all work together to help schools reopen, especially in low-income communities that are disproportionately suffering and may lack the resources. I stand with the AAP, CDC, European CDC, WHO, and UNICEF to support safe school re-opening." Lekha M. Rao is a pediatric neurologist. She shares her story and discusses her KevinMD article, "Children cannot afford to wait: We need to all work together to help schools reopen." (https://www.kevinmd.com/blog/post-author/lekha-m-rao)

"We, as a profession, must accept some blame for many of the developing problems in health care delivery. No, I am not suggesting that we caused the problem. I am stating that we have had ample opportunities to manage the debacle and even to reverse some of the disturbing trends, yet we rarely allow our voices to be heard. Is health care reform impossible? It certainly isn't. But we, as doctors, need to step up to the plate, to stand up to the growing bureaucracy in the system, and make sure our voices are heard. The change will be long, slow, and painful, but we can't allow the system to continue to swallow us whole. The change must come from us." Alejandro Badia is an orthopedic surgeon and author of Healthcare from the Trenches. He can be reached at Healthcare from the Trenches and on Facebook and Instagram @badiahandtoshouldercenter. He shares his story and discusses his KevinMD article, "Health care from the trenches: Change must come from us." (https://www.kevinmd.com/blog/2020/10/health-care-from-the-trenches-change-must-come-from-us.html)

"Many friends have asked for my perspective on the COVID vaccine. Answering this requires both an explanation of clinical trials and an understanding of what normally slows down pharmaceutical development. Importantly, COVID vaccines are required to go through the same process as every other pharmaceutical. Vaccination is a personal choice, but I 100 percent recommend it. Personally, I can't wait to get vaccinated and am so grateful to the thousands of heroes who made this possible." Alexandra Fairchok is a medical student. She shares her story and discusses her KevinMD article, "Why can I trust the COVID vaccine?" (https://www.kevinmd.com/blog/2020/12/why-can-i-trust-the-covid-vaccine.html)

"With 2020 behind us and the pandemic still raging, it is incumbent upon us to take a close look in the rear-view mirror. While the vaccines' approval gives us all hope, the vaccination initiative's slow rollout should worry us. Physicians, health care providers, nurses, and essential workers, and patients and family members have borne the brunt of the pandemic. On the last count, about 3,000 health care workers had lost their lives due to COVID-19. The toll that the pandemic is wrecking on the health care community's emotional and mental health is only starting to become apparent. Health care systems, local, state, and federal governments have responded in different ways to ease the pandemic burden. While we can debate the level and adequacy of the response, we may have a larger problem on our hands if we fail to learn lessons and make the necessary changes going forward. I want to offer my perspective on the changes that physicians and health care providers should pursue that would allow us to emerge stronger." Manish Thapar is a gastroenterologist. He shares his story and discusses his KevinMD article, "2020 in hindsight: What we can learn." (https://www.kevinmd.com/blog/2021/01/2020-in-hindsight-what-we-can-learn.html)

"There is a frenzy of trying to use technology to re-establish the healing human connection in the doctor-patient interaction. These efforts range from advanced transcription of voice-to-record, scribes who do the data recording during a patient encounter, and so on. The IT department at NYU Grossman Medical School, where I teach, worked with the dominant and much-loathed electronic medical record to create a patient-focused dashboard for each doctor. The dashboard both improved quality of outcomes and reduced costs. These attempts are useful, but they don't address the root cause of this inhuman encounter: billing, the link of patient data to cash. In each of these tech improvements, the doctor is still forced by the money-people to massage the bill for the highest private insurance payments. There is a war across the screen — and like all wars, it's about money. On one side, doctors are forced by the accountants to bill the most. On the other side, insurance people are striving to pay the least. No 'program' or 'bot' could do this job. It's trapping doctors in the epidemic called burnout, moral injury, or just plain abuse. Forcing us to lie, to provide maximum payment. So long Hippocratic Oath. I think the solution is obvious. Why are VA hospitals' electronic medical record systems widely preferred to any of the other ones out there? Because they are not-for-profit billing machines. All across the U.S., each VA diagnosis and treatment has approximately the same reimbursement. No war across the screen. No Hippocratic hypocrisy." Samuel Shem is a psychiatrist. He shares his story and discusses his books, the House of God (https://amzn.to/3cVEOZc) and Man's 4th Best Hospital. (https://amzn.to/3rFUhAH)

"For me, the team room became a safe space filled with light, stories, laughter, and food. There, my residents helped me read CT scans, interpret CBCs, come up with the differential for bradycardia, and organize my oral presentations. My residents gifted me confidence, advice on the third year and specialty selection, and Dr. Pestana's Surgery Notes. They took away from their time on the wards to go over my notes, and from their time with their loved ones at home to prepare me short and helpful whiteboard lectures." Reem Al Shabeeb is a medical student and can be reached on Twitter @reemalshabeeb. She shares her story and discusses her KevinMD article, "The role of residents in teaching and creating a positive clinical learning environment." (https://www.kevinmd.com/blog/2020/10/the-role-of-residents-in-teaching-and-creating-a-positive-clinical-learning-environment.html)

"As we continue to deal with the COVID-19 pandemic causing spiking numbers of cases, the scientific and medical communities continue to search for effective treatments and preventive measures. We have clearly established the importance of wearing masks, physical distancing, and frequent handwashing. As of this article's writing, there are over two hundred fifty articles on PubMed about the connection between vitamin D and COVID-19. As the research studies are undergoing, evidence is mounting that adequate vitamin D levels may be a protective factor against COVID-19 infection and severity. Here's what the research shows." Teresa Fuller is a pediatrician. She shares her story and discusses her KevinMD article, "Is there a role for vitamin D in the treatment of COVID-19?" (https://www.kevinmd.com/blog/2020/11/is-there-a-role-for-vitamin-d-in-the-treatment-of-covid-19.html)

"Separated by less than a month (Boseman on August 28th and Ginsburg on September 18th) and both due to gastrointestinal cancers (Boseman had colon cancer and Ginsburg had pancreatic cancer), the situations of Ginsburg's and Boseman's deaths is emblematic of the racial disparity in American health outcomes. Boseman was African American/Black and was diagnosed with stage III colon cancer at the age of 39 while Ginsburg was Jewish/White and fought three separate primary cancers of different stages in multiple bouts – colon, lung, and pancreatic – starting at the age of 66." Adeel Khan is a hematology-oncology fellow. He shares his story and discusses his KevinMD article, "Ruth Bader Ginsburg and Chadwick Boseman: a tale of two cancers in America." (https://www.kevinmd.com/blog/2020/10/ruth-bader-ginsburg-and-chadwick-boseman-a-tale-of-two-cancers-in-america.html)

"When it comes to using telehealth to treat patients out of state, most physicians are mindful about licensure issues. But some are not aware that if you don't have a license to practice medicine in a given state, it isn't just malpractice: It's a criminal offense. Licensing restrictions have been eased to facilitate care during the pandemic, and the new normal of greater state-to-state cooperation for access to care may persist after the pandemic. Still, the savvy physician knows that many restrictions apply and that understanding them reduces risk. When we talk about interstate licensure, we're not concerned with a one-time interaction with an established patient who happens to be traveling. For instance, say a physician has recently seen a patient, perhaps performed a procedure. Thereafter, the patient calls the physician with a question or a problem from another state while traveling. In such a case, the physician can simply address the patient's concerns, whether that's by a phone conversation, a telemedicine visit, a recommendation to go to the emergency room where they are, or whatever is appropriate, according to their best clinical judgment. That's just practicing good medicine." David L. Feldman is chief medical officer, The Doctors Company. He shares his story and discusses the KevinMD article, "Interstate licensure for telehealth can fuel medical practice growth." (https://www.kevinmd.com/blog/2020/10/interstate-licensure-for-telehealth-can-fuel-medical-practice-growth.html)