The Podcast by KevinMD

"Some may say that we all come into this world with our own luck, and if we end up having to endure a disability, then other people in society should not be held financially responsible. To that I say, do we not have a moral imperative to ensure that we create a society that we would be proud to live in? Humankind has only come so far on the basis of cooperation, trust, and looking after each other. We can't just abdicate our responsibilities in the face of selfishness, or because it feels easier. United we stand, divided we fall. I would hope that if one day you find yourself a victim of fate, someone extends a hand to you in your time of need. Because we're all healthy—only until we're not." Shreya Kumar is a medical student. She shares her story and discusses her KevinMD article, "Eradicate the disability tax, before it's too late." (https://www.kevinmd.com/blog/2021/08/eradicate-the-disability-tax-before-its-too-late.html)

"Attending physicians struggling with a mental health issue should consider contacting a counselor first, rather than a department head or employer resource. A counselor can assess the mental health issue, offer treatment recommendations, and provide therapy that meets the physician's needs – all while protecting that person's privacy. Mental health providers are legally obligated to maintain confidentiality except under the most narrow of circumstances. Despite the concerns that licensing boards and employers have about the risk to patients or impairment, there is little evidence that simply having a mental health issue, or receiving treatment for one, imperils patients. We have abundant evidence, however, that avoidance of treatment imperils physicians. Many physicians have successfully undergone counseling while continuing to work without ever notifying their employer or department, imperiling patient care, or incurring licensing consequences. Until changes occur that mitigate the causes of burnout, depression, anxiety, and substance use disorders among physicians, our priority must be increasing access to and engagement in treatment. Physician-specialized private counseling practices are one way to accomplish that." Vickie Mulkerin is a family physician and owner, White Coat Counseling, LLC. She shares her story and discusses her KevinMD article, "Why physician-specialized private counseling practices are important." (https://www.kevinmd.com/blog/2021/08/why-physician-specialized-private-counseling-practices-are-important.html)

"I called my wife of 31 days, anxious and dazed. I told her that the pace I was on was crushing me. I told her I had done seven admits since 5 p.m. and taken floor calls, too. It was not yet midnight. I told her I don't know if I can do this job. But I soldiered on. It was the first of July. I picked up my first chart of the shift and began to walk to see the patient. Felt some apprehension. I looked at the chart and noticed the name printed in the box for the attending physician. The name was mine. I felt awe. I felt pride. I felt fear." Duane Corsi is an emergency physician. He shares his story and discusses his KevinMD article, "An emergency medicine life." (https://www.kevinmd.com/blog/2021/07/an-emergency-medicine-life.html)

"Chiefs, remember, one of those interns is going to fill your shoes in a few years. They may model you in that role, so you want to raise them well! As a former chief resident, I have lots of pearls for those entering residency. However, what I will tell you now is different from what I would have told you then. I have since learned that there are possibilities to create the results that we want and not just follow the path we are told to take. Recently, a former intern of mine — who went on to be a chief resident and subsequently a program director — tweeted that he received advice from another chief: "If you are unhappy in residency, you need to adjust your expectations." He pondered that this suggestion was a mixed bag. Can you see both sides? Residents, who is responsible for your happiness? Is it the institution, the program, the program director, the chief resident — or you?" Marion McCrary is an internal medicine physician and can be reached at Marion McCrary Wellness. She shares her story and discusses her KevinMD article, "A word of advice from one chief resident to another." (https://www.kevinmd.com/blog/2021/07/a-word-of-advice-from-one-chief-resident-to-another.html)

"In January of 1991, at twenty-two months old, Nick had another heart catheterization. Andy and I had started thinking about the next stage of surgery to finish the heart repair. Just before Nick was discharged, I discussed it briefly with Dr. Kanter. 'Tell me when you would like to do the surgery,' he said. 'Never, if it's up to me.' We were in no hurry for Nick to go into the OR again. The older Nick grew, the more difficult it became to agree to procedures. At least this operation would be one of the planned surgeries. By now, heart surgeons were doing an additional repair, completing the surgery in two stages instead of one. The positive side was that at least we would be taking a step forward. Andy and I wanted the surgery date to be sooner rather than later, but we still had questions. I asked Dr. Kanter to call me. He and I discussed the pros and cons of the repair. There was a pause in the conversation, and then Dr. Kanter asked, 'Susan, are you sitting down?'" Susan May is a writer and author of Nick's New Heart: 30 Years and Counting. She shares her story and discusses her KevinMD article, "The story of a heart transplant in a 1-year-old, as told by his mother." (https://www.kevinmd.com/blog/2021/05/the-story-of-a-heart-transplant-in-a-1-year-old-as-told-by-his-mother.html)

"After my last promotion, my institution adopted new guidelines and criteria for incorporating social media into promotion. I understand several other academic institutions have taken similar approaches, and it is enlightening to learn that academic medicine is evolving to match the current state of medical education. I encourage anyone considering promotion to become familiar with your institution's criteria and consider how to leverage that with your work. I also encourage you not to discount the work you do on social media and consider how you can translate into more traditional checkboxes such as teaching, advocacy, and national reputation. Social media has fundamentally changed how the world receives information. Science, medical expertise, and fundamental facts are under constant assault. Thousands of medical professionals are engaged online and interacting in positive ways to help combat misinformation. It's time for this important work to be recognized and rewarded by academic institutions. Good luck, colleagues, and please feel free to reach out on social media if I can help in any way." David R. Stukus is a pediatric allergist and can be reached on Twitter @AllergyKidsDoc. He shares his story and discusses his KevinMD article, "How I used social media to get promoted to professor." (https://www.kevinmd.com/blog/2021/07/how-i-used-social-media-to-get-promoted-to-professor.html)

"Imagine this scenario: a busy mom struggles to balance work and parenting during the pandemic when suddenly her teenage son begins to anger. He gets out of control, screams threats, and kicks a hole in the wall. Neighbors call the police, who recommend the family go to the emergency department (ED). When the family arrives at the ED, the stresses of enforced isolation show on their exhausted, tearful faces. And unfortunately, in these extraordinary times, they're far from alone." Gregg Miller and Seth Thomas are emergency physicians. They share their stories and discuss their KevinMD article, "As the pandemic winds down, another crisis may be looming." (https://www.kevinmd.com/blog/2021/05/as-the-pandemic-winds-down-another-crisis-may-be-looming.html)

How does a physician become a thriller author? Where do his stories come from? How long does it take to go from idea to finished product? How did his experience as a physician influence his books? John Bishop is a retired orthopedic surgeon. He shares his story and discusses his transition from physician to medical thriller author.

"Feedback in the assessment stage is always useful for improving the design of a device — especially as it relates to improving long-term aspects, such as patient outcomes or cost-effectiveness. This kind of feedback can only come after a device has been on the market and in use for a while, and after doctors have had a chance to see the long-term effects that use of a product has for their patients — for example, in the recovery period following procedures. The involvement of doctors is of utmost importance in all stages of the development of any medical technology. Doctors should recognize the value their feedback holds for improving the technologies they will ultimately use. When it comes to understanding the problems in need of solutions, doctors should see themselves as partners in the development of medical technologies that will serve the ultimate goal — better care of and outcomes for patients." Lena Levin is a health care executive. She shares her story and discusses her KevinMD article, "Here's how doctors can support medtech innovation." (https://www.kevinmd.com/blog/2021/06/heres-how-doctors-can-support-medtech-innovation.html)

"As I approach this last stretch of residency, still entrenched in the rigors of training and the intensity of raising three young children under five years old, I am in a unique position of being able to reflect on the years and look ahead at what I want to build at the same time. It has been a lonely, emotional, seemingly endless journey at times. We mothers and doctors are barraged with messages that we do not belong here, straddling both roles. The work of dismantling these messages will be impossible for any single person, but cumulatively we can. And for future young women who are budding doctors and hopeful mothers, I hope their search for answers and advice results in them finding a large community of support and belongingness. And I will continue my part to advocate, to mentor, to fight this cycle of self-blame that our training system perpetuates, to continually question these messages of what priorities 'belong' in medicine, until finally, we expand this radius of belonging. Despite all that I have encountered, my spirit is not broken. I have work to do." Eunice Stallman is a psychiatry resident. She shares her story and discusses her KevinMD article, "So, are you committed to medicine — or your baby?" (https://www.kevinmd.com/blog/2021/07/so-are-you-committed-to-medicine-or-your-baby.html)

"While the COVID-19 pandemic exposed and normalized the need for increased mental and behavioral health services over the last year and a half, addressing mental health issues as a regular form of their wellness will persist beyond the pandemic. However, as the adoption of virtual technologies continues to open up more access to care, the potential to successfully meet the rising demand for these services is promising. The last 18 months have shown us that providers are making huge strides in helping patients from all walks of life facilitate their own care virtually. Even with the challenges we are still experiencing in the current pandemic, it's an exciting time for the evolution of mental health care." Sara Smucker Barnwell is a licensed clinical psychologist and clinical director of behavioral health, 98point6. She can be reached on LinkedIn and at her self-titled site, Sara Smucker Barnwell PhD. She shares her story and discusses her KevinMD article, "Debunking common virtual therapy myths and 4 tips for new patients." (https://www.kevinmd.com/blog/2021/08/debunking-common-virtual-therapy-myths-and-4-tips-for-new-patients.html)

"I'm smart enough to be a physician. As if being the smartest person in the room makes you the best physician in the room. Hint, it doesn't. Being a good physician is a culmination of knowledge, skills, and strengths that you, as an individual physician, uniquely brings to the field. It's taken some rewiring to pull shame out of my professional narrative. Shame is not there to serve you. It's there to diminish you and to prevent you from fully embracing and accepting all parts of yourself, flaws and all. It chokes off growth and evolution. It starts with subtly shifting the narrative in difficult situations from who you are to what you did. You can deal with what you did. You can learn and do differently next time. On that first call night of my formal medical career, I wasn't a mistake. I made a mistake." Tracy Asamoah is a child and adolescent psychiatrist and can be reached at Tracy Asamoah Coaching. She shares her story and discusses her KevinMD article, "How shame tried to hijack my medical training." (https://www.kevinmd.com/blog/2021/04/how-shame-tried-to-hijack-my-medical-training.html)

"In times of uncertainty, human behavior often makes people resort to less-than-stellar behaviors; unhealthy personal environments can become manifest as well. Often, these coincide with health care being used more frequently and the safe haven of health care delivery being sought. With all physicians being leaders, it is incumbent upon us to demonstrate a variety of professional qualities, and we must also draw on our own human qualities to succeed as well." Peter Angood is CEO and president, American Association for Physician Leadership, and author of All Physicians are Leaders: Reflections on Inspiring Change Together for Better Healthcare. He shares his story and discusses his KevinMD article, "Professionalism: We must also draw on our own human qualities to succeed." (https://www.kevinmd.com/blog/2021/03/professionalism-we-must-also-draw-on-our-own-human-qualities-to-succeed.html)

"I implore you — even if it's difficult — if you don't like your doctor, take the time and find a new one! How do you do that? Check your insurance for who they cover, and then ask your friends who they see and like. Google the physician. Google the practice. Google the hospital. Put as much effort into this as you would buying a car. This person needs to be reliable, safe, up-to-date and needs to make sense for you. Let's all make 2021 the year we take better care of ourselves. You deserve excellent care and goodness of fit." Caitlin Bass is a hospice and palliative care fellow. She shares her story and discusses her KevinMD article, "You deserve a doctor who's a good fit for you." (https://www.kevinmd.com/blog/2021/04/you-deserve-a-doctor-whos-a-good-fit-for-you.html)

"We focus on ensuring our solution works equally well for English speakers with any accent. We regularly hear from doctors how much of a difference this makes in their ability to deliver high-quality patient care. It's our hope that more health tech vendors will take a good look at what they've chosen to prioritize and how that may contribute to inequities within the system. The factors which inspired the American Medical Association to recognize racism as a public health threat demand that we all play our role in the multi-faceted structures that contribute to delivering equitable health care to all Americans." Matthew Ko is co-founder and COO, DeepScribe Inc., and can be reached on Facebook and Twitter @DeepScribeAI. He shares his story and discusses his KevinMD article, "Examining structural racism in health tech." (https://www.kevinmd.com/blog/2021/06/examining-structural-racism-in-health-tech.html)

"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)

"With this single word, mom had now completely altered her willingness to see the deep suffering of her child. This single word watered all of this child's five years of depression, crippling anxiety, history full of ACEs, and very significant struggle down to a simple, selfish, flippant choice. Furthermore, mom said that the nursing staff asked her about the medications. Mom informed me that: 'The nurse said maybe it's the Wellbutrin making her this way. Maybe she is suicidal because of this?' If the team had spent five minutes doing a real assessment of suicidal thinking, they would have learned her suicidal thoughts started years prior to her being on medications and have actually decreased in frequency since starting these meds in the hospital. I could see in mom's eyes. She now did not trust me when I spoke about the importance and urgency of treatment. Her child was now an inconvenience, my medication recommendations could be damaging, and our work together was now a waste of their time. Mom declined my recommendation to titrate up meds because of her concern about them now brought on by the nurse." Shivana Naidoo is a child psychiatrist. She shares her story and discusses her KevinMD article, "How one word may have harmed my patient." (https://www.kevinmd.com/blog/2021/06/how-one-word-may-have-harmed-my-patient.html)

"While we still lack a complete cause and effect model of Alzheimer's disease, there is no doubt that the etiology is multifaceted and nonlinear. This accounts for the fact that it takes an incredibly long time for Alzheimer's disease to develop. I mention this because one of the major problems with FDA approval has always been that it insists on utilizing the same framework and methodology of approving drugs designed to treat long-term diseases as it would with short-term diseases." Robert Trent is a graduate student who blogs at Medaphysics. He shares his story and discusses his KevinMD article, "Does the FDA approval of aducanumab mark the return of science-based medicine?" (https://www.kevinmd.com/blog/2021/07/does-the-fda-approval-of-aducanumab-mark-the-return-of-science-based-medicine.html)

"Dehumanizing patients can lead to indifference in physicians. It is a privilege to be trusted to take care of every patient we encounter, yet we can lose sight of this and begin to see our patients as a burden, or as units of work, rather than as individuals. When individual patients cease to matter, we cease to care. This is the precipice of burnout and invites mistakes and poor behavior, such as cutting corners or pushing the envelope by exposing patients to excessive risks. Often, physicians hold themselves to unachievable standards of perfection. No surgery is ever perfect, yet we expect perfection from ourselves and from our colleagues. Partly the result of training, these unrealistic standards also interfere with emotional connection or empathy. Complications are an inevitable part of the work we do, yet physicians often lack self-compassion. Self-compassion is a crucial component of emotional flexibility; unrelenting self-criticism does not promote learning or modification of maladaptive behaviors." Joseph D. Stern is a neurosurgeon and author of Grief Connects Us: A Neurosurgeon's Lessons on Love, Loss, and Compassion. He shares his story and discusses his KevinMD article, "Emotional agility is an essential element for patients and practitioners." (https://www.kevinmd.com/blog/2021/06/emotional-agility-is-an-essential-element-for-patients-and-practitioners.html)

"Toward the end of my clinical career, I didn't feel like I had control over much at all. The patient safety issues loomed large. We used ridiculous workarounds for broken processes. The constant vigilance to provide excellent care in a suboptimal environment was exhausting. I didn't see anything I could change. Based on my work with physicians as a coach, I think that the sense of powerlessness and being a "cog in a wheel" is now at an all-time high. While on an uninspiring stretch of road on a recent family trip, a realization came to me: There are many, many system issues over which physicians have little control. But physicians do have control over three things: How they lead in both formal and informal leadership roles How effectively they advocate for change Who they show up as every day" Diane W. Shannon is an internal medicine physician and physician coach and can be reached at her self-titled site, Diane W. Shannon. She shares her story and discusses her KevinMD article, "The sense of powerlessness and being a cog in a wheel is now at an all-time high." (https://www.kevinmd.com/blog/2021/06/the-sense-of-powerlessness-and-being-a-cog-in-a-wheel-is-now-at-an-all-time-high.html)

"Physicians have had a rough century, so far. In addition to battling COVID-19, doctors have spent the past two decades fighting the health care industry's fiercest players and losing, badly. Power in the industry now belongs to health insurance companies, major drugmakers, and hospital tycoons. Physicians feel beaten up, burned out, and abused by a system so overrun with regulations that clinicians now spend more time filling out paperwork than helping patients. Doctors long for the last century. Back then, they were paid well, revered by everyone, and largely left alone to practice as they please. As the war against COVID-19 winds down, doctors believe now is the time to demand a return to the glory days when physicians ruled medicine. To get there, doctors want more money, respect, and autonomy. They'll get none of that because our nation can't afford to give it to them." Robert Pearl is a plastic surgeon and author of Uncaring: How the Culture of Medicine Kills Doctors and Patients. He can be reached on Twitter @RobertPearlMD. He shares his story and discusses his KevinMD article, "Doctors and the 5 stages of grief." (https://www.kevinmd.com/blog/2021/07/doctors-and-the-5-stages-of-grief.html)

"Maybe it's a testament to a hardy relationship that there was no resulting argument. Without thinking, I blurted out, 'You are so sexist!' I could immediately tell by my husband's face, his upper eyelids and eyebrows lifted a bit, his mouth freeze-framed in a small 'o' — my exclamation surprised and insulted him. Maybe it was a completely unfair assessment; after all, he was standing at the sink, his hands covered in soap, washing the dinner dishes. Can you be sexist and clean up after a meal? Can you be sexist and love your spouse? Can you be sexist and a female MD?" Christine J. Ko is a dermatopathologist. She shares her story and discusses her KevinMD article, "Confession from a female doctor: I am sexist." (https://www.kevinmd.com/blog/2021/06/confession-from-a-female-doctor-i-am-sexist.html)

"Suffering something similar in my career, I know the detrimental impact of not having a voice or being heard in the medical community. Medical professionals do not want to appear weak, so they continue until something breaks. As a pain physician, I understand where the frontline health care workers are coming from. The intense pain and suffering that they are experiencing. I want to help those that feel this pain before it becomes too much. In my writings, I reveal my own personal journey from burnt out to balanced life in medicine and the advice that helped me. I hope it will help you too. You are not alone." Olivia Ong is a pain and rehabilitation medicine physician in Australia. She shares her story and discusses her KevinMD article, "The unspoken pandemic in frontline health care workers." (https://www.kevinmd.com/blog/2021/06/the-unspoken-pandemic-in-frontline-health-care-workers.html)

"Extensive media coverage of the emotional and death tolls that COVID-19 inflicted on nursing homes has intensified concern for preserving the humanity of an often-overlooked population. There is an opportunity to re-examine the policies and practices that shape the nursing home experience and to add quality metrics that capture the aspects of life and community that matter most to residents and their families." Carol Podgorski is an associate professor of psychiatry. She shares her story and discusses her KevinMD article, "We need to re-examine quality-of-life metrics in nursing homes." (https://www.kevinmd.com/blog/2021/06/we-need-to-re-examine-quality-of-life-metrics-in-nursing-homes.html)

"Looking to other countries that provide universal coverage to see what works and what would fit well for the U.S. is an option. Countries like France, Australia, and England provide universal coverage and rank their health care systems very highly, and are culturally and socioeconomically similar to the U.S. Whatever health care direction the country moves toward, it is essential to prioritize universal coverage. Otherwise, Americans will eventually end up paying for inefficient, expensive services in the form of higher premiums and taxes, while millions of Americans will remain uninsured, without access to health care or life-saving medications. Many, like my friend and patient, will die. That is too high a cost to pay." Payman Sattar is a cardiologist. He shares his story and discusses his KevinMD article, "Why it is essential to prioritize universal coverage." (https://www.kevinmd.com/blog/2021/06/why-it-is-essential-to-prioritize-universal-coverage.html)

"Like many scary health scenarios where patients seek some modicum of influence, the COVID-19 pandemic has led to patient demand for 'immune-boosting' dietary supplements. Toilet paper wasn't the only essential item being limited by stores; bottles of zinc and vitamin C flew off the shelves as consumers stocked up. The role of vitamin D in COVID-19 has been conflated and deflated depending on the study-du-jour. And of the eight 'drugs' in President Trump's top-of-the line treatment, three of them were natural products. The medical professional has, for the most part, dismissed vitamins as nothing more than 'expensive pee.' But as an integrative medicine physician examining the data, I urge my colleagues to take a more thoughtful approach to supplement recommendations and consider whether unconscious biases are influencing how you counsel patients." Melinda Ring is an integrative medicine physician. She shares her story and discusses her KevinMD article, "6 unconscious biases against vitamins and supplements." (https://www.kevinmd.com/blog/2021/01/6-unconscious-biases-against-vitamins-and-supplements.html)

"Remember, board certification is supposed to be an option and not a requirement. Unfortunately, finding and keeping your dream job if you're not board certified will add unwanted stress for you and your family. And in case you're wondering, I don't work for or have anything to gain from informing you about any other board. I want you to know that you have other valid options for taking your boards, regardless of what you're made to believe during residency. So at this point, you may be asking yourself, why hasn't an article like this ever been written before? Well, the answer is quite simple: It's called monopoly." Emmanuel K. Konstantakos is an orthopedic surgeon. Jeff Morris is chief executive officer, American Board of Physician Specialties. They share their stories and discuss the KevinMD article, "You have options when it comes to board certification." (https://www.kevinmd.com/blog/2020/11/you-have-options-when-it-comes-to-board-certification.html)

"Visit a nursing home and talk with some of the residents. They are not only moms and dads, but also retired teachers, first responders, former athletes, government employees, and soldiers—the basis of our country's past lives within these walls. Older adults should be honored with the dignity they deserve. As we again open as a society after this pandemic, make that commitment and visit a nursing home. Just make sure after you enter, the door doesn't lock behind you." Gene Uzawa Dorio is an internal medicine physician who blogs at SCV Physician Report. He shares his story and discusses his KevinMD article, "The nursing home crucible." (https://www.kevinmd.com/blog/2021/07/the-nursing-home-crucible.html)

"COVID-19 has changed nearly every aspect of society as we know it, and doctors in hospitals across America are at the forefront of those changes. As a pediatric infectious diseases doctor who also writes curriculum to help the next generation of doctors prepare for their medical exams, I've seen firsthand how this current pandemic is changing our roles with patients, shifting what families and communities expect from us, and expediting advances in training and information sharing across the field. While my work at a children's hospital is obviously focused on children and adolescents, the shifts I'm observing and the lessons I've learned impact doctors in all areas of practice who want to provide exceptional care to their communities." Nicholas Rister is a pediatric infectious disease physician. He shares his story and discusses his KevinMD article, "3 lessons I've learned as a doctor during the pandemic." (https://www.kevinmd.com/blog/2021/04/3-lessons-ive-learned-as-a-doctor-during-the-pandemic.html)

"As a family physician, guest lecturer at a local medical school, and creator of a pre-med curriculum for young learners, I'm often asked by parents how to support their child who wants to be a doctor. The most important point to remember is that you don't need to have any science background or be a professional of any sort to support your child. We all want to help our children follow their dreams! Most parents know as little about supporting a budding physician as I do about how to help my son, who wants to dance professionally. That's OK! I do the same thing as you: I look for answers online. And I'm here to give you some ideas. If you know anything about dancing classical ballet professionally, you're welcome to help me in return! So here is the advice I give parents who want to do their best for their child who wants to be a doctor." Robin Dickinson is a family physician and creator, Dr. Robin's School. She shares her story and discusses her KevinMD article, "My child wants to be a doctor." (https://www.kevinmd.com/blog/2021/05/my-child-wants-to-be-a-doctor.html)

"When a colleague in health care mentioned hesitation to get the COVID-19 vaccine in two separate instances, I was shocked and dismayed. If we recommend vaccination to our patients, how can we not take the same precautions for ourselves? With COVID-19 especially, anyone working in health care is exposed to many people and should be especially motivated to get vaccinated. As cut-and-dry as this issue seems to me, I do remember similar issues with encouraging the flu vaccine and even mammograms among health care workers. We need to remember what worked in those instances and use the same tactics to improve vaccination rates among our colleagues." Dava Gerald is a physician surveyor, The Joint Commission. She shares her story and discusses her KevinMD article, "4 steps to convincing health care colleagues to get vaccinated." (https://www.kevinmd.com/blog/2021/05/4-steps-to-convincing-health-care-colleagues-to-get-vaccinated.html)

"Our nation is at a crossroads, but one thing is clear – the health of our country depends on the health of all individuals in it, regardless of income, gender, or race. ACPM is committed to doing our part to promote and advance health and safety for all populations. On a community level, there are several options that can be taken to maintain support. As preventive medicine specialists, I call on all my colleagues, more than 10,000 across the country, to continue to bridge the gap by encouraging policymakers to strive to eradicate structural racism and inequalities in our cities and states." Stephanie Zaza is a preventive medicine physician. She shares her story and discusses her KevinMD article, "Addressing racial disparities in health begins upstream with racial equity in society." (https://www.kevinmd.com/blog/2021/05/addressing-racial-disparities-in-health-begins-upstream-with-racial-equity-in-society.html)

"I think back to the first time I ever brought Natalie to an emergency room. It was my fault. It was an odd accident. I had lifted her out of her car seat, grabbing my purse and a bag of groceries at the same time while turning and closing the car door and in doing this I also closed Natalie's foot in the door. I didn't know that I had done it until I pulled away and couldn't go any further because she was caught. I actually had to open the door with the handle to release her foot. For me, it was horrific. For Natalie, less so, because while she fussed, she wasn't nearly as hysterical as I was. I immediately put her back in the car seat and headed to the hospital. All my arrivals at the emergency room are frantic, and this one was as well. But I guess that's common. Which is why they have to weed people out according to severity and even have signs explaining that this is not a first-come first-serve establishment. After I explained the reason we were there and frantically waving Natalie's chubby little foot at everyone who would look or listen, I was escorted back pretty quickly." Christine Naman is a writer and author of About Natalie: A Daughter's Addiction. A Mother's Love. Finding Their Way Back to Each Other. She shares her story and discusses her KevinMD article, "A daughter's addiction. A mother's love." (https://www.kevinmd.com/blog/2021/05/a-daughters-addiction-a-mothers-love.html)

"If you don't ask for something you want, then you have already accepted the answer of no. Go ahead and ask for what you want and need. You may not get it this time but ask again in the future. We will change health care eventually. In the meantime, you can change your thoughts today. Reach out if I can help. Reach out to many resources on the internet, Facebook, your community. You are not alone." Dawn Sears is a gastroenterologist and can be reached on Twitter @GutGirlMD, YouTube, and at GutGirlMD Consulting. She shares her story and discusses her KevinMD article, "10 replaceable thoughts (and 15 books) to help you survive burnout." (https://www.kevinmd.com/blog/2021/05/10-replaceable-thoughts-and-15-books-to-help-you-survive-burnout.html)

"A few weeks ago, a white physical therapy colleague of mine unconsciously committed a racial microaggression. She was interviewing her patient, a middle-aged Black male, about his living environment. She asked him if his daughter was at home with him all day or if she went to work. He asked her why she would even assume that his daughter did not work. The patient was so upset that a third party intervened to help the therapist finish the assessment. How did this incident impact his care? How did their dismantled communication impair information exchange and shared decision-making? How might this encounter affect his physical therapy outcomes?" Jerenda Bond is a physical therapist and postgraduate student. She can be reached on Twitter @jerendabond. She shares her story and discusses her KevinMD article, "The white guys vs. the janitors: How racial microaggressions lead to poor care outcomes." (https://www.kevinmd.com/blog/2021/06/the-white-guys-vs-the-janitors-how-racial-microaggressions-lead-to-poor-care-outcomes.html)

"When harnessing easy-to-use technology to provide answers to frequently asked questions such as the ER wait time, or the ER's address, for instance, patients and their families are properly informed, and clinical staff are given the time to focus on their most important job: caring for patients. The use of a secure, encrypted, and HIPAA-compliant application allows registration staff to complete their clerical work, patients can obtain the answers they need through an easy-to-use app on their phone, and triage nurses can efficiently and quickly conduct their work without interruption—it's a win, win for all. Technology helps patients feel connected to their health care journeys. Prioritizing patient-centric care with AI-tools enables a better experience for patients, clinicians, and care teams. Focusing on improving a patient's journey starting from the ER creates a supported and more manageable experience for all involved, not to mention increasing patient loyalty and hospital satisfaction rates." Justin Schrager is an emergency physician. He shares his story and discusses his KevinMD article, "3 ways technology in the ER boosts the patient experience." (https://www.kevinmd.com/blog/2021/04/3-ways-technology-in-the-er-boosts-the-patient-experience.html)

"In the Spring semester of my final year as a football player, my college team faced necessary coaching, staff, and player position changes. At this point in my college career, we had yet to have a winning season. These changes were made to shift our program's culture and give us new life going into the upcoming Fall season. My new position coach, our team's former linebacker coach, greeted us all in the defensive line room during our very first Spring position meeting with a stark message that, to this day, has changed my way of thinking about the hardships, especially now as a medical student during the COVID-19 pandemic. During his message, he put up the Japanese symbol kiki (危機) on the overhead screen and questioned if any of us in the meeting room knew its meaning. As my teammates and I looked at each other thinking, what the heck is this guy up to … our coach informed us the symbol is written in kanji and translates to 'crisis.' (We thought he was only foreshadowing the imminent torture we were about to face that Spring as we prepared to change the trajectory of our program.)" Casey Paul Schukow is a medical student. He shares his story and discusses his KevinMD article, "In crisis, danger and opportunity are present." (https://www.kevinmd.com/blog/2021/06/in-crisis-danger-and-opportunity-are-present.html)

"As a former hospitalist who transitioned out of clinical practice in 2015, I've been deep in the physician wellness space for years. Far and away, the most effective way I've supported health care professionals during this time (often in my role as a founding board member of the mindful health care collective) is with a tool called tapping, otherwise known as the emotional freedom technique or EFT. Tapping is a powerful, evidence-based stress-reduction and healing technique that uses the same meridians as acupuncture (without the needles). By tapping on these meridians, you can induce profound changes in the brain and nervous system, which send calming signals to the stress center of the brain (the amygdala and hippocampus) in the face of stress. The results are astonishing." Jill Wener is an internal medicine physician and can be reached at her self-titled site, Jill Wener, MD. She shares her story and discusses her KevinMD article, "Tap — yes, tap — to relieve stress." (https://www.kevinmd.com/blog/2021/06/tap-yes-tap-to-relieve-stress.html)

"The primary benefits for mobile care units are the fact that they decrease patient travel times by arriving at their residences and ensuring that appointments are never missed. It also relieves the stress of finding transportation for dialysis patients, outright eliminating the need for the CMS to find alternative transport methods for patients. By utilizing mobile care units alongside health IT solutions for preventive care services, the CMS can finally do the impossible and establish a basic health care standard for rural citizens." Thanh Tran is a health IT executive. He shares his story and discusses the KevinMD article, "Will U.S. health care match Native Americans' treatment of chronic kidney disease?" (https://www.kevinmd.com/blog/2021/05/will-u-s-health-care-match-native-americans-treatment-of-chronic-kidney-disease.html)

"While physicians provide a vital service to the U.S., they often have blind spots when it comes to maintaining their own financial health. Many in the medical field believe that financial planning is as simple as having an IRA account and that estate planning will be taken care of by a will. Unfortunately, particularly for those in this profession, financial planning is more important than ever, and President Biden's proposed tax changes could have a profound effect on physicians' financial planning in particular. Working with a fiduciary financial advisor to understand how the new laws affect physicians and implementing strategies that can lessen the impact is key to navigating these changes." Syed Nishat and Aadil Zaman are partners, Wall Street Alliance Group. They are regularly quoted and interviewed in media outlets like Medical Economics, Forbes, US News, Bloomberg, and Yahoo Finance. This special episode is the audio version of the webinar, "President Biden's tax proposal and its effects on estate and income tax planning for physicians," sponsored by Wall Street Alliance Group. (http://www.wallstreetag.com/) Watch the full webinar. (https://www.kevinmd.com/blog/2021/07/president-bidens-tax-proposal-and-its-effects-on-estate-and-income-tax-planning-for-physicians.html)

"President Joe Biden recently signaled that a multi-trillion-dollar spending plan for our country should be paid for by the rich corporations and wealthy individual Americans who make over $400,000. Doctors fit the latter category and should tune in. Beyond the government, the unique qualities of doctors make us a target for many who want to access our high income and our business revenue. Our passivity to these poachers places us at great risk because they recognize that we lack the time and proficiency to avoid them. Add our financial illiteracy to this, and you have a recipe for stakeholders reaching into our paycheck every pay period and inconspicuously taking their share from us. Let's take a look at the stakeholders who are targeting us." Tod Stillson is a rural family physician who does surgical obstetrics and teaches residents and medical students. He is also founder, SimpliMD, Doctor Incorporated, and The Employed Physician's World Facebook group. He is also the author of You Are a Target Strategies For Doctors to Keep More of Their Money. He shares his story and discusses his KevinMD article, "Doctors beware: There's a $400,000 target on your back." (https://www.kevinmd.com/blog/2021/06/doctors-beware-theres-a-400000-target-on-your-back.html)