The Podcast by KevinMD

"What if I had access to real solutions? What if I had resources to provide to a person to help them overcome their problem? As a primary care provider with over 20 years of experience, I know viscerally that I will never "fix" anyone. I can teach, I can guide, I can comfort; but I'm never going to fix a single person. Still, I wish I had more to offer. In my current iteration, I take care of people experiencing homelessness. Having spent much of my career taking care of people with homes, I'm currently grant-funded to care for people experiencing homelessness. The problems, I find, are not fundamentally different, but the phenotype, the manifestation of common, universal problems, such as social isolation, poor nutrition, insecurity, addiction, comes with sharper edges." Nancy Connolly is an internal medicine physician. She shares her story and discusses her KevinMD article, "What if this physician had access to real solutions?" (https://www.kevinmd.com/blog/2021/05/what-if-this-physician-had-access-to-real-solutions.html)

"I think doctors are just wired that way. We are productive. We get things done. It is expected. We are supposed to do more, do it all, and be all the things to all the people. We come to a point where we try to satisfy this, and then we cannot do enough for ourselves. We cannot rest. We must keep trying to check things off the list to get things done. And it is overwhelming. It does lead to burnout. I am still a work in progress. I am writing this on a work night because it is burning in my brain, wanting to come out. Perhaps I should be doing nothing, resting for a full day. But if I do that, I will feel guilty that I have wasted this time when I could have been putting my thoughts down on paper. The mind is always going. This is me, but I think it applies to many other physicians. Look at your habits and see if you have some of my same tendencies. If you do, let's start talking about how to reverse this tide of overwhelm to create some time for yourself when you are doing nothing and not regretting it." Marion McCrary is an internal medicine physician and can be reached at Marion McCrary Wellness. She shares her story and discusses her KevinMD article, "Why doctors can't rest." (https://www.kevinmd.com/blog/2021/05/why-doctors-cant-rest.html)

"It's rare for anyone to try and tally the precise cost of unnecessary care. But when they do, the estimates are staggering. The Washington Health Alliance, a nonprofit dedicated to making care safe and affordable, analyzed insurance claims from 1.3 million patients who received one of 47 tests or services that are considered overused or unnecessary. What they found should make patients and doctors rethink that next referral. In a single year, more than 600,000 patients underwent a treatment they didn't need, costing an estimated $282 million. More than a third of the money spent on the tests went to unnecessary care, their study found. Unnecessary medical care has 'become so normalized that I don't think people in the system see it,' Dr. Vikas Saini told me. Saini is president of The Lown Institute, a Boston think tank focused on making health care more effective, affordable and just. Lown researchers have shown how overtreatment happens across the spectrum of medical care. Doctors may push for Caesarean sections for their own convenience, not so moms and babies can be healthy. Breast cancer, prostate cancer and thyroid cancer get over-diagnosed, leading to harmful and costly treatment. Around a third of colonoscopies are unnecessary, research has shown. That's not just wasting our money. It's also putting us at risk of harm." Marshall Allen is a journalist and author of Never Pay the First Bill: And Other Ways to Fight the Health Care System and Win. He shares his story and discusses his KevinMD article, "How to avoid treatment you don't need." (https://www.kevinmd.com/blog/2021/06/how-to-avoid-treatment-you-dont-need.html)

"A sad truth is this: Most everywhere, health care is a low-margin industry that lacks resources to invest in leadership development. Although our business's central, sacred function is caring for our fellow human beings, many who move up in the health care hierarchy do so without possessing the so-called 'soft skills' that facilitate one's ability to lead groups and motivate others. 'Soft skills,' a military term that arose in the 1960s, refers to the interpersonal savvy that it takes for organizational stakeholders to succeed. Soft skills are about more than the weaponry and the machinery; they're about the people. Whether it's academic medicine, corporate medicine, or public sector medicine, we are simply not taking enough time to focus our leaders' attention on the interpersonal dimension of their work. Excellent training and supervision enhance essential managerial skills, but most health care organizations choose not to invest in that which is 'soft.'" Steve Adelman is a psychiatrist and can be reached at his self-titled site, AdelMED. He shares his story and discusses his KevinMD article, "The joylessness of harried medical leaders." (https://www.kevinmd.com/blog/2021/07/the-joylessness-of-harried-medical-leaders.html)

"During my medical school clerkships, an attending recognized a truth within me that I'd hidden for many years. Just a few hours into my pediatrics rotation, the attending asked me, 'You had a rough childhood, didn't you?' I was astonished. How had he known? I asked him, needing to know what gave away my most deeply kept secret. And he said something that surprised me. 'You don't react. When patients tell you about risky behaviors, you treat them like regular people and just keep talking to them. You don't look shocked by anything they say.' I accepted his insight and started to notice how different my interactions with patients were. That secret part of me led to a deep, intuitive understanding of patients who were often unseen and unheard. Because for much of my early life, I was not seen or heard by people who I desperately needed to have protect me. I spent several years as a homeless teen in Hollywood before my life finally stabilized, but the scars remained." Sheryl Recinos is a hospitalist and author of Hindsight: Coming of age on the streets of Hollywood. She shares her story and discusses her KevinMD article, "The story of how a homeless teen became a physician." (https://www.kevinmd.com/blog/2019/05/the-story-of-how-a-homeless-teen-became-a-physician.html)

"On a recent call with a small health organization in rural Uganda, I asked the director about the C-section rate in the community. In some private maternity centers, this procedure is performed far more often than one might expect. I've learned that while this practice may be financially motivated, the extra fees also pay for staff and encourage doctors to maintain practices in these remote areas. This, in turn, keeps more pre- and post-natal care in those communities, including family planning and HIV care. For almost every 'best practice' cost in global health care, there is a benefit. One of the fascinating aspects of my work is to discern those rationales." Ann Messer is a family physician. She shares her story and discusses her KevinMD article, "Don't push harsh health care realities under the rug." (https://www.kevinmd.com/blog/2021/04/dont-push-harsh-health-care-realities-under-the-rug.html)

"Excited by the promise our research holds for PKD patients, we have been packaging a variety of PKD drugs into our nanoparticles, testing their ability to act as a courier service for renal drug delivery. We've been testing this process on drugs that show therapeutic benefits in animal models but are shadowed by off-target side effects. Because our nanoparticles can carry more than one drug — and even gene therapy — we can help develop and deploy a therapeutic combination that may soon offer patients more benefit than any single drug. Because the biology of ADPKD is not entirely understood, drug discovery has been slow. As we are seeing with the dramatic success of the COVID-19 vaccines, however, nanomedicine can catalyze research efforts. Nanoparticles offer a promising new way to deliver medicine, making it simultaneously less toxic and more effective." Eun Ji Chung is a biomedical engineer. She shares her story and discusses her KevinMD article, "Using nano 'couriers' to deliver PKD drugs to just the right address." (https://www.kevinmd.com/blog/2021/05/using-nano-couriers-to-deliver-pkd-drugs-to-just-the-right-address.html)

"Hypertensive disorders with onset during pregnancies are among the leading causes of maternal and infant mortality and morbidity in the U.S. and can have far-reaching consequences for the long-term health of the mother and child. In Dr. Jerome Adams' recent Call to Action to recognize and address hypertension control as a public health priority, the former Surgeon General referenced the success of health care providers who have promoted shared management of hypertension through self-measured blood pressure monitoring (SMBP), empowering patients through blood pressure (BP) management and goal setting. It's not an unusual recommendation— SMBP is well accepted in primary care for managing hypertension — but its use in pregnancy has not been routine. That's beginning to change for several reasons." Lauren Demosthenes is an obstetrician-gynecologist. She shares her story and discusses her KevinMD article, "Hypertension is killing pregnant mothers. Blood pressure monitoring can help." (https://www.kevinmd.com/blog/2021/03/hypertension-is-killing-pregnant-mothers-blood-pressure-monitoring-can-help.html)

"As working women, we have an opportunity to be an example of living with passion and priorities, of working hard, of staying committed, not necessarily to work itself but to the priorities we set around our work and our personal lives. When we work and parent simultaneously, we have a chance to teach our kids resilience — letting our kids see that even if they struggle with something they can handle it and get stronger from it — and to embrace a village mentality, not in a better way than stay-at-home moms can but in a very different way. Above all, we have the unique pleasure of encouraging our own kids to find real balance and real joy as they live their lives and as they go on to work and parent the next generation." Whitney Casares is a pediatrician and author of The Working Mom Blueprint: Winning at Parenting Without Losing Yourself. She shares her story and discusses her KevinMD article, "Winning at parenting without losing yourself." (https://www.kevinmd.com/blog/2021/05/winning-at-parenting-without-losing-yourself.html) This episode is sponsored by the Substance Use Disorder Treatment and Recovery Loan Repayment Program. Would you like to help communities recover from the opioid epidemic? If you said yes, and you are a behavioral health professional or paraprofessional, then I have great news for you. Receive up to $250,000 in student loan repayment in exchange for service in a community disproportionately affected by the opioid crisis. Learn more and apply to join STAR LRP, the Substance Use Disorder Treatment and Recovery Loan Repayment Program (https://bhw.hrsa.gov/funding/apply-loan-repayment/star-lrp). Applications close on July 22.

"Doctors undergo mandatory training sessions in medical school to prepare for unexpected medical emergencies. Health care workers are mandated reporters who have to undergo specific training for the purpose of identifying child and elder abuse or neglect. Bystander intervention should also be on that continuum of responsibility and training. I urge bystander intervention training to be widely adopted by health care workers, professional workplaces, and the broader community to end everyday harassment and racism, for microaggressions and violence, alike. In medical simulations, health care professionals are always taught to ask two questions first that can be useful to keep in mind in any situation: 1) Is the scene safe, and 2) Should I call for help?" Michelle Lee is a resident physician and can be reached on Twitter @MichelleLeeMD. She shares her story and discusses her KevinMD article, "Bystander intervention training can save a life." (https://www.kevinmd.com/blog/2021/05/bystander-intervention-training-can-save-a-life.html) This episode is sponsored by the Substance Use Disorder Treatment and Recovery Loan Repayment Program. Would you like to help communities recover from the opioid epidemic? If you said yes, and you are a behavioral health professional or paraprofessional, then I have great news for you. Receive up to $250,000 in student loan repayment in exchange for service in a community disproportionately affected by the opioid crisis. Learn more and apply to join STAR LRP, the Substance Use Disorder Treatment and Recovery Loan Repayment Program (https://bhw.hrsa.gov/funding/apply-loan-repayment/star-lrp). Applications close on July 22. This episode is sponsored by the Substance Use Disorder Treatment and Recovery Loan Repayment Program. Would you like to help communities recover from the opioid epidemic? If you said yes, and you are a behavioral health professional or paraprofessional, then I have great news for you. Receive up to $250,000 in student loan repayment in exchange for service in a community disproportionately affected by the opioid crisis. Learn more and apply to join STAR LRP, the Substance Use Disorder Treatment and Recovery Loan Repayment Program. Applications close on July 22.

"The FDA recommended an updated boxed warning and standardization of product labels across the drug class. They recommended judicious prescribing and a gradual taper to mitigate withdrawal reactions. While I am optimistic about these changes, the updated warning doesn't tell the whole story. After reviewing the newly updated Xanax Medication Guide, I have some concerns." Christy Huff is a cardiologist and co-director, Benzodiazepine Information Coalition. She can be reached on Twitter @christyhuffMD. She shares her story and discusses her KevinMD article, "The updated benzodiazepine boxed warning: What you need to know." (https://www.kevinmd.com/blog/2021/03/the-updated-benzodiazepine-boxed-warning-what-you-need-to-know.html) This episode is sponsored by the Substance Use Disorder Treatment and Recovery Loan Repayment Program. Would you like to help communities recover from the opioid epidemic? If you said yes, and you are a behavioral health professional or paraprofessional, then I have great news for you. Receive up to $250,000 in student loan repayment in exchange for service in a community disproportionately affected by the opioid crisis. Learn more and apply to join STAR LRP, the Substance Use Disorder Treatment and Recovery Loan Repayment Program (https://bhw.hrsa.gov/funding/apply-loan-repayment/star-lrp). Applications close on July 22.

"This is a message to any medical doctor who is unhappy with their career. The individual reasons for this dissatisfaction will vary. Whatever the issue, it is important to ask, 'Is the problem correctable?' If yes, then you must act and secure your happiness. If no, you must consider other options. One uncomplicated choice is to stay in medicine and practice somewhere else. However, you may also be unhappy in your career because you don't like medicine. Maybe you are burnt out or no longer feel challenged. Then again, maybe you just don't want to do it anymore or explain (for the 7,000th time) why a patient doesn't need antibiotics. This means your options are now down to pursuing a nonclinical medical career or leaving medicine altogether. Regardless, if you don't like clinical medicine, then why are you still doing it? Perhaps reality is teaching you a lesson: that once you're in medicine, it's hard to leave it. This begs the question: Why is medicine so hard to quit?" Elijah Sadaphal is an emergency physician. He shares his story and discusses his KevinMD article, "Why quitting medicine is hard." (https://www.kevinmd.com/blog/2021/04/why-quitting-medicine-is-hard.html) This episode is sponsored by the Substance Use Disorder Treatment and Recovery Loan Repayment Program. Would you like to help communities recover from the opioid epidemic? If you said yes, and you are a behavioral health professional or paraprofessional, then I have great news for you. Receive up to $250,000 in student loan repayment in exchange for service in a community disproportionately affected by the opioid crisis. Learn more and apply to join STAR LRP, the Substance Use Disorder Treatment and Recovery Loan Repayment Program (https://bhw.hrsa.gov/funding/apply-loan-repayment/star-lrp). Applications close on July 22.

"American medicine is facing an identity crisis. The COVID-19 pandemic brought renewed attention to socioeconomic health disparities and turned up the heat on the question of whether health care is a right or a privilege. The financial strain on hospitals resulting from the temporary postponement of scheduled surgeries exposed a vulnerability caused by an inherently flawed payment system. The answer to the right versus privilege question has much more significant implications than the resolution of a philosophical debate. It determines which economic model — that of a public good, a private good, or a common good — makes the most sense for the delivery of medical services. For health care to be what we want it to be, broadly accessible, with no socioeconomic disparities, and long-term affordability, it must eventually be recognized as a common good, with all of the economic implications that come with such a recognition." Tom Robertson is a health care economist. He shares his story and discusses his KevinMD article, "Health care as an uncommon good." (https://www.kevinmd.com/blog/2021/04/health-care-as-an-uncommon-good.html)

"Before COVID-19, clinical research was a little-known part of health care. Despite this process being responsible for determining the safety and efficacy of all the drugs, medical devices, vaccines, and other medical therapies available, less than 5 percent of the U.S. population actually participates in clinical research. One reason why clinical research has little awareness and even lower participation is that, unlike other major industries, the pharmaceutical industry and many regulatory bodies never fully embraced technology to reduce the burdens of participation. We use our mobile devices to do our banking and place retail orders. Why can't we use similar technology in clinical research?" Kent Thoelke is a science executive. He shares his story and discusses his KevinMD article, "Accelerated by COVID-19, technology carves new pathways for everyone to access health care." (https://www.kevinmd.com/blog/2021/03/accelerated-by-covid-19-technology-carves-new-pathways-for-everyone-to-access-health-care.html)

"I have a form of genetic primary immunodeficiency and several heart issues, among other things. I know that I need to be far more vigilant than someone with a fully armed and operational immune system, so I try to take as much responsibility for that as I can. First tactic: Not going out at all. I've followed doctors' orders on this one and have only left my home for medical care since March 2020. Most medical appointments have been conducted online for the past year. More than a few conversations with my doctors have included some variation of the phrase "we'll schedule this when it's safer." But some, such as my infusions, imaging, and bloodwork, must be done in person. Second: I try to get the first appointment in the morning, no matter how early that might be. I've been scheduled for MRIs at 6:30 in the morning. Being there early usually means that there are fewer people in the facility. Third: I ask if there's an isolated place where I can wait. I'm not trying to cut the line. That needs to be understood. I'll wait as long as you need me to. 'Patient' is both a noun and an adjective. I just need to do that somewhere that is not a crowded waiting room. I have an immune deficiency, I pick up infections a bit more easily than some of your other patients, and we're in a pandemic." Denise Reich is a patient advocate. She shares her story and discusses her KevinMD article, "Medical facilities: Please keep your immune-deficient patients safe." (https://www.kevinmd.com/blog/2021/04/medical-facilities-please-keep-your-immune-deficient-patients-safe.html)

"For thousands of generations, parents, relatives, and the extended community raised and prepared children to become successful adults, to acquire knowledge, and strengthen the abilities needed to meet the challenges of their time. How did they do it? Until relatively recent times in human history there were no schools or organized institutions, nor were there self-help or parenting books. We believe the foundation of this process was accomplished by drawing upon seven important instincts that evolved over tens if not hundreds of thousands of years in ours and other hominid species. In some species instincts are fixed patterns of behavior leading to a certain outcome such as a bird building a nest for the first time or a salmon returning upriver to its birthplace to spawn. We believe that in our species instincts represent an intuitive way of thinking and/or acting that increase the chances of survival and success. In viewing instincts in this way we appreciate that knowing what to do and doing what you know are not synonymous and are very much dependent on experience. These instincts are more important than ever in preparing today's children for tomorrow's successes. Tenacity provides the power to build self-discipline and resilience. For these instincts to develop and flourish they require the nurturing and support of caring, knowledgeable adults. In short, it is our job to help children harness the power of their instincts." Robert B. Brooks is a psychologist and co-author of Tenacity in Children: Nurturing the Seven Instincts for Lifetime Success. He shares his story and discusses his KevinMD article, "Tenacity in children and the 7 instincts." (https://www.kevinmd.com/blog/2021/05/tenacity-in-children-and-the-7-instincts.html)

"When I was diagnosed as gene-positive for HD, just over ten years ago, there wasn't anything promising on the horizon in terms of a cure. It has only been since new clinical trials were announced in the past few years that I have allowed myself to feel a tiny bit of hope, that maybe there will be a treatment on time for me. How is it possible to be hopeful for a cure while still remaining realistic and preparing for my future with the disease? Even though I do not have any disease symptoms yet, genetic testing has completely changed my life. Living with the knowledge that my future includes HD is a huge challenge. It has only been with time that I have learned how to balance many opposing views. With the plethora of genetic testing available these days (even the mail-in kits), it is so important for people to consider the impacts such tests might have on their lives. Quite often, there are unforeseen consequences that one can struggle to come to terms with for years to come." Erin Paterson is a writer. She shares her story and discusses her KevinMD article, "A patient's perspective on genetic testing." (https://www.kevinmd.com/blog/2021/05/a-patients-perspective-on-genetic-testing.html)

"I've been semi-retired in clinical medicine for almost four years now. Initially, I found myself coaching burned out physicians: Helping them recover, finding careers they love, and even starting their own businesses outside the box. However, as I listened to my inner voice, I was led back to my healing roots, and that opened up a career opportunity I would have never imagined to have. Let me back up a bit. I'm a regular old family doc by training. Well, that's the way things began, anyway. I remember choosing the specialty the summer after the first year. I worked with a rural family doc who was a full spectrum doc. For those of you who are family medicine like me, you know what this means. He did everything! For me, that was fascinating. However, as you know, what we see as med students is often a sliver of the real world as it pertains to practice. As I progressed, I discovered integrative and functional medicine, and that is where my real love settled as a family physician. However, after seven years of having a private practice (even one where I set my own hours and ran my own ship) became less than fulfilling after a while. I felt like I had outgrown that purpose." Maiysha Clairborne is an integrative family physician and is the co-author of Conscious Anti-Racism: Tools for Self-Discovery, Accountability and Meaningful Change. She shares her story and discusses her KevinMD article, "How deep mindset work helped me find the courage to make my career transition." (https://www.kevinmd.com/blog/2021/04/how-deep-mindset-work-helped-me-find-the-courage-to-make-my-career-transition.html)

"This plea for help is on behalf of every hospital worker who has been on the front lines of the COVID-19 pandemic — from the environmental services staff and medical assistants who are often not recognized, to the social workers and chaplains who are surrounded by distress, to the physicians and nurses who continue to stand and receive the sick — we need more time off in the coming year. Some hospital workers will need to continue to be paid; others will just need permission and people to back-fill their roles until they return. If you are a business leader who makes logistical, technological, charitable, and financial decisions every day: I am asking for your time, financial wherewithal, personal connections, commitment, and expertise in strategic planning in order to give every front line COVID-19 hospital worker more time off in the next year than they can and will be allotted by their health systems. Consider using your unique talents to radically change how our country's health care system moves on from this crisis. Please help us. Help my friends and my colleagues. Help us do the thing we diligently, faithfully, and without hesitation tried to do for over half a million Americans this year. Help us survive." Kristin Adams Forner is an anesthesiologist and palliative medicine physician who blogs at Mending the Fractured Story. She shares her story and discusses her KevinMD article, "A plea for help from the front lines of the COVID-19 pandemic." (https://www.kevinmd.com/blog/2021/05/a-plea-for-help-from-the-front-lines-of-the-covid-19-pandemic.html) This episode is sponsored by the Substance Use Disorder Treatment and Recovery Loan Repayment Program. Would you like to help communities recover from the opioid epidemic? If you said yes, and you are a behavioral health professional or paraprofessional, then I have great news for you. Receive up to $250,000 in student loan repayment in exchange for service in a community disproportionately affected by the opioid crisis. Learn more and apply to join STAR LRP, the Substance Use Disorder Treatment and Recovery Loan Repayment Program (https://bhw.hrsa.gov/funding/apply-loan-repayment/star-lrp). Applications close on July 22, 2021.

"The right choice of words, at the right time, can lift a person out of despair and literally save a person's life, while an ill-chosen word, or worse, a purposely harsh one, can scar a person. The entire field of narrative medicine is formed around the principle of reviving empathy in doctors towards patients and their colleagues so that we keep the inner human alive in us as we treat the obstacles we are faced with daily. If you are a physician seeing a multitude of patients daily, try spending time with the patient and offer them a word or two to heal." Natasha Khalid is a physician in Pakistan. She shares her story and discusses her KevinMD article, "I'm a doctor who had COVID. Did I deserve this? Does anyone?" (https://www.kevinmd.com/blog/2021/05/im-a-doctor-who-had-covid-did-i-deserve-this-does-anyone.html)

"'That's great. You want to start a women in medicine program! How are you going to pay for it?' This is the most common question and potential barrier from colleagues, leaders, and those who understand the value of these programs. We found that our two-year Women Leaders in Medicine program improved burnout, retention, and engagement of the over 400 women physicians who participated. However, funding remained the chronic barrier to sustainability. I will introduce you to ten possible funding strategies to get your creative strategy-building blood pumping." 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 ways to pay for women in medicine programs." (https://www.kevinmd.com/blog/2021/04/10-ways-to-pay-for-women-in-medicine-program.html)

"We know the ER's revolving door will continue to spin for so many children and adolescents who seek help in the heat of their personal crisis. Some will need to stay in the hospital – to heal their bodies and minds and even fight for their lives. Some – the lucky ones – will be able to go home, but by no means are they out of danger. Their lives too are threatened, and they will need ongoing support from parents, family, friends, teachers, and mental health providers – who will likely care for them across a virtual platform. Human contact has been gravely compromised this past year, and we, as pediatric ER doctors, as members of our community, and as parents, are seeing the fallout in the children we care for." Rachel Kowalsky and Shari Platt are pediatric emergency physicians. They share their stories and discuss the KevinMD article, "Dying of loneliness: the COVID-19 epidemic in children and adolescents." (https://www.kevinmd.com/blog/2021/04/dying-of-loneliness-the-covid-19-epidemic-in-children-and-adolescents.html)

Listen to psychiatrist Emily Watters' work with the homeless population and how she got her start writing cartoons, educating patients using out-of-the-box communication strategies. Emily Watters is a psychiatrist and can be reached at The Cartoon Shrink. She shares her story and discusses her KevinMD articles, "Blood clots and the Johnson & Johnson vaccine: a comic explanation" (https://www.kevinmd.com/blog/2021/05/blood-clots-and-the-johnson-johnson-vaccine-a-comic-explanation.html) and "If the COVID vaccines don't make you sick, why do some people feel sick?" (https://www.kevinmd.com/blog/2021/03/if-the-covid-vaccines-dont-make-you-sick-why-do-some-people-feel-sick.html)

"For the folks who are either physicians or becoming care providers, I hope you choose to familiarize yourself with this odd yet common form of loss. I encourage you to respect a woman's right to decide at what point and to what degree her fetus and its life or loss has meaning to both her regardless of your views. I implore you to become familiar with laws, regulations, and general procedures surrounding fetal death and disposal of remains in the state(s) in which you choose to practice and how it may vary in pregnancy. Last, I hope this helps the women who yearn to know the personal experience of someone with VTS, as I did during my pregnancy." Nichole Cubbage is a biomedical researcher. She shares her story and discusses her KevinMD article, "Let's talk about vanishing twin syndrome." (https://www.kevinmd.com/blog/2021/04/lets-talk-about-vanishing-twin-syndrome.html)

"I often think about how I can make you see these things about yourself that others see. I think about the ways I can tell you that things will get better even though the darkest of days is upon you right now. But I know I can't make you see these things; no one can. I know these things may not be helpful to hear, irrelevant, noisy. So instead of trying to convince you, dear one, I'm going to be here for you. I'm going to listen to you. I'm going to advocate for you. I'm going to help pull you out of this depression. I'm going to help you live a valued life with chronic pain. I'm not going anywhere. Please, please stay here too." Melissa Geraghty is a psychologist and can be reached on Twitter @mindfuldrg. She shares her story and discusses her KevinMD article, "To the patient who wants to die: a psychologist's perspective." (https://www.kevinmd.com/blog/2021/04/to-the-patient-who-wants-to-die-a-psychologists-perspective.html)

"As a species, we have been an abject failure in dealing with a worldwide crisis. We politicize things for money, political reasons and some kind of weird power, even when it kills us in the process. We already have a World Health Organization (WHO). Would it be so difficult to staff it with the best scientists from every country, without any political pressure and follow their recommendation worldwide, without local bureaucratic interference? The first vaccine approved by the WHO — no prizes for guessing — mRNA Pfizer. Humans have a way of complicating life by breaking even common sense into silos guided by politics, power, hubris, and finance. We read history and shake our heads when we see some of the haunting tragedies of mankind. And yet, we continue making the same fundamental mistakes. To paraphrase, "The tragedies will continue; we just will have different entries and exits."" Dinesh Arab is a cardiologist. He shares his story and discusses his KevinMD article, "The vaccine rollout's tragic dance." (https://www.kevinmd.com/blog/2021/05/the-tragic-dance-of-the-vaccine-rollout.html)

"From a charting standpoint, the sins of commission easily outnumber the sins of omission. Our group's progress note template begins with a summary that eventually becomes the narrative for the discharge summary. Most of the time, most of the important stuff is in there. It's just obscured by what data scientists technically describe as 'oodles' of no-longer-relevant details. Like a package of cheap ramen, the single cube of chicken meat is in there. Your job is to find it. Why do we do this to ourselves? Why do we keep simply adding details to a note rather than subtracting the no-longer relevant ones?" Craig Bowron is an internal medicine physician and can be reached at his self-titled site, Craig Bowron, MD. He shares his story and discusses his KevinMD article, "Bloated notes are a huge problem and a time suck." (https://www.kevinmd.com/blog/2021/05/bloated-notes-are-a-huge-problem-and-a-time-suck.html)

"We believe optimal postoperative pain management should provide adequate pain relief, minimize adverse effects, and reduce chances of drug misuse. While we cannot undertreat pain, we also cannot go back to the practice of over-prescribing or unnecessarily prescribing opioids for minor operations. There needs to be a carefully nuanced balance in treating pain, especially for pediatric and adolescent patients. Going forward there needs to be continued parent and patient education about expectations for recovery post-surgery and proper pain management. This needs to include consistent messaging to families regarding safe use, storage, and disposal of opioids as well as the risks for non-medical use and substance use disorder. This critically important topic deserves more research and clarification so that the medical community can properly treat pediatric and adolescent pain. Stigmatizing the select use of opioids for children and adolescents after surgery is counterproductive and additional guidance should not emphasize the fear of opioid diversion or misuse over appropriate pain management." Rita Agarwal is an anesthesiologist. She shares her story and discusses the KevinMD article, "Pediatric patients need appropriate pain management after surgery." (https://www.kevinmd.com/blog/2021/03/pediatric-patients-need-appropriate-pain-management-after-surgery.html)

"The symptoms of EDS aren't limited to the musculoskeletal system and commonly affect everything from hearing and vision to integumentary issues such as prolonged wound healing and easy bruising. It also became apparent that the specialists I had seen had contributed valuable information to the overall puzzle but were simply not able to put it all together. I had accrued an impressive list of diagnoses commonly associated with EDS: migraine, gum disease, anxiety, fibromyalgia, chronic fatigue, restless leg syndrome, sleep disorder, lumbar spondylolisthesis, sacroiliac dysfunction, hiatal hernia, hearing loss, and early-onset osteoarthritis. EDS explained everything right down to the bumps on the sides of my heels called piezogenic papules and my velvety soft, delicate skin. One physician explained how she makes sense of this constellation of multi-system symptoms by using the phrase: 'If you can't connect the issues, think of connective tissues.' Finally, it all made sense." Julie Griffis is a physical therapist. Linda Bluestein is an integrative medicine physician. They share their stories and discuss this KevinMD article, "The difficult to diagnose comorbidity that plagues Ehlers-Danlos syndrome patients." (https://www.kevinmd.com/blog/2021/05/the-difficult-to-diagnose-comorbidity-that-plagues-ehlers-danlos-syndrome-patients.html)

"The impact of the pandemic on the lives of Americans will be felt for years, if not generations, to come. This includes its alarming effect on health behaviors that contribute to the already formidable challenge of obesity in this country. Now, more than ever, we must look for creative solutions within the broader health ecosystem that can help individuals adapt their behaviors, in spite of socio-environmental challenges, to prevent, manage, and maybe even reverse chronic disease. The very health of our nation depends on new solutions to our country's age-old societal, cultural, and behavioral challenges." Rami Bailony is an internal medicine physician. He shares his story and discusses his KevinMD article, "The overlooked factors driving weight gain in the pandemic." (https://www.kevinmd.com/blog/2021/03/the-overlooked-factors-driving-weight-gain-in-the-pandemic.html)

"Interviewing for medical schools was intense, excruciating, and terrifying. Despite the difficult questions, there are three that stand out to me. The first was to differentiate sympathy from empathy, where I spent 30 minutes defending my answer to be met with complete silence. He could have asked me anything, yet he sat in silence for almost my entire interview and asked me to explain emotional differences between two incredibly similar words. Or are they? I have been left to contemplate this repeatedly, and I have come to realize my first medical school lesson happened before I was even in training. That day, he taught me to see how we as physicians need to examine emotions, become aware of our capacity to both feel and heal, understand our patients, share their struggles and triumphs even if we haven't walked in their diagnoses, and take the time—even if it is painful and met with silence—to realize the gravity of our position is not only responsibility for people's lives but to be emotionally available." Erika Visser Aragona is a family physician. She shares her story and discusses her KevinMD article, "The life cycle of emotion in medicine." (https://www.kevinmd.com/blog/2021/05/the-life-cycle-of-emotion-in-medicine.html)

"Mid-career colleagues: it's time to go back to the future. Time to learn again. Time to build professional and social networks at work. Take a lunch break. Bring home a few fewer RVUs. I recently started a monthly journal club for our small section of gastroenterologists as a way to recreate some of what I loved about residency. A case conference to discuss difficult cases is next. While the rewards of these diversions are not quantifiable, they are still valuable. I hope my colleagues feel the same way. Maybe I'll throw in some free movie tickets, as well." Anish Sheth is a gastroenterologist. He shares his story and discusses his KevinMD article, "Attention mid-career physicians: Let's find our ikigai." (https://www.kevinmd.com/blog/2021/04/attention-mid-career-physicians-lets-find-our-ikigai.html)

"COVID was ominously not only drowning people in their own spit but struck in different shades to alter human personality that kept helplessly getting lost in the maze of their own minds. It made the young maniacal, hearing voices and talking to walls in a schizophrenic frenzy. It made the elderly become muted in silence. The face of helpless madness. Every now and then, the balm of soothing whispers would lull them to slowly break free from this trance. This strange malady kept fogging up brains behind the faces. Faces of disintegrating seizures. Faces staring into oblivion. My penlight shining down dark pupillary tunnels, in vain, felt futile. And then there were other faces. Of hospital caregivers, faithfully grooming seemingly lifeless bodies. I would feel enriched when they shared on my rounds, updates from up close, and personal patient care moments." Ayushi Chugh is a neurologist. She shares her story and discusses her KevinMD article, "Unmasking the faces of COVID: pages from a neurologist's diary" (https://www.kevinmd.com/blog/2021/02/unmasking-the-faces-of-covid-pages-from-a-neurologists-diary.html) and "The science of compassion." (https://www.kevinmd.com/blog/2020/10/the-science-of-compassion.html)

"We all go through our early lives in the S-curve of our medical education–college, medical school, residency, early practice. As you reach the mastery phase, I would posit that there is a downward dip as we realize that we are no longer in that exciting hypergrowth phase. The search for a new curve happens, the desire to ascend the second mountain, to find a more meaningful purpose. How do you begin to find that purpose? Some people take a sabbatical or quit their job entirely. Some physicians look for leadership positions or transition to a non-clinical role. But while this may fix some of the career discontentment, you will stay in the dip, the valley, the bottom of the U-curve without a true search within yourself. It is through a reassessment of your true values that you will find your why." Beverly Joyce is an obstetrician-gynecologist and physician coach. She shares her story and discusses the KevinMD article, "Physicians and the midlife dip." (https://www.kevinmd.com/blog/2021/03/physicians-and-the-midlife-dip.html)

"We won't know until 2022 or later whether there will be an increase in claims related to the pandemic. When a medical error occurs, it's not like an automobile accident. Everybody nearby knows when there's been an automobile accident because they hear screeching tires, a loud crash, and then sirens. But when a medical error occurs, generally speaking, neither the doctor nor the patient immediately knows that something is amiss. It can take months or years for people to realize that something untoward has occurred. Claims from medical errors that occurred before the pandemic bring additional uncertainties. In 2020, we saw fewer than expected overall claims filed from events occurring 18 to 24 months before the pandemic. In total, 20 percent fewer claims were filed than in 2019. This may have had to do with courts shutting down, people being reluctant to meet with attorneys to discuss a claim, and/or lawyers working from home. We may see these claims filed later than expected, or maybe we won't see them at all." Robert E. White, Jr. is chief operating officer, The Doctors Company. He shares his story and discusses his KevinMD article, "Malpractice claims from the COVID-19 pandemic: more questions than answers." (https://www.kevinmd.com/blog/2021/04/malpractice-claims-from-the-covid-19-pandemic-more-questions-than-answers.html)

"We know this is true in our hearts and minds, but we also know it to be true in documentable terms. Studies have proven that strong, empathic engagement between doctors and their patients increases patients' willingness to report symptoms and concerns. That in turn improves diagnostic accuracy. Empathy increases patient engagement and compliance. Some studies suggest it even improves survival rates. Connection is a powerful intangible—like family, or love, or hope. So how can a doctor bring connection into the room in the small, often intense increments of time we have with our patients? Often, it's through surprising secret tools—things like laughter, empathy, and music. There's notable science to each. Laughter has been shown to reduce stress and improve immune function. Empathy strengthens patients' ability to cope with difficult treatments and eases suffering during end-of-life care. And music—wow—studies show music can lower patient anxiety levels during invasive procedures, ease the nausea caused by chemotherapy, decrease pain perception, and inspire feelings of peace and spirituality. And that's just the medical stuff. On a personal level, listening to and making music together creates a sense of shared experience and kinship. It fires up emotional receptors that otherwise remain dormant. It is an honest, authentic shortcut to connection." Steven Eisenberg is a hematologist-oncologist and author of Love Is the Strongest Medicine: Notes from a Cancer Doctor on Connection, Creativity, and Compassion. He shares his story and discusses his KevinMD article, "Love is the strongest medicine." (https://www.kevinmd.com/blog/2021/05/love-is-the-strongest-medicine.html)

"How do we combat all these beliefs that can make doctors into bad investors? I have a few thoughts. First of all, don't panic. Most of us are indeed starting behind the eight-ball when it comes to wealth accumulation. But even with a shorter runway, physicians make enough money to make up for lost time. With a well-constructed financial plan, you can hit your goals, whatever they might be. Second of all, be humble. Recognize that vast scientific knowledge doesn't always translate into financial wizardry. Take the time to educate yourself in any area where you plan to invest. For example, I only started to accelerate my real estate investment after I took a formal real estate investing course. Finally, take ownership. Realize that your financial future is your responsibility. Don't offload all the details to an advisor without having a basic understanding of what is happening to your money. Daniel Shin is a urologist who blogs at The Darwinian Doctor. He shares his story and discusses his KevinMD article, "Why doctors are such bad investors." (https://www.kevinmd.com/blog/2021/04/why-doctors-are-such-bad-investors.html)

"These are extraordinary times. Leaders have the opportunity to seize the day, to lean into this turning point in health care delivery, to drive organizational transformation, and to emerge from the devastation of the pandemic with an organization in which patients and clinicians thrive. You simply have to ask yourself, are you willing to change? Are you willing to dive into the fray and adapt to save your clinicians with the same commitment that your clinicians have demonstrated throughout the pandemic? If you are, your organization will succeed beyond what you think is possible." Paul DeChant is a family physician and health care consultant. He shares his story and discusses his KevinMD article, "Caring for caregivers post-pandemic." (https://www.kevinmd.com/blog/2021/05/caring-for-caregivers-post-pandemic.html)

"We can move from being a reactor to creator. Creators think of the future and make it start happening today. Reactors are just dealing with the crisis at hand, not progressing, feeling stuck, feeling like life is unfair. Reactors are people-pleasing, reacting to everything said, constantly worrying about how to win the approval of others. That's the trouble with people-pleasing: You are always reacting. We think we are making others happy, but we despise ourselves and resent others. We should start taking the time to please ourselves. It is only from this space that we can start helping others. If you think this will be a waste, or you can't take a break because there is work to do, your brain will find ways to prove this thought true. If you tell yourself this is stupid and a waste of time, then you will squander the day and prove yourself right. If you tell yourself they can't live without out you (and your confidence depends on them wanting you), you will allow the interruptions. If you find yourself saying you really can't take the time off, then you have a non-sustainable job. Give yourself permission. Start to develop strong boundaries. Understanding what we can and cannot do in a day. Setting aside days for us to reflect, listen deeply to our inner thoughts, and strategize the path we are meant to live are keys to a successful life. If we're too busy and never take time to stop, we will never see the path in front of us." Amy Vertrees is a general surgeon and co-founder, The Common Thread Women Surgeon Coaching. She shares her story and discusses her KevinMD article, "Physicians need growth days." (https://www.kevinmd.com/blog/2021/02/physicians-need-growth-days.html)

"With the obvious accounted for, we turned to the obscure, the area of medicine where judgment and experience come into play. Fortunately, we received sound advice and guidance from the infectious disease physicians. Stick to the basics, they stressed, only do them better. We continued our patient on the first-line anti-TB drugs he had been on, this time at a slightly higher dose, and added one dose intravenously since he had inflammation in his abdomen and likely wasn't absorbing a lot of the medicine he had been taking. We supported his immune system with appropriate calories through a feeding tube and kept the pressure in his lungs low on the ventilator. In this case, there could have been an urge to change the plan radically, to alter the anti-TB drugs or give steroids or other immune modulators. The art of medicine is knowing when to give up and start anew versus when to stay with the basic plan, executed better. In this case, we stuck with the basic plan. Gradually, the inflammation in the chest and abdomen calmed down. We were able to give the patient physical therapy, and he got off the ventilator and went to the general medical floor. We stuck to the basics of antibiotics and nutrition, and he did well. When in doubt in medicine, stick to the basics are indeed words to live by." Michael J. Stephen is a pulmonary physician and author of Breath Taking: The Power, Fragility, and Future of Our Extraordinary Lungs. He shares his story and discusses his KevinMD article, "The lungs and the common good." (https://www.kevinmd.com/blog/2021/01/the-lungs-and-the-common-good.html)

"We need you to join the ranks of this time-honored profession with new eyes and determined minds and eyes that see medicine's problematic foundations and minds that are willing to act on it. Because it is you, future medical students, who will soon take up the mantle of pushing medicine to change — as medical students have done for generations. We look forward to working alongside you. Welcome to medicine." Kathryn Crofton, Jay Hwang, and Catherine Jay are medical students. They share their stories and discuss their KevinMD article, "From future doctors to new ones: We need you." (https://www.kevinmd.com/blog/2021/04/from-future-doctors-to-new-ones-we-need-you.html)

"Ever the teacher, the Dr. Lown we knew modeled 'The Lost Art of Healing' (the title of one of his books) in the clinic, the laboratory, and the halls of power. As health professionals, we watched him listen carefully to his patients; as citizens, we saw him listen deeply to our neighbors. We heard him importune our health care enterprise to do what is best for democracy with an eye on the future, instead of what helps today's bottom line. And he entreated us to bear witness to the harms and risks of our social choices, to shine a light on the possible, and to lead toward a future that is better than the past. 'If you can see the invisible,' Dr. Lown said, 'you can do the impossible.' Dr. Bernard Lown was the best of his generation. Kind and wise. A listener, a thinker, a doer. A teacher and prodder. A challenger and inspirer. Impossible to equal. And impossible to ignore." Michael Fine is a family physician. He shares his story and discusses the KevinMD article, "In memory of Bernard Lown." (https://www.kevinmd.com/blog/2021/04/in-memory-of-bernard-lown.html)

"Legislative advocacy has become difficult for the severe autism population since the DSM-5 lumped Asperger's syndrome with autism spectrum disorders (ASD). Further complicating the matter, a new population recently emerged who identify as "autistic" without having a diagnosis from a qualified health care professional. Without a clear distinction for various parts of the spectrum, we are comparing apples and oranges. We will not render meaningful information, and we make it difficult for the entire spectrum, but especially for those most affected." Irene Tanzman is a patient advocate and author of Abie and Arlene's Autism War. Jill Escher is president, National Council on Severe Autism (NCSA). They share their stories and discuss the KevinMD article, "Why health care professionals must call for splitting the autism spectrum." (https://www.kevinmd.com/blog/2021/02/why-health-care-professionals-must-call-for-splitting-the-autism-spectrum.html)

"My thoughts immediately went to the tragic loss of one of my best clients, a physician who recently passed away after battling COVID-19. I remember him not only as an excellent physician but even more so as a great person. Unlike many physicians I speak to in the course of my work, this client had the foresight to do some careful estate planning. While his loss cannot be measured, this planning has provided his grieving family with some financial peace of mind and allowed them to focus on him during his illness. According to the latest CDC data, physicians on the front lines throughout this pandemic have been some of the most affected by COVID-19; over 460,000 health care professionals have been diagnosed with COVID-19. Estate plans are not one-size-fits-all, and the various strategies may not work for everyone. Without some experienced professional guidance, anyone might make some mistakes in decisions that seem unimportant at the time but could have huge ramifications on your family's financial future. Here are some of the most common mistakes that are best to avoid." Syed Nishat is a partner, Wall Street Alliance Group. He can be reached on LinkedIn and on Twitter @syedmnishat. He shares his story and discusses his KevinMD article, "8 estate planning mistakes for physicians to avoid." (https://www.kevinmd.com/blog/2021/04/8-estate-planning-mistakes-for-physicians-to-avoid.html)

"Even though there has been a lot of progress, LGBTQ youth are still struggling with discrimination. I am disheartened that 40 percent of LGBTQ youth surveyed by the Trevor project in 2020 seriously considered suicide in the previous 12 months, and the amount of LGBTQ youth reaching out to the Trevor project crisis centers has doubled at times during the COVID 19 pandemic. I have pediatric patients in my clinic tell me that they are nervous to reveal their sexual identities to family and friends. Many of my young LGBTQ patients have mental health issues. According to a recent Human Rights Campaign survey, only 26 percent of LGBTQ teens say they always feel safe in their school classrooms. Only five percent of LGBTQ teens say all of their teachers and school staff support LGBTQ people. Additionally, sixty-seven percent of LGBTQ teens report that they have heard family members make negative comments about LGBTQ people. Many LGBTQ youths are still homeless. It is clear that there is much more work that needs to be done." Alexis Smith is a family physician. She shares her story and discusses her KevinMD article, "The importance of teaching young children about the existence and acceptance of LGBTQ people." (https://www.kevinmd.com/blog/2021/03/the-importance-of-teaching-young-children-about-the-existence-and-acceptance-of-lgbtq-people.html)

"Taking control of distress is done by embracing the concept of 'mental fitness.' Being mentally fit enables one to overcome the negative emotions that have traditionally sabotaged our lives, both personally and professionally. Similar to physical fitness optimizing our bodily strength, mental fitness promotes achievement in our performance, relationships, and sense of well-being. Much research has been done in neuroscience, cognitive and positive psychology, and performance science, showing the true benefit of mental fitness. In particular, the concept of neuroplasticity suggests that with the continued strengthening of certain neural pathways in the brain, modifications in brain architecture can be achieved. These changes have been shown with functional MRI, demonstrating increased density of grey matter in areas that correspond to certain thought processes." Susan Wilson is an emergency physician and physician coach. She shares her story and discusses her KevinMD article, "It's time to reframe second victim syndrome." (https://www.kevinmd.com/blog/2021/04/its-time-to-reframe-second-victim-syndrome.html)

"Before COVID-19, I left the practice of medicine for what would turn out to become an entire year. While away, I found a new way of seeing our hearts and bodies as humans in the medical profession, allowing me to return. Here are five lessons I learned in the hope they might help others." Jennifer Lycette is a hematology-oncology physician and can be reached on Twitter @jl_lycette. She shares her story and discusses her KevinMD article, "What I learned from stepping away from medicine for a year." (https://www.kevinmd.com/blog/2021/03/what-i-learned-from-stepping-away-from-medicine-for-a-year.html)

"Don't be the patient that says: 'Doc, just tell me what to do …' Instead, you should ask for information to empower yourself to make decisions about your healing process. Framing questions around the clinician's experience is always a good starting point; pretend to be the doctor for just a moment and consider the difference in how you might answer the following questions: 'Is there something wrong with the X-rays of my spine?' 'In your experience with patients like me, do most people get back to all normal activities following being rear-ended in an accident with findings on an X-ray like this?' The first question does not give the clinician an opportunity to see you as an individual and truly help you on your path forward. Instead, it sets up a situation where the doctor is free to look at the X-ray in a general way and give a vague and simple answer. She might say: 'No, everything looks fine,' even though your back still hurts, or '… Well, I see you have some scoliosis here,' without giving you any actionable steps to take moving forward. If you keep the focus on the experience of the clinician from their work treating a large number of other individuals with similar patterns of findings, it encourages both of you to keep the bigger picture in mind. But David, you might be thinking, what's wrong with being told the findings of some specific test or measure? Simple, it's because one specific test or measure rarely tells the full story. Imaging, for example, is just an illustration of shadows that lay beneath the skin, and has limited capability to depict underlying issues, especially when it comes to a holistic view of the body. In fact, there are specific cases when performing imaging is required by insurance before they are willing to reimburse the clinician for certain procedures to be performed. Unfortunately, this can skew their clinical decision-making. This is yet another reason why you must be the one in control, and work with people you trust." David Meyer is a physical therapist and author of Injured to Elite: A Guide To Empowering Yourself to Transform Your Life After Injury. He shares his story and discusses his KevinMD article, "Don't be the patient that says this." (https://www.kevinmd.com/blog/2021/04/dont-be-the-patient-that-says-this.html)

"Continuing to do this work the way I was doing it was not sustainable. I needed to get off the merry-go-round. I just didn't know how. I didn't think I could stop myself—transplant was my duty, my responsibility, and what I was trained and programmed to do. It was hard to imagine leaving my post, but I needed to find a graceful exit, an elegant off-ramp that would satisfy my need for a tidy conclusion. One way or another, I wanted off the roller coaster, so I could never again be crushed by a patient like Tina. That had been my life for nearly twenty years. That was enough. I felt yanked around by the ups and downs of the job, my emotions seesawed, and all the while I had to make rational decisions for my patients. But for me, the job was no longer a pure and simple exercise in rationality. I had mastered the mechanics of being a transplant doctor— that was the easy part. But now, from an emotional standpoint, every wife was my wife, every child was my child, and every father was my father. And I needed to save them all." David Weill is a pulmonary and transplant physician and author of Exhale: Hope, Healing, and a Life in Transplant. He shares his story and discusses his KevinMD article, "A transplant physician faces facts about his career." (https://www.kevinmd.com/blog/2021/05/a-transplant-physician-faces-facts-about-his-career.html)

This episode is sponsored by the Dragon Ambient eXperience at Nuance. The exam of the future has arrived with clinical documentation that writes itself. Recently, I participated in a virtual webinar, "How AI technologies improve the patient experience," along with Dr. Jesse Affonso, orthopedic surgeon at Cape Cod Orthopedics. We discussed the difference between patient experience and patient satisfaction, the correlation between the two, and the role technology plays. In a nutshell, I think it's this: A poor patient experience can lead to low patient satisfaction. A good patient experience can lead to high patient satisfaction. According to the Agency of Healthcare Research and Quality, the patient experience encompasses the range of interactions patients have with the health care system and includes several aspects of health care delivery such as timely appointments, easy access to information, and good communication with health care providers. At the same time, patient satisfaction is about whether a patient's expectations about a health encounter were met. This all begs the question: How can one improve the patient experience and satisfaction? Patients want the best care possible. And physicians want to provide the best care possible. The fusion of art and medicine can deliver a better patient experience with AI-powered, voice-enabled documentation that's revolutionizing health care. Jared Pelo is an emergency physician and chief medical information officer, Dragon Ambient eXperience at Nuance. https://www.nuance.com/healthcare/campaign/demo/dax-group-demos.html?cid=7010W000002T9aqQAC&utm_campaign=DHX_AO_202008_DAX_livesteam_demo_digital&utm_medium=Display&utm_source=kevinmd