The Podcast by KevinMD

"What has kept me comprised during this entire time has been the realization that this whole situation is not normal. It's not normal for me; it's not normal for millions of other people. This is not how pregnancy is supposed to go. This is a pandemic and an uncertain time for everyone. Many of us have caved under pressure, either it is financial, or the risk of exposure to a high-risk individual at home, or the fear of losing your friends and family. Each of us has reasons to be afraid. Being pregnant is just one of them and should be considered that way. It is important to acknowledge the unfamiliarity of this all and be thankful for what we have. I am thankful for supportive family, friends, and colleagues who have supported me (virtually) and practically in so many ways. I am thankful for the many work from home days, where I have felt so exhausted to get out of bed. I am thankful for health and food on my table, and my heart goes out to those who haven't been fortunate enough. And with that, I am also hopeful for better days, and a healthy child." Saba Fatima is a pediatric hospitalist. She shares her story and discusses her KevinMD article, "What it's like to be pregnant in a pandemic." (https://www.kevinmd.com/blog/2020/07/what-its-like-to-be-pregnant-in-a-pandemic.html)

"We can clearly see that exponential technologies are disrupting cars and phones. So why wouldn't these technologies find their way into health care and gastroenterology? What do stool tests have to do with self-driving cars? We'll soon find out. But let's first go back to the discussion we had earlier on the shift to digital. Screening for cancer through colonoscopy, while a gold standard, reminds me of a field that's at the crossroads of disruption—much like music or photography was before iTunes or smartphones. If you consider the argument for a moment, a colonoscopy is largely limited to one doctor and one patient at a time. When a doctor performs a colonoscopy, he or she can't scale beyond the procedure. With each procedure, the learning happens within the capacity of that one doctor. To put that into context, only a very small percentage of doctors become endoscopists. And an even smaller percentage achieve mastery in endoscopy. Statistically speaking, we are talking of a very few highly qualified individuals who can reliably screen for cancer using sophisticated methods. Ask yourself what could make the field of cancer screening go digital? Something that can accelerate cancer screening and give control to the nonexperts. I'm sure you might have arrived at DNA testing or artificial intelligence." Praveen Suthrum is president and co-founder, NextServices and blogs at redo | healthcare. He shares his story and discusses his KevinMD article, "What does colon cancer screening have to do with self-driving cars?" (https://www.kevinmd.com/blog/2020/08/what-has-colon-cancer-screening-got-to-do-with-self-driving-cars.html)

"Hiring locum tenens clinicians often proves to be more efficient, and when a position goes unfilled, health care organizations are potentially leaving millions of dollars on the table in unrealized revenues. Once in place, locum tenens clinicians can help organizations expand their service lines, provide access to specialists, relieve existing staff workload, keep the operating room running, manage throughput in the emergency department, and cover call. They are also part of a growing natural progression in health care — telemedicine. Locum tenens clinicians are being used in telehealth settings, allowing the flexibility to simply video chat with a patient for a consult or provide a second opinion to another physician. Utilizing locum tenens clinicians ultimately benefits patient care while positively impacting the bottom line. Among the available strategies to deal with the current challenges in clinician recruitment, the locum tenens model can undoubtedly evolve into a viable and attractive long-term strategy for the provision of everyday health care access." Sridhar Rajamani is a pulmonary physician and member of the advisory board, LocumTenens.com. He shares his story and discusses his KevinMD article, "How can we redefine locum tenens?" (https://www.kevinmd.com/blog/2020/03/how-can-we-redefine-locum-tenens.html)

"In my work with physicians and physician leaders in academic medicine, I learned that physicians are highly self-reflective and aware of the pressures they face; however, they are frequently the last to ask for help, and the first to deprioritize their own self-care. This has led to high suicide rates in the overall physician population. For coaches partnering with physicians on wellness, leading with mindfulness first could cause an adverse reaction. A colleague and I held a workshop on physician wellness and began the session with mindfulness. Several left the room, and a few others spoke up, indicating that what they needed was not mindfulness, but solutions for inefficient processes and increased demands from their medical coding departments. We did not make that mistake again! These professionals are overwhelmed; they are just trying to get through the day and meet their goals. Oh, and take care of their patients. Mindfulness can be seen as "another thing to do" in an already packed schedule or can make physicians feel angry or "guilty" for not already trying something that seems so simple and cause them to close down to exploring other solutions." Cory Colton is an executive coach. He shares his story and discusses his KevinMD article, "When coaching physicians with wellness, don't lead with mindfulness." (https://www.kevinmd.com/blog/2020/09/when-coaching-physicians-with-wellness-dont-lead-with-mindfulness.html) This episode is sponsored by Elsevier Health (https://www.us.elsevierhealth.com/). Looking to update your personal or professional medical library? Shop Elsevier Health's Holiday Sale and save up to 35% on your purchase of medical books! Plus, you can take an extra 5% off your order with code KEVINMD at checkout. Take advantage of the biggest sale of the year from Elsevier, the world-leading provider of medical books and reference materials. Shop us.elsevierhealth.com now through December 31.

"A few months ago, I signed up for a virtual conference for women in medicine. It's a group of women, over 10,000 of us, who have watched me and supported me through the past two years of my career. Two years of struggle. Two years of personal and professional pain. Two years of opportunity for growth, and two years of numerous setbacks that were only overcome with all of their assistance. At the close of each interview with women leaders in various industries, the organizer asks them what 2020 has taught them. A friend of mine from the group reached out to a few of us and asked us what 2020 had taught us. In my response, I referenced so much of what we have touched on in this class and things that have been brought to the surface by the turmoil of this year. The only way to save medicine, save our country, and to save ourselves is to pivot." Nicole M. King is an anesthesiologist. She shares her story and discusses her KevinMD article, "The only way to save medicine, save our country, and to save ourselves is to pivot." (https://www.kevinmd.com/blog/2020/09/the-only-way-to-save-medicine-save-our-country-and-to-save-ourselves-is-to-pivot.html) This episode is sponsored by Elsevier Health (https://www.us.elsevierhealth.com/). Looking to update your personal or professional medical library? Shop Elsevier Health's Holiday Sale and save up to 35% on your purchase of medical books! Plus, you can take an extra 5% off your order with code KEVINMD at checkout. Take advantage of the biggest sale of the year from Elsevier, the world-leading provider of medical books and reference materials. Shop us.elsevierhealth.com now through December 31.

"Most Americans have remained dangerously unaware of this revolution in health care. Being treated by a non-physician is not on the radar of the average patient, most of whom assume that anyone in a white coat is a physician. If patients do wonder about being treated by a non-physician, they are reassured that their nurse practitioner or physician assistant is "just as good" as a doctor, an idea reinforced by multi-million-dollar direct-to-patient advertising campaigns. But is care by nurse practitioners and physician assistants really as good as that of physicians?" Rebekah Bernard is a family physician. She is the co-author of Patients at Risk: The Rise of the Nurse Practitioner and Physician Assistant in Healthcare. (https://amzn.to/2UIhL9H) She shares her story and discusses the article that she co-authored, "Proponents of independent non-physician practice make a dangerous assumption." (https://www.kevinmd.com/blog/2020/11/proponents-of-independent-non-physician-practice-make-a-dangerous-assumption.html) This episode is sponsored by Elsevier Health (https://www.us.elsevierhealth.com/). Looking to update your personal or professional medical library? Shop Elsevier Health's Holiday Sale and save up to 35% on your purchase of medical books! Plus, you can take an extra 5% off your order with code KEVINMD at checkout. Take advantage of the biggest sale of the year from Elsevier, the world-leading provider of medical books and reference materials. Shop us.elsevierhealth.com now through December 31.

"Humans are complex. Humans are multifaceted. Humans are capable of grit and determination. This means that humans are also worthy of hope. If I learned anything from watching this moment in history, I realize that it's not about being a 'Democrat' or a 'Republican' it's about being human. What we do now will echo through future generations. My hope is that we choose to be better tomorrow than we are today." 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, "Can there be hope amid politics?" (https://www.kevinmd.com/blog/2020/08/can-there-be-hope-amid-politics.html) This episode is sponsored by Elsevier Health (https://www.us.elsevierhealth.com/). Looking to update your personal or professional medical library? Shop Elsevier Health's Holiday Sale and save up to 35% on your purchase of medical books! Plus, you can take an extra 5% off your order with code KEVINMD at checkout. Take advantage of the biggest sale of the year from Elsevier, the world-leading provider of medical books and reference materials. Shop us.elsevierhealth.com now through December 31.

"Frontline medical professionals must collectively share what they experienced as a whole. We must piece together these narratives and unearth commonalities to truly know what happened. Just as we must continue rigorous quantitative research on the virus itself, we must also conduct a qualitative examination. In the peri-COVID era, it will be critical to cultivate lasting empathy for the frontline and process the collective trauma that has likewise claimed lives as the virus itself. Only by establishing widespread, lasting awareness will empathy-driven solutions arise and will continued behavior change (e.g., social distancing, wearing face coverings) persist. The act of storytelling comes with the added bolstering of mental health; it is a means of coming to terms with a challenging and rapidly changing work environment being directly in harm's way with inadequate protective — both physical and psychological — equipment." Vibhu Krishna is a medical student. She shares her story and discusses her KevinMD article, "The mental health benefits of sharing stories." (https://www.kevinmd.com/blog/2020/05/the-mental-health-benefits-of-sharing-stories.html) This episode is sponsored by Elsevier Health (https://www.us.elsevierhealth.com/). Looking to update your personal or professional medical library? Shop Elsevier Health's Holiday Sale and save up to 35% on your purchase of medical books! Plus, you can take an extra 5% off your order with code KEVINMD at checkout. Take advantage of the biggest sale of the year from Elsevier, the world-leading provider of medical books and reference materials. Shop us.elsevierhealth.com now through December 31.

"Have you ever wondered how much time we spend worrying about call, versus the amount of time that we actually spend being on call? What about the Monday after a long weekend, returning from vacation, or an overnight shift? Is it as bad as we think it's going to be, even a fraction of the time? Is it worth all of that anticipation?" Katie Townes is a physician and founder, Physician Lounge Online. She shares her story and discusses her KevinMD article, "4 ways to decrease your dread of being on-call." (https://www.kevinmd.com/blog/2020/08/4-ways-to-decrease-your-dread-of-being-on-call.html) This episode is sponsored by Elsevier Health (https://www.us.elsevierhealth.com/). Looking to update your personal or professional medical library? Shop Elsevier Health's Holiday Sale and save up to 35% on your purchase of medical books! Plus, you can take an extra 5% off your order with code KEVINMD at checkout. Take advantage of the biggest sale of the year from Elsevier, the world-leading provider of medical books and reference materials. Shop us.elsevierhealth.com now through December 31.

"I was admitted to the hospital for psychiatric evaluation and stabilization just after my third year of medical school. Leading up to my episode, I thought I was fine – stressed, sure, overworked, definitely, but I thought that was normal for someone just finishing a year of clinical rotations. I deteriorated rapidly, and by the time I was admitted, I felt dazed, disoriented, and completely exhausted. I didn't know what day it was or where I was, but I knew one thing with crystalizing certainty – I wanted to be dead. It was an incredibly isolating experience, one that left me feeling alone and terribly frightened. But since then, I've come to realize the harsh reality: I am not alone. Mattie Renn and Thomas Pak are medical students. They share their stories and discuss their KevinMD article, "The mental health jeopardy of our youngest healers." (https://www.kevinmd.com/blog/2020/09/the-mental-health-jeopardy-of-our-youngest-healers.html) This episode is sponsored by Elsevier Health (https://www.us.elsevierhealth.com/). Looking to update your personal or professional medical library? Shop Elsevier Health's Holiday Sale and save up to 35% on your purchase of medical books! Plus, you can take an extra 5% off your order with code KEVINMD at checkout. Take advantage of the biggest sale of the year from Elsevier, the world-leading provider of medical books and reference materials. Shop us.elsevierhealth.com now through December 31.

"When I was regularly working 80+ hours a week, and was on call almost every day, I had to admit that something needed to change. I stepped back and did significant research to find a strategy to help coach myself out of constant exhaustion and put myself first. Today, I'm a peak performance speaker who helps other ambitious and overworked health care professionals to find their voice, feel more confident as influential leaders, and fall back in love with their career. I believe with the right system, ambitious professionals can be both: powerhouses in health care and passionate people in life. You just have to say no to almost everything, so you can say 'heck yes' to the only things that matter! Let me share with you the three-step process that has helped me to fall back in love with my career." Sabrina Runbeck is a cardiothoracic surgery physician assistant. She shares her story and discusses her KevinMD article, "How to bring joy and be valued while avoiding burnout." (https://www.kevinmd.com/blog/2020/09/how-to-bring-joy-and-be-valued-while-avoiding-burnout.html) This episode is sponsored by Elsevier Health (https://www.us.elsevierhealth.com/). Looking to update your personal or professional medical library? Shop Elsevier Health's Holiday Sale and save up to 35% on your purchase of medical books! Plus, you can take an extra 5% off your order with code KEVINMD at checkout. Take advantage of the biggest sale of the year from Elsevier, the world-leading provider of medical books and reference materials. Shop us.elsevierhealth.com now through December 31.

"I write in my book, 'I know from experience that nothing positive comes from directing blame at yourself.' When it comes to chronic illness (which includes chronic pain), it's crucial to remember that you are not the enemy. Anyone can get sick, physically or mentally, and anybody can develop chronic pain. I just got an email from a women who turned 20 last month and has been in chronic pain for most of her young life. Chronic pain and illness come with the human condition. It's not your fault when they come calling. Don't make things worse by adding self-blame to the mix. Instead, add self-compassion to help alleviate your emotional suffering." Toni Bernhard is a patient advocate and the author of How to Be Sick: Your Pocket Companion. (https://amzn.to/3pCHcb9) She shares her story and discusses her KevinMD article, "10 challenges faced by those with chronic pain and illness." (https://www.kevinmd.com/blog/2020/09/10-challenges-faced-by-those-with-chronic-pain-and-illness.html) This episode is sponsored by Elsevier Health (https://www.us.elsevierhealth.com/). Looking to update your personal or professional medical library? Shop Elsevier Health's Holiday Sale and save up to 35% on your purchase of medical books! Plus, you can take an extra 5% off your order with code KEVINMD at checkout. Take advantage of the biggest sale of the year from Elsevier, the world-leading provider of medical books and reference materials. Shop us.elsevierhealth.com now through December 31.

"Ultimately, our job is a difficult one. It's hard to take usual comfort in heartwarming statistics or hollow promises of prosperity when you find yourself loving and grieving your patients. I have found there is comfort and an impenetrable hope that comes from this; this is the life-hack for training: Seek the welfare of the program, the institution, the city where you have found yourself. For in its welfare, there you will also find your welfare. As you start, finish, or continue your training, let the foundation of your vocation be marked by the virtue of hope rooted in doing the little things with great love. This rhythm will help you not only in the transition to or from training, but will also allow you thrive in the wake of this pandemic." Sumner Abraham is an internal medicine physician. He shares his story and discusses his KevinMD article, "A letter to medical interns, in the midst of a pandemic." (https://www.kevinmd.com/blog/2020/04/a-letter-to-medical-interns-in-the-midst-of-a-pandemic.html) This episode is sponsored by Elsevier Health (https://www.us.elsevierhealth.com/). Looking to update your personal or professional medical library? Shop Elsevier Health's Holiday Sale and save up to 35% on your purchase of medical books! Plus, you can take an extra 5% off your order with code KEVINMD at checkout. Take advantage of the biggest sale of the year from Elsevier, the world-leading provider of medical books and reference materials. Shop us.elsevierhealth.com now through December 31.

"If we are serious about supporting the optimal health and well being of our nations' patients and physicians, we need to start believing and implementing the science across the public and private sectors. We need to recognize that at its core, the practice of medicine is a human science. We need to allocate and deploy resources to the people and programs in health care doing the work of healing our nation. We need to provide a 'self-care as health care' optimal health system, which is educative, accessible, preventative, and patient-centered. This is what a successful health care system looks like." Lillie Rosenthal is a physiatrist. She shares her story and discusses her KevinMD article, "This is what a successful health care system looks like." (https://www.kevinmd.com/blog/2020/09/this-is-what-a-successful-health-care-system-looks-like.html) This episode is sponsored by Elsevier Health (https://www.us.elsevierhealth.com/). Looking to update your personal or professional medical library? Shop Elsevier Health's Holiday Sale and save up to 35% on your purchase of medical books! Plus, you can take an extra 5% off your order with code KEVINMD at checkout. Take advantage of the biggest sale of the year from Elsevier, the world-leading provider of medical books and reference materials. Shop us.elsevierhealth.com now through December 31.

"Recently, a fellow physician mom ended her life. While outwardly, a very vibrant, lively, and happy woman, she fought her own internal demons for some time. From what we know, she struggled with depression but was still committed to being a good mom, physician, and wife. Sadly, a few days before her birthday, she could no longer bear her sadness and decided to end her agony. I know many physicians' lives follow these patterns. What shook me this time, though, was a discussion I had with a very close group of friends. These are all very highly educated professionals whom I love, respect, and admire. But, none are physicians." Fariha Shafi is an internal medicine physician. She shares her story and discusses her KevinMD article, "Who are the doctors who end their own lives?" (https://www.kevinmd.com/blog/2020/01/who-are-the-doctors-who-end-their-own-lives.html) This episode is sponsored by Elsevier Health (https://www.us.elsevierhealth.com/). Looking to update your personal or professional medical library? Shop Elsevier Health's Holiday Sale and save up to 35% on your purchase of medical books! Plus, you can take an extra 5% off your order with code KEVINMD at checkout. Take advantage of the biggest sale of the year from Elsevier, the world-leading provider of medical books and reference materials. Shop us.elsevierhealth.com now through December 31.

"In medicine, the guise of 'professionalism' is an example of how an oppressive system has led us to believe that we ought not to advocate for our rights. It would be 'unprofessional' to organize for a better health care system for both patients and workers. To work towards personal liberation, Boal calls for a transformational process to bypass the censorship of habit and find 'antibodies' to oppression. With this situation so clearly revealed, the COVID-19 crisis has become an unprecedented moment for physician organizing. Where does this leave the mental health profession and their role in managing this current crisis? We are very much equipped to address individual concerns. But addressing systemic issues does not come naturally to the mental health profession, which was founded in large part on individually-based approaches. But any approach to mental health today must recognize that if the system we work in is making us sick, then it is not enough to change ourselves." Eden Almasude is a psychiatry resident. She shares her story and discusses the KevinMD article that she co-wrote, "COVID-19 is the symptom. Chronic oppressive job conditions are the disease." (https://www.kevinmd.com/blog/2020/07/covid-19-is-the-symptom-chronic-oppressive-job-conditions-are-the-disease.html) This episode is sponsored by Elsevier Health (https://www.us.elsevierhealth.com/). Looking to update your personal or professional medical library? Shop Elsevier Health's Holiday Sale and save up to 35% on your purchase of medical books! Plus, you can take an extra 5% off your order with code KEVINMD at checkout. Take advantage of the biggest sale of the year from Elsevier, the world-leading provider of medical books and reference materials. Shop us.elsevierhealth.com now through December 31.

This episode is brought to you by Doc2Doc Lending (https://www.doc2doclending.com/), a novel lending platform created for doctors, by doctors, with the aim of facilitating fast access to personal loans at rates that make sense. "For the vast majority of us doctors, a career in medicine will also mean spending a significant portion of our adult lives carrying multiple forms of debt. Understanding student loans (the average medical school graduate in 2019 had $201,490 in student loans while the average dental school graduate had $292,159), credit card debt, home mortgages, car loans, and practice loans, becomes a worthy exercise given the potential impact – both positive and negative – these products can have on our personal and professional lives as we consume them. We'd like to propose a methodology to understand and assess loan options, using a doctor-specific perspective, to better appreciate when the pros outweigh the cons or vice versa. This methodology is based on our experience in speaking with applicants through the Doc2Doc Lending platform (the platform facilitates personal loans exclusively to physicians and dentists, and as part of the application process offers each applicant a call with a doctor-member of our Doc2Doc team to speak through the product, application process, and the applicant's goals) and it is by no means meant to be financial advice. Through these conversations, we have observed many similar themes that arise from applicant to applicant which has formed the basis for this construct. In our experience, there are three common areas that will generally be the determining factors as to whether a loan may make sense: the immediate and future impact on cash flow the total cost of the money borrowed over the entire term of the loan the degree of flexibility built into the terms of the product As doctors, debt is a real and important part of our personal and professional lives. We hope this framework may serve as a starting point for better understanding when a loan is the right decision for you." Kenton Allen and Zwade Marshall are anesthesiologists. They are cofounders, Doc2Doc Lending (https://www.doc2doclending.com/), a novel lending platform created for doctors, by doctors, with the aim of facilitating fast access to personal loans at rates that make sense. Doc2Doc Lending was founded on the belief that doctors are a unique group that are more responsible in repaying debt obligations than the general population. Doc2Doc Lending employs a proprietary underwriting algorithm that considers doctor-specific metrics to enable interest rates that are often more favorable than those found at traditional banks. Drs. Allen and Marshall are neither licensed financial nor investment advisors; they are not accountants or attorneys. Any opinions expressed above are solely their own. Learn more at www.doc2doclending.com.

"I'm now CMO at a private biotech company focused on developing therapies for patients with rare endocrine diseases. We are conducting a trial in the U.S., Europe, and Israel. I mention this to raise the possibility of travel in pharma/biotech roles. In most companies, roles are both 'functional' (i.e., clinical development, medical affairs, marketing) and geographic (i.e., global, regional). I've had both global roles, being responsible for the entire world strategy for a therapy, and U.S. specific roles where I've focused on the U.S. only. Some roles, like medical science liaison, are smaller areas of focus (state or several states). I enjoy travel and have been able to do so extensively; however, there are roles where travel is limited. One of the great things about physician roles – there is a broad range of careers that can be had, and it's likely there is one to fit your life needs! There is a need for physicians in pharma/biotech, and physicians need to more exposure to this career path. I encourage doctors to network; connect with people to learn and make your name known. My final piece of advice is to understand how all of your past experiences, whether leadership, management, or research translate into supporting your resume for a role in pharma/biotech; do not undersell your experience!" Nerissa Kreher is a pediatric endocrinologist and founder, The IndustryMDCoach. She shares her story and discusses her KevinMD article, "How physicians can find jobs in the pharmaceutical and biotechnology industries." (https://www.kevinmd.com/blog/2020/08/how-physicians-can-find-jobs-in-the-pharmaceutical-and-biotechnology-industries.html) This episode is sponsored by Elsevier Health (https://www.us.elsevierhealth.com/). Looking to update your personal or professional medical library? Shop Elsevier Health's Holiday Sale and save up to 35% on your purchase of medical books! Plus, you can take an extra 5% off your order with code KEVINMD at checkout. Take advantage of the biggest sale of the year from Elsevier, the world-leading provider of medical books and reference materials. Shop us.elsevierhealth.com now through December 31.

"My sister called me. I answered. And, then, I lost it: 'He died. He died,' I repeated. 'Our patient died. I literally did CPR on this guy. We tried to save his life, and he died,' I repeated over and over. The tears streaming down my cheeks were cathartic. More than signifying a loss, the tears signified that I was still human, that I haven't lost touch with reality. Residency hasn't changed me. Death still affects me. I'm not numb. I'm human. My tears were confirmation that I haven't changed in that way. I was not calloused. He died. And I still felt it. I had a heart." Maseray S. Kamara is a general surgery resident and can be reached on Instagram @drkamara. She shares her story and discusses her KevinMD article, "Death still affects me. I'm not numb. I'm human." (https://www.kevinmd.com/blog/2020/09/death-still-affects-me-im-not-numb-im-human.html) This episode is sponsored by Elsevier Health (https://www.us.elsevierhealth.com/). Looking to update your personal or professional medical library? Shop Elsevier Health's Holiday Sale and save up to 35% on your purchase of medical books! Plus, you can take an extra 5% off your order with code KEVINMD at checkout. Take advantage of the biggest sale of the year from Elsevier, the world-leading provider of medical books and reference materials. Shop us.elsevierhealth.com now through December 31.

"The dictionary definition of learning is 'the acquisition of knowledge or skills through experience, study, or by being taught.' For leaders, the most crucial and common way of learning happens through experience, and as we often say, leadership is flying the plane while building it. Moreover, the onus of making the process of learning an active one is on the leader, and self-reflection is the key to it. So, what's self-reflection? Simply put, reflection is a conscious consideration and analysis of our thoughts, feelings, and behaviors for the sole purpose of learning. Experiences can be messy, but reflection gives us an opportunity to unravel and sort through our feelings and thoughts, and the ability to gauze new perspectives. Self-reflection helps us see the bigger picture, see ourselves in a richer multidimensional way, and create meaning." Priti Golechha is a pediatrician and a physician executive. She shares her story and discusses her KevinMD article, "Lifelong learning through skillful self-reflection." (https://www.kevinmd.com/blog/2020/08/lifelong-learning-through-skillful-self-reflection.html) This episode is sponsored by Elsevier Health (https://www.us.elsevierhealth.com/). Looking to update your personal or professional medical library? Shop Elsevier Health's Holiday Sale and save up to 35% on your purchase of medical books! Plus, you can take an extra 5% off your order with code KEVINMD at checkout. Take advantage of the biggest sale of the year from Elsevier, the world-leading provider of medical books and reference materials. Shop us.elsevierhealth.com now through December 31.

"Being an entrepreneur can be a lonely road. Everyone dreams of life after a successful round of funds being raised, staff being hired, and plunging headfirst into the making and shipping of widgets. But there are many days which no one talks about, where a budding entrepreneur must find a way to get ideas from their brain to a whiteboard to a minimum viable product. In those times, progress can seem elusive, and sometimes even when the resources are at hand, we may not know if we are moving forward." Amelia L. Bueche is an osteopathic physician and founder, This Osteopathic Life. Akash Sharma is a nuclear radiologist and can be reached at Jeevun. They share their stories and discuss their KevinMD article, "Accountability partnership: a secret ingredient for entrepreneurial success." (https://www.kevinmd.com/blog/2020/08/accountability-partnership-a-secret-ingredient-for-entrepreneurial-success.html) This episode is sponsored by Elsevier Health (https://www.us.elsevierhealth.com/). Looking to update your personal or professional medical library? Shop Elsevier Health's Holiday Sale and save up to 35% on your purchase of medical books! Plus, you can take an extra 5% off your order with code KEVINMD at checkout. Take advantage of the biggest sale of the year from Elsevier, the world-leading provider of medical books and reference materials. Shop us.elsevierhealth.com now through December 31.

"I'm exhausted. As the pandemic rages on, the mental toll of dealing with COVID-19 has started to wear on me. As a practicing hospitalist in the Midwest impacted by one of the many hotspots caused by the meatpacking industry, I have spent a fair bit of time with this virus on the frontline. Some aspects of practicing medicine in a pandemic have actually improved, such as the increase in possible treatments and data to support those treatments. But one of the most stressful aspects of practicing medicine right now is the unexpected second front—the propagation of information from an increasingly vocal group of people who think the dangers of COVID-19 are imagined or manufactured." Clarissa Barnes is an internal medicine physician and can be reached at Dr. Clarissa Explains Healthcare. She shares her story and discusses her KevinMD articles, "COVID-19 is a war on two fronts" (https://www.kevinmd.com/blog/2020/05/covid-19-is-a-war-on-two-fronts.html) and "To my health care colleagues in South Dakota." (https://www.kevinmd.com/blog/2020/10/to-my-health-care-colleagues-in-south-dakota.html) This episode is sponsored by Elsevier Health (https://www.us.elsevierhealth.com/). Looking to update your personal or professional medical library? Shop Elsevier Health's Holiday Sale and save up to 35% on your purchase of medical books! Plus, you can take an extra 5% off your order with code KEVINMD at checkout. Take advantage of the biggest sale of the year from Elsevier, the world-leading provider of medical books and reference materials. Shop us.elsevierhealth.com now through December 31.

"Now, in her afterlife, she occasionally accompanied Maggie on excursions into my head, usually at night. Make that a double vodka. I thought I had finally learned in sobriety how to put them in the past, encased in a box, and keep them there. Still, sometimes they found a way out to visit me. The program taught me how to at least limit their appearances. I worked hard over the months, showing up for shifts with an energy I had not seen in myself for decades, a newfound enthusiasm I had not felt since my residency days back in Baltimore." "J. D. Remy" is an emergency physician and author of Ballad of a Sober Man: An ER Doctor's Journey of Recovery. (https://amzn.to/3lZlBHu) He shares his story and discusses his KevinMD article, "A sober emergency physician returns to work, just in time to face the COVID-19 pandemic." (https://www.kevinmd.com/blog/2020/08/a-sober-emergency-physician-returns-to-work-just-in-time-to-face-the-covid-19-pandemic.html) This episode is sponsored by Elsevier Health (https://www.us.elsevierhealth.com/). Looking to update your personal or professional medical library? Shop Elsevier Health's Holiday Sale and save up to 35% on your purchase of medical books! Plus, you can take an extra 5% off your order with code KEVINMD at checkout. Take advantage of the biggest sale of the year from Elsevier, the world-leading provider of medical books and reference materials. Shop us.elsevierhealth.com now through December 31.

"You have made difficult choices about your family's health and safety already. Pediatricians help parents make these kinds of decisions all the time. The shared- decision model for practicing medicine encourages doctors like me to help provide information and counseling to empower you to make decisions. You've already made decisions essential to your family's health, whether about vaccination, safe sleep, or car seats. Other more everyday decisions parents make also carry real risk — driving while tired or distracted or selecting other activities like skiing or soccer. You can make difficult decisions and, in the process of coping with the pandemic, maybe you'll learn more about what's important to your family." Kelly Fradin is a pediatrician and author of Parenting in a Pandemic: How to help your family through COVID-19. She shares her story and discusses her KevinMD article, "Parenting in a pandemic: Making the best decisions for your family." (https://www.kevinmd.com/blog/2020/08/parenting-in-a-pandemic-making-the-best-decisions-for-your-family.html) This episode is sponsored by Elsevier Health (https://www.us.elsevierhealth.com/). Looking to update your personal or professional medical library? Shop Elsevier Health's Holiday Sale and save up to 35% on your purchase of medical books! Plus, you can take an extra 5% off your order with code KEVINMD at checkout. Take advantage of the biggest sale of the year from Elsevier, the world-leading provider of medical books and reference materials. Shop us.elsevierhealth.com now through December 31.

"These strategies on how the rich get richer do not only apply to the wealthy. These same opportunities and strategies are open to us as well. If we want to accumulate wealth, or simply keep more of the money we currently have without paying a large portion in taxes, then we should consider following the strategies above. Think about what you are good at or what you like doing and consider a business you could start, product you could create/sell, or service you can render then file it as an LLC (or other business entity). Before you know it, you've "started your own business" and can now take advantage of tax rules that allow you to write off many of the expenses you already paid for. If you feel you pay too much in taxes, then meet with a tax advisor or talk to an experienced professional about ways you can lower your taxes. If you'd like to have your net worth increase in value so you can start living the life you've always envisioned, then talk to a financial planner and start investing. If you don't have a financial planner or don't think you can afford one, then start by putting money aside in your job's 401(k) plan and investing the money in that account into a low-cost index mutual fund. (If you're an advanced investor, then start learning about real estate and other active/passive investments.)" Altelisha Taylor is a family medicine resident and can be reached at Career Money Moves. She shares her story and discusses her KevinMD article, "3 ways the wealthy increase their net worth." (https://www.kevinmd.com/blog/2020/08/3-ways-the-wealthy-increase-their-net-worth.html) This episode is sponsored by Elsevier Health (https://www.us.elsevierhealth.com/). Looking to update your personal or professional medical library? Shop Elsevier Health's Holiday Sale and save up to 35% on your purchase of medical books! Plus, you can take an extra 5% off your order with code KEVINMD at checkout. Take advantage of the biggest sale of the year from Elsevier, the world-leading provider of medical books and reference materials. Shop us.elsevierhealth.com now through December 31.

"A majority of physicians see between 11 and 20 patients per day, and among all practices, the majority of doctors spend between 17 and 24 minutes with each patient. Assuming a five-day workweek, this translates to more than 900 patient interactions per year and over 1,066 minutes spent communicating with patients. Today, many of these interactions fall short of effective communication so pivotal to building rapport, trust, and loyalty with patients and ultimately driving down the bottom-line results. While most physicians are compassionate by nature, many struggle to convey that compassion. A recent survey on doctor-patient interactions found that 71% of patients reported they've experienced a lack of compassion when speaking with a medical professional, and 73% stated that they always or often feel rushed by their doctor. These findings highlight the need for medical professionals to develop the 'soft skills' – verbal and non-verbal communication techniques, listening skills, and empathy – critical for transforming the patient experience, increasing patient satisfaction, and improving outcomes." Anthony Orsini is neonatologist and founder, The Orsini Way. He is the author of It's All In The Delivery: Improving Healthcare Starting With A Single Conversation. He shares his story and discusses his KevinMD article, "The case for compassionate communication." (https://www.kevinmd.com/blog/2020/08/the-case-for-compassionate-communication.html)

"Around the time of the coronavirus outbreak, 2019 also marked a full century since the death of Sir William Osler, who revolutionized medical training. Despite some lingering debate over whether Dr. Osler's pneumonia-related death should be counted among the 50 million lost to the 1918 influenza pandemic, his notes suggest that he believed the flu precipitated his demise. As a chaplain who teaches medical humanities and professional identity formation in a medical school, I've been thinking about how Dr. Osler might have guided medical students during COVID-19. Here, the evidence is a little clearer. Dr. Osler advocated for trainees to 'let no day pass without contact with the greatest literature in the world,' and to spend 30 minutes each night reading from a bedside library of ten classics. Included among these recommended texts were the Old and New Testaments and Sir Thomas Browne's Religio Medici, a physician's spiritual testament." Elizabeth J. Berger is an advanced practice board-certified chaplain and a narrative medicine specialist. She shares her story and discusses her KevinMD article, "Why spiritual health is so important for medical students." (https://www.kevinmd.com/blog/2020/08/why-spiritual-health-so-important-for-medical-students.html)

"Our country, and the world, is beyond exhausted by COVID-19 and the utter chaos and destruction of lives it has caused. All people, including physicians, are being pushed beyond capacity. What do we mean, collateral damage? Originally related to war: the unintended result of a terrible, unprecedented event or action. We may not be in a traditional war, but make no mistake, we are in a war. We can and must do better for our mentally ill patients. They deserve it. Their families deserve it. As physicians, we took an oath to care for all people, not just those with a 'cool kid's disease.' It is time." Ann L. Contrucci is a pediatrician. She shares her story and discusses her KevinMD article, "Mental health care is the not so silent collateral damage of COVID-19." (https://www.kevinmd.com/blog/2020/07/mental-health-care-is-the-not-so-silent-collateral-damage-of-covid-19.html)

"Antiracism requires action-oriented work and calls us to ask, how will we work to become antiracist? How will we change our institutional culture and systems to become antiracist? As Latina medical students, we have seen and experienced racism in many aspects of society and have felt the need to change our institutional culture. If we act now, we will foster physician leaders adequately equipped to address health disparities. We are calling on other Latinx people, other non-Black people, and allies in medicine to go beyond these protests and commit to the journey of antiracism and health equity for all." Yesenia Salazar and Camila Hurtado are medical students. The share their stories and discuss their KevinMD article, "Declaring racism as a public health crisis from the lens of two Latinx student doctors." (https://www.kevinmd.com/blog/2020/07/declaring-racism-as-a-public-health-crisis-from-the-lens-of-two-latinx-student-doctors.html)

"In medicine, empiric therapy is treatment that is administered based on the probability of success because we don't have all of the information. We make our 'best guess.' Actually, empiric decision-making exists in our everyday lives — running the garbage disposal when the sink is clogged, jiggling the key in the lock when it doesn't turn. Mr. Thomas was in stable condition, and I estimated that his chances of finding an answer to his chest pain with another specialist, was very low. It was time to make my best guess. I explained my theory to Mr. Thomas and suggested we try some myofascial bodywork. In the best case, he would feel a difference; and in the worst case, he would feel a little sore and looser in his body, but without pain relief. Mr. Thomas was definitely interested. With hope and caution, we proceeded. I started with the sides of his chest … zig … then his abdominals … zag … then low back … zig … I checked with him frequently as he groaned with each maneuver, but he always nodded to continue. When the trial was over, I helped him sit up on the exam table." Cathy Kim is a family physician and can be reached at Dr. Cathy. She shares her story and discusses her KevinMD article, "Fascia in primary care: When chest pain is not in your chest." (https://www.kevinmd.com/blog/2020/08/fascia-in-primary-care-when-chest-pain-is-not-in-your-chest.html)

"While there is a myriad of expert opinions on what long term effects this pandemic will have on our children and their physical and mental health, we must also remember the age-old idiom: this too shall pass. We must also be sensitive to not add to parents' already full plates. Meditation is not meant to be another task on the already burdened shoulder of parents, but quite the opposite: a way to cope with the increasing demands placed on us by the pandemic. Despite the ubiquitous and understandable parental concerns regarding what type of adults these baby zoomers will turn out to be, pediatricians have a unique opportunity to counsel and provide some small silver linings. For example, many children are learning to adapt quickly to unpredictable situations. Many are becoming adept in technology, which will give them lifelong computer proficiency that may help in future careers. Many more are becoming excellent self-learners, and many parents are getting a unique opportunity to observe their children in a classroom setting. Finally, pediatricians can suggest the introduction of meditation and mindfulness as a means to counteract the possible negative effects the pandemic may have on our children." Ana Pal and Samira Hodges are pediatricians. They can be reached on Twitter @thepedipals. They share their story and discuss their KevinMD article, "Why the pandemic is the perfect opportunity to introduce meditation to children." (https://www.kevinmd.com/blog/2020/09/why-the-pandemic-is-the-perfect-opportunity-to-introduce-meditation-to-children.html)

"Appreciation in the personal finance world has two different components to it: Quantitative: increasing value of net worth and financial assets Qualitative: feeling of gratitude for one's finances, resources, and circumstance. This is not dependent on the dollar amount. These are both important, but the qualitative is the best predictor of increasing wealth and personal wellbeing. We are programmed by these components, which makes our brain to focus on what is wrong and what is insufficient. We tend to focus on what needs to be fixed than what we already have. When all our attention is on what needs fixing in our lives, our relationships, and our finances, we spiral into negative feelings." Latifat Alli-Akintade is a gastroenterologist and can be reached at MoneyFitMD. She shares her story and discusses her KevinMD article, "Appreciation in the personal finance world." (https://www.kevinmd.com/blog/2020/08/appreciation-in-the-personal-finance-world.html)

"While the rise in substance use disorders during COVID will become more apparent as the pandemic eventually ebbs, the silver lining is that this is not a novel problem. We understand substance use disorders far better than we understand COVID-19, and we also know that one of the largest obstacles to treatment is the shame associated with admitting that one has a problem. Furthermore, we also possess lifesaving drugs (such as Naloxone) that can prevent those with opioid use disorder from dying of an overdose. Moving forward, we in the mental health community should encourage efforts to eliminate stigmas associated with addiction. More concretely, policymakers should be ready for the increase in opioid-related overdoses and ensure first responders have access to drugs like Naloxone. Secondly, COVID-19 patients and family members should receive easier access to mental health care to improve resiliency and potentially reduce instances of substance abuse disorders that begin as PTSD-related self-medication." Samoon Ahmad is a psychiatrist. He shares his story and discusses his KevinMD article, "COVID-related stressors and increasing instances of substance abuse." (https://www.kevinmd.com/blog/2020/08/covid-related-stressors-and-increasing-instances-of-substance-abuse.html)

"We are social beings. Evolution has taught us that in order to survive, we must work together. Community trust (trusting your fellow citizen) is a very effective way to build community resilience when hardships strike. Studies have been done in the wake of natural disasters and have shown that social infrastructure and connections have equal, if not more, impact on the ability of a community to 'bounce back' than physical infrastructure. During this terrible pandemic, let's make compassion go viral. Let compassion be the vaccine for society. As so eloquently said by the Dalai Lama: 'Compassion is not religious business, it is human business, it is not a luxury, it is essential for our own peace and mental stability, it is essential for human survival.'" Aseem Desai is a cardiac electrophysiologist and author of Restart Your Heart. He shares his story and discusses his KevinMD article, "During this terrible pandemic, let's make compassion go viral." (https://www.kevinmd.com/blog/2020/06/during-this-terrible-pandemic-lets-make-compassion-go-viral.html)

"Why real estate? By having a 'why' you want something, it'll help keep you motivated to pursue your goals when setbacks and mistakes occur. For our family, we wanted passive income streams. Passive income gives you options. I love options. It doesn't matter if you want to work forever, retire early, or change careers, multiple income sources can make it happen. Our passive income is not only tax-free, but we're also able to access it if needed, unlike traditional retirement accounts." Jeff Anzalone is a periodontist who blogs at Debt Free Dr. He shares his story and discusses his KevinMD article, "Hassle-free real estate investing for busy doctors." (https://www.kevinmd.com/blog/2020/09/hassle-free-real-estate-investing-for-busy-doctors.html)

"Like 9/11, we have a new reference point touching everyone on the planet: life before COVID-19 and life after. Regardless if you get it or don't, the unknowns and secondary consequences are scary. Life before COVID was scary, too, minus the urgency. Before COVID, we sensed the weight of living on a sick planet. We felt powerless to change the tide of forces affecting our lives for the worst. We normalized the slow spiral down the drain of political divisions, economic inequality, costly health care, deteriorating education, unreliable information, and unsustainable living. We let our existential fear buzz like a refrigerator's white noise. COVID innocently shines a floodlight on our curious collective permissiveness. It illuminates silent fear." Ruchi Puri is an obstetrics-gynecology physician and can be reached at her self-titled site, Ruchi Puri, MD. She shares her story and discusses her KevinMD article, "COVID illuminates silent fear." (https://www.kevinmd.com/blog/2020/07/covid-illuminates-silent-fear.html)

"The inflammatory response elicited by the novel coronavirus can do great damage to the essential function of lungs. People with underlying lung disease are more vulnerable to this coronavirus, including people with asthma, emphysema, lung fibrosis, and even people with high exposure to air pollution. Smoking and vaping are perfectly preventable forms of high-intensity air pollution. We strongly urge city, county, and state governments across the planet to place a temporary moratorium on the sale of all inhalable products to protect our lungs and our freedom." Jayshree Chander is an occupational medicine physician. She shares her story and discusses her KevinMD article, "A call for a moratorium on the sale of inhalable products." (https://www.kevinmd.com/blog/2020/08/a-call-for-a-moratorium-on-the-sale-of-inhalable-products.html)

"Holding space means being physically, mentally, and emotionally present for someone. It means putting your focus on someone to support them as they feel their feelings. An important aspect of holding space is managing judgment while you are present. Like when you tell a patient that they have stage IV pancreatic cancer and that it is nonsurgical and even with the best treatments, their time is very short. Then you hold space. You say nothing. You sit there and provide support by sitting there-next to their emotions. You don't run to offer false hope. You don't run to talk about 5 percent of the patients that respond to the newest therapy. You don't try to look at the bright side. Change the subject. Or worse, run out the room. You hold space. Sometimes, you sit for 2 minutes. Sometimes 10 minutes. While saying nothing. It feels like an impossibly long time, but I wish I could tell you how you are bearing the weight of that news by just sitting there. Holding space." Faryal Michaud is a palliative care physician and can be reached at Write Your Last Chapter. (https://writeyourlastchapter.com/) She shares her story and discusses her KevinMD article, "The importance of holding space." (https://www.kevinmd.com/blog/2020/08/the-importance-of-holding-space.html)

"The reality of being a medical practice owner is that we are small business owners and very vulnerable to the impact of COVID. Having previously worked in the telemedicine industry and because I am a psychiatrist, I initially felt that I was in a good position to adapt to this crisis – and this has been overall true, but the reality is it hasn't been so easy in other ways. I was able to transition to a full telemedicine practice rather quickly and seamlessly; I am fortunate that I have been able to work to some degree while some of my colleagues have not. On the business side, I have had a significant decline in my overall revenue because patients were, especially for the months of March through May, seeking less health care overall, didn't have sufficient privacy for telehealth sessions, or even simply preferred to wait for in-person visits to become available. As you know, New York was hit particularly hard, so this has been a prolonged situation of waiting until the coast is clear. Despite decreased revenues, operating costs remain at their pre-COVID levels – I am carrying the expense of my office rent and utilities, malpractice insurance, and other insurances, for example, accountant, biller, receptionist, and none of those expenses will be decreasing anytime soon if ever. I am the only clinician in my practice, but I would like to be able to rehire and re-expand my practice again but am facing some challenges in hiring due to poor cash flow." Sharon M. Batista is a psychiatrist. She shares her story and discusses her KevinMD article, "7 tips to balance family and professional needs during the pandemic." (https://www.kevinmd.com/blog/2020/08/7-tips-to-balance-family-and-professional-needs-during-the-pandemic.html)

"To help the reader understand the issues better, I would like to relate some stories. A friend of mine was dying of pancreatic cancer. He had an implantable morphine pump and was on both hospice and palliative care. Still, he found that his suffering was unbearable and wanted to die sooner. Doctors told him that his only option to end his suffering was to voluntarily stop eating and drinking, which he did. As a result, he developed psychosis, and his loving family has been scarred by the experience. He died after 10 agonizing days. I heard about an individual with ALS (Lou Gehrig's disease), which is incurable and causes the death of neurons that control muscles and eventually leads to the inability to move and then the ability to breathe. This person killed himself with a gun before he lost the use of his arms. I had a number of patients with cancer that we were not able to control their pain, and I gave them palliative sedation (a morphine drip that caused them to become unconscious) to control their suffering. Had it been available, medical aid in dying could have helped all these people. When my cancer gets worse, I expect to have a great deal of pain. I would like the option of having medication to put me to sleep, end my suffering, and to die, at home, with my family and friends around me." The author would like to correct the following statistics from the podcast: 17 percent of terminally Ill individuals discuss medical aid in dying with family and friends. 2 to 10 percent discuss medical aid in dying with a physician. 0.6 percent get medical aid in dying prescriptions. 0.3 to 0.4 percent use a medical aid in dying drug. Roger Kligler is an internal medicine physician. He shares his story and discusses his KevinMD article, "Medical aid in dying is not assisted suicide." (https://www.kevinmd.com/blog/2020/10/medical-aid-in-dying-is-not-assisted-suicide.html)

"There are some things that we are living through as a result of COVID-19 that I did not imagine in my fictional account. For example: the timeline. As we are now four full months into this pandemic in the U.S., some experts estimate that we are still early in the game. As one doctor put it, we are only at about the twenty-yard line of the football field. My imagined timeline was much shorter. Another thing I didn't foresee was the perception of danger dividing along political lines. In fact, I imagined the opposite: that people would, in the name of self-preservation, view with suspicion any political down-playing of the danger of a global pandemic and insist on any means possible of protecting themselves. And among the most devastating consequences of this pandemic that I hadn't imagined for my novel was the situation of people dying alone in hospitals without their loved ones. Not being able to hold the hand, give a final hug, say goodbye. Undoubtedly, penning an imaginary pandemic is much less stressful than living through one. Living through a pandemic day by day has carried with it a chronic anxiety that I did not anticipate: not just the fear of contracting the illness, but the constant worry of pre-symptomatically transmitting it, thus second-guessing every errand, every visit to loved ones. As we all work through this unprecedented medical crisis, I hope we continue to make steady progress in treatment and prevention of this devastating illness. Stay safe." Teresa Fuller is a pediatrician. She shares her story and discusses her KevinMD article, "Imagining a pandemic as a physician novelist." (https://www.kevinmd.com/blog/2020/07/imagining-a-pandemic-as-a-physician-novelist.html)

"As our office begins to return to pre-COVID operations, it has been uplifting to have a relative sense of normalcy, even though morale seems to be reduced. It is difficult to promote team building and improve morale when everyone has to maintain social distancing. I would love to go out for a meal with my staff, hug my patients, and lecture our trainees face-to-face in a classroom. While the hope is that all of these distancing measures are temporary, avoiding despair is another layer added onto an already heightened level of stress. I think all of us in medicine who have survived the pandemic thus far are grateful, even as we mourn the tremendous loss of life. There are signs that we can overcome this new normal moral injury involving fear, stress, and work-life imbalance. Several things that were burdensome pre-COVID such as licensing regulations, charting requirements, being unable to do telemedicine, for example, all were revised in some positive way as a result of the pandemic. In the same way that protests for social justice are rising, so are voices in medicine that will hopefully use this time of uncertainty to potentially change and improve health care systems. As we continually provide hope to our patients, perhaps there is hope for our profession to improve when we come out of this challenging time." Marc Braunstein is a hematology-oncology physician and can be reached on Twitter @docbraunstein. He shares his story and discusses his KevinMD articles, "My new normal moral injury" (https://www.kevinmd.com/blog/2020/07/my-new-normal-moral-injury.html) and "Practicing oncology during COVID-19." (https://www.kevinmd.com/blog/2020/03/practicing-oncology-during-covid-19.html)

"The duty of physician officials in the government exceeds that of other officials. As physicians, they have a unique moral obligation to do more than protect the constitution from enemies, foreign and domestic. They have a duty to be unambiguously truthful, to use their power to do good, and to avoid harm. If they fail in any of those regards, they must be held accountable by their peers, and by society. This is especially urgent when those who appointed them to these positions of authority fail to manifest in their actions the moral necessity of telling the truth, doing good, and avoiding harm. In that case, peer and public accountability are all that is left to uphold these essential ethical standards. If this level of peer accountability seems extreme, imagine the consequences if the most powerful and public-facing physicians in the country continue to erode public trust in their own profession. Physicians have always held one another accountable to the highest ethical standards of medicine. The need is more urgent than ever. The potential for great human suffering demands that the unified voice of medicine muster its moral courage and act as though its life depends on it." Charles E. Binkley is a bioethicist and general surgeon. He shares his story and discusses his KevinMD article, "The failure of the U.S. government's physicians to do good, avoid harm, and tell the truth." (https://www.kevinmd.com/blog/2020/09/the-failure-of-the-u-s-governments-physicians-to-do-good-avoid-harm-and-tell-the-truth.html)

"Growing up, my family sheltered and protected me with everything related to vitiligo. People never really asked me what happened to my skin. And, if I did get questions, I honestly did not know how to answer them, so I would say 'oh, they're just sunburn scars' or some version of that story, and moved on. Thinking back, I probably was too supported and busy to really have an opportunity to be bothered by it. That, in itself, was a blessing. I pursued many years of schooling and training to ultimately become a practicing physician. Now that I've been in medicine for many years, I primarily value and cherish the connection with my patients, as I sincerely believe medicine is fundamentally about the human experience. But, when I hear statements like 'you don't look Indian' from patients, I am constantly reminded each time that I have vitiligo. Reflecting on how best to answer this question, I ask myself if I should react and explain the skin condition, or just let it go. The truth is that the majority of the time, I do 'let it go' when it comes to discussing my skin condition with patients. I simply don't want to explain to patients that I have vitiligo." Dhaval Desai is a hospitalist. He shares his story and discusses his KevinMD article, "The story of an Indian doctor with vitiligo." (https://www.kevinmd.com/blog/2020/06/the-story-of-an-indian-doctor-with-vitiligo.html)

"The daily email update on COVID-19 affecting our hospital system is a glaring reflection of the health disparities amongst those in marginalized groups. The farther south you go, generally in San Diego, the higher the number of socioeconomically disadvantaged persons, and that tends to include a disproportionate number of persons of color. These populations may be unable to physically distance due to living conditions and job conditions. Perhaps there is a higher number of persons living together per household, in a smaller space, along with the inability to work from home. And the mortality rates of those from COVID-19 amongst these persons is higher than white counterparts. Sometimes there is an inherent distrust in the medical system. COVID-19 and racism intersect. However, this is not a unique situation in health care—many chronic illnesses portend worse outcomes for those in marginalized groups. Marginalization means just that: glaringly apparent in health outcomes and socioeconomic disparities." Ni-Cheng Liang is a pulmonary physician and founder, the Mindful Healthcare Collective. She shares her story and discuss her KevinMD article, "COVID-19 becomes a magnifying glass for health disparities." (https://www.kevinmd.com/blog/2020/07/covid-19-becomes-a-magnifying-glass-for-health-disparities.html) Resources mentioned in the show: Implicit bias test: https://implicit.harvard.edu/implicit/takeatest.html Health Disparities Widget: https://www.healthypeople.gov/2020/data-search/health-disparities-data/health-disparities-widget Strategies for Reducing Health Disparities: https://www.cdc.gov/minorityhealth/strategies2016/index.html Conscious Anti-Racism: https://www.jillwener.com/consciousantiracism

"Signing up for an improv class was unchartered territory. It was far beyond my comfort zone, like skydiving, for a little thrill. I'm not an adrenaline junkie interested in the ultimate adventure nor an aspiring actress hoping for a guest appearance on SNL. I'm a physician and a physician leader. Learning improvisational theatre wasn't on my comprehensive, personal to-do list. But I'm also a physician coach. I sense what others feel in the moment without interpretation or judgment. However, when I tried to turn the same discerning sage on myself, I was faltering. The voice of compassion that I once used during patient visits and that I now use during client sessions, is sometimes muted by an inner critic that tells me to keep self-awareness out of awareness. It is this voice that I wanted to stifle when I hit the submit button." Terri Malcolm is an obstetrician-gynecologist and founder, Master Physician Leaders. She shares her story and discusses her KevinMD article, "How improv helps physician leaders." (https://www.kevinmd.com/blog/2020/08/how-improv-helps-physician-leaders.html)

"What on earth are we doing here, folks? To try to save a tanking economy, workers were sent back to their jobs much too early, causing again a spike in cases of the virus. I realize that the loss of a paycheck is a major traumatic situation for any breadwinner, but so is the loss of life. Our doctors and nurses are doing their best to treat COVID-19 patients under their care. Many are putting themselves in harm's way and risking their health to care for those hospitalized. Some have been separated from their own families so as not to potentially carry the virus to them. And how do we repay them for their valiant efforts? By ignoring the guidelines put forth by the CDC and all other medical institutions. That doesn't make sense." Michele Luckenbaugh is a patient advocate. She shares her story and discusses her KevinMD article, "The loss of a paycheck is a major traumatic situation. The loss of life is worse." (https://www.kevinmd.com/blog/2020/07/the-loss-of-a-paycheck-is-a-major-traumatic-situation-the-loss-of-life-is-worse.html)

"I have been depressed. I have been burned out. I have been both. I have been neither. How do you know if you are depressed vs. burned out when your chief complaint is, "I feel like crap?" It's time to call a consult. I don't mean curbsiding your colleagues to fill your medications off the record without evaluation. I mean, ask for real help, from someone who can objectively help you define your diagnosis and the best path forward. If you "feel like crap" and think you may be depressed or burned out, please reach out to a trusted physician, therapist, or coach. You are not alone, and there is hope and help waiting for you." Kara Pepper is an internal medicine physician and can be reached at her self-titled site, Physician Life Coach: Kara Pepper, MD. She shares her story and discusses her KevinMD article, "Call a consult: depression vs. burnout." (https://www.kevinmd.com/blog/2020/09/call-a-consult-depression-vs-burnout.html)

"An increasing number of institutions are relying on telemedicine to continue delivering care to patients in lieu of typical outpatient visits in response to the COVID-19 pandemic. Telemedicine has been lauded as a potential equalizer in health care access. Indeed, it allows for safe and easy access to medical professionals. It especially benefits patients with transportation issues or those seeking specialty care from far away. Some pitfalls such as reimbursement issues and lack of physical exam notwithstanding, telemedicine overall is a helpful service at a time like this. However, telemedicine does not benefit all patients equally. In fact, it exposes and amplifies the existing health care disparity in a subgroup of patients." Wenjing Zong is a pediatric gastroenterology fellow. She shares her story and discusses her KevinMD article, "Telemedicine in COVID-19: Disparities still exist." (https://www.kevinmd.com/blog/2020/05/telemedicine-in-covid-19-disparities-still-exist.html)

"While our bodies have been a bastion of the heart and soul of medicine, a group of our peers thought it was acceptable to diminish the capabilities of our bodies to pictures on social media. They thought our ability to be exceptional physicians was inversely proportional to the number of pictures that showed us holding a drink or wearing a bikini. Our bodies do so much more than just practice medicine. What we choose to do with our bodies in our own free time should not become part of an investigation that is packaged as peer-reviewed research. Our bodies may have tattoos, ride motorcycles, or compete in pole fitness competitions for sport. None of that impacts our practice of medicine negatively. It's past time we start celebrating the strength of our bodies and hold accountable those who try to negate our accomplishments with an ill-perceived attitude of sexism and misogyny." Jessica Pearce is an obstetrician-gynecologist. She shares her story and discusses her KevinMD article, "Let us talk about the underlying situation of #medbikini." (https://www.kevinmd.com/blog/2020/07/let-us-talk-about-the-underlying-situation-of-medbikini.html)