The Podcast by KevinMD

"As I approached retirement from medical practice, I had an epiphany to take up writing and attended the Harvard CME course on Writing, Publishing, and Social Media for Healthcare Professionals. I met some extraordinary people working in the health care universe who wanted to share their insights. Through my writing as an advocate for patients and physicians on popular social media platforms, I landed a new job. I was recruited by the CEO of a health care startup to become the director of digital health communications. Sharing my experiences as a physician and helping tell the stories of the many professionals with whom I collaborate, I feel a new sense of pride in the work that I do. I am no longer personally delivering medical care, but I know what physicians go through. I intend to make their insights known to a broader audience than might be heard in grand rounds at a hospital. That is my new mission, communicating the connection between patients and physicians, a relationship that requires trust above all else. It's never too late." Paul Pender is an ophthalmologist and can be reached at his self-titled site, Dr. Paul Pender. He is the author of Rebuilding Trust in Healthcare: A Doctor's Prescription for a Post-Pandemic America. He shares his story and discusses his KevinMD article, "It's never too late for physicians to change directions and land new jobs." (https://www.kevinmd.com/blog/2021/02/its-never-too-late-for-physicians-to-change-directions-and-land-new-jobs.html)

"As if COVID-19 weren't bad enough during the pandemic, another public health crisis – substance use disorder (SUD) – has gone from bad to worse, while access to behavioral health services is shrinking. As of September, more than half (52%) of community behavioral health organizations have seen an increase in demand for services, and half of those that offer SUD services saw their demand jump in the previous three months. At the same time, due to lack of revenue or pandemic-related restrictions, 65% have had to cancel programs, reschedule, or turn patients away. Nearly 40% of these organizations reported they may not last six months, given the revenue shortfalls." Nishi Rawat is a critical care and emergency physician. She shares her story and discusses her KevinMD article, "The COVID-19 vaccine won't solve major substance use disorder treatment gaps." (https://www.kevinmd.com/blog/2020/12/the-covid-19-vaccine-wont-solve-major-substance-use-disorder-treatment-gaps.html)

"With my natural affinity for numbers, I analyzed the reviews' precise impact after a few years, and the results were astounding. The system generated over $225,000 during a 3-year period. My practice acquired 162 new 5-star reviews on Google, and my partner and I generated over 200 5-star reviews on Yelp. I calculated that each 5-star review was 'worth' over $900 to my practice in the form of new referrals, and the overall return on investment was 1,900 percent. Needless to say, it was a huge success." Orrin Franko is an orthopedic surgeon and hand specialist. He shares his story and discusses his KevinMD article, "How 5-star reviews generated over $225,000 in revenue for my practice." (https://www.kevinmd.com/blog/2021/01/how-5-star-reviews-generated-over-225000-in-revenue-for-my-practice.html)

"You're a clinician. You had a patient die under your care, and now your hospital is being sued. You are not named in the lawsuit, but you are being asked to give a deposition. How much of your time is this going to take? If some lawyer sends you thousands of pages to review before scheduling multiple phone calls and prep sessions and, finally, a deposition under oath … what do you say? What is your obligation to testify in court as a scientific expert?" Judy Melinek is a forensic pathologist and CEO, PathologyExpert Inc. She shares her story and discusses her KevinMD article, "What to do when physicians get subpoenaed as witnesses." (https://www.kevinmd.com/blog/2019/07/what-to-do-when-physicians-get-subpoenaed-as-witnesses.html)

"If you are happy with where you are in the current system – that is wonderful, continue what you are doing. However, if you are feeling trapped, frustrated, or like the work you are doing is no longer meaningful, then there are plenty of opportunities for you to get out of the system. Start looking at your options – start learning about them and looking for opportunities now. Whether you end up deciding on an alternative clinical career, a nonclinical career within medicine, or a career outside of medicine altogether – you have the skills you need to succeed as long as you are persistent. There are options if you want to stay employed and opportunities to start your own business. The critical thinking skills, listening skills, and drive to succeed that you need to survive training to become a physician can help you create a career that will support you and your family and allow you to live a fulfilling life. The first step is to start." Nithya Natrajan is a family physician and can be reached at Blossoming Mamas. She shares her story and discusses her KevinMD article, "How this physician escaped the system." (https://www.kevinmd.com/blog/2021/02/how-this-physician-escaped-the-system.html)

"When faced with an existential crisis, any organization, as large as a nation or as small as a marriage, will go one of two ways. Either it will bond together, coalesced in a common purpose, or it will collapse in a spasm of blame and shame. While our health care institutions displayed the inestimable value of coalescence, our political leaders demonstrated the catastrophic impact of divisiveness. And our national statistics confirm the result. More than a half million deaths to date from a preventable pandemic. Is there any hope for our nation? Can we learn an important lesson from the health care industry? Can we find the will to coalesce as health professionals have done? I believe we can. We have done so many times in our history, and the current administration is already displaying a penchant for facing the truth, learning from science, and promoting the collaboration needed to overcome our common foe. Coalescence. Let's support our leaders in this welcome change." Nate Link is chief medical officer, Bellevue Hospital, New York City, NY, and author of The Ailing Nation: Lessons from the Bedside for America's Leaders. He shares his story and discusses his KevinMD article, "Responding to the COVID pandemic: a lesson in coalescence." (https://www.kevinmd.com/blog/2021/02/responding-to-the-covid-pandemic-a-lesson-in-coalescence.html)

"Coffee in hand, I decided to try and collect my thoughts. I realized that a large portion of the literature we grew up reading has in many ways tried to implant this subconscious bias that contributes to gender disparities and these ideas about women that have continued to ruminate throughout parts of society to this day. Literature in and of itself is a reflection of the times in which it is and was written. Sadly, examples of stark contrasts in comportment, demeanor, and overall health and well-being amongst men and women are nowadays ever-present and are all around us. It is of paramount importance that we as physicians now take a step back and analyze how subconscious bias affects us in all aspects of medicine." Theodore Klug is a clinical research fellow. He shares his story and discusses the KevinMD article, "Gender disparities in medicine: How popular literature mirrors 2020 society." (https://www.kevinmd.com/blog/2021/02/gender-disparities-in-medicine-how-popular-literature-mirrors-2020-society.html)

"When a patient is dissatisfied with his or her care, he or she can consult an attorney, who will enlist a physician 'expert' to determine if a doctor has deviated from the standard of care and whether that deviation caused a negative outcome. Over the past decade of reviewing cases involving medical malpractice, I have identified five categories of medical error, which has improved how I care for my patients." Scott Choi is a gastroenterologist. He shares his story and discusses his KevinMD article, "How reviewing medical malpractice claims made me a better gastroenterologist." (https://www.kevinmd.com/blog/2021/04/how-reviewing-medical-malpractice-claims-made-me-a-better-gastroenterologist.html)

"The corporatization of medicine has destroyed primary care as a specialty. The primary care physician is supposed to be your go-to doctor, your advocate, the coordinator of your health care. Now that corporations buy out hospitals and private practices in an almost predatory fashion, the priority is turning a profit for the corporation at the expense of not only patient health but also the health and well-being of the primary care physician. Who do you think bears the brunt of patient frustration and public misconception? The PCP." Alexis Gopal is an internal medicine physician and can be reached at Vitality Medicine of New York. She shares her story and discusses her KevinMD article, "Rest in peace, primary care." (https://www.kevinmd.com/blog/2021/01/rest-in-peace-primary-care.html)

"For physicians who lack experience in end-of-life counseling, the process can be daunting at the beginning. However, they can be confident that once they have obtained the proper training, preparation, and experience, these conversations will be among the most fulfilling of their careers. By regarding end-of-life planning as a shared responsibility, physicians can become more well-rounded professionally and help patients conquer their most profound fears. It's time to start the conversation." Caroline DeFilippo is an internal medicine physician. She shares her story and discusses her KevinMD article, "End-of-life conversations: Why physicians should embrace the responsibility." (https://www.kevinmd.com/blog/2020/11/end-of-life-conversations-why-physicians-should-embrace-the-responsibility.html)

"Nowadays, I go on long walks through the city alone. I make dinner for one. When I go on bike rides, it's a solo activity. I find comfort in myself, slowing down and making every small occasion a simple, peaceful one. I have a stronger sense of self, and through that, I have rekindled the fire that I felt during my first years of being in medicine. When I return home from the hospital, I don't dive into the distraction of another person. Now, I write daily journal entries that help get my heart on a page, where I can set it aside and leave it be for some time before revisiting it. I put music on in my apartment, and dance and dance and dance. My new self-soothing methods aren't perfect (none are), but at least they are now focused on nurturing and strengthening myself. No distractions, just facing my feelings head-on. It's an art I am starting to get the hang of." Fae Kayarian is a medical scribe. She shares her story and discusses her KevinMD article, "Falling in love during a pandemic: a lesson in self-soothing." (https://www.kevinmd.com/blog/2021/01/falling-in-love-during-a-pandemic-a-lesson-in-self-soothing.html)

"Every professional I have done the exercise with admitted that their ideal patient was inspired by someone they were close to in their personal life. It was usually a family member, a best friend, or themselves. The ones who carry the most unbearable sufferings-the kind that reminds us of ourselves and our loved ones most likely would become our "ideal patients." After all, our compassion for others' aches comes from understanding our own pain. We heal to be healed. Healing's mutualism continues to amaze me every day. It's a gesture of kindness and love that elevates both the giver and the receiver." Tedi Zeng is an acupuncturist. She shares her story and discusses her KevinMD article, "Who is the ideal patient?" (https://www.kevinmd.com/blog/2021/01/who-is-the-ideal-patient.html)

"The science of complexity lays a conceptual foundation for understanding "complex adaptive systems." What all complex adaptive systems have in common is that they are all bound by the same set of physical laws. Their "behavior," i.e., growth, maintenance, and death, can all be described using the same set of mathematical relationships. These systems (animals, plants, ecosystems, etc.) are the most productive and functionally effective systems known to man. Unfortunately, our health care system has not been bound by the same physical laws and mathematical relationships as other complex adaptive systems. Thus, it has not been able to implement the same mechanisms that our ecosystems and cells have in order to obtain optimization in their ability to perform a function. This is most blatantly highlighted by the fact that 100,000 to 400,000 (depending on the source) Americans die each year due to medical errors." Robert Trent is a graduate student. He shares his story and discusses his KevinMD article, "What role does the science of complexity play in medicine?" (https://www.kevinmd.com/blog/2019/08/what-role-does-the-science-of-complexity-play-in-medicine.html)

"As health professionals, we have the platform to enact change within our own institutions, as well as local and federal governments. We must elect leaders and officials who spearhead climate action. We must reduce the carbon footprint of healthcare. And we must educate our colleagues and our patients about the impact of climate change on health. We need every single one of us to take action. Our patients' health depends on it." Sarah Hsu is a medical student. She shares her story and discusses the KevinMD article, "5 things medical professionals can do to take climate action." (https://www.kevinmd.com/blog/2020/10/5-things-medical-professionals-can-do-to-take-climate-action.html)

"Instead of focusing on one organ system, I want to know everything. The diagnostic challenge is to discern patterns of insults, symptoms, and lab tests that correlate with specific microbes, specific organ dysfunction, specific diet issues, and environmental exposures. We keep asking questions until we detect patterns in the chronically ill patient that correlate with any number of overlapping issues such as infections, hormone deficiencies, immune dysregulation, toxic exposures, and diminished capacity to detoxify. And then we explore the interrelationship of all these problems. Differentiation then integration." Daniel Kinderlehrer is a physician and author of Recovery from Lyme Disease: The Integrative Medicine Guide to Diagnosing and Treating Tick-Borne Illness. He shares his story and discusses his KevinMD article, "Our work as physicians and healers is to see the whole patient." (https://www.kevinmd.com/blog/2021/03/our-work-as-physicians-and-healers-is-to-see-the-whole-patient.html)

"Suicide is a path, whether fast or slow, that a person chooses to take because of their own reasons. We certainly can never predict suicide or truly understand it. But with that said, every time it happens, it is a tragic loss of life that time can and will never heal. We must do more to support our physicians in training, residents, and established clinicians. Like how we sit at the bedside with patients and listen to their stories, someone needs to listen to what doctors have to say. This is an epidemic that we must address right now. We must shine a light on the underpinnings of stress, dissatisfaction, grief, guilt, and pain. And we must drag out of the shadows a broken healthcare system that burdens many of our physicians. It starts with making it OK to talk about suicide and to foster an environment where it is safe for medical students and physicians to share their stories privately and publicly. We absolutely must create safe spaces for conversations to be had at all levels of medical education." Ton La, Jr. is a medical student and can be reached on LinkedIn. He shares his story and discusses his KevinMD article, "Physician suicide: We need safe spaces to talk about it." (https://www.kevinmd.com/blog/2021/03/physician-suicide-we-need-safe-spaces-to-talk-about-it.html)

"Our relationship with Big Pharma is a dangerous, nasty, and abusive one, and it can prove to be fatal too. Benzos aren't limited to a specific class, race, gender, creed, etc. Many stars have died from mixing benzodiazepines with opioids or illegal drugs. It has been a little over a year that I have been off of Klonopin, and I'm happy to report that most of my withdrawal symptoms are gone. I handle stress better now, and I feel emotions more deeply and genuinely. Please be patient with the process and with yourself. It gets better, I promise." Bethany Silverman is a writer. She shares her story and discusses her KevinMD article, "My Klonopin withdrawal story." (https://www.kevinmd.com/blog/2021/01/my-klonopin-withdrawal-story.html)

"Had I understood the nature of my struggles and felt permitted and supported in actively addressing them, I would have been more effective, a better learner, and more fulfilled. After trying out a few clinical settings, a lot of reading, and some much-needed coaching, I found my identity as a healthy, inspired physician. Eventually, by setting boundaries and understanding my patterns, I discovered what I needed to thrive. So, maybe we need to reimagine medical education. From medical school onward, physician education and training should be conceptualized as a career-long process supporting the holistic development of life-long learners, leaders, and healers. Certainly, there has got to be a better way than my circuitous, self-designed, and at times, painful and exhausting pathway." 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, "It's time to focus medical education on training the whole person." (https://www.kevinmd.com/blog/2021/01/its-time-to-focus-medical-education-on-training-the-whole-person.html)

"Dr. Fauci navigated the delicate balance between his obligation to the American people as one of our most respected physician-scientists and holding on to his job in a federal government whose leader doesn't take kindly to independent thought that potentially upstages his own. Dr. Fauci not only survived multiple appearances on the national stage with Trump, as the task force morphed into charade, but he even emerged as a popular folk hero, all the while maintaining his status as a respected medical authority. Despite having ample opportunity to confront the president on his misinformation, Dr. Fauci focused his unwavering attention on mitigation of the virus, refuting Trump's often puzzling and sometimes harmful pronouncements, without even having to directly acknowledge them." Michael Miyamoto is a cardiologist. He shares his story and discusses his KevinMD article, "Dealing with a bad boss: lessons from Dr. Fauci." (https://www.kevinmd.com/blog/2021/01/dealing-with-a-bad-boss-lessons-from-dr-fauci.html)

"I am a nurse who has worked at a rural hospital. My husband is a board-certified family medicine doctor. In the fall of 2020, I was raped by my massage therapist. I know that everyone has an opinion of what they would do in that situation, and I was probably one of those people. However, to my complete shock (quite literally), I didn't behave in any manner that I would have thought. Much to my embarrassment, I was a nurse who had no idea what to do when I was raped on top of the previously mentioned humiliation." The guest is an anonymous nurse who shares her story and discusses her KevinMD article, "There needs to be a better approach to victims of sexual violence." (https://www.kevinmd.com/blog/2020/12/there-needs-to-be-a-better-approach-to-victims-of-sexual-violence.html)

"When the public was made aware of the risk of transmitting the virus and the far-reaching measures of social distancing, closing schools, and lock-down, most Americans willingly complied. After all, they became aware, for the first time, of the risk of aerosolized viral particles present in theatres, churches, restaurants, and classrooms. But we physicians already knew that. We knew that when we went into the operating room or the bedside to repair a laceration in the emergency department, we wore masks to protect our patients from the microorganisms living in our noses and mouths. We already knew that the spread of norovirus and other food-borne illness can be mitigated by the use of hand-washing and the use of sanitizing cleaners. Physicians already knew that the world was a rather naïve and scary place in terms of infectious disease." Joan Naidorf is an emergency physician. She shares her story and discusses her KevinMD article, "Influenza: a deadly risk in schools before COVID." (https://www.kevinmd.com/blog/2021/03/influenza-a-deadly-risk-in-schools-before-covid.html)

"Now the room is silent as if nothing at all occurred. I stand watching the red stain forming on the pristine white sheet, mocking me in my failure. I trained at excellent institutions, survived residency, and served in combat. Now, here at a Level 1 trauma center, I could not save this life with every possible medical tool at my disposal. This injury, this particular injury, always has, and forever will, haunt my dreams. The hubris to think that I could be the difference, that I am better than those who came before me, was answered tonight, as it has been before, by this deserved slap in the face. I absorb the charged silence; my mind wanders back to my third year of medical school. I was doing well, a moderate prodigy of the medical department. I was ready for every conference, every patient, well-read and well prepared, until that fateful day." Richard Morand is a trauma surgeon. Melissa Fournier is a social worker. They are, respectively, contribute and co-editor, The Healer's Burden: Stories and Poems of Professional Grief. They share their stories and discuss the KevinMD article, "I could not save this life with every possible medical tool at my disposal." (https://www.kevinmd.com/blog/2020/11/i-could-not-save-this-life-with-every-possible-medical-tool-at-my-disposal.html)

"I really shouldn't complain. I haven't lost my housing or job. I have plenty of food and toilet paper, and so far, no close friend or family have died from COVID. That said, this pandemic is hard. In fact, it is exhausting. During the spring and summer, I gave positive COVID results to a number of patients from my home's safety, thanks to telehealth. But the reality of telling patients how to self-quarantine when six people live in two rooms with one bathroom, or giving resources about food and other basics because the household provider lost a job, or can't work because s/he is COVID positive, is tough. Tough on the recipient of the advice and tough on me." Therese Zink is a family physician and can be reached at her self-titled site, ThereseZink.com. She is the author of COVID Chronicles: How Essential Workers Cope. She shares her story and discusses her KevinMD article, "The long journey of COVID." (https://www.kevinmd.com/blog/2020/11/the-long-journey-of-covid.html)

"It is dangerously unfortunate that the use of masks has been politicized in many parts of our nation. The Dakotas (or North and South COVID as they were recently called on Saturday Night Live) are far from exempt from this phenomenon. Likely, if Governor Burgum's decision was less influenced by fear of criticism from his constituents and political retaliation, he would have required a mask mandate long before making it acceptable for infected individuals to leave their home. Masks have time and again proven to be safe and effective. It's not a big ask." Sheetal Khedkar Rao is an internal medicine physician. She shares her story and discusses her KevinMD article, "The problem with allowing COVID-positive health care workers to continue working." (https://www.kevinmd.com/blog/2020/11/the-problem-with-allowing-covid-positive-health-care-workers-to-continue-working.html)

"If PCPs want to meet the new competition from virtual primary care plans, I suggest that they gradually increase the percentage of their visits that they do through telehealth. Now that payers are reimbursing those visits at the same level as in-person visits, they have nothing to lose financially. Of course, there are some ancillary services that might be performed in their offices, such as lab tests, X-rays or bone density scans. But PCPs could order some of these when patients came in for visits, and they could also reduce their spending on staff and office space if they saw fewer patients in-house. Such a move would represent a big change for PCPs. But they've already adopted telehealth to a much greater extent than ever before. A fuller embrace of the technology could help them survive financially, and it might even improve chronic disease care if virtual follow-ups were combined with regular office visits." Ken Terry is a journalist and author of Physician-Led Health Care Reform: A New Approach to Medicare for All. He shares his story and discusses his KevinMD article, "PCPs could counter virtual plans by increasing telehealth visits." (https://www.kevinmd.com/blog/2021/03/pcps-could-counter-virtual-plans-by-increasing-telehealth-visits.html)

"Looking back on these words at the end of my rotation, I understand what I had felt, and I feel confident naming it: the futility of medicine. We can comfort and treat patients, but there's nothing more we can do after a certain point. As a bright-eyed medical student who wrote on all her medical school applications that she wanted to save lives, it was and still is difficult for me to understand that." Shereen Jeyakumar is a medical student. She shares her story and discusses her KevinMD article, "My first end-of-life conversation." (https://www.kevinmd.com/blog/2020/12/my-first-end-of-life-conversation.html)

"Motherhood has been the biggest gamble of my adult life thus far. How was I going to operate for 12-plus hours while 39-weeks pregnant? Where would I be when I went into labor? How would was I going to return after three weeks? How would I pump during and in between OR cases? I did it. It certainly wasn't easy. And I would do it all over. My son is beautiful and healthy. I've never been prouder of anything I've ever done. He is the first thing I think about in the morning and the last thing I think about at night. He's made me a better clinician and surgeon." Lauren A. Umstattd is a facial plastic surgery fellow. She shares her story and discusses her KevinMD article, "Advice to a pregnant surgical resident." (https://www.kevinmd.com/blog/2019/10/advice-to-a-pregnant-surgical-resident.html)

"COVID-19 disproportionately impacts those with pre-existing conditions, and our health care system leaves one in five Americans with a pre-existing condition uninsured. Further, with multiple COVID-19 vaccines already in early but slow distribution, attaining universal coverage is critical, particularly in light of uninsurance having an inverse relationship with vaccination rates. President Biden will need to act with a legislative urgency that matches these times to pass a public option. With two-thirds of the country approving President Biden's handling of the transition, now is his opportunity. He may just need to take a few pages out of the 'Johnson treatment' playbook in crafting the 'Biden treatment.'" Jonathan Staloff is a family medicine resident and can be reached on Twitter @jonstaloff. He shares his story and discusses his KevinMD article, "How President Biden's quest for a public option mirrors LBJ's passage of Medicare and Medicaid." (https://www.kevinmd.com/blog/2021/01/how-president-bidens-quest-for-a-public-option-mirrors-lbjs-passage-of-medicare-and-medicaid.html)

"The patient knocking on your door is not your enemy. They're sick. They're scared. They're in pain. They don't know why, and they're hoping for an answer. If you can't find the source of a problem quickly, it doesn't mean it's not there." Denise Reich is a patient advocate. She shares her story and discusses her KevinMD article, "Patients don't need quick diagnoses. They need accurate ones." (https://www.kevinmd.com/blog/2021/01/patients-dont-need-quick-diagnoses-they-need-accurate-ones.html)

"I can tell you what I don't want to do. I don't want to mill through 50 patients a day, mindlessly clicking through EMR checkboxes so an insurance auditor five states away will deem that I've done my job and deserve reimbursement. That's a high volume, high overhead game, and I don't want to play it. I recently spoke with a doctor who was getting so many insurance denials that they needed to hire 14 additional billers at an estimated cost of somewhere around half a million dollars a year. Insurance companies want to make it difficult for doctors to get paid. They will only add more hoops to jump through, meaning that I need to hire more hoop jumpers as a doctor. Hiring hoop jumpers costs a lot of money, which means I need to see more patients. Seeing more patients in the same amount of time leads to shorter visits and worse care. Not to mention the pressure from hospital administrators to "expand your indications," or in layman's terms, operate on someone who may not really need it." Daniel Paull is an orthopedic surgeon. He shares his story and discusses his KevinMD article, "I am an orthopedic surgeon who decided to stop taking insurance." (https://www.kevinmd.com/blog/2021/01/i-am-an-orthopedic-surgeon-who-decided-to-stop-taking-insurance.html)

"Humanities can be seen as part of the fabric, society, and culture of human experience. In many ways, they might be seen as the disciplines that make us human and make life meaningful. They broadly encompass ancient and modern languages, literature, philosophy, religion, visual and performing arts, such as music and theater. Even more expansively, they may also include, amongst others, history, archaeology, anthropology, law, and linguistics. These diverse fields explore and foster empathy, compassion, beauty, joy, awe, love, reasoning, tolerance, curiosity, possibility, community. Are we richer as human beings or physicians without this education, or are we abandoning ourselves to the loneliness, sadness, and despair of a more sterile, rigid, negative, and dysfunctional way of thinking?" Jacqueline Huntly is a family physician and physician coach. She shares her story and discusses her KevinMD article, "Medicine for the soul: Harness the power of the humanities to counteract burnout." (https://www.kevinmd.com/blog/2020/11/medicine-for-the-soul-harness-the-power-of-the-humanities-to-counteract-burnout.html)

"Most residents are young, often in their mid to late 20s, having spent years ensconced in libraries, research labs, and classrooms learning pathophysiology and pharmacology. Upon graduation from medical school, they are now drafted to the front lines of a generational pandemic, working long hours, often in cities where they are strangers (the process of "matching" into a residency program is one where residents are not in full control of their destiny or geography). They do so while putting their own health in jeopardy. The resident's experience of the COVID-19 pandemic has been unlike any other, because on average, residents spend almost twice as much time at work as other providers. Residents are allowed to work 80 hours a week on balance, which means it's fine to log 90 hours in the ICU if the following week is a mere 70." John P. Murray is an internal medicine physician. He shares his story and discusses his KevinMD article, "In gratitude to our nation's residents." (https://www.kevinmd.com/blog/2021/01/in-gratitude-to-our-nations-residents.html)

"Keep it Simple is a bumper sticker slogan. Life during a pandemic has been anything but simple, and the holiday season presents (not the gift kind) its own special challenges. So does living alone and trying to stay humanized. In his book Together: The Healing Power of Human Connection in a Sometimes Lonely World, Surgeon General-elect Vivek Murphy describes loneliness as associated with increased risk of mental and health difficulties in the BC era (before COVID-19). All the more so within such a challenging year of physical separation and trying to maintain a connection with others, with ourselves. So much angst, uncertainty, loss … And yet … here we are poised at the brink of a new year with vaccines being distributed and a true sense of hope and healing. We're medical educators who teach health professions students and professionals about resilience and adapting to adversity, but here we are, needing to walk the talk. Big-time. We met via Zoom for a Virtual Tea to share about our lives and not just our work. There was some laughter, the best medicine. And we reflected on negotiating living alone and the stuff of life that sustains, even enriches. Daily "little sparks of joy" can help. We offer you our "21 for '21" and hope the simple can be profound." Hedy S. Wald is a clinical professor of family medicine, Warren Alpert Medical School, Brown University, Providence, RI. She can be reached on Twitter @hedy_wald. Monica van de Ridder is an assistant professor, College of Human Medicine, Michigan State University/Spectrum Health, Grand Rapids MI. She can be reached on Twitter @MvdRidder. They share their stories and discuss their KevinMD article, "21 for '21: little sparks of joy." (https://www.kevinmd.com/blog/2020/12/21-for-21-little-sparks-of-joy.html)

"Lights, camera, action! You get a call from your hospital's public relations office asking you to speak to the local news. Even though this isn't your first time, your heart is pounding, with a mix of nerves and excitement. You start doubting whether you have anything valuable to say about the topic, even though, yes – you went through many years of medical school and residency before this moment. You are also worried about how to avoid looking foolish or unprofessional on-air. Or worse, how to avoid having your words taken out of context. No? OK, then maybe that's just me. There are still some key tips and tricks you should know to optimize your performance." Tyeese L. Gaines is an emergency physician and branding and media coach. She shares her story and discusses her KevinMD article, "8 things physicians should know before they're interviewed by the media." (https://www.kevinmd.com/blog/2020/12/8-things-physicians-should-know-before-theyre-interviewed-by-the-media.html)

"Ultimately, patient care is at the center of medicine and is the main reason many physicians chose to go into the field. A good understanding of the business side of medicine and personal finance can help future physicians focus on just that. There are plenty of options when it comes to how we can begin to integrate these topics into medical education. There are clear benefits that come with learning these skills, and many students are eager to do so. We need more medical schools to integrate these subjects into their curriculums, and students who are given the opportunity to gain this knowledge can become more well-rounded physicians as a result." Martinus Megalla is a medical student. He shares his story and discusses his KevinMD article, "Why medical students should be taught the business side of medicine." (https://www.kevinmd.com/blog/2020/07/why-medical-students-should-be-taught-the-business-side-of-medicine.html)

"There should be no grades in medical school. Forty-something percent of applicants get accepted to one or more medical schools. To even apply to medical school, one needs to have not only graduated or be on track to graduate college, but also needs to have passed the MCAT and have the support of a pre-medical application committee. I am no mathematician, but I do not think that it is a stretch to say that less than 10 percent of those who wanted to go to medical school on their first day of college do, in fact, end up matriculating into medical school." Adam Lieber is a medical student. He shares his story and discusses his KevinMD article, "End medical school grades." (https://www.kevinmd.com/blog/2021/01/end-medical-school-grades.html)

"Have you ever watched a movie, television show, or read a book where the villain is a medical doctor? If you are a psychiatrist, you will be alarmed by how many times the villain in these stories turns out to be a psychiatrist. In all fairness, psychiatry has had its share of blunders. However, in recent years psychiatry has made a significant effort to enhance the use of evidence-based medicine and procedures. The diagnostic criteria for mental disorders continue to be revised and updated regularly. New medications and procedures are developing at an increasingly rapid rate. With all of the advances in the field, why does popular media continue to represent psychiatry as a barbaric field with poor patient outcomes and medications/treatments that do not work?" Garrett Rossi is a psychiatry resident who blogs at Shrinks in Sneakers. He shares his story and discusses his KevinMD article, "Film and television continue to depict psychiatrists as heartless swindlers." (https://www.kevinmd.com/blog/2020/10/film-and-television-continue-to-depict-psychiatrists-as-heartless-swindlers.html)

"As a Black physician, I urge you to consider taking the COVID-19 vaccine when it becomes available to you. Vaccines save lives. Preventing poor outcomes, as in death, is an exciting effect of this vaccine. I will be first in line when it is offered to me, and I hope to see you in line next to me. Masked up, of course." Erkeda DeRouen is a family physician and can be reached at her self-titled site, Dr Erkeda DeRouen. She shares her story and discusses her KevinMD article, "A letter to Black America for those who do not want to take the COVID-19 vaccine." (https://www.kevinmd.com/blog/2020/12/a-letter-to-black-america-for-those-who-do-not-want-to-take-the-covid-19-vaccine.html)

"It is not enough to say we are anti-racist; we have to modify our systems to recognize that we have placed individuals of color at risk of poorer outcomes. Lack of insurance, lack of finances, or even the presence of certain diagnoses may reflect less about the person and more about our society, our infrastructure, and our systems. As members of smaller communities and a larger society, we must make adjustments in our attitudes and knowledge as well as the services we provide to individuals who have experienced harm by insidious but ever-present racist structures. Glaring disparities in treatment aren't only happening in protests. They are happening in all of society, and in our hospitals. Only when we address systemic racism will we be able to realize the ethical imperatives of safe and equitable health care for all." Jane Gagliardi is an internal medicine physician and a psychiatrist. She shares her story and discusses her KevinMD article, "It is not enough to say we are anti-racist. We must address glaring disparities in treatment." (https://www.kevinmd.com/blog/2021/01/it-is-not-enough-to-say-we-are-anti-racist-we-must-address-glaring-disparities-in-treatment.html)

"Just a few seconds after the needle penetrated my arm, I felt a mild soreness, kind of like a flu shot. But as I sat for the required 15 minutes of observation time, a wave of something engulfed my body. It was such a strange, unfamiliar sensation that I didn't realize what was happening. I looked around the room at the other medical personnel getting their shots, and no one seemed to pay me any attention. I wasn't changing color, short of breath, or breaking out into a sweat. I did harbor reservations about the safety of this new vaccine that seemed rushed to market. Was I about to become a statistic in the next FDA safety bulletin? It seemed like forever, but finally, I divined what was happening to me. I felt different inside. A fundamental change had occurred deep within my body. I sensed that others in the room experienced a similar feeling. I struggled to recall the name of the emotion. It had been so long. It was happiness." Andrew N. Wilner is a neurologist. He shares his story and discusses his KevinMD article, "An unexpected COVID-19 vaccine side effect." (https://www.kevinmd.com/blog/2021/01/an-unexpected-covid-19-vaccine-side-effect.html)

"Many colleagues in medicine already talk about medicine never going back to its state pre-COVID-19 – be it telehealth for patients, new flexibility to work/life scheduling, or a new acceptance of telecommuting outside of direct patient care. There has been too much suffering as a result of the COVID-19 pandemic and stressors of 2020 to progress through 2021 and beyond without lessons learned. New recognition of the need to broaden the definition of what 'counts' in careers, be it in health care or beyond, along with a means to articulate that, must be a lasting outcome of our nation's response to the pandemic if we want to avoid losing more of our best and brightest in these fields." Avital O'Glasser is an internal medicine physician. She shares her story and discusses her KevinMD article, "The COVID-19 pandemic brought many new challenges in medicine. A novel tool may help to overcome some of them." (https://www.kevinmd.com/blog/2021/02/the-covid-19-pandemic-brought-many-new-challenges-in-medicine-a-novel-tool-may-help-to-overcome-some-of-them.html)

"The tragedy that's happening in medicine today is that the loss of respect and the constant threats to fair payment are making physicians regret that they ever chose medicine. They were fascinated with science and wanted to help people, and their reward is insult. It's no wonder that some newly trained physicians leave anesthesiology quickly; there's little risk to running a hangover clinic in Las Vegas. Many physicians from all specialties get MBAs because they see that the real rewards in healthcare lie in becoming a CEO. Look at the salaries of top executives: the CEO of Anthem made more than $14 million in 2018, as an example, while insurance companies did everything they could to avoid or delay signing fair contracts and paying clinical physicians for patient care. There is a growing shortage of physicians, not just in primary care but in specialties too. The American Association of Medical Colleges (AAMC) estimates that the U.S. will be desperately seeking surgeons in the next 10 to 12 years, and looking for more anesthesiologists to work with them. As older physicians retire, and younger ones aren't willing to work the long hours that used to be routine, this will only get worse, while increasing numbers of older Americans will need more complex medical care. Maybe your barber will learn to operate on you, just like the barber surgeons of old, and your local gun store will sell you a bullet to bite on. Best of luck." Karen S. Sibert is an anesthesiologist who blogs at A Penned Point. She shares her story and discusses her KevinMD article, "Keep insulting doctors, and good luck finding a physician in 10 years." (https://www.kevinmd.com/blog/2020/01/keep-insulting-doctors-and-good-luck-finding-a-physician-in-10-years.html)

"This is our call to action. I have the experience, knowledge, expertise, and deep passion for teaching every medical student these skills. I cannot do it alone. I need you. We need to do this together. I am seeking those of you who are caring, innovative clear thinkers involved in medical school curriculum creation. We owe it to our physician seedlings. We owe it to their future patients. Who out there can now see 20/20? It is time to change the culture of medicine and focus on prevention. I am 100 percent in. Who is with me?" Robyn Tiger is a radiologist and can be reached at Stress Free MD. She shares her story and discusses her KevinMD article, "The Rx we were never taught to write." (https://www.kevinmd.com/blog/2021/01/the-rx-we-were-never-taught-to-write.html)

"We need full transparency and empowerment of patients and doctors to make wise decisions. We must renew and restore the sanctity of the patient-doctor relationship. We need to stop pretending that health care can be 'free,' stop calling premium price prepaid care 'insurance,' and use market forces like choice and competition to cut our bloated costs. 'Insurance' needs to 'insure' against the unexpected, not pay for the routine. I am a proud independent physician. Taking care of patients is what I know. It is what I do best. Get the government and the insurance company out of my exam room and let us all do what we do best. Patients will be the ultimate winners." Mary Tipton is an internal medicine-pediatrics physician. She shares her story and discusses her KevinMD article, "Why socialized health care is not right for America." (https://www.kevinmd.com/blog/2020/10/why-socialized-health-care-is-not-right-for-america.html)

"Health care delivery will always be inherently unpredictable and challenging. Those drawn to medicine are among our most resilient, but the current landscape reveals acutely a rise in burnout that exceeded acceptable levels even before the COVID-19 outbreak. Such innate resilience in clinicians and clinical care teams is an individual and strategic asset worthy of recognition, protection, and system-wide approaches that nurture and potentiate it. Such system-wide advocacy serves to proactively promote the vitality of health care delivery, quality of care, individual and group purpose, life-work satisfaction, and balance. Ultimately, these all are recognized as antidotes to burnout." Pennie Sempell is an attorney and co-founder and CEO, StressPal. She shares her story and discusses the KevinMD article, "Persistent stressors and resilience: a new way forward for health care communities." (https://www.kevinmd.com/blog/2020/12/persistent-stressors-and-resilience-a-new-way-forward-for-health-care-communities.html)

"This is not what I signed up for. Have you ever said this when you are rushing home 1.5 hours after the last patient left and you still haven't finished all your charting? You grab a handful of forms to take home with you with the hopeful expectation that you will get them done tonight too. After you have done 'enough' to appear to be a present parent and prepared supper and said goodnight to the kids, that is. You sink into the couch at the end of the household rush with the guilty constant 'should be' invading your every breath. I should be finishing my notes. I should go empty that inbox. I should tackle one or two of those forms. But your body feels heavy, and your couch entraps you with its soft embrace, you open Facebook and disappear." Sarah J. Smith is a family physician and can be reached at the Charting Coach. She shares her story and discusses her KevinMD article, "You didn't sign up for this. You don't have to drown in the paperwork." (https://www.kevinmd.com/blog/2021/01/you-didnt-sign-up-for-this-you-dont-have-to-drown-in-the-paperwork.html)

"I now say getting divorced was one of the best things that ever happened to me. Through that painful circumstance, I rediscovered me. I learned more about myself and my ability to do hard things than at any point in my life since medical training. I'm not the same person that I was before my divorce, and that's OK. I'm more confident, decisive, and self-assured. Those are all qualities that not only benefit me, but benefit my patients as well. Because of my divorce, my patients now get Dr. Trina Dorrah, version 2.0, and we are all better off because of that." Trina E. Dorrah is an internal medicine physician and can be reached at Dr Trina Dorrah Life Coaching. She shares her story and discusses her KevinMD article, "How divorce helped this physician." (https://www.kevinmd.com/blog/2021/02/how-divorce-helped-this-physician.html)

"One of the best solutions to rising obesity and non-communicable disease rates lie in primary care. Medical professionals can influence the U.S. food system indirectly through demand and collective purchasing power by educating their patients to choose and purchase healthier options. Merely improving nutrition education succeeds in shifting people's thinking about food. Simultaneous with the WHO's declaration of the Decade of Action on Nutrition is the "food is medicine" movement that has been growing in response to mounting evidence that a nutritionally-sound diet and access to quality foods improve health outcomes. The theory behind food is medicine is that food is a preventative public health system. This movement includes prescription meals to people with multiple chronic conditions and low income, food delivery services, and community food quality assessment. So far, the food is medicine solution has proven cost-effective, and one study reported a 16 percent reduction in health care costs in meal recipients. We know that widening health disparities are partially diet-dependent. Integrating nutrition into primary care is really a social necessity. Just as everyone should have access to medical care, all Americans should have equal access to proper nutritional guidance and nutritious food." Melinda Mesmer is an internal medicine physician. She shares her story and discusses her KevinMD article, "Put nutrition counseling in primary care." (https://www.kevinmd.com/blog/2020/10/put-nutrition-counseling-in-primary-care.html)

"I have closed my practice, but I have no plans to retire at the age of 52. I have started the journey to become a high school science teacher. There are frequent internet postings and blogs by physicians with strategies to retire young. I suspect that many of us, not near traditional retirement age, still desire to work. At this point, I do not yet have a passion for traveling the world or for driving around the country in an RV like many former physicians. Furthermore, I still have two children who are not yet college age. I enjoy working, and I fear mental stagnation were I to retire at this point. Currently, I am pursuing a Master of Arts in Teaching degree. From pre-school through hand fellowship, I have had 28 years of formal education. It is time for me to reciprocate and to honor the extraordinary minds of my teachers and mentors. I am excited to become a high school teacher. I was a chemistry major in college, and it will be a smooth transition to teach high school science. I judge success not by financial wealth, but by contributing to the community and finding happiness in life. I don't miss my pager." Timothy Bill is a plastic surgeon. He shares his story and discusses his KevinMD article, "Why this plastic surgeon closed his practice to become a high school science teacher." (https://www.kevinmd.com/blog/2020/12/why-this-plastic-surgeon-closed-his-practice-to-become-a-high-school-science-teacher.html)

"Definitions ground us in our profession and in our world. Definitions matter because they help us pause, give our body a moment to settle, and our breath time to move in and out. Our racist actions, inactions, and comments are invasive throughout our waking hours, but we can change them if we can define them. Racist. Anti-racist. Microaggression. Institutional racism. Don't let the words keep you tense. Let's move forward together and breathe." Joy Eberhardt De Master is a pediatrician. She shares her story and discusses her KevinMD article, "Racist. Anti-racist. Microaggression. Institutional racism. The power of a definition." (https://www.kevinmd.com/blog/2020/12/racist-anti-racist-microaggression-institutional-racism-the-power-of-a-definition.html)