The Podcast by KevinMD

"The good news is that imposter syndrome can be quieted with increased awareness and replacing negative internal messages with positive ones. In our work together, I helped Sheila identify the voices, understand the positive role the voices fill (and there is always a positive or protective role), and find specific mechanisms for turning down the volume. Imposter syndrome may crop up again, but she now has a toolkit to quiet the intrusive thoughts and move ahead with confidence. Not only is Sheila now waking up without dread, she's explored several career paths and settled on one that she's excited about. You don't need to stay imprisoned in the dank dungeon of imposter syndrome. With the right tools, freedom is possible. Think of all you can accomplish, and how much lighter you will feel, when a more positive set of voices fills your head." Here's a questionnaire to assess imposter syndrome. (https://paulineroseclance.com/pdf/IPTestandscoring.pdf) Diane W. Shannon is an internal medicine physician and physician coach and can be reached at her self-titled site, Diane W. Shannon. She shares her story and discusses her KevinMD article, "Solving imposter syndrome in physicians." (https://www.kevinmd.com/blog/2020/12/solving-imposter-syndrome-in-physicians.html)

"In the world of medicine, inordinate stress is instead accepted as just part of the job. If you can't handle the heat, get out of the kitchen- or see a therapist on your own time and dime. I strongly believe that traditional therapy and psychiatry are vital and valuable disciplines- I might not be here without them. But not everyone who needs help living through this crisis (or pre-coronavirus life) is mentally ill or needs a diagnosis in order to qualify for guidance and support. No one should have to go through this pandemic, or life itself, alone. Literally or metaphorically. Not even doctors. As we wait for scientists to develop a vaccine and improve the reliability of testing, it is a good time to confront the obvious: in order to come out intact, healthy and whole on the other side of this pandemic, we are going to have to build our emotional intelligence and learn how to be vulnerable again. The only way to heal is to feel." Tracey O'Connell is a radiologist and physician coach. She can be reached at her self-titled site, Tracey O'Connell, M.D. She shares her story and discusses her KevinMD article, "Vulnerability is challenging but necessary for health care professionals." (https://www.kevinmd.com/blog/2020/05/vulnerability-is-challenging-but-necessary-for-health-care-professionals.html)

"As a young girl, I'd stand on my tiptoes, craning my neck to watch her sweep cerulean eye shadow across lids and smear foundation on sunken cheeks. While my high school friends resorted to secondhand eye shadow instruction from the pages of Teen magazine, I learned by watching my mom transform the face of a corpse with her skilled makeup application. My mother's gentle and methodical lipstick application entranced me. Back and forth. Slowly outlining the cupid's bow of a mouth. Delicately tracing of the arch in a feathery eyebrow. Until, wondrously, the corpse's vacant mask appeared serenely lifelike. With her artistry complete, no one could spot the thin line of super glue keeping the embalmed lips from springing open, or the plastic eye caps that gave the appearance of eyeballs peacefully resting in sockets. As I grew older, I pondered their last moments before this transition. What was the final word they spoke? Who received their last hug? What were they thinking when they realized their mortal roller-coaster ride was coming to a full and complete stop?" Lara Salyer is a family physician and author of Right Brain Rescue: One physician's journey from burnout to bliss reveals the creative muse in all of us. (https://amzn.to/3bw5XiQ) She shares her story and discusses her KevinMD article, "One physician's journey from burnout to bliss reveals the creative muse in all of us." (https://www.kevinmd.com/blog/2020/10/one-physicians-journey-from-burnout-to-bliss-reveals-the-creative-muse-in-all-of-us.html)

"I just started laughing. It was early on Monday morning during our COVID surge. I couldn't help myself. Phones were not on yet, but I already had triage COVID calls. "Put on your roller skates" was all I was thinking. I questioned my laughter. The day and a life of a primary care physician during COVID. Not a fun one by any means. Certainly not one to laugh at. But, if we don't laugh, we would cry. Everyone knows that cliche. Our days never end. We don't leave. The EMR has made sure of that. The nurses and staff are expected to smile and be respectful. They have, in fact, been so amazing during this pandemic. They have shown up every day with smiles on their faces." Kelly Lisciandro is an internal medicine physician. She shares her story and discusses her KevinMD article, "Why do I laugh during a pandemic?" (https://www.kevinmd.com/blog/2021/01/why-do-i-laugh-during-a-pandemic.html)

"As a professional woman who most identifies as a physician more than any other title, I know that I run the risk of losing myself to this disease. I am not ignorant to the risk. I understand that my identity is supposed to be separate from my achievements and that my babies are supposed to make me value something greater than my career. But my oath runs through me in a way that I can only describe as visceral. And for this reason, the pain is that much worse. Because as much as I miss them. And as much as I miss me. I can't not keep going. Because they deserve the best we have to offer. And those of us who have stood here on the front lines for over 10 months know more than anyone else, that if we don't do it, then who will?" Nicole M. King is an anesthesiologist. She shares her story and discusses her KevinMD article, "I keep going because I miss them. And I miss me." (https://www.kevinmd.com/blog/2021/01/i-keep-going-because-i-miss-them-and-i-miss-me.html)

"Research conducted by the Center for Talent Innovation (CTI), a nonprofit research organization in New York, defines the three pillars of executive presence (EP) as gravitas, communication, and image. Stated differently, EP reflects how you act, how you speak, and how you look. CTI concluded that when people are perceived as capable of becoming leaders, they are more likely to be promoted into leadership roles. This is particularly important for aspiring female leaders who continue to battle both conscious and unconscious gender bias. Studies show that men are more often associated with leadership qualities and women with nurturing qualities. This forces women to confront the need to master an intricate balancing act that simultaneously conveys both softness and strength." Nandita C. Gupta is a cardiologist. She shares her story and discusses her KevinMD article, "Executive presence for women leaders." (https://www.kevinmd.com/blog/2020/10/executive-presence-for-women-leaders.html)

"I am grateful that I work in a small rural hospital that is like a family. I am grateful that my organization has done everything in its power to protect us… but I hope we can do better. I hope medical workers have enough left within them to give their all for the coming months. Now we are in November with cases on the rise throughout the country: I hope we are more prepared. As the medical community, we do everything we can to protect our patients, our loved ones, and ourselves. Life in the emergency department during COVID has been some of the most emotionally and physically taxing of my career, but I remain optimistic that there is hope." Andrew Tisser is an emergency physician. He shares his story and discusses his KevinMD article, "Life in the emergency department during COVID: a rural physician's perspective." (https://www.kevinmd.com/blog/2020/11/life-in-the-emergency-department-during-covid-a-rural-physicians-perspective.html)

"Let's meet in the middle and listen to what's happening in communities. All across U.S. communities, there are pockets of promise and programs focused on family interventions, behavior change, and health disparities, but there are many obstacles to true change. Currently, the work relies on visionary champions within a community, but when the champion leaves the work, the work often goes away. There is a lack of resources on every level, from public health, research, primary care, specialty care, and advocacy, especially to sustain and scale effective efforts. The burden of sustainability must not be placed on one champion's shoulders, but rather viewed as an opportunity for sustainability and must be a shared effort among multiple partners representing multiple sectors." Karla Lester is a pediatrician. She shares her story and discusses the KevinMD article, "When it comes to weight stigma in children and teens, let's meet in the middle." (https://www.kevinmd.com/blog/2020/12/when-it-comes-to-weight-stigma-in-children-and-teens-lets-meet-in-the-middle.html)

"When you're applying to medical school, it's remarkable how much four years or more of intense work can come down to one single day. The medical school interview is high stakes: studies have found that interview performance is the most important factor in admissions decisions. While your MCAT score and your GPA can help secure an interview invitation, it's your interview performance that matters most when it comes to acceptance to medical school. I've advised many students who are prepping for their interviews, and what I've found is that overall they're great about avoiding certain common mistakes. They practice their handshake, know what to wear, and already researched the school's interview format. But I've found that many talented and highly accomplished applicants still make several other (very common) mistakes in their interview preparation." Rajani Katta is a dermatologist and author of Conquer the Medical School Interview and The Successful Match. She shares her story and discusses her KevinMD article, "5 common and commonly overlooked mistakes in the medical school interview." (https://www.kevinmd.com/blog/2020/11/5-common-and-commonly-overlooked-mistakes-in-the-medical-school-interview.html)

"Despite forces not within our control, namely the thoughts and actions of others, headway has been made in my local practice area: the decline in mortality, the advances in clinical knowledge about the pathophysiology, more efficient testing, more PPE, an uprooting and great revealing of the need for prioritization of health care worker wellness, the impact of stress and isolation on health, the magnification of health care disparities, racism, and sexism, an opportunity for the interweaving connection of humanity for some, along with the stark divisiveness that continues to exist. But we get to choose how this pandemic plays out for us. I choose extreme caution, gratitude for this opportunity for temporary seclusion, an opportunity to recharge while reconnecting. I wait in the uncertainty." Ni-Cheng Liang is a pulmonary physician and founder, the Mindful Healthcare Collective. She shares her story and discusses her KevinMD article, "A physician waits in uncertainty." (https://www.kevinmd.com/blog/2020/11/a-physician-waits-in-uncertainty.html)

"At the start of the pandemic when hospitals were overrun, testing and PPE were scarce, and unknowns about COVID-19 transmission abound, such restrictions were reasonable, perhaps even essential. But we have made progress since then; most hospitals test most if not all admitted patients for COVID-19; most Americans own a mask, and hospitals are able to provide to those without one. We must still take reasonable precautions. Allowing only one visitor at bedside, placing restrictions on movement of visitors throughout the hospital, and ensuring they practice social distancing from other hospital staff. With this, we can maintain patient and staff safety but also prioritize a part of care that is currently being undervalued. And as hospitals and cities across the country continue to try and get a handle on the pandemic, we must also continually re-examine what aspects of care we determine to be essential and must preserve in some way. And we must realize that family at the bedside is part of that essential care our patients need to heal." Taimur Safder is a cardiology fellow. He shares his story and discusses his KevinMD article, "It's time to end draconian hospital visitation policies during COVID-19." (https://www.kevinmd.com/blog/2021/02/its-time-to-end-draconian-hospital-visitation-policies-during-covid-19.html)

"A scientific achievement can never have success on its own unless if it has acceptance in the social context by the masses. I think that the concerns brought forward by the vaccine-doubters cannot be dismissed as ignorance, and it is hard to convince people. As a physician, it is not uncommon that I see a patient become indecisive and anxious about various treatment decisions facing them. I don't shy away from asking them to put their faith in me as their physician at moments like this. There is a simple strategy that makes the decision-making relatively easier, and that is to think of each patient as your own family member and recommend to them what you would want done if they were your own mother or grandfather. When presented this way, it usually goes very well with the patient, and a bond of trust is built, which ends up in successful care for the patient. I would say the same thing to a vaccine-doubter. If I am being vaccinated myself as a health care worker and if I agree to vaccinate my children, please trust me that you should do the same." Farhan S. Imran is a hematology-oncology physician. He shares his story and discusses his KevinMD article, "What this physician says to vaccine-doubters." (https://www.kevinmd.com/blog/2020/12/what-this-physician-says-to-vaccine-doubters.html)

"The rapid change-over to telemedicine in March of 2020 brought predictable challenges to health care at large and substance use disorder treatment in particular: patients without the skill set to navigate HIPAA-compliant apps, phones with too little smarts to handle video conferencing, lack of connectivity in rural and economically depressed areas. But telemedicine brought unexpected benefits: the no-show rate plummeted. Patients were more empowered by their own motivation to engage in care than limited by bus schedules' vagaries. Suboptimal face-to-face interactions among individuals in the throes of addiction (otherwise known as "mayhem in the parking lot") ceased immediately. Most of all, telemedicine mitigates the stigma associated with substance use treatment." Julie Craig is an addiction medicine specialist. She shares her story and discusses her KevinMD article, "Telemedicine reduces the stigma in substance use disorder patients." (https://www.kevinmd.com/blog/2020/12/telemedicine-reduces-the-stigma-in-substance-use-disorder-patients.html)

"While behavioral health integration (BHI) has been a long-standing conversation in collaborative care or health's team-based approach, it hasn't always been clearly defined and rarely means more than referring a patient in need to a specialist. The biggest shift over the past twenty years has simply been recognizing just how vital behavioral health is to overall wellness. To effectively and efficiently achieve true BHI, we must engage people in the digital age we currently live in. This modernization begins with innovative technology at its core to drive connected care." Chris Molaro is a health care entrepreneur and CEO, Neuroflow. He shares his story and discusses his KevinMD article, "Pandemic or not, we're failing patients when it comes to behavioral health." (https://www.kevinmd.com/blog/2020/11/pandemic-or-not-were-failing-patients-when-it-comes-to-behavioral-health.html)

"When we think about holistic medicine, many assume that it requires human-to-human touch points and, therefore, doesn't lend itself well to technology and innovations such as artificial intelligence. In fact, holistic medicine and whole-person care advocates often view technology as manufactured or impersonal and therefore dismiss its utility for health care. This is because there is a perception that health care tech values the human experience only for the purpose of developing better widgets or to refine machine learning algorithms. As a result, it can be difficult to envision high-tech holistic medicine that is supported by a whole-person care model. Nevertheless, I see a future where both technology and holistic medicine can complement each other for the advancement of whole-person care." Trisha Swift is a health care executive. She shares her story and discusses her KevinMD article, "The future of whole-person care: high-tech holistic medicine." (https://www.kevinmd.com/blog/2020/08/the-future-of-whole-person-care-high-tech-holistic-medicine.html)

"I would encourage you to see amazing women on social media for who they are in the future. Maybe figure out where they have been and what they are working toward. Maybe even figure out how ways to help each other solve the problems this country faces. Instead of looking at someone's appearance, listen to their story. You got unlucky with me; you can't intimidate someone who has lived through the war. I'm hoping that you choose to go in a more professional direction with the next woman you message because of these words. We are not transactions. We are intelligent, determined, passionate, and persistent people. It's far better to be our ally than our foe." Kellie Lease Stecher is an obstetrician-gynecologist. She shares her story and discusses her KevinMD article, "When a colleague asks you for nude photos." (https://www.kevinmd.com/blog/2021/01/when-a-colleague-asks-you-for-nude-photos.html)

"Yearly physicals are usually afforded a longer time than regular visits. If I can use most of that time focusing the discussion on what a healthy life means to each of my patients and what they need to achieve it, I feel that I've accomplished more than doing palpation, range of motion, and auscultation. Discussing medications and finding opportunities for de-prescribing, and discussing annual routine labs' futility is also an equally important and welcome part of my yearly rituals. As our population ages and we are faced with more chronic diseases, our goal is to maximize our patients' abilities to function, relate to family and community, and live a life of purpose. Expanding the visit to discuss health status, strengths, weaknesses, and goals is a good time investment in achieving healthier people and enriching our relationship with patients. For my part, it also adds joy and purpose to my life." Alina Urriola is a family physician. She shares her story and discusses her KevinMD article, "What are your health goals for the coming year?" (https://www.kevinmd.com/blog/2021/01/what-are-your-health-goals-for-the-coming-year.html)

"For a vaccination campaign to be highly effective, we need to be open to having difficult conversations with people who disagree with our perspective. If we don't, the result will be a polarization of philosophical ideas and not an unbiased and unemotional assessment of the data where maybe we can meet in the middle. As we share our pictures and experiences regarding getting our vaccines, let's try to admit what we know and, more importantly, what we don't know. Let's not speak down to those who have questions. And let's not be afraid to say that maybe we are a little afraid ourselves of some of these unknowns but that we are willing to take the potential risk of getting a vaccine because over the past then months, there are a few more knowns about the actual virus that scare us even more. Happy conscientious and kind posting." Alicia Billington is a plastic surgeon. She shares her story and discusses her KevinMD article, "The COVID vaccine selfie: The caption matters as much as the picture." (https://www.kevinmd.com/blog/2020/12/the-covid-vaccine-selfie-the-caption-matters-as-much-as-the-picture.html)

"In addition to being a pediatrician, I am Jewish and the granddaughter of a sole Holocaust survivor. My grandfather's family perished in Auschwitz, a concentration camp in Poland. My grandfather alone escaped, skiing through the night, to his safety and ultimate survival. The request from my hospital, the presidential debate, and the seeming dismissal of parentless children reminds me of a quote from Elie Wiesel, a Nobel Prize-winning writer, and Holocaust survivor. "What hurts the victim most is not the cruelty of the oppressor, but the silence of the bystander." I will not tone it down. I will not be silent. I believe a medical institution that is dedicated to the well-being of all people would not ask me to do otherwise." Ariana Witkin is a pediatrician. She shares her story and discusses her KevinMD article, "Why politics has a place in medicine." (https://www.kevinmd.com/blog/2020/10/why-politics-has-a-place-in-medicine.html)

"There is a unique non-clinical consulting opportunity any physician can learn to do full-time, as part of your existing practice, or in lieu of retiring. I'm Dr. Armin Feldman, and I'm a full-time medical-legal consultant in legal cases. A little over 13 years ago, I started and now, through the years, have been refining a new subspecialty of forensic medicine. I've trained over 1,600 physicians to do this consulting work. When doctors and lawyers think about lawyers hiring doctors, they only think of one thing: Hiring doctors to be expert witnesses. It's important to know, you won't act as a medical expert, and you won't participate in medical malpractice cases. There is a big difference between a medical-legal consultant and a medical expert witness in legal matters. In fact, they are two completely different things." Armin Feldman is a medical consultant to attorneys. He shares his story and discusses his KevinMD article, "An introduction to medical-legal consulting." (https://www.kevinmd.com/blog/2020/12/an-introduction-to-medical-legal-consulting.html)

"Children cannot afford to wait, especially our youngest learners who have difficulty engaging on a screen. We need to all work together to help schools reopen, especially in low-income communities that are disproportionately suffering and may lack the resources. I stand with the AAP, CDC, European CDC, WHO, and UNICEF to support safe school re-opening." Lekha M. Rao is a pediatric neurologist. She shares her story and discusses her KevinMD article, "Children cannot afford to wait: We need to all work together to help schools reopen." (https://www.kevinmd.com/blog/post-author/lekha-m-rao)

"We, as a profession, must accept some blame for many of the developing problems in health care delivery. No, I am not suggesting that we caused the problem. I am stating that we have had ample opportunities to manage the debacle and even to reverse some of the disturbing trends, yet we rarely allow our voices to be heard. Is health care reform impossible? It certainly isn't. But we, as doctors, need to step up to the plate, to stand up to the growing bureaucracy in the system, and make sure our voices are heard. The change will be long, slow, and painful, but we can't allow the system to continue to swallow us whole. The change must come from us." Alejandro Badia is an orthopedic surgeon and author of Healthcare from the Trenches. He can be reached at Healthcare from the Trenches and on Facebook and Instagram @badiahandtoshouldercenter. He shares his story and discusses his KevinMD article, "Health care from the trenches: Change must come from us." (https://www.kevinmd.com/blog/2020/10/health-care-from-the-trenches-change-must-come-from-us.html)

"Many friends have asked for my perspective on the COVID vaccine. Answering this requires both an explanation of clinical trials and an understanding of what normally slows down pharmaceutical development. Importantly, COVID vaccines are required to go through the same process as every other pharmaceutical. Vaccination is a personal choice, but I 100 percent recommend it. Personally, I can't wait to get vaccinated and am so grateful to the thousands of heroes who made this possible." Alexandra Fairchok is a medical student. She shares her story and discusses her KevinMD article, "Why can I trust the COVID vaccine?" (https://www.kevinmd.com/blog/2020/12/why-can-i-trust-the-covid-vaccine.html)

"With 2020 behind us and the pandemic still raging, it is incumbent upon us to take a close look in the rear-view mirror. While the vaccines' approval gives us all hope, the vaccination initiative's slow rollout should worry us. Physicians, health care providers, nurses, and essential workers, and patients and family members have borne the brunt of the pandemic. On the last count, about 3,000 health care workers had lost their lives due to COVID-19. The toll that the pandemic is wrecking on the health care community's emotional and mental health is only starting to become apparent. Health care systems, local, state, and federal governments have responded in different ways to ease the pandemic burden. While we can debate the level and adequacy of the response, we may have a larger problem on our hands if we fail to learn lessons and make the necessary changes going forward. I want to offer my perspective on the changes that physicians and health care providers should pursue that would allow us to emerge stronger." Manish Thapar is a gastroenterologist. He shares his story and discusses his KevinMD article, "2020 in hindsight: What we can learn." (https://www.kevinmd.com/blog/2021/01/2020-in-hindsight-what-we-can-learn.html)

"There is a frenzy of trying to use technology to re-establish the healing human connection in the doctor-patient interaction. These efforts range from advanced transcription of voice-to-record, scribes who do the data recording during a patient encounter, and so on. The IT department at NYU Grossman Medical School, where I teach, worked with the dominant and much-loathed electronic medical record to create a patient-focused dashboard for each doctor. The dashboard both improved quality of outcomes and reduced costs. These attempts are useful, but they don't address the root cause of this inhuman encounter: billing, the link of patient data to cash. In each of these tech improvements, the doctor is still forced by the money-people to massage the bill for the highest private insurance payments. There is a war across the screen — and like all wars, it's about money. On one side, doctors are forced by the accountants to bill the most. On the other side, insurance people are striving to pay the least. No 'program' or 'bot' could do this job. It's trapping doctors in the epidemic called burnout, moral injury, or just plain abuse. Forcing us to lie, to provide maximum payment. So long Hippocratic Oath. I think the solution is obvious. Why are VA hospitals' electronic medical record systems widely preferred to any of the other ones out there? Because they are not-for-profit billing machines. All across the U.S., each VA diagnosis and treatment has approximately the same reimbursement. No war across the screen. No Hippocratic hypocrisy." Samuel Shem is a psychiatrist. He shares his story and discusses his books, the House of God (https://amzn.to/3cVEOZc) and Man's 4th Best Hospital. (https://amzn.to/3rFUhAH)

"For me, the team room became a safe space filled with light, stories, laughter, and food. There, my residents helped me read CT scans, interpret CBCs, come up with the differential for bradycardia, and organize my oral presentations. My residents gifted me confidence, advice on the third year and specialty selection, and Dr. Pestana's Surgery Notes. They took away from their time on the wards to go over my notes, and from their time with their loved ones at home to prepare me short and helpful whiteboard lectures." Reem Al Shabeeb is a medical student and can be reached on Twitter @reemalshabeeb. She shares her story and discusses her KevinMD article, "The role of residents in teaching and creating a positive clinical learning environment." (https://www.kevinmd.com/blog/2020/10/the-role-of-residents-in-teaching-and-creating-a-positive-clinical-learning-environment.html)

"As we continue to deal with the COVID-19 pandemic causing spiking numbers of cases, the scientific and medical communities continue to search for effective treatments and preventive measures. We have clearly established the importance of wearing masks, physical distancing, and frequent handwashing. As of this article's writing, there are over two hundred fifty articles on PubMed about the connection between vitamin D and COVID-19. As the research studies are undergoing, evidence is mounting that adequate vitamin D levels may be a protective factor against COVID-19 infection and severity. Here's what the research shows." Teresa Fuller is a pediatrician. She shares her story and discusses her KevinMD article, "Is there a role for vitamin D in the treatment of COVID-19?" (https://www.kevinmd.com/blog/2020/11/is-there-a-role-for-vitamin-d-in-the-treatment-of-covid-19.html)

"Separated by less than a month (Boseman on August 28th and Ginsburg on September 18th) and both due to gastrointestinal cancers (Boseman had colon cancer and Ginsburg had pancreatic cancer), the situations of Ginsburg's and Boseman's deaths is emblematic of the racial disparity in American health outcomes. Boseman was African American/Black and was diagnosed with stage III colon cancer at the age of 39 while Ginsburg was Jewish/White and fought three separate primary cancers of different stages in multiple bouts – colon, lung, and pancreatic – starting at the age of 66." Adeel Khan is a hematology-oncology fellow. He shares his story and discusses his KevinMD article, "Ruth Bader Ginsburg and Chadwick Boseman: a tale of two cancers in America." (https://www.kevinmd.com/blog/2020/10/ruth-bader-ginsburg-and-chadwick-boseman-a-tale-of-two-cancers-in-america.html)

"When it comes to using telehealth to treat patients out of state, most physicians are mindful about licensure issues. But some are not aware that if you don't have a license to practice medicine in a given state, it isn't just malpractice: It's a criminal offense. Licensing restrictions have been eased to facilitate care during the pandemic, and the new normal of greater state-to-state cooperation for access to care may persist after the pandemic. Still, the savvy physician knows that many restrictions apply and that understanding them reduces risk. When we talk about interstate licensure, we're not concerned with a one-time interaction with an established patient who happens to be traveling. For instance, say a physician has recently seen a patient, perhaps performed a procedure. Thereafter, the patient calls the physician with a question or a problem from another state while traveling. In such a case, the physician can simply address the patient's concerns, whether that's by a phone conversation, a telemedicine visit, a recommendation to go to the emergency room where they are, or whatever is appropriate, according to their best clinical judgment. That's just practicing good medicine." David L. Feldman is chief medical officer, The Doctors Company. He shares his story and discusses the KevinMD article, "Interstate licensure for telehealth can fuel medical practice growth." (https://www.kevinmd.com/blog/2020/10/interstate-licensure-for-telehealth-can-fuel-medical-practice-growth.html)

"I will never forget these words. This physician validated my efforts to emotionally connect with patients. This message will indelibly shape the way I allow myself to care for and become invested in the patients to come in my future. Illness is often incredibly unfair, and sometimes we cannot overcome. However unbeatable a disease may be, a doctor can always remind a patient they are not going through this alone. We can be the one to hold their hand every day and stand with them until the very end. The magic of medicine sometimes lies in the brilliance of a treatment or cleverness of a diagnosis, but most often, it stems from the empathy of one heart opening itself to another." Claire Brown is a medical student. She shares her story and discusses her KevinMD article, "The magic of medicine stems from the empathy of one heart opening itself to another." (https://www.kevinmd.com/blog/2020/10/the-magic-of-medicine-stems-from-the-empathy-of-one-heart-opening-itself-to-another.html)

"Something had to give, and it would either be clinical medicine, or my business. I finally had to admit I was no longer fulfilled to the same level doing hospitalist work. So I made the decision to leave my clinical job. It was so terrifying that I put off making a decision for months. I thought about what it would mean for my blog readers that I wouldn't be in the trenches with them anymore. I thought about how it would affect my family if our real estate portfolio ever fell apart and I needed to be able to make money. I had a lot of fears. But I'd made the decision, long ago, that I would never make decisions from fear alone. So I submitted my resignation. And I threw out my Danskos." Letizia Alto is a hospitalist and who blogs at Semi-Retired MD. She shares her story and discusses her KevinMD article, "After 4,380 days, a pair of Danskos — and a calling — fall apart." (https://www.kevinmd.com/blog/2020/09/after-4380-days-a-pair-of-danskos-and-a-calling-fall-apart.html)

Vaccine hesitancy can have a negative impact on rollout. A striking example comes from long-term care facilities. Approximately 78 percent of residents received a vaccine. In contrast, only 37 percent of staff members agreed to be vaccinated. Reasons for refusal include: perceived rapidity of vaccine development inadequate information received about vaccine safety, side effects, and administration skepticism regarding the clinical trials and vaccine approval process HERO-TOGETHER is an opportunity for people working in health care to continue the fight against COVID-19. HERO-TOGETHER participants will receive learnings and study updates, and compensation for their time. Taking part is an easy way to help fight COVID-19 and learn how to keep our communities and families healthy and virus-free. Signup at heroesresearch.org/together (https://heroesresearch.org/together/?utm_source=kevinmd&utm_medium=podcast&utm_campaign=podcast-signup) Emily O'Brien is an epidemiologist, an associate professor in population health sciences at Duke University School of Medicine, and a faculty member of the Duke Clinical Research Institute. Emily is also the principal investigator of the HERO-TOGETHER study. Jessica Mega is co-founder and chief medical and scientific officer at Verily. Verily's mission is to develop the infrastructure and solutions to harness the profusion of health information for good. Their data-driven solutions across research, care, and innovation aim to improve the well-being of our communities.

"As the COVID-19 cases continue to rise across the globe, companies are working hard to develop innovative solutions to fight the coronavirus pandemic. Chinese companies such as Alibaba have led the way using artificial intelligence, data science, and technology. Startups are teaming up with clinicians, engineers, and government entities to reduce the spread of COVID-19. As we continue our fight in the management and eventual eradication of the virus, here are innovative ways companies are helping on the frontlines." Amita Kundra is a cardiac anesthesiologist. She shares her story and discusses her KevinMD article, "How technology is a weapon in the fight against COVID-19." (https://www.kevinmd.com/blog/2020/09/how-technology-is-a-weapon-in-the-fight-against-covid-19.html)

"It is still extremely early in the Bitcoin story. This is due to the same network effect that Facebook, Amazon, and Apple have had as adoption of new technologies rapidly expand and are adopted by society. Bitcoin has passed its 'tipping point.' Converting some of your money to Bitcoin now is like taking an ownership stake in the Internet itself back in 1995. Ultimately, Bitcoin will either have a massive price appreciation or go to zero - meaning it is a hugely asymmetric investment. A mere 1% allocation could potentially 2x the value of your portfolio; a 10% investment could 11x the value of your portfolio. Losing 1% of your portfolio is an extremely small risk given the upside to bitcoin. Finding the right allocation is up to you, but having 0% allocated to Bitcoin is a massive risk since risk in bitcoin is asymmetric to the upside." Noah Kaufman is an emergency physician and financial planner. He is founder and CEO, Kaufman Medical Group, and can be reached on Twitter @noahkaufmanmd. He is also founder of the Facebook group, Physician Options Traders. He shares his story and discusses his KevinMD article, "How physicians should invest in Bitcoin." (https://www.kevinmd.com/blog/2020/11/how-physicians-should-invest-in-bitcoin.html)

"The memory of these patients, and their families' utter anguish, stays with me. There was nothing I could have done to save them, nothing I did wrong. I've lost sleep, questioned my career choice, and sought mental health counseling to manage the stress of their loss. But the pain of their unexpected and tragic deaths lingers, like the torn knee tendon that heals but still throbs. I can walk on it, but it will occasionally start to ache—a reminder of trauma." Shira Shiloah is an anesthesiologist and can be reached on Twitter @ShiraShiloahMD. She can be reached at her self-titled site, Shira Shiloah, MD. She shares her story and discusses her KevinMD article, "Second victim syndrome: The pain of unexpected and tragic deaths lingers with physicians." (https://www.kevinmd.com/blog/2020/12/second-victim-syndrome-the-pain-of-unexpected-and-tragic-deaths-lingers-with-physicians.html)

"We are all interrelated. This is the foundational basis of osteopathic medicine. Whether considering internal relationships of the systems of the body or the external relationships of a person with the world around them, connection is a key principle at the core of osteopathy. Developed at a time when the baseline medical practice was lacking and offered as an answer to the beckoning call for a new perspective on methods of practice, osteopathic medicine is itself a call to curiosity and creativity. It is an invitation to challenge the status quo while standing in reverence of the grand design of human form and respect for the engagement with all of nature. Is there anything about the current practice of medicine that frustrates you? Do you notice outcomes that seem inappropriate, unfair, or discriminatory? Considering the possibility of health, do you see untapped potential in patients? Osteopathic philosophy offers the opportunity to see through to possible solutions." Amelia L. Bueche is an osteopathic physician and founder, This Osteopathic Life. She shares her story and discusses her KevinMD article, "Expanding the osteopathic concept for the health of all things." (https://www.kevinmd.com/blog/2020/10/expanding-the-osteopathic-concept-for-the-health-of-all-things.html)

"COVID-19 has propelled the nation into widespread telehealth services to provide consumer-based care, especially for those who access this technology. Equity issues arise when using digital communication because many underserved populations lack access to digital and/or mobile services. Inevitably, this brings up the greater concern of an unintentional exacerbation of disparities because low-income groups face limited access to both computers, mobile services, and the internet. Hence, investing in access to the internet and smartphones should be prioritized for underserved populations. As telehealth expands, broadband providers and municipal broadbands will cater to the demands in unserved areas by expanding their internet services." Sammi Wong is a medical student. Krysti Lan Chi Vo is a psychiatrist. They share their stories and discuss the KevinMD article, "Telehealth in underserved populations needs telecommunication expansion." (https://www.kevinmd.com/blog/2020/11/telehealth-in-underserved-populations-needs-telecommunication-expansion.html)

"At that point, I realized Thanksgiving came early this year, and I missed it. It was a reminder of why many of us go into medicine. I didn't go into medicine for glory or fame. Nor did I go into medicine for financial reward. Still, I often told the resident physicians I was training, after seeing a particularly kind patient, 'Can you believe we just got paid for seeing such a nice person?' I went into medicine because I enjoyed helping people. Sometimes, we need a little reminder of that. Or, in this case, a big box of reminders." Marc L. Frost is a dermatologist. He shares his story and discusses his KevinMD article, "Thanksgiving came early this year. I just didn't appreciate it." (https://www.kevinmd.com/blog/2020/12/thanksgiving-came-early-this-year-i-just-didnt-appreciate-it.html)

"The first thing my husband said when I told him about MBA school was, 'the NBA has a school?' It didn't help that we first had our conversation about MBA school during the NBA playoffs but really – NBA school? I quickly overcame this moronic start to the conversation by saying 'M' as in Michael Jordan – MBA school. He got it from there and every day since. And every day since has led me to this point of reflecting over the past two years. How did I get an MBA? Why did I get an MBA? Was it worth it? Rewinding the clock to April 2018 brings back many fond memories and some memories I would sooner like to forget. I was 37 years old with a 1-year-old baby and a few months into my full-time job as a transplant nephrologist at a thriving transplant department. The job demands were significant, but the rewards matched the demand. I learned exponentially about transplant nephrology, which I find incredibly gratifying today; however, the learning curve, demand, and stress had me concerned about my long term ability to do this job while maintaining a healthy physical and mental disposition. Out of all of this uncertainty came one certainty: I wanted to possess the ability to pivot to a new job if necessary." Manpreet Samra is a nephrologist. She shares her story and discusses her KevinMD article, "To MBA or not to MBA as an MD: a physician's journey." (https://www.kevinmd.com/blog/2020/11/to-mba-or-not-to-mba-as-an-md-a-physicians-journey.html)

"I am a veterinarian. More specifically, I am a veterinary specialist, board-certified in emergency and critical care. I don't play with puppies and kittens. I treat the worst of the worst in a specialty hospital setting with a state-of-the-art ER and ICU. Despite years of education, including veterinary school, internship, fellowship, and residency to obtain this education and specialty board certification, I was not prepared for the emotional toll of becoming a veterinarian." Garret Pachtinger is a veterinarian. He shares his story and discusses his KevinMD article, "Suicide in veterinary medicine is a huge problem right now." (https://www.kevinmd.com/blog/2020/10/suicide-in-veterinary-medicine-is-a-huge-problem-right-now.html)

"I am a medical doctor—a hospitalist working in an environment with many talented professionals. We share our knowledge and our approach to medicine with one another in ways that profoundly affect our patients and other personnel in the hospital. At our best, we are a community whose foundation is a willingness and openness to discuss hard facts and make difficult decisions. So why is it that when I was first diagnosed with infertility, I felt so alone? I was 1 in 8. Where were the others? There are hundreds of thousands of female doctors; where were the thousands who shared my situation? I didn't know anyone else. Because no one talks about it." Kate Hoppock is an internal medicine physician and can be reached at Fertility Found. She shares her story and discusses her KevinMD article, "Normalizing infertility conversations in the workplace." (https://www.kevinmd.com/blog/2020/11/normalizing-infertility-conversations-in-the-workplace.html)

"Oh, Canada! Every presidential election cycle, my colleagues joke that if the election result is not to their liking, they will move to Canada. On election night 2016, 'move to Canada' trended on Google, and the Canadian immigration website crashed. This election cycle America is having an existential crisis. What does America stand for? Who is American? What are American values? This time around, my colleagues aren't chuckling. Instead, they are frantically emailing Canadian colleagues, scouring the Royal College of Physicians & Surgeons site for details, and hoping they don't have to take additional exams. So, to ease the presidential election anxiety, here's a guide on practicing medicine in Canada." Ashwini Bapat is a palliative care physician. She shares her story and discusses the KevinMD article, "Election anxiety? Here's a guide to practicing medicine in Canada." (https://www.kevinmd.com/blog/2020/11/election-anxiety-heres-a-guide-to-practicing-medicine-in-canada.html)

"It is often difficult to reflect on the holidays when we are grieving positively. One thing to keep in mind is that the loved one/ones we lost would want us to remember them fondly and enjoy the holiday season. The holidays are rare occasions when families who are often separated by long distances come together. That time is precious, and as we well know, is limited. Making the most of the time, you have together will be a work in progress and a pathway to healing." Anjani Amladi is a psychiatrist and can be reached at her self-titled site, Anjani Amladi, MD. She shares her story and discusses her KevinMD article, "Empty chairs at the table this holiday season." (https://www.kevinmd.com/blog/2020/11/empty-chairs-at-the-table-this-holiday-season.html)

"The pandemic has been difficult, but it has managed to change my perspective for the better. I mourn for the suffering and loss we have experienced as humanity, and moving forward, I have a new sense of appreciation. I am hopeful for the future, and I know we are in this together. We should try to focus on appreciation, resilience, adaptability, and self-discipline. This is the most difficult time to do it as it seemingly has been forced upon us, but if we do not try it now, then when? As you read this, I want to know how the pandemic affected you directly. What have you improved upon, what have you grown to appreciate even more? I think we can all learn from each other, and if we focus on our resilience and some positivity, it may be a little easier to move forward and focus on hope for our future." Jasmine Toor is an internal medicine physician. She shares her story and discusses her KevinMD article, "Positive growth from the COVID-19 pandemic." (https://www.kevinmd.com/blog/2020/11/positive-growth-from-the-covid-19-pandemic.html)

"Vaccines have been around as early as 1776 when Edward Jenner first pioneered the smallpox vaccine and Louis Pasteur produced a rabies vaccine. As a microbiologist's child, I grew up hearing these stories from my father and thinking of these men as heroes. Vaccines have been proven so effective and safe that we are guilty of taking them for granted. There may have been a few mishaps, but given current standards for testing efficacy and safety, there is very little to worry about. In 1980, the World Health Organization declared that smallpox was eradicated from the face of the earth, and there was no need for further vaccination. I, for one, cannot wait to hear the same about COVID-19." Anupama Verma is a nephrologist and can be reached on Twitter @anuvmd. She shares her story and discusses her KevinMD article, "#ThisIsOurShot to end the pandemic." (https://www.kevinmd.com/blog/2021/01/thisisourshot-to-end-the-pandemic.html)

"COVID-19 wreaks havoc on multiple areas of the body, and myself and my fellow frontline workers across the globe have been forced to quickly identify what tools work best in our quest to keep our patients alive. While we're working to identify which technologies can improve our patients' outcomes, it's encouraging that policy work is being done to ensure we can access the technology that allows us to provide life-saving care. We can't do it alone. As we anticipate a potential surge of cases in the coming months, we must be prepared with the proper PPE, medications, and medical technologies that will result in less devastation than what we experienced this spring. When it comes to pandemics, that means we're intentional about establishing, nurturing, and supporting domestic manufacturers who can provide U.S. hospitals with the resources they need." Maria DeVita is a nephrologist. She shares her story and discusses her KevinMD article, "The need for on-demand access to medical technologies when treating COVID-19 patients." (https://www.kevinmd.com/blog/2020/11/the-need-for-on-demand-access-to-medical-technologies-when-treating-covid-19-patients.html)

"The peer-review process is fallible, slow, and biased, and it takes advantage of the scientific community's altruism. We need to keep pushing the conversation forward about making publishing more equitable, timely, accessible, and fair. An obvious and easy way to begin is to pay the experts who perform the peer reviews. Either the journals need to reform their practices, or the medical community should establish an alternative." Andrew Spector is a neurologist. He shares his story and discusses his KevinMD article, "Fairness in medical publishing: Reforming the peer review process." (https://www.kevinmd.com/blog/2020/11/fairness-in-medical-publishing-reforming-the-peer-review-process.html)

"I can do better. We can do better. Please partner with me and advocate for the ability for doctors and residents in our profession to receive medical and psychiatric care without fear of losing our licenses or having to face stigma and judgment. It can save lives. Please, we are more stressed than ever, and we need to speak the names of our fellow friends and colleagues who have died by suicide. We need to advocate for them and for all of us to have access unfettered by fear to utilize the very lifesaving treatments we recommend to our patients." Courtney Markham-Abedi is a psychiatrist. She shares her story and discusses her KevinMD article, "Doctors are killing themselves, and who is taking notice?" (https://www.kevinmd.com/blog/2020/10/doctors-are-killing-themselves-and-who-is-taking-notice.html) This episode is sponsored by Augmedix: Ambient medical documentation and live clinical support powered by virtual scribes. (https://augmedix.com/kevinmd) Did you know that nearly 75 percent of clinicians surveyed in a recent study say they spend over 10 hours per week on paperwork and medical notes? Augmedix is a leading provider of remote medical documentation, using remote AI-assisted live scribes to observe, listen, and capture relevant details from natural conversation for over 35 specialties. Augmedix provides real-time support that includes orders, referrals, and reminders to deliver accurate, complete, and timely medical notes. Augmedix brings back the joy of practicing medicine. To learn more and to bring the Augmedix joy to your practice, visit Augmedix.com/kevinmd (https://augmedix.com/kevinmd).

"Is the ACA perfect? Not by a long shot. In Kentucky, where I live, there are only 2 insurers selling individual policies on the exchange. A Silver plan for my husband and myself costs $1,800 per month in premiums, with a $13,600 deductible and an out-of-pocket maximum of $14,600. Therefore, the total exposure every year is over $36,000! Furthermore, there are no alternatives for individual coverage other than the exchange. However, without the ACA protections, we might not be able to buy health insurance at all. The best solution? The U.S. must join all the other developed countries around the globe and implement universal health coverage. Make health care affordable and accessible for everyone. It should be the American way." Susan G. Bornstein is an obstetrician-gynecologist. She shares her story and discusses her KevinMD article, "Why the preservation of the Affordable Care Act should matter to you." (https://www.kevinmd.com/blog/2020/10/why-the-preservation-of-the-affordable-care-act-should-matter-to-you.html) This episode is sponsored by Augmedix: Ambient medical documentation and live clinical support powered by virtual scribes. (https://augmedix.com/kevinmd) Did you know that nearly 75 percent of clinicians surveyed in a recent study say they spend over 10 hours per week on paperwork and medical notes? Augmedix is a leading provider of remote medical documentation, using remote AI-assisted live scribes to observe, listen, and capture relevant details from natural conversation for over 35 specialties. Augmedix provides real-time support that includes orders, referrals, and reminders to deliver accurate, complete, and timely medical notes. Augmedix brings back the joy of practicing medicine. To learn more and to bring the Augmedix joy to your practice, visit Augmedix.com/kevinmd (https://augmedix.com/kevinmd).

"Being a neonatologist and a mother is living with the knowledge that the question 'What would you do?' could so easily become real, not hypothetical. And so what would I do? I don't know, heartbroken mama. Because I feel too much, but I don't feel enough. Because I know too well, but I don't know at all. Being a neonatologist and a mother means sitting in those painful, fearful spaces of uncertainty, at a loss for what to say because I know that nothing I could ever say will be enough. And so I just sit. In that space. With that other mother." Diana Montoya-Williams is a neonatologist. She shares her story and discusses her KevinMD article, "Being a neonatologist and a mother." (https://www.kevinmd.com/blog/2020/08/being-a-neonatologist-and-a-mother.html) This episode is sponsored by Augmedix: Ambient medical documentation and live clinical support powered by virtual scribes. (https://augmedix.com/kevinmd) Did you know that nearly 75 percent of clinicians surveyed in a recent study say they spend over 10 hours per week on paperwork and medical notes? Augmedix is a leading provider of remote medical documentation, using remote AI-assisted live scribes to observe, listen, and capture relevant details from natural conversation for over 35 specialties. Augmedix provides real-time support that includes orders, referrals, and reminders to deliver accurate, complete, and timely medical notes. Augmedix brings back the joy of practicing medicine. To learn more and to bring the Augmedix joy to your practice, visit Augmedix.com/kevinmd (https://augmedix.com/kevinmd).