The Podcast by KevinMD

"While individual doctors have obligations to both the individual and public health, their first concern is their patients. And these decisions have to acknowledge fears and respect the stance. Providers must balance reassurance with acknowledgment, care, data, and the intent to 'do no harm.' It is undeniable that the COVID vaccination has saved countless lives and will be crucial to come out of this crisis. In particular, the OAZv has many advantages for global use. But the success of a vaccination program should not expend of public trust or we may jeopardize the future of global public health." Mallika Sekhar is a hematologist-oncologist. She shares her story and discusses her KevinMD article, "Fear of vaccines grows with the need for medical ethics." (https://www.kevinmd.com/blog/2021/04/fear-of-vaccines-grows-with-the-need-for-medical-ethics.html)

"The variant keeps me up at night a little bit because it has 32 mutations in the spike protein, in contrast to the Delta mutation. But it's not just the mutations. In terms of biological plausibility, it's plausible that it could be more evasive against immunity. Not just vaccines, but potentially reinfection. What really worries me is seeing the signals line up in the wrong way. It first started in Botswana, but it's surging not just in one part of South Africa, but across six different provinces in South Africa, all at once." Eric Feigl-Ding is an epidemiologist and health economist. He can be reached on Twitter @DrEricDing. He shares his story and discusses the new COVID Omicron variant.

"Cultivating compassion for ourselves and others is a practice in which we release judgment, anger and heal our emotional wounds. We can then move forward to a version of a better world where we have evolved to a new beginning. Change is always happening, and that is our constant. What we focus on while it happens is what will determine how much we will suffer or thrive as we go through it. So, as we emerge through this time, whether as a health care worker, a parent, a newlywed or whatever your role is, let us stay present in what we have gained and be hopeful of the world that we will create tomorrow. Let us focus not on what seems to be an obvious loss or grieving process but one in which we can find introspection, wisdom, strength, and a new set of purpose. It is in this that we can evolve personally and as a collective. It is not easy. There is a lot of discomfort in shedding our old self and grieving our collective loss. Yet if we do this with compassion, we can find comfort knowing hope is waiting for us on the other side." Diana Londoño is a urologist. She shares her story and discusses her KevinMD article, "Grieving our collective loss with compassion." (https://www.kevinmd.com/blog/2021/11/grieving-our-collective-loss-with-compassion.html)

"Mr. Rodgers, I'm glad you're feeling well. This isn't altogether unsurprising given your younger age and elite physical fitness (though cases in young unvaccinated people can and have become severe) and I hope you continue to feel well as you quarantine. The medical and scientific community works on data, lots and lots of data. The process of running clinical trials and publishing data is rigorously vetted and peer-reviewed. We do not have good data that supports the use of ivermectin. In fact, a couple of preprint studies have been removed from the internet due to inaccuracy and flaws in their data. Furthermore, I fear you are missing — and propagating — a very important point. We don't just get vaccinated for ourselves, but for the greater good. As I've said, I'm glad you're feeling well. As an unvaccinated young, healthy person you pose a greater risk of spreading the virus to the portion of the very young, very old, and immunocompromised population who do not share in your level of fitness than if you were fully vaccinated, especially with the travel required of you and going maskless. Some of these people make up your fan base. As someone who has been part of a team for his whole life, I wish you would see these individuals as part of your larger "team." We have to all be in this together to achieve our goals of herd immunity just as you have had to work together with your teammates to win games and titles. I wish Mr. Rodgers a speedy recovery and hope he uses this time to reevaluate some of his recent statements and their possible repercussions. I'll be watching and cheering on Jordan Love and the rest of the team." Allison Neitzel is a physician and public health student. She shares her story and discusses her KevinMD article, "To Aaron Rodgers, from a physician and Packers fan." (https://www.kevinmd.com/blog/2021/11/to-aaron-rodgers-from-a-physician-and-packers-fan.html)

"The COVID-19 pandemic challenged health care systems and patients' personal economic capacity, leading to approximately six million adults losing their dental insurance. Additionally, the World Health Organization and the American Dental Association recommended dentists to limit their practices to emergency and urgent dental care. In the list of these diagnoses requiring emergency care, jaw pain (temporomandibular disorder (TMD) that includes several clinical problems involving the temporomandibular joint and group of muscles that help with chewing and other associated structures), was not included. This is not acceptable." Soumya Padala is a craniofacial orthodontist. She shares her story and discusses her KevinMD article, "Delta surge warning: Ignoring jaw pain comes at too high a price." (https://www.kevinmd.com/blog/2021/08/delta-surge-warning-ignoring-jaw-pain-comes-at-too-high-a-price.html)

"Thanks for gathering today in this anonymous detached space. Since it's unlikely that we'll ever publicly convene in a circle on metal folding chairs, I'm reaching out through this letter. You can peruse this in private and perhaps see a piece of yourself here. As a non-practicing physician who speaks openly about my decades of suicidal ideations, I know there's a thirst for connection on this topic. Colleagues pull me aside to whisper that they, too, have felt "that way." See this letter as my way of firing a flare into the dark cavernous topic of physician suicide in order to faintly shed light and, above all, signal that you are not alone." Eliza Shin is an actor and former radiologist. She shares her story and discusses her KevinMD article, "To my fellow physicians who are struggling with suicidal ideation." (https://www.kevinmd.com/blog/2021/09/to-my-fellow-physicians-who-are-struggling-with-suicidal-ideation.html)

"I left my primary care practice earlier this year to focus on life coaching. Why did I leave? Because I wanted to do more and make a bigger impact. I remember how eager I was to complete medical training as I approached the light at the end of the tunnel. I thought I could finally relax and enjoy life as an attending after all the delayed gratification from becoming a doctor. All I ever wanted was to help people feel better and live a life of ease myself. However, I was disappointed and frustrated by our broken health care system and how care coordination could impact patient outcomes negatively. Working as a PCP in the pandemic didn't make it any easier. I saw so many patients suffer and felt helpless that I couldn't do more. I wanted to offer healing on a deeper level by examining the root cause in order to change things for good and care for the person as a whole. But I was feeling stuck. I was afraid to leave my stable job. Medicine was all I knew. What else could I do?" Cindy Tsai is an internal medicine physician and can be reached on Twitter @cindytsaimd. She shares her story and discusses her KevinMD article, "Should you stay or leave medicine?" (https://www.kevinmd.com/blog/2021/09/should-you-stay-or-leave-medicine.html)

"Economics taught me that I didn't have to culture cells in a dish to do interesting and life-changing work. I built a habit of being inquisitive and intellectually curious about the world around me because I learned in undergrad that our human, flawed world contains elegant experiments, puzzling oddities, and fertile ground for inquiry. That profound change in mindset is the most important lesson I could have learned from my undergraduate major, and I'll always be a grateful ex-economist." Dan Donoho is a pediatric neurosurgeon and can be reached on Twitter @ddonoho. He shares his story and discusses the KevinMD article, "An ode to econ: the best major for a would-be MD." (https://www.kevinmd.com/blog/2021/03/an-ode-to-econ-the-best-major-for-a-would-be-md.html)

"Disrupting weight stigma and bias in health care starts with calling it out. The power of stories and shared experiences highlights the collective voice. I'm coaching TikTok Followers to own their health power and start speaking up during clinic visits to make sure they get their questions answered. Future directions and next steps are to disrupt weight stigma and bias by speaking up, calling it out, and calling on doctors, nurses, and all of health care to do better. Back to TikTok!" Karla Lester is a pediatrician. She shares her story and discusses the KevinMD article, "Medical gaslighting due to weight stigma and bias is harmful: a viral TikTok study." (https://www.kevinmd.com/blog/2021/06/medical-gaslighting-due-to-weight-stigma-and-bias-is-harmful-a-viral-tiktok-study.html)

"No matter how extensive or well-developed your capacity for empathy may be, you cannot feel empathy for everyone all the time. Whether we're talking about doctors who have never been patients, or clinicians who have never faced discrimination, we know that people's ideas can change, when properly educated and supported. In a randomized, controlled trial, one of the most exciting findings within my own research into the malleability of empathy looked at physicians of six different medical and surgical specialties. Using the E.M.P.A.T.H.Y.(R) acronym and other techniques, physicians learned how to accurately "read" their patients' states of emotion and respond more empathically. Post-intervention, the training group received significantly higher patient satisfaction scores than the control group. The good news about our research is that it showed that we can be hopeful about changing the culture of medicine. We now have evidence-based tools to accomplish this. There is hope for a brighter future in health care and all relationships when empathic principles are learned and practiced at the local, regional, and societal levels." Helen Riess is a psychiatrist and author of The Empathy Effect: Seven Neuroscience-Based Keys for Transforming the Way We Live, Love, Work, and Connect Across Differences. She shares her story and discusses her KevinMD article, "How to preserve empathy in medicine." (https://www.kevinmd.com/blog/2021/10/how-to-preserve-empathy-in-medicine.html)

"I believe there is a formula that can reduce the risk of burnout and save primary care, rooted in one key objective: Remove work from primary care doctors and nursing staff's plates immediately. Easier said than done. And that's where technology and clinical navigation must be leveraged — to assist, facilitate, streamline, and support. Where EMR messages, not requiring doctor expertise, are responded to by clinical navigators harnessing technology to guide patients to the right outcome. Where these teams of clinical navigators are integrated into the clinical pyramid and delegated all tasks that do not require physician attention. Integrated technology + navigation = relief." Ronald Dixon is an internal medicine physician. He shares his story and discusses his KevinMD article, "As doctor burnout climbs, can we save primary care?" (https://www.kevinmd.com/blog/2021/09/as-doctor-burnout-climbs-can-we-save-primary-care.html)

"My brain is still struggling to comprehend the battle for the status quo a physician faces each day; one who must, by default, be cognizant of the lurking dangers of an opioid prescription, while also helping the patient on their swiftest way to recovery, led by the very same guidelines. But what happens when the patient slips on the road to recovery and out from underneath the physician's caring cloak towards substance abuse? Whether the patient's role changes at that very threshold is a different story. While it certainly is a part of this somewhat self-perpetuated epidemic, the struggle to keep a status quo has ancient roots and every physician has — if not knowingly so — sworn to abide by them when uttering the anecdotal resemblance of the Hippocratic Oath: 'I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism.' But what if we dare to question the application of this ancient commitment on this particular matter? Should we have already done so, or can we afford to wait until the death toll reaches an unspeakable capita? Should opioids for postoperative pain even be permitted to dance on this slippery spectrum between adequate analgesia and addiction? I wish the answer were that simple." Jesse Seilern und Aspang and Mara Schenker are orthopedic surgeons. They share their stories and discuss the KevinMD article, "America's prescription epidemic: Breaking an ancient promise." (https://www.kevinmd.com/blog/2021/07/americas-prescription-epidemic-breaking-an-ancient-promise.html)

"I am a woman of history who stands up and tells the truth, irrespective of what other people say. I remember the words of the late Representative John Lewis, 'Do not get lost in a sea of despair. Be hopeful, be optimistic. Our struggle is not the struggle of a day, a week, a month, or a year. It is the struggle of a lifetime. Never, ever be afraid to make some noise and get in good trouble, necessary trouble.' Black female physicians are not OK, but it is our collective duty to do something about it. It is our collective duty to go against the tide. It is time to take a stand and institute change that we need to initiate ourselves." Tomi Mitchell is a family physician. She shares her story and discusses her KevinMD article, "The unique agony of being a Black female doctor." (https://www.kevinmd.com/blog/2021/11/the-unique-agony-of-being-a-black-female-doctor.html)

"I am exhausted and sad and disappointed and discouraged. I am losing faith in humanity. Where is the 'love your neighbor as yourself'? Where is the willingness to help each other? Where is the solidarity of those first days? Physicians have gone from being heroes to being villains. We have dedicated decades of our lives to learning how to care for you, but now our knowledge and expertise are being thrown back in our faces as not good enough and not as believable as your cousin's friend who saw something on social media. It is hard to keep going. But we do. We keep going because we have dedicated our lives and careers to our patients. We follow our Hippocratic Oath, and we do the best we can for every patient no matter who they are, what they believe, or what choices they make. But many of us are barely clinging to our passion to serve. Each day, I get out of bed, swallow my frustration and disappointment, and pray for the fortitude and resilience to face another workday, because I know that if I can make a difference, however small, it means something. And I know that my patients and their families bring me joy! But each day, my heart breaks a little more. It shouldn't have to be this way, but this is the world we live in right now. I am exhausted." Lisa Cronk is a pediatrician. She shares her story and discusses her KevinMD article, "Physicians have gone from being heroes to villains." (https://www.kevinmd.com/blog/2021/09/physicians-have-gone-from-being-heroes-to-villains.html)

"The truth is, we were all drowning, alone, and hiding behind the image of perfection. Clearly, each of us secretly thought that the others had it all figured out. We were so afraid of admitting weakness or asking for help, so we kept it to ourselves and muddled through, burnt out and miserable, terrified of being judged for our vulnerability. When we negatively judge ourselves for needing help, we end up judging others who need our help too. Our patients feel this undercurrent of judgment when they ask for our help. They don't want to face that vulnerability because they too feel judged. Asking for help and facing our struggles with honesty is a sign of courage and compassion. It is human nature to need each other and to feel connection. Maybe if we'd all been a little less armored, more vulnerable, and shared our struggles with each other, our cohort of future doctors could have leaned on each other to cope better back during our intern year too." Jordana Rothschild is a preventive medicine physician. She shares her story and discusses her KevinMD article, "Doctors are humans, not heroes." (https://www.kevinmd.com/blog/2021/08/doctors-are-humans-not-heroes.html)

"What are altcoins, and should you be investing in them? I cannot speak to whether investing in altcoins is appropriate for you. Altcoins are a highly volatile and risky asset class that offers the potential for high returns. Every investor must decide whether they are willing to bear the associated risk. When evaluating thousands of coins to select the best opportunities, it is critical to have an appropriate framework to work from. That is why I am sharing my 5-step framework." John Stillson is a medical student and an investment manager. He shares his story and discusses his KevinMD article, "Alternative cryptocurrencies: 5 tips for physicians." (https://www.kevinmd.com/blog/2021/08/alternative-cryptocurrencies-5-tips-for-physicians.html)

"Go ahead, give yourself permission, summon the compassion and grace you'd bestow on your best friend, and tell yourself, "This is the breadth of the human experience, and I'm only human." There is immense beauty and strength in that vulnerability. I lied to myself for too long, couldn't see the road ahead through the cracked glass until it, and I, in turn, shattered. Once those broken shards that obscured and distorted the path forward have been swept away, only then can the clarity of a stronger, more resilient soul begin to emerge. I'm not back to normal, and it's possible I may never get there. But each day, there are glimmers of hope that I might be closer to my true self than before — and that's all I can ask for right now." Luyi Kathy Zhang is a palliative care physician and can be reached on Twitter @DrKathyZ. She shares her story and discusses her KevinMD article, "Maybe we're not all hanging in there. And that's OK." (https://www.kevinmd.com/blog/2021/02/maybe-were-not-all-hanging-in-there-and-thats-ok.html)

"When the medical profession—a career you have pursued for years, a career you love and trust to do no harm does something to shatter the foundations of your sense of trust and worldview, the resulting trauma can be severe resulting in loss of sense of self and life-altering betrayal grief that mirrors the stages of acceptance of one's own death (or the death of a piece of one's soul when swept up in the betrayal cascade)—denial, anger, bargaining, depression, and acceptance. As a witness to immense betrayal within the medical profession, I've felt them all." Pamela Wible is a family physician and author of Physician Betrayal: How Our Heroes Become Villains. She shares her story and discusses her KevinMD article, "Medicine's culture of betrayal." (https://www.kevinmd.com/blog/2021/09/medicines-culture-of-betrayal.html)

"I was first diagnosed with major depressive disorder as a preteen after my teenage sister died. I attempted suicide three years later. This would be the first of several attempts and the first of countless times I felt my life was not worth living. But I am not unique. According to the Centers for Disease Control (CDC), 1 person dies by suicide every 11 minutes. My depression is like a chronic autoimmune disease — constitutively present at a low level with flares. But there's no Humira for depression. At baseline, I am exhausted, anxious, lacking motivation, and full of self-doubt. When severely depressed, I am at the bottom of the sea, struggling to breathe and unable to swim. I am paralyzed by a high-pressure, heavy and humid darkness. Through physical or mental isolation, I may not see another living creature for hours, days or weeks. I can look up and see the sun shining beyond the water surface, but the surface is miles beyond my reach. I must physically force myself to breathe as my mind tells me to stop. Trying to take a test, see patients or study can prove impossible." This anonymous medical student shares her story and discusses her KevinMD article, "Surviving medical school with depression." (https://www.kevinmd.com/blog/2021/06/surviving-medical-school-with-depression.html)

"I am here to testify that it is possible, and I am not alone in this specialist direct care market. There are other specialists' practices like mine, hidden gems for patient care. During my journey, I learned specialists are thriving to remove the "middlemen" and reconnect with patients. Patients are eager to shop for their health, discover transparent pricing and excellent quality. Patients and physicians desire mutual accountability. Since the direct primary care movement started approximately ten years ago, many patients that signed up to this model quickly realized the benefit of having access, affordability, and price transparency. Specialists in direct care now exist across the country. In the last two years, I have been in contact with many thriving physicians providing a direct care model. However, it was so hard to find and connect. Our hope – and our patients' need – is that connecting patients with direct care specialists gets easier. We are working on that now – we are working to change the system because our patients need it – and practicing good health care depends on it. This is just the beginning of a new era in medicine, where patients and physicians reunite." Diana M. Girnita is a rheumatologist and founder and CEO, Rheumatologist OnCall. She can also be reached on Facebook, Instagram, and YouTube. She shares her story and discusses her KevinMD article, "The emergence of direct specialty care." (https://www.kevinmd.com/blog/2021/09/the-emergence-of-direct-specialty-care.html)

"At the hospital, the nurse is the one who is at the patient's bedside around the clock. When the patient has to go to the bathroom or needs help to sit up in a chair, he or she calls the nurse. The nurse is the one who is changing the diapers for the elderly; she is the one cleaning the sputum and the spilled urine; she is the one holding the patient's hand and stroking his hair while he is having a painful procedure done. She is the one arranging the flowers and picture frames in the room. She is the one administering the medications when the patient is in pain or nauseous. She is the foremost advocate for the patient. She is at the bedside when the patient is taking his last breath, and she is the one to call the doctor to pronounce him dead after having first witnessed and confirmed it herself." Farhan S. Imran is a hematology-oncology physician who blogs at Did I Ask? He shares his story and discusses his KevinMD article, "A nurse is to a patient what a mother is to a child." (https://www.kevinmd.com/blog/2021/05/a-nurse-is-to-a-patient-what-a-mother-is-to-a-child.html)

"Many patients, doctors, nurses, and health care administrators appear to have a seat on the blimp with little concept of how the game has evolved over the years and is being played now. They may have attended the game in the past, but they likely haven't seen the action from 5,000 feet above the field—and seeing the health care picture from the big picture distance can create some impetus for adapting to the new rules. We need to not only explain the new rules of the game but also show how passion of the team can overcome adverse conditions and ultimately prevail. Everyone on the blimp needs to become engaged, including those who have been riding involuntarily. The health care game has changed. We will find season ticket holders. And those of us on the field will get messy, no doubt. But who knows? Our game might just become a national pastime." Paul Pender is an ophthalmologist and can be reached at his self-titled site, Dr. Paul Pender. He is the author of Rebuilding Trust in Healthcare: A Doctor's Prescription for a Post-Pandemic America. He shares his story and discusses his KevinMD article, "Getting messy in the game of health care." (https://www.kevinmd.com/blog/2021/08/getting-messy-in-the-game-of-health-care.html)

I did not realize I was a perfectionist. I was far from perfect. It was not until I listened to a master class on perfectionism from a physician coach that I had my "aha moment." I am now working extremely hard on training my brain to be an imperfectionist. To do that means to let go of the mental constructs that I have created for myself. In particular, I had to let go of the narrative that said to me: You are not someone unless you look like the epitome of success. I was a young African-American doctor full of "firsts." However, these firsts did not protect me from the hurt of failure or the heartache associated with imperfection. For sure, it did not provide me with what I longed for most, self-worth and validation." Frieda Millhouse-Jones is an internal medicine physician. She shares her story and discusses her KevinMD article, "A Black physician's perfectionism." (https://www.kevinmd.com/blog/2021/05/a-black-physicians-perfectionism.html)

"We have observed that delays in screenings and intervention for patients with certain common chronic conditions can contribute to claims. Now, clinicians have the opportunity to identify patients whose conditions merit priority contact, such as those with cardiac conditions, those on blood pressure medication, or those with diabetes, and request they come in for delayed screenings or checkups. Explicitly recommending that those without medical contraindications get vaccinated not only helps slow the spread of COVID-19, but may also stop a patient from claiming that they remained unvaccinated for lack of counsel from their physician. Whether or not a practice or institution is distributing vaccines, it should communicate to patients that COVID-19 vaccines are extremely safe, remarkably effective, and vital to ending the pandemic. Invite patients who have questions about vaccines to communicate their concerns. Since risks exist even if patients did not present for care, documenting the practice's efforts to reach patients who have delayed care will reduce litigation risks. If a patient is considering filing a claim, a review of the patient's medical record will be among a plaintiffs' attorney's first steps. Therefore, documenting patient communications is a defense against suits before they are filed." Richard E. Anderson is chairman and chief executive officer, The Doctors Company and TDC Group. He shares his story and discusses his KevinMD article, "Mitigating risks from care during COVID-19." (https://www.kevinmd.com/blog/2021/05/mitigating-risks-from-care-during-covid-19.html)

"The diagnosis is well-established. A cure is within our reach, and the wisest among our practitioners of the healing arts are offering valuable counsel. When the U.S. government and science, in its most principled form, work together, insulated from a culture of insidious and invidious profiteering, they can put a man on the moon, and launch a helicopter on Mars. They can also deliver better health care in a much more equitable and cost-effective way. It is time for the patient to listen to her best doctors. They are giving it to her straight." Jeffrey Fraser is a neurologist. He shares his story and discusses his KevinMD article, "Diagnosis: malformation of a health care system." (https://www.kevinmd.com/blog/2021/07/diagnosis-malformation-of-a-health-care-system.html)

"After much searching, I was fortunate to find a fellowship that though inexperienced in LGBTQ health recognized an opportunity. Faculty and mentors worked from a growth mindset rooted in finding what I needed to succeed rather than what they knew they had to offer at that moment. With their and others' support, despite the discouragement and fears of being "superficial," I now try to serve as an example to other students and trainees who wish to pursue a career that weaves their personal and professional interests in LGBTQ health. Carl Streed, Jr. is an internal medicine physician. He shares his story and discusses his KevinMD article, "Professional gay: Charting a career in LGBTQ health." (https://www.kevinmd.com/blog/2021/08/professional-gay-charting-a-career-in-lgbtq-health.html)

"We physicians must come to terms with the trauma caused by the financial insecurity built into our training and the ripple effect it has even after we finish training, both as a way to repair ourselves individually and as a way to assure that our profession survives. The cost of medical education is high, but the cost of the financial lessons learned in the course of obtaining that education is even higher. It may be a price too high for future doctors to bear." Elizabeth Hughes is a dermatologist. She shares her story and discusses her KevinMD article, "How medical training teaches doctors to be financially unhealthy." (https://www.kevinmd.com/blog/2021/08/how-medical-training-teaches-doctors-to-be-financially-unhealthy.html)

"We have to heal ourselves first. That begins with caring for our own minds and bodies, and souls. It means not avoiding (as I did) caring for our own physical and especially our mental health. It means we must be a part of the lives of our families and loved ones as well. Once that is accomplished, then and only then can we move on effectively to heal and revitalize our beloved profession. And likewise, that is not a battle that can be shouldered alone. We must join with and support each other. We must arm ourselves with knowledge and motivation by taking advantage of mentors and coaches. And perhaps most importantly, we must be aware of when we need to be the mentor and when to be the protégé. Only then will we heal ourselves. Randy Cook is a surgeon and physician coach. He shares his story and discusses his KevinMD article, "How to heal and revitalize our beloved profession." (https://www.kevinmd.com/blog/2021/09/how-to-heal-and-revitalize-our-beloved-profession.html)

"If you are encountering families with feeding concerns, I strongly encourage you to ask them if sitting down together for meals is part of their regular routine. The more prescriptive 'eat this, not that' or calorie counting model that has been traditionally used in medicine is clearly not working well. As we see continue to see increased obesity and disordered eating alongside decreased resilience in our children, a return to the daily 'ritual' of the family meal may be the most beneficial first step for some of our struggling families. Encourage them to start small if necessary. If they are currently not eating together set the goal of one meal per week. If they are already doing it, suggest that they do so with more verve and intention. Educate yourself on the overwhelming benefits of the family meal for children and parents alike. Practice it in your own home so that you too may know the magic of this simple act. Family meals are a small change that is accessible and manageable for just about anyone— and maybe just what the doctor ordered." Kristin Saxena is a pediatrician. She shares her story and discusses her KevinMD article, "The surprising power of family meals." (https://www.kevinmd.com/blog/2021/09/the-surprising-power-of-family-meals.html)

"Like some insidious conditions, feelings can fester. They can spread like cancer, and sap the spirit of nourishment until it starts to die, riddled with doubt and sensations of inadequacy. They can degrade the soul, as though it were suffering from a systemic inflammatory disease. But this progression, like many conditions of the flesh, is treatable. With early detection, the process can be arrested and cured. Talking about feelings, journaling, praying, or finding an outlet in wellness activities that channel joy is as essential to academically thriving as studying, practicing, and pushing to meet the demands of a health care provider." Stephanie Wottrich is a medical student. She shares her story and discusses her KevinMD article, "Joy is our antibiotic. Let not your stings fester." (https://www.kevinmd.com/blog/2021/08/joy-is-our-antibiotic-let-not-your-stings-fester.html)

"Bipolar runs in my family, so I knew the harsh realities of this untreated illness. A family member faked his own death after a counterfeiting spending spree. My grandfather told people that I would die in a car accident, and he would take my body up to the mountain and bring me back to life. When I was younger, surrounded by this family chaos, it was easy to tell myself, 'They are crazy!' I bought into many of the stigmas of mental illness — that those with mental illness are unpredictable, incompetent, and have trouble holding down a job. I thought I was different. I was married to a hospital CEO, attended charity events, lived in a beautiful home, and had three healthy children. Yet, life felt unbearable. The stigmas around mental illness kept me from getting the help I desperately needed, so I continued to suffer in silence." Sonja Wasden is a mental health advocate and co-author of An Impossible Life. She shares her story and discusses her KevinMD article, "I bought into the stigmas about the mentally ill, until I became one of them." (https://www.kevinmd.com/blog/2021/06/i-bought-into-the-stigmas-about-the-mentally-ill-until-i-became-one-of-them.html)

"How do we create a world where all of us can express our unique selves the way we choose without derisiveness and shame? I am not here to criticize the wonderful parents and caregivers who are reading this – they only love their children. Common sense must prevail. I only ask with respect that parents and caregivers let their kids explore freely so we all can find a way to live together with our differences celebrated. What a wonderful day that will be." Craig Pomranz is a vocalist and actor. He shares his story and discusses his KevinMD article, "Tomgirl and tomboy: Rethinking gender stereotypes." (https://www.kevinmd.com/blog/2021/08/tomgirl-and-tomboy-rethinking-gender-stereotypes.html)

"We all know watching a module on resilience, sitting in a lecture about mindfulness, being told to practice more yoga and breathing techniques does not make you feel less burnout. It's having the support and buy-in from your workplace, to actually have the time to do the things that feed your soul and fill your cup. Adding more onto an already overflowing plate of life's stressors only makes it heavier and more overwhelming. I want support. I want authentic connection and compassion. I want someone invested in my well-being who prioritizes my self-care to prevent me from having to be perpetually resilient. I want someone who values my heartiness and helps to cultivate an environment that fosters continued growth for myself and others." Michelle Owens is a palliative care physician. She shares her story and discusses her KevinMD article, "I do not want to be resilient." (https://www.kevinmd.com/blog/2021/08/i-do-not-want-to-be-resilient.html)

"As the next wave of the pandemic unfolds, the rise in cases is once again straining health care systems. But that's not the only reason hospitals and health systems could experience an influx of emergency or critical care visits. Findings from the National Poll on Healthy Aging based at the University of Michigan Institute for Healthcare Policy and Innovation revealed that nearly one in three Americans between the ages of 50 and 80 put off an in-person appointment for medical care in 2020 because they were worried about potential COVID-19 exposure, and with the emergence of new variants, that trend could continue. There is a growing concern that patients will either see a relapse in their illness or will experience new complications as a result of waiting too long to visit the doctor. Put simply, there could essentially be two health crises crowding the system: those who have tested positive for the coronavirus, and those who delayed routine preventative and ongoing care for ailments such as chronic disease or mental health." Matt Dickson is a health care executive. He shares his story and discusses his KevinMD article, "Why now is the time to get patients back to in-person routine care." (https://www.kevinmd.com/blog/2021/08/why-now-is-the-time-to-get-patients-back-to-in-person-routine-care.html)

"Frontline workers may have temporarily experienced a heightened sense of personal success and gratification, but I doubt many of us are still able to feel satisfied at this point, after all the repeated moral injuries and losing so many patients. COVID-19 assuredly changed me. The virus changed my residency experience. It changed the hospital, and it changed the entire world. As Prime Minister Boris Johnson recently stated, 'We simply cannot revert instantly … to life as it was before COVID.' We must try our best to carry on, cautiously, into the new unknown era of vaccines and virulence. For me, that means wearing a mask in public long after restrictions are gone." Elizabeth Sarah Haberl is a resident physician. She shares her story and discusses her KevinMD article, "Carry on, my weary one: Persevering in the aftermath." (https://www.kevinmd.com/blog/2021/08/carry-on-my-weary-one-persevering-in-the-aftermath.html)

"As a mother, a physician, and an educator, I refuse to accept this as normal. It is not! What should we tell the parents of these young physicians? How do we explain to them that their dream of being a doctor became a nightmare with a tragic ending? What do we tell their children when they ask for daddy's good night kiss, or for mommy's caring hugs? Where are the leaders? How did nobody notice their sadness, lack of hope, and deep desperation? Sadly, this tragedy is not isolated. These types of events are happening around the country and in different institutions. The hopes of young physicians are transforming on fears, the excitement on stress, the smiles on tears. Where are the leaders? How did nobody know that something wrong was happening?" Miriam Zylberglait Lisigurski is an internal medicine physician. She shares her story and discusses her KevinMD article, "Physician suicide: Where are the leaders?" (https://www.kevinmd.com/blog/2021/08/physician-suicide-where-are-the-leaders.html)

"Provider organizations may look at their budgets and think the traditional model of fax machines and landlines is serving their entity in optimizing revenue streams. They may even look at their providers' full schedules and believe there isn't a patient population that still needs care. But this would be a miscalculation. Without appropriate methods to close the gap on referrals and communicate appointment information to patients, no-show and cancellation rates risk burdening providers and costing practices and health systems millions. With the right technology and procedures at the care coordinator level, patients in need of care can be seen quickly. Patients that otherwise would slip through the cracks in a health system's infrastructure are connected with the care they desperately need. Finally, with this increased connectivity and patient care, provider organizations can continue to expand their networks and connect with more providers and services to make sure they stay competitive and relevant across the health care ecosystem." Curtis Gattis is a health care executive. He shares his story and discusses his KevinMD article, "Why clinicians can't keep ignoring care coordination." (https://www.kevinmd.com/blog/2021/08/why-clinicians-cant-keep-ignoring-care-coordination.html)

"During COVID, the medical training system had to adapt because people couldn't meet in person and even those that could didn't have access to patients or facilities in the same capacity. However, the explosion of remote training tools that became available make this hybrid training method as good in many ways, and perhaps even preferable to one that consists mainly of in-person lectures. In fact, some medical schools have suggested that all preclinical classes should be available exclusively online by 2025. As a result, schools and other stakeholder organizations should examine alternative methods of medical training and can use this opportunity to embrace new technologies in order to effectively and efficiently educate trainees. It may be time to abandon the old ways and fully embrace the advantages virtual training environments, including video games, have to offer." Peter Lio is a dermatologist. He shares his story and discusses his KevinMD article, "The evolution of medical training in dermatology and the impact of technology." (https://www.kevinmd.com/blog/2021/09/the-evolution-of-medical-training-in-dermatology-and-the-impact-of-technology.html)

"As you wait, you have a lot of time to think. You comb through the past in search of something you might have missed. If we had acted sooner on the signs of his illness—had the cancer been diagnosed earlier—would Lee have had a better chance? You think about your child as a toddler and as a kid and as a teen. Did you push him too hard or not enough? How did you handle his skinned knees and his successes? You remember the first time he got drunk. (Lee was 14 and had discovered the punchbowl at Heidi's Sweet Sixteen party.) You remember his first hockey goal." Alan Pesky is founder, Lee Pesky Learning Center and co-author of More to Life than More: A Memoir of Misunderstanding, Loss, and Learning. He shares his story and discusses the KevinMD article, "A memoir of misunderstanding, loss, and learning." (https://www.kevinmd.com/blog/2021/09/a-memoir-of-misunderstanding-loss-and-learning.html)

"Last March, I was working in a small primary care practice on the west side of Denver. COVID-19 came to town. On Thursday, March 12, we were told the schools would be closing. On Friday, we were told that clinic staff had to wear masks — and the clinic had to start testing patients for COVID-19. The only problem? There were no medical-grade masks to be had. Not through the state health department, not on Google, not anywhere. Likewise, there were no COVID tests available. A patient came into the clinic late that afternoon, complaining of a high fever and a bad cough for three days. He wanted to know if he had COVID-19. So did I! But there was no way to test him." Janet Tamaren is a family physician and author of Yankee Doctor in the Bible Belt: A Memoir. She shares her story and discusses her KevinMD article, "I was thinking about retiring, and COVID-19 gave me a push." (https://www.kevinmd.com/blog/2021/08/i-was-thinking-about-retiring-and-covid-19-gave-me-a-push.html)

"There has been a growing wave of entrepreneurial physicians finding joy and value in starting consulting and coaching businesses. Many use their expertise to work with physicians exclusively. Our company has been excited to play a part in better spotlighting these businesses. Today it is now even easier to find doctors who can give you guidance on everything from running your own practice more efficiently, build a better relationship with your spouse, to negotiating your next job contract. We are all aware of the tired refrain that 'physicians are bad at business.' It is time to retire that phrase. Business has not been our primary focus, and perhaps the state of medicine may result from that. So if given a choice, consider supporting more physician-owned businesses. If you have a problem that needs solving, there may be a colleague out there who has already figured it out and can help." Michael Woo-Ming is a physician entrepreneur. He shares his story and discusses his KevinMD article, "Why physician-owned businesses need our attention and support." (https://www.kevinmd.com/blog/2021/06/why-physician-owned-businesses-need-our-attention-and-support.html)

"Transections, eviscerations, exsanguinations, amputations, decapitations, disembowelments, penetrations, disarticulations, emasculations, enucleations, incinerations—these things he has seen. But of late he chooses to see only the glimmering vials. His vision fades and darkens as he draws closer to the OR where the ultimate reality lies prepped, draped, framed, and illuminated, waiting for the surgeon to fix it all, to make sense of it all. Exposure in surgery is everything." Michael J. Collins is an orthopedic surgeon and author of All Bleeding Stops. He can be reached on Twitter @mjcollinsmd. He shares his story and discusses his KevinMD article, "Exposure in surgery is everything." (https://www.kevinmd.com/blog/2021/09/exposure-in-surgery-is-everything.html)

"Her face is decorated in colors of the earth. With events on Earth Day and throughout the week, New York City celebrates sustainability and ways to live in harmony with the planet. Scheduled festivities include a march down Broadway with a mix of virtual talks and celebrations and in-person walks and volunteer opportunities across the boroughs. Earth Day began in 1970 as a way to raise awareness about environmental issues and became a global event in 1990; the event has been celebrated in parks across the city since 2000." Glenn Mark Losack is a psychiatrist and author of The Bonds We Share: Images of Humanity, 40 Years Around the Globe. He shares his story and discusses his KevinMD article, "A physician shares images of humanity." (https://www.kevinmd.com/blog/2021/07/a-physician-shares-images-of-humanity.html) This episode is sponsored by Tradeoffs, available on your favorite podcast platform.

"A child is born with a food allergy. They do not choose to have their immune system compromised. Parents do not get the choice to opt-in or out of having their child's body recognize ordinary food as a threat. Food allergies are a unique disease in that we need the help of those around us to keep our children safe. Let us remember that children, especially when they are young, often cannot protect themselves. A young child also may not truly understand the potential danger of sharing food with a friend. This is why food allergy education is critical for both teaching staff and students. But such education is often lacking." Lianne Mandelbaum is founder, the No Nut Traveler, and can be reached on Twitter @nonuttraveler. She shares her story and discusses her KevinMD article, "When celebrities attack children with food allergies." (https://www.kevinmd.com/blog/2021/05/when-celebrities-attack-children-with-food-allergies.html) This episode is sponsored by Tradeoffs, available on your favorite podcast platform.

"I believe there is an art to medicine, a psychological connection to your patients through a hands-on patient encounter. There are nuances AI may take decades to compete with. For now, in my lifetime, I hope that people examine patients and when there are questions about the quality of care, institutions perform a deeper dive into the real problem. (Was it the overall experience, a poor relationship with the doctor, financial stress that would be assumed by paying the medical bill, or actual malpractice?) Without support from our employers, physicians will continue to feel the accumulation of burnout and insecurity that leads to emotional duress, leaving medical practice or the worst outcome: physician suicide. We are not machines. The burden cost is evident, but when will the medical community, investors, and hospital administrators begin to truly support physicians and prevent these terrible outcomes?" Gina Ambrose is an emergency physician. She shares her story and discusses her KevinMD article, "The psychological repercussions of patient complaints." (https://www.kevinmd.com/blog/2021/07/the-psychological-repercussions-of-patient-complaints.html) This episode is sponsored by Tradeoffs, available on your favorite podcast platform.

"We can't expect those with a business school mindset to solve physician burnout. What is needed is leadership throughout health care organizations by those with expertise in the core business, deep commitment to health care workers and patients, extensive tacit knowledge, and credibility. Physician CEOs have better outcomes in all critical metrics, including engagement among staff. And physician leaders have an ethical and fiduciary responsibility to serve patients. Those with a business school mindset do not." Patty Fahy is an internal medicine physician and founder, Fahy Consulting. She can be reached on Twitter @pattyfahyMD. She shares her story and discusses her KevinMD article, "The business school mindset doesn't mind physician burnout." (https://www.kevinmd.com/blog/2021/08/the-business-school-mindset-doesnt-mind-physician-burnout.html) This episode is sponsored by Tradeoffs, available on your favorite podcast platform.

"I can imagine the horror of watching a colleague being attacked. I worry about the coworker who Lynne protected that day, since being a survivor can be so bittersweet. I can feel the shock of how quickly the violence escalated, tasting the bitterness from the desperation of being so alone in the immediate first seconds of the downwardly spiraling situation." June Garen is a nurse and author of Hey! I Could Use a Little Help Here! My Story of Healthcare Workplace Violence. She shares her story and discusses her KevinMD article, "In memory of a nurse who died from injuries sustained during a patient assault." (https://www.kevinmd.com/blog/2021/08/in-memory-of-a-nurse-who-died-from-injuries-sustained-during-a-patient-assault.html) This episode is sponsored by Tradeoffs, available on your favorite podcast platform.

"The first amendment protects your right to free speech. But it does not make you more right, more ethical, or more kind. And nor does it give one license to rewrite history as has been occurring since July 27th, adding insult to our experience. Let me break this down. On one hand, three pediatric medical professionals and one student spoke eloquently and rationally about facts, guidelines, and personal experiences. On the other hand, grown adults belonging to ironically named groups claiming to "protect kids," tried to intimidate, bully, and silence a child for exercising her first amendment right to free speech. We now have a vaccine against COVID-19. And even though we (individually and as a medical profession) anticipate continued harassment by these groups, bringing their hateful rhetoric and actions to light is the only inoculation we have against bullying." Anusha Viswanathan is a pediatric infectious disease physician. Jennifer Bish is a pediatric nurse practitioner. They share their stories and discuss the KevinMD article, "A pandemic of the bullies over others." (https://www.kevinmd.com/blog/2021/08/a-pandemic-of-the-bullies-over-others.html) This episode is sponsored by Tradeoffs, available on your favorite podcast platform.

"Is your health care organization reeling from a bad EHR implementation? There have been rumblings from hospital leadership and congressional committees about the Veterans Administration (VA) Hospitals' implementation of the Cerner Corporation electronic health record (EHR) replacing the VistA EHR. The $10 million EHR overhaul has been controversial since the staggered rollout started in Spokane, Washington. One report noted that months after the go-live, fewer users knew how to operate the system well. From the perspective of an outside informaticist, such frustration can be multifactorial. The typical issues are made worse by the COVID-19 hospital restrictions on normal hospital operations. However, many of these issues could have been mitigated by offering expanded in-person expert support to hospital staff supported by virtual technical assistance." Afua Aning is a physician informaticist. She shares her story and discusses her KevinMD article, "How to recover from a bad electronic health records implementation." (https://www.kevinmd.com/blog/2021/08/how-to-recover-from-a-bad-electronic-health-records-implementation.html) This episode is sponsored by Tradeoffs, available on your favorite podcast platform.

"Scarcity has, in many ways, defined the COVID-19 experience in the U.S., from shortages in personal protective equipment to ICU ventilators and hospital capacity, to COVID test kits, to drugs like Remdesivir in hard-hit states. These shortages have added impetus and new dimensions to existing conversations around health care supply chains, some of which had originally stemmed from a climate-conscious, sustainability lens. As suggestions are put forth to re-evaluate hospital supply chain design, from procurement to waste disposal, this momentum can be harnessed to achieve the dual aims of bolstering pandemic preparedness and improving sustainability in the health care sector. COVID-19 illustrates the need for greater resiliency within health care's supply chain. Dependence on expansive global networks for raw materials, manufacture, and distribution of critical health care supplies created a pathway prone to breakdown during a worldwide pandemic. Of note, this pathway is similarly vulnerable to the climate crisis, as worsening natural disasters can disrupt critical junctures of the U.S. supply chain." Genevieve Silva is a medical student. Cassandra Thiel is an assistant professor, NYU Langone Health's Departments of Population Health and Ophthalmology. They share their stories and discuss their KevinMD article, "Is COVID a turning point for sustainability in hospital supply chains?" (https://www.kevinmd.com/blog/2020/10/is-covid-a-turning-point-for-sustainability-in-hospital-supply-chains.html) This episode is sponsored by Tradeoffs, available on your favorite podcast platform.