The Clinical Excellence Podcast

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.

In this installment of our series talking with medical trainees, we're joined by Dr. Ava Ferguson Bryan, a general surgery resident at the University of Chicago. Dr. Ferguson Bryan shares her winding path to medicine, from initially pursuing English and art history, to discovering a passion for surgery during her clinical rotations.She provides an honest look at the challenges and sacrifices of surgical training, including the lengthy 7-8 year commitment and the impact on work-life balance, especially as a woman having children during residency. Dr. Ferguson Bryan also discusses the evolving landscape of surgical education, including competency-based assessments that may allow for more flexibility in training duration.This episode offers valuable insights for aspiring physicians navigating the realities of surgical specialties and the broader effort to diversify the field. Dr. Ferguson Bryan's personal experience provides a nuanced perspective on the progress made, as well as the work still needed to support the next generation of surgeon-trainees.

Gaining an inside look at the realities of medical training, this episode features a conversation with Layne Keating, a chief medical resident at the University of Chicago. Layne shares her experiences navigating the transition from medical school at the Frank H. Netter MD School of Medicine at Quinnipiac University to residency, highlighting the importance of being given autonomy and the ability to make real clinical decisions.She explains how this hands-on responsibility, even with the support of her team, has been critical for developing the confidence and problem-solving skills needed to be an effective physician. Layne contrasts this with concerns that overprotecting trainees from having to make tough choices during their education can make the leap to independent practice much more difficult.The conversation also touches on the use of letters of recommendation in the residency application process. Layne and Dr. Adam Cifu discuss how more holistic, thoughtful approaches may be needed to evaluate the suitability of medical trainees.This transparent discussion provides a unique perspective on the highs and lows of the clinical training journey, as well as insights into improving medical education to better prepare the next generation of physicians.To read more:https://medicine.qu.edu/https://www.sensible-med.com/p/letters-of-recommendation-should-fb0