The Clinical Excellence Podcast

Genetic information can raise the stakes of a clinical conversation in ways that go far beyond test results. Dr. Adam Cifu and Dr. Sonia Kupfer reflect on how uncertainty, evolving evidence, and family implications shape the way physicians counsel patients. Kupfer draws from her experience in clinic to illustrate how recommendations may shift over time, while emphasizing the responsibility of helping patients feel supported, informed, and firmly in control of decisions that can affect far more than just one person.

Winner of the 2025 Bucksbaum-Siegler Institute Clinical Excellence Award, Dr. Kertesz reflects on the work of building a relationship before clinical decisions take shape, particularly with patients who arrive wary after difficult experiences with healthcare. He describes how poorly chosen language can instantly make a patient feel judged, forcing him to slow down and work his way back into the interaction. The discussion also underscores why understanding what a patient wants from an encounter is essential to how care is explained and delivered.

Dr. Mary Rinella, a transplant hepatologist, talks with Dr. Adam Cifu about the human side of caring for patients with complex liver disease. She describes how she approaches patients who arrive guarded or resistant and how digging into the fear that drives their behavior helps her build trust with them. The conversation touches on the time she invests in nurturing those relationships and how that closeness often includes patients’ families, especially when she is helping them through difficult moments. Later in the discussion she reflects on the loss of a patient and the emotional weight of that experience, especially given the bonds she forms with both patients and their families.

Dr. Adam Cifu talks with pediatric dermatologist Dr. Sarah Stein about the tricky triangle between doctor, teen, and parent. She reflects on finding the right balance between a young patient’s growing independence and a parent’s need to stay involved, and how empathy, trust, and experience shape those interactions. Together they explore what genuine communication looks like when everyone in the room has a different perspective.

Dr. Julie Oyler, a general internist and medical educator, shares her fascinating journey of integrating social and medical histories in patient care. She discusses the evolution from handwritten notes to tech-assisted visits, which allow her to focus on patients as individuals. Julie humorously navigates the challenges of balancing empathy with clinical efficiency, especially when family dynamics come into play. She reflects on the growth of long-term patient relationships while managing complex care, offering a thoughtful perspective that resonates with clinicians.

Dr. Jason Alexander, an associate professor at the University of Chicago and a specialist in evidence-based medicine, joins to discuss the evolving doctor-patient relationship in mid-career. He shares insights on transitioning from new physician to experienced clinician, emphasizing the importance of authenticity and listening. Jason highlights the challenges of treating colleagues and their families while maintaining boundaries. He also discusses how embracing uncertainty fosters trust and the vital role of reflective practice in reinforcing successful care.

Dr. Michael Drazer, a hematologist-oncologist and geneticist with expertise in hereditary blood disorders and cancer, shares insights on enhancing the doctor-patient relationship. He reflects on how diverse mentorship has shaped his clinical approach and emphasizes the importance of adapting to patients' needs over time. Dr. Drazer discusses the significance of aligning treatment choices with patient goals, the impact of ongoing research on care, and his commitment to clear communication during uncertain diagnostic journeys.

Dr. Alex Lickerman, a direct primary care physician and author, shares insights from his extensive medical career. He emphasizes the importance of balancing authority and empathy in doctor-patient interactions. Trust is crucial in modern medicine, especially amidst misinformation. Alex discusses strategies for managing frustrations with patients while avoiding care withdrawal. He highlights the significance of long-term relationship building and applies psychological insights to enhance patient adherence. Finally, he shares his experiences in guiding families through end-of-life decisions with compassion.

In this season finale episode, Dr. Adam Cifu sits down with transplant nephrologist Dr. Michelle Josephson to explore the unique challenges and opportunities that arise in the later stages of an academic medical career. Dr. Josephson openly discusses the struggle to maintain a sense of relevance, the need to redefine one's priorities and goals, and the bittersweet experience of losing colleagues to retirement and passing. However, she also highlights the freedom and excitement that can come with this transitional phase, allowing her to pursue new global initiatives in areas like green nephrology. This provides an insightful look at navigating the "third phase" of a distinguished career.

In this episode, we speak with Dr. Jennifer Brokaw about her varied and impressive career in medicine. Dr. Brokaw shares how she transitioned from emergency medicine into founding a private practice focused on advanced illness management and end-of-life care, driven by a desire to tackle complex societal challenges she witnessed in the ER. She discusses the unique value she was able to provide as an independent advocate for patients and families, as well as the challenges of building a sustainable business model around these services. Dr. Brokaw's insights offer a fascinating look at alternative paths for doctors beyond traditional clinical roles. This conversation provides an engaging glimpse into one physician's remarkable career journey.