The Podcast by KevinMD

"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).

"As the mother of a child born with hypoplastic left heart syndrome, besides going through four open-heart surgeries and coding, my son has also had eight abdominal surgeries, including a Ladd's procedure and resection of his colon. William also functions without his appendix, spleen, and gall bladder. In addition to every kind of therapy imaginable, he has had to endure pamidronate infusions, daily shots, G-tube feedings, and TPN. Who knows how many times he's been X-rayed and poked by a needle. It's been a roller coaster, but he wouldn't be here without you: all of you." Wendy Hind is a health care consultant. She shares her story and discusses her KevinMD article, "Thank you pediatric medical professionals, as we fondly bid you adieu." (https://www.kevinmd.com/blog/2020/11/thank-you-pediatric-medical-professionals-as-we-fondly-bid-you-adieu.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).

"Rumor has it that the SARS-CoV 2 virus was brought into prison via inmates who were on a work-release program. Allegedly, they boarded a city bus with a driver who was ill. From there, it crept beyond the work-release camp and wafted over to the general prison population. The pandemic had reached this impenetrable fortress; a tiny virus with no proper consideration of human incarceration rules. It had failed to stop at the gatehouse. Traditionally, due to the nature of prisons and the nature of convicts, infectious illnesses do have a presence in prison systems. SARS-CoV 2 is no exception. As the alarms within the prison rose from orange to red, and new hotspots named, the direness increased. Then, the ebb and flow of prison life ceased and came to a complete halt. Similarly, in the free world, those who had no convictions or felonies became imprisoned in their homes. When once, a workday end meant freedom as we left the gatehouse behind, now it only meant further seclusion. Prison had crept outside the gatehouse. We left one boiling pot only to enter into another." Edna Wong McKinstry is an internal medicine physician. She shares her story and discusses her KevinMD article, "How to find joy in prison." (https://www.kevinmd.com/blog/2020/11/how-to-find-joy-in-prison.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).

"What form the incoming winter will take depends on the location and status of the COVID-19 pandemic. Each city must find a method that will provide the most relief and assistance for their homeless population. Analyzing the results of the measures already taken by shelters in the country will prove vital to developing individualized intentional plans for others. Finances will have to be the deciding factor on whether a shelter will install an HVAC system, engage in strict lockdowns, tap into the community, or develop a hybrid solution. Whatever the choice, shelters and the cities best act fast, because after all – winter is coming." Miracle Diala is a medical student. He shares his story and discusses the KevinMD article he co-wrote, "Stuck between a virus and a cold place: A choice for homeless Americans awaits." (https://www.kevinmd.com/blog/2020/12/stuck-between-a-virus-and-a-cold-place-a-choice-for-homeless-americans-awaits.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).

"Everything I ever have and ever will accomplish is in part due to the doctors, nurses, administrators, and security officers who gave me safe, compassionate care. This was no fairytale ending; I wish I never had to make this choice, and I grieved for months for the path I did not choose. But I often think of the resident who held my hand in the procedure suite and told me I would make a fantastic doctor. And when I look at what she gave me — the freedom to pursue my medical education, the privilege to care for patients, the right to live my life how I choose — I hope I've made her proud." Shira Fishbach is a medical student. She shares her story and discusses her KevinMD article, "I will be a doctor because I was once a patient." The opinions expressed in this episode are those of the guest and are not necessarily those of the host or the host's employer. Please review KevinMD's terms of agreement under "Information disclaimer."

"At first, it may seem strange that 'physician' and 'side gig' are even used in the same sentence. After all, the average physician in the United States is already working more than a 40 hour work week and struggling with issues related to work-life balance. As someone who talks about physician burnout and as the founder of the Physician Side Gigs Facebook group, I've been asked many times how adding yet another thing to the physician's plate could possibly be a good idea. And yet, I'm a strong believer that physicians should have additional revenue streams and pursue other interests. Why?" Nisha Mehta is a radiologist and founder, Physician Side Gigs and the Physician Side Gigs Facebook group. She can be reached at her self-titled site, Nisha Mehta, MD, and on Twitter @nishamehtamd. She shares her story and discusses her KevinMD article, "Why physicians need side gigs." (https://www.kevinmd.com/blog/2018/01/physicians-need-side-gigs.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).

"In Wooster, Ohio, where I practiced, a small not-for-profit hospice agency relied on local physicians, clergy, and many other volunteers to supplement the skills and dedication of their employed staff. It was through this work with Hospice of Wayne County, in making home visits when needed, that I learned the immeasurable value of presence. By continuing to care for my cancer patients until they died, I acquired insight into the equally essential virtue of nonabandonment. When I first attended a hospice and palliative medicine conference in the early 1990s, I realized that I had found my home—a community of professionals of various disciplines who had found what I had discovered: that it is the people, not the diseases, that matter. It would be years before I would totally focus my medical practice on the care of the dying, but in the meantime, the lessons I learned from those at the end of their lives made me a better oncologist and maybe even a better person. As I mentioned above, the most important of those lessons is the realization that I also am mortal, and I too will die." Jeff Spiess is an oncologist and palliative care physician. He is the author of Dying with Ease: A Compassionate Guide for Making Wiser End-of-Life Decisions. (https://amzn.to/2NpqrSf) He shares his story and discusses his KevinMD article, "Death is personal for this physician." (https://www.kevinmd.com/blog/2020/09/death-is-personal-for-this-physician.html)

"A practicing anesthesiologist for the past 14 years, when COVID hit, and the ORs came to an abrupt halt, I needed to occupy my mind. An opportunity to learn about the business behind running a practice came to me via a good friend who is a founding member of an award-winning Fintech on a mission to make a change in the credit card processing industry. I was stunned to learn about the questionable practices common in this industry. Medical education does not include business training, leaving us particularly vulnerable – no matter how great our office manager! I've seen first-hand how a little knowledge can yield significant savings in time and money. Here are the basics about what we, as doctors, should know." Jennifer Mogan is an anesthesiologist and account executive, Park Place Payments. She shares her story and discusses her KevinMD article, "How doctors are losing money every time a patient pays a bill." (https://www.kevinmd.com/blog/2020/10/how-doctors-are-losing-money-every-time-a-patient-pays-a-bill.html)

"Just as the pandemic has forced massive technology adoption in the delivery of care, we will see the rapid, widespread implementation of innovative solutions that medical education has desperately needed for years. Technologies like computer-based training, adaptive learning using artificial intelligence, video game-based learning, and extended reality such as virtual reality and augmented reality can close the educational gap. Virtual colonoscopies can be practiced 100 times before touching an actual patient. Many companies innovating in this space are seeing tremendous market interest in the wake of the pandemic. Most of these new technology-based educational tools can be used remotely, synchronously, or asynchronously, often without a teacher or proctor present. Although training will always require clinical experience, innovations at the bedside will also provide a major advantage over the traditional educational path. Hence learning can continue, and learning losses minimized. This is the way forward for most, if not all, institutions in the foreseeable future, and institutions that adopt these technological solutions will outpace those that resist." Eric Gantwerker is a pediatric otolaryngologist. He shares his story and discusses his KevinMD article, "Health care's tech renaissance during the pandemic." (https://www.kevinmd.com/blog/2020/09/health-cares-tech-renaissance-during-the-pandemic-extends-to-medical-training.html)

"We lack the necessary signaling of the nonverbal cues when only looking at one's face. The presenter's large face only a few inches from our screen may evoke our primordial threat response with its resulting cascading transmitters. The angulation of computer and phone cameras causes facial distortions. Unless one aligns oneself to be at the same level as the camera, the camera angulation may cause one to feel either looked down upon or looked up to, but rarely on the same playing field. Our neurons are living and breathing cells, and they need to eat and rest. The brain is responsible for filtering through vast quantities of homeostatic signaling from the rest of our bodies, which may affect the limitation of information that we can process. Our neural circuitry limits our information processing capacity. Just ask why can't we pay attention to two ongoing conversations at one time? Electrical circuits have breakers for overload. We just have coffee." Lester Gottesman is a colorectal surgeon. He shares his story and discusses his KevinMD article, "Zoom is foie gras of the brain." (https://www.kevinmd.com/blog/2020/10/zoom-is-foie-gras-of-the-brain.html)

"The COVID-19 pandemic has impacted everyone, especially those of us in health care. Our way of practicing medicine has been changed; some would say forever. We find ourselves affected not only clinically but also emotionally. As a result, clinicians are experiencing more stress and anxiety than ever before. These feelings are not new but have been heightened in the face of the pandemic. Physicians are perceived as self-reliant, emotionally stoic, and pillars of the medical community. Society expects perfection from our health care system and turns to us in times of medical crisis. As clinicians, we need to recognize our humanity; doctors are people too, with the same emotional needs as any other individual. In fact, one could argue that medicine demands require an even greater level of emotional support than other professions." Susan Wilson is an emergency physician and physician coach. She shares her story and discusses her KevinMD article, "Peer-to-peer support and the second victim syndrome." (https://www.kevinmd.com/blog/2020/11/peer-to-peer-support-and-the-second-victim-syndrome.html)

"Doctors are indeed noble for what they do. Their work is undoubtedly physically intense and emotionally taxing. But the notion that they are 'superhuman' and 'different' from the rest of society is exactly the trap that we fall into the moment we don our white coats as medical students. It is because of this trap that we get tunnel vision and let mistakes during our medical school training define our self-worth. We forget that there is a world outside of our flashcards, PowerPoint slides, exams, and clerkships teeming with people, adventures, and stories that, if we so choose, we can enrich our lives with, intellectually, physically, and spiritually. There's a reason depression, anxiety, and burnout is disproportionately higher among medical students and physicians. In fact, nearly 400 physicians commit suicide a year, the highest of any profession. Might it be because we are anchored to one thing and one thing only? Those of us who pursue medicine have built our entire personhood around the goal of becoming a doctor. If that is all that is meaningful to us, should we really be surprised at the statistics on mental health?" King Pascual is a medical student. He shares his story and discusses his KevinMD article, "Why medical students should not let medicine define them." (https://www.kevinmd.com/blog/2018/10/why-medical-students-should-not-let-medicine-define-them.html)

"I am left wondering what would have happened if I was the patient's daughter, niece (who she said I reminded her of), or friend. The nurse made a quick judgment based on my physical characteristics, and she was completely incorrect. I am blessed to be able to challenge people's implicit bias on a daily basis. When I walk down a hall in the hospital with my medical student badge, I feel both proud and out of place. Medicine has a long way to go in terms of making sure that people of color who are underrepresented in medicine feel comfortable, welcomed, and included wherever they go. It starts with making sure we do not make quick judgments when we see Black people and assume that they are there to take out the trash." Akosua Y. Oppong is a medical student. She shares her story and discusses her KevinMD article, "A medical student's story of racism and bias." (https://www.kevinmd.com/blog/2020/10/a-medical-students-story-of-racism-and-bias.html)

"My own dream-induced pain started at the same time this child was mowed down. Then and there is when and where my faith in God died because God, the higher power, had allowed this unspeakable nightmare to happen. My hope for the future evaporated, all while helplessness chewed through my guts From Left to Right. This was the same moment I realized that humanity is connected in a definitive, tangible, and spiritual way. A trigger-happy and scared Marine was likewise connected. He made an understandable mistake in the heat of the moment and accidentally destroyed this innocent little girl. His solitary action grew into horror, altering all of our lives. We are all intrinsically connected, and yet, we point weapons at each other, pulling triggers, and then we deal with a fragmented, amputated existence. War eviscerates us all." Reagan Anderson is a dermatologist and author of Universal Death Care. (https://amzn.to/38u63Ht) He shares his story and discusses his KevinMD article, "The trauma of a combat doctor in Iraq." (https://www.kevinmd.com/blog/2020/11/the-trauma-of-a-combat-doctor-in-iraq.html)

"The new American Medical Association policy recognizing racism as a public health threat and providing an anti-racist approach to equitable care will have no effectiveness unless health care organizations get their own houses in order and actively do anti-racism work in their own institutions. Although I'm not a health care provider, as a health care communicator whose role is dedicated to diversity, equity, and inclusion, I sit in rooms where health disparities in hard-hit communities due to systemic racism are regular topics of conversations. But in the hallways, on Zoom meetings, in texts and email conversations, I also learn about all how disparities due to systemic racism are rampant inside an institution and make organizational health equity seem like a faraway dream. How can you fight to advance health equity and racial justice out in the community when you're not doing the same within your own organization?" Nikki Hopewell is a communications strategist. She shares her story and discusses her KevinMD article, "Health care organizations: Clean up your house first, then you can tackle racism in patient care." (https://www.kevinmd.com/blog/2020/12/health-care-organizations-clean-up-your-house-first-then-you-can-tackle-racism-in-patient-care.html)

"To understand how to create good shifts irrespective of external factors, I turned to the ancient philosophy of Stoicism. One of its core tenets is that we must focus on what is within our control. Epictetus said: 'Happiness and freedom begin with a clear understanding of one principle: Some things are within our control, and some things are not. It is only after you have faced up to this fundamental rule and learned to distinguish between what you can and can't control that inner tranquility and outer effectiveness become possible.' Too often, we ignore his admonitions, and we focus our efforts on things that are outside our control while paradoxically relinquishing control of things that are within our control. Things within our control, per the Stoics, are our own thoughts, emotions, and actions. We relinquish control of them by allowing our emotions to be unduly affected by external things. 'That person said something that made me upset,' or 'I'm angry because I couldn't get something I needed.' On the other hand, we try to control things that are outside our circle of control, such as other people's actions or opinions, politics, coronavirus, or even the weather. We try to control them in our minds by resisting their presence, continuously wishing them away, or perseverating that they should be different. In order to have the inner tranquility and outer effectiveness Epictetus encouraged, we must give up the fiction that we can control things outside ourselves and maintain better control of ourselves." Christina Shenvi is an emergency physician and can be reached on Twitter @clshenvi. She shares her story and discusses her KevinMD article, "How to (almost) never have a bad shift." (https://www.kevinmd.com/blog/2020/10/how-to-almost-never-have-a-bad-shift.html)

"Touted by some as a 'great equalizer,' the COVID-19 pandemic has brought to the forefront long-standing disparities in access to health for Black, Latinx, immigrant, and low-income communities. While we are all in this fight together, some are bearing the burden more than others. Studies have shown that Blacks in the United States are especially affected, with them being represented twice as often among COVID-19 deaths as they are in the population (13 percent of the population vs. 27 percent of COVID-19 deaths). In New York City (NYC), primarily Black and Latinx neighborhoods are being ravaged, while whiter and wealthier areas are seeing fewer cases and deaths. Furthermore, there has been a mass exodus from whiter and wealthier neighborhoods, while New York's Blacks, Latinxs, immigrants, and those from socioeconomically disadvantaged backgrounds have been unable to escape financial, mental, and literal suffocation by the virus." Aishwarya Raja is a medical student. Inginia Genao is an internal medicine physician. They share their stories and discuss their KevinMD article, "Unmasking inequality: the power of community organization during COVID-19." (https://www.kevinmd.com/blog/2020/10/unmasking-inequality-the-power-of-community-organization-during-covid-19.html)

"Today and for the foreseeable future, COVID-19 is a serious threat, virulent and contagious, not only leading to an impressive display of human vulnerability and arrogance, but also demonstrating how innovative and creative humans can be during a time of crisis. On a daily basis, I am inspired by the outpouring of courage, empathy, and compassion, as well as the injection of original and mutated ideas that will govern the blueprint of our destiny. The truth is that the coronavirus has gone viral and, in so doing, opened the door to other remarkable evolutionary adaptations. Adaptations that will both thwart its virility and enhance our society's immunity, resilience, and long-term survivability.' Pringl Miller is a general surgeon. She shares her story and discusses her KevinMD article, "The new meaning of the phrase, 'going viral'." (https://www.kevinmd.com/blog/2020/04/the-new-meaning-of-the-phrase-going-viral.html)

"I do want you all to know that shame is a very familiar brain track (like an 8-track tape, if you know what that is), but not one I am stuck in. The above experience of failing a class turned out to be amazing. I am now appreciative of how far I have come — of what I have learned, through much transformational therapy, mindfulness and coaching work. I am lucky enough to have a choice in my thoughts and to not disengage. I don't have to be stuck there. I can put it on speaker-phone with trusted individuals in my life. I can dedicate the work I do now to the memory of my patient and her family. I continue to heal and offer healing. Life is really an amazing tapestry with short fibers, longer fibers, many colors and most of all — each thread woven to make a perfect whole. It is when we feel stuck that guilt and shame can get the better of us, impacting all areas of our life. I am sharing this very personal story to make a difference with those stuck in the negative talk and the feeling that the core of who we are is not worthy. Enduring shame is associated with depression, anxiety, PTSD and addiction. Shedding light into the dark areas of thoughts we keep secret make a huge difference." Robyn Alley-Hay is an obstetrician-gynecologist and can be reached at her self-titled site, Dr. Robyn Alley-Hay. She shares her story and discusses her KevinMD article, "How shame almost ruined a physician's life." (https://www.kevinmd.com/blog/2019/02/she-was-dead-how-shame-almost-ruined-a-physicians-life.html)

"Environmental cleaning rightfully plays a more prominent role within health care facilities to control the spread of other diseases, but even hospitals have overreacted when it comes to contact precautions for SARS-CoV-2. I recently went to get a flu shot from one of the hospitals I cover, and I couldn't help but think that several steps in this process seemed wasteful. Even though everyone was already masking and maintaining appropriate distance, recipients were each assigned one large desk and one pen to fill out the obligatory paperwork. Once complete, the pens went into a "dirty" cup, and a gloved staff member had to wipe down the pen, clean the entire desk surface and dispose of the cup before anyone else was allowed to use that station. Before I could sit down and receive the vaccine, I had to stand back and allow the administering nurse to wipe down the whole chair with isopropyl alcohol. We didn't go to these lengths before the pandemic, so why go over the top now for a virus that, for all intents and purposes, is not spread by contact?" Clayton Foster is an infectious disease physician and founder, AirborneID. He can be reached on Facebook and Twitter @AirborneID_CO. He shares his story and discusses his KevinMD article, "COVID transmission should not be a touchy subject." (https://www.kevinmd.com/blog/2020/09/covid-transmission-should-not-be-a-touchy-subject.html)

"It has been over a month since I started this new hobby. I told my middle-school-aged daughter tonight, 'I am going to write a post about how ocean plastic picking has made me a better pediatrician.' She replied, 'You mean better than other pediatricians?' 'No, I mean a better pediatrician than I was before,' I answered in all seriousness. I know where her thoughts were coming from. I have always thought that anyone who makes it through the medical training process, including her mother, must have some level of narcissism and arrogance to make it and succeed. We have to convince parents, patients, and colleagues that we are just special enough to deserve their trust, their respect, and that we know what we are doing. Being mid-career, I certainly know I am competent. But the regular ritual of collecting ocean plastic has helped me be a better and more humble pediatrician." Vi Thuy Nguyen is a pediatrician who blogs at Dr. Plastic Picker. She shares her story and discusses her KevinMD article, "How ocean plastic picking made me a better pediatrician." (https://www.kevinmd.com/blog/2019/12/how-ocean-plastic-picking-made-me-a-better-pediatrician.html)

"I am overwhelmed right now. I know I am not alone. I hear it in the voices of my friends, family, colleagues, patients. We are all feeling it. I am overwhelmed by this virus. There is so much to learn, so much to teach. Every day the information changes. Who is credible? Who is just shouting the loudest? It can be hard to sort, but it must be done. As I figure it out, I need to pass on the information in the most compassionate but clearest way possible, despite the naysayers. I am overwhelmed by our numbers. In my small county of about 40,000, we had two cases on March 22, ten on April 1, seventeen on May 1. We seemed to be doing ok. Then we climbed from 76 on June 1 to 196 on July 1. And as of July 8, we are up to 346. That's 150 in a week. That more in one week than we had in 3 months. And it is not just from testing more. Our hospital, COVID-free for weeks, is now seeing more and more COVID-19 patients not only in the ER but needing admission and serious treatment. The numbers are heart-stopping." Diana R. Twiggs is a family physician and can be reached at her self-titled site, Diana Twiggs, MD. She shares her story and discusses her KevinMD article, "I am overwhelmed right now. I know I am not alone." (https://www.kevinmd.com/blog/2020/07/i-am-overwhelmed-right-now-i-know-i-am-not-alone.html)

"Each year, medical students across the country prepare to start the long-anticipated core clinical rotations. Suddenly, we're thrust into a world of constant adaptation and evaluation, with many highs and many lows. As I finish up the year and new students get ready to start, I've been asked time and time again for my advice. I decided to aggregate my key takeaways from the year, and what I wish I had been told." Netana Markovitz is a medical student. She shares her story and discusses her KevinMD article, "13 tips for medical students starting their clinical rotations." (https://www.kevinmd.com/blog/2020/09/13-tips-for-medical-students-starting-their-clinical-rotations.html)

"We in medicine are experts in delayed gratification. We've been in school for what, about 21 years before residency? Then we finally become an attending. Then we can splurge a little. But still, we were told to hold back. Live like a resident. This is a great skill to have as an entrepreneur. Their world is tough. Countless working hours, low pay, myriad emotions, and a light at the end of the tunnel. Sounds just like residency, right? Now I know the idea of doing another residency doesn't sound that great, but it's possible. You've already survived one. Many even more than one or a fellowship. You have the power to do another if you wanted." Pranay Parikh is a hospitalist and can be reached at his self-titled site, Pranay Parikh. He shares his story and discusses his KevinMD articles, "Doctors make bad entrepreneurs" (https://www.kevinmd.com/blog/2020/09/doctors-make-bad-entrepreneurs.html) and "Doctors make great entrepreneurs." (https://www.kevinmd.com/blog/2020/09/doctors-make-great-entrepreneurs.html)

"What has become of medicine today? What has become of the sacred patient-physician relationship? What has become of medical offices- aren't they supposed to be healing places? Who goes to a medical clinic (no matter how Big the Name) to be insulted and diminished and hurt? What has become of physicians as stewards of healing? Why is this happening to us? How much have we been hurt, as doctors, to not be able to see past our own ego and agenda and use our hard-earned healing potential to harm instead of soothe and heal?" Corina Fratila is an endocrinologist. She shares her story and discusses her KevinMD article, "Are physicians the stewards of healing that they are meant to be?" (https://www.kevinmd.com/blog/2020/10/are-physicians-the-stewards-of-healing-that-they-are-meant-to-be.html)

"I plan to reach out to climate organizations and see what I can do to get involved. Whether that means writing more op-eds like this one or writing to legislators, I now recognize that as part of the medical field, especially in regard to mental health, I have a role to play. I invite all of you in the medical field to join me in this effort. You can hear the rumblings in certain pockets that, just like with gun control, medicine should stay in its lane and not be involved in issues like climate advocacy. That's simply not a tenable stance. With a warming planet and without action, the human population will simply get sicker. That stands in direct conflict with our oath to "Do no harm." So again, get involved with the climate movement in the best way you know how. Our patients' and future patients' lives are on the line." Derek Wolfe is a medical student. He shares his story and discusses his KevinMD article, "Dear medical community, it's time to engage in the climate movement." (https://www.kevinmd.com/blog/2020/09/dear-medical-community-its-time-to-engage-in-the-climate-movement.html)