The Podcast by KevinMD

"Both clinical and direct-to-consumer genetic testing have become significantly less costly and more common, providing people with access to a wealth of information about everything from their ethnicity and family lineage to their risk for certain diseases and how they will respond to medications such as blood thinners and antidepressants. But before you decide to take the plunge into your gene pool, there are a number of issues you should carefully consider. Genetic testing can have unintended consequences, both personal and medical, so it's wise to weigh the value of any information you may gain against the potential issues that the testing may raise." Miles J. Varn is chief executive officer, PinnacleCare, and can be reached on LinkedIn. He shares his story and discusses his KevinMD article, "Genetic testing: Could there be unintended consequences?" (https://www.kevinmd.com/blog/2020/04/genetic-testing-could-there-be-unintended-consequences.html)

"Locum tenens means 'to hold the place of, to substitute for' and locum tenens contracts are a common form of agreement for physicians who provide temporary medical services in place of full-time physicians. Now, during the COVID-19 pandemic, increased demand puts physicians in a better position to negotiate their locum tenens contracts. However, too many practitioners sign them without fully understanding their implications. This is a mistake. A well-drafted locum tenens contract (a) protects the physician's interests beyond compensation, (b) anticipates and addresses disputes, and (c) limits risks." Jack A. Gordon and Andrew E. Sarti are attorneys, Kent, Beatty, & Gordon, LLP. They share their story and discuss the KevinMD article that they co-wrote, "Anatomy of locum tenens contracts: a physician's guide to understanding contractual provisions to maximize opportunities and minimize risks." (https://www.kevinmd.com/blog/2020/07/anatomy-of-locum-tenens-contracts-a-physicians-guide-to-understanding-contractual-provisions-to-maximize-opportunities-and-minimize-risks.html)

"Misinformation about COVID-19, if propagated, can be deadly. The stakes are high. Physicians need to have a voice in this discussion and work towards impacting policy in a positive way. Physician-led groups such as IMPACT aim to advocate for evidence-based solutions for the protection of communities and serve an advisory role to those in charge of public policies. As physicians, our primary purpose is the well-being of our patients. We owe it to them to share not only information about sinus infections and sore throat, but how to protect themselves from COVID-19. We must share what we know. We can and should begin to reintegrate into society, but as physicians, our responsibility to the community is to educate and protect. We should not shy away from sharing our expertise with others. This may include uncomfortable conversations with friends and family whose views differ from our own, but if we come from a place of respect and understanding, we can and will get through this together." Inna Husain is an otolaryngologist. She shares her story and discusses the KevinMD article that she co-wrote, "Physicians' role in bridging the COVID-19 health recommendations divide." (https://www.kevinmd.com/blog/2020/07/physicians-role-in-bridging-the-covid-19-health-recommendations-divide.html)

"When doctors ignore the evidence showing that a support system doesn't have to be traditional in order to be effective, that's not a medical judgment. It's a personal prejudice that puts singles at serious risk. Classifying patients as married or unmarried when studying the effects of social support undoubtedly makes research easier, with groups determined by a simplistic either-or. But since social support is not, in fact, limited to marriage, the results of such studies are bound to be flawed — not to mention perpetuating discriminatory treatment that can cost single people our lives." Joan DelFattore is a writer. She shares her story and discusses her KevinMD article, "Patients without partners, and the doctors who stereotype us." (https://www.kevinmd.com/blog/2016/11/patients-without-partners-doctors-stereotype-us.html)

"Single payer is the solution. And the time for it is now. A single-payer system would guarantee health care coverage immediately to every American. So whether a loved one gets sick from COVID, has a heart attack, or gets in a car accident, she will receive the care she needs without it causing financial hardship. A single-payer system will eliminate employer health insurance contributions. This will provide huge relief to hundreds of thousands of struggling small businesses across the country. The money saved can go towards paying their employees a living wage or hiring new workers, which will help get our economy back on track. A single-payer system will relieve the burden of finding health insurance from individuals. Freelancers and gig, self-employed, and per diem workers can pursue employment without having to worry about providing health coverage for their families. And with families relieved of the insecurities created by surprise medical bills and massive out-of-pocket costs, they will be more likely to contribute to our consumer-driven economy. COVID has absolutely quelled consumerism; single payer can help to bring it back." Toby Terwilliger is an internal medicine-pediatric resident. He shares his story and discusses his KevinMD article, "Is now the time for single payer?" (https://www.kevinmd.com/blog/2020/07/is-now-the-time-for-single-payer.html)

"Doctors are people, and people are capable of prejudice and discrimination. But, in medicine, there is no place for prejudice and discrimination because a patient's life is at stake. Stereotyping a customer and assuming that they cannot afford a certain product is emotionally hurtful, but it is far less dangerous than stereotyping a patient and misdiagnosing a life-threatening condition. The nature of the medical profession is handling a patient's life; doctors are the last line of defense between life and death. As such, doctors have to balance every aspect of the patient when choosing the right treatment, and ample evidence suggests that a patient's culture, including race, ethnicity, and class, is an important factor in determining a health outcome. With the stakes this high, it is vital that doctors understand the intersection of culture and medicine, and they understand it as soon as their journey into medicine begins." Shvetali Thatte is a premedical student. She shares her story and discusses her KevinMD article, "Why cultural competency courses should be requisites for medical school." (https://www.kevinmd.com/blog/2020/07/why-cultural-competency-courses-should-be-requisites-for-medical-school.html)

"My experience with recent knee surgery that left me significantly disabled for over a month brought this to my attention yet again. I was completely dependent on others for basic self-care since I was unable to get in and out of the tub/shower without help. I was only able to walk with significant pain on crutches and was completely incapable of navigating stairs. Driving was out of the question. I experienced acutely the loss of independence that my older patients feel about having to surrender their driving license. I was unable to cook, clean, and interact with family since I was fairly bed-bound and sedentary until I regained my mobility. I learned several important lessons from this experience." Rizwana Khan is a pulmonary and critical care physician. She shares her story and discusses her KevinMD article, "When physicians get sick: We are just as human as the patients we treat." (https://www.kevinmd.com/blog/2020/08/when-physicians-get-sick-we-are-just-a-human-as-the-patients-we-treat.html)

"With COVID-19, all of those memories have come flooding back. It is as if I am back in the NICU staring at that tiny infant and worried that she would get sick. Only now I have to pull myself out of that horrific daydream and stare at my teenager and pray that she will get through this. I am not alone in this. Parents of premature babies worldwide and some of whom had children on the very edge of viability are absolutely terrified. I also worry about the parents in the NICU now. I worry about the preemies that are now teens, young adults, adults, and in the elderly years. Each of them has at least one underlying health condition that can turn COVID-19 into a severe and yes, fatal case. To health responders and the health care professionals on the front end: I hear you on the seriousness of this illness. Thank you for guiding us on the challenges with COVID-19. You have us parents of vulnerable children and your former tiny patients backing up your concerns completely. To the general public heeding that concern to #stayhome and do the right thing by the young and the old and the immunocompromised, again, we are grateful. You are all our heroes." Deb Discenza is co-author of the Preemie Parent's Survival Guide to the NICU and founder, PreemieWorld. She shares her story and discusses her KevinMD article, "COVID-19 is rattling the nerves of preemie parents everywhere." (https://www.kevinmd.com/blog/2020/03/covid-19-is-rattling-the-nerves-of-preemie-parents-everywhere.html)

"As a runner, my pulse rests around fifty, but the ICU team had worried when it dipped to thirty-five, and my blood pressure hovered around ninety over fifty. Understandably, bags of saline were hung, and steroids were added. My headache improved, but my ankles disappeared, and I was often short of breath. Upon discharge, I went into full diuresis mode and spent the whole night after Thanksgiving toddling to and from the bathroom. As I passed through my parents' room, my mom, brows furrowed, muttered: 'You are going to pass out if you keep going like this.' Early in the morning, I was shaky and frail but wanted to take full advantage of the large oval bathtub with the delicious array of bath oils and loofas. I crept to my mother's side and informed her that I was going to take a bath, ignoring the nausea that was just starting to burn deep in my throat. I sat astride the tub and felt the warm stream of water flowing into the lattice of bubbles." Eve Makoff is an internal medicine physician. She shares her story and discusses her KevinMD article, "A physician's story: 'Please come quickly. My brain is bleeding.'" (https://www.kevinmd.com/blog/2020/06/a-physicians-story-please-come-quickly-my-brain-is-bleeding.html)

"I called the locum agency in the morning to air my concerns. To their credit, they admitted that the COVID-19 pandemic is an unprecedented event for which no one could have planned. They had developed a fund through which they could support health workers in need. If I took ill, I would have to call them for support. My health care will depend on the benevolence of the locum agency. My other concern predates COVID-19, but the potential of getting sick helps to clarify all sorts of work-related risks. If I were to develop a cough with sniffles and unable to work around children, I wouldn't have a timesheet to submit, and that would mean no income for the week to ten days while I am off sick. Now that my locum contract is over, but the COVID-19 pandemic rages on, I'd be hard-pressed to take another locum contract without health insurance and income protections. Locum agencies must be as meticulous with asking that their contractors have health and disability insurance, with the protection of incomes, as they are with credentialing and malpractice protections. These benefits should be offered by the agency just as they provide medical liability coverage." Koye Oyerinde is a pediatrician. He shares his story and discusses his KevinMD article, "The COVID-19 pandemic reveals gaping holes in locum tenens contracts." (https://www.kevinmd.com/blog/2020/07/the-covid-19-pandemic-reveals-gaping-holes-in-locum-tenens-contracts.html)