Explore The Space

Shoshana Ungerleider is a Hospitalist, founder of End Well & an educator focusing on end-of-life care. She joins us to discuss the evolution of her career, changing the narrative around how we talk about death, and her Oscar-nominated documentary “End Game.” Key Learnings 1.  The origins of Shoshana’s work and interest in end of life care and her feelings of “moral distress” in the ICU 2. Evolving from having an awakening to what’s important to something scalable and impactful on a population level 3. How she broke from the usual way messages are exchanged in healthcare into public speaking, writing, and movie-making 4. Medical lingo and how it derails communication with patients 5. Is she experiencing any pushback to her work around end-of-life care? 6. The goal behind End Well and creating documentaries like “End Game” 7. The difficulty that comes when a patient is sick & there is lack of clarity around goals of care 8.  Barriers posed by social determinants of health, racial and gender biases associated with end of life care 9. What it’s like to find out you’ve been nominated for an Oscar 10. How the film has allowed for the creation of a toolset for discussing end of life care as part of a larger call to action Links Shoshana’s home page: https://www.shoshanaungerleider.com End Well: https://www.endwellproject.org End Game movie: http://endgame-documentary.com #endoflife, #oscars, #medicine, #palliativecare, #hospice, #hospitalist, #SDOH

Aimee Gardner has a PhD in Organizational Psychology and is Assistant Dean of Evaluation & Research at Baylor College of Medicine. She joins us for a provocative discussion of how residency programs select medical students. This is a fraught issue for our profession and the concepts around recruiting are generalizable across any organization. Key Learnings 1.  How we connected during the controversy surrounding standardized tests for medical students. 2.  The major criteria that make a candidate attractive to a residency program 3. Defining Step 1 of the USMLE and the stakes and stress associated with it 4. How the exam moved from a standard pass-fail to a variety of purposes it is neither intended nor designed for. 5. The rational steps that should be taken when assessing whether a candidate is right for any type of organization 6. The implications that the mis-application of USMLE has on fairness and diversity as well as why other industries stay away from standardized tests 7. The risks and stresses that USMLE Step I puts medical students through 8. The challenges that programs making selections face in this same equation 9. A hard look at the unstructured way resident selection is done now 10. Building a selection process built around a fair, equitable and scientific manner 11. The components & metrics of a rigorous selection process that apply to medicine and across any industry 12. Facing the harsh reality around effectiveness of what is currently compiled by medical students in their applications 13. The search for new criteria and where to look, including a place you might not expect 14. How much enthusiasm is there to change the current processes 15. Ensuring proper attention is paid to socioeconomics, gender and racial equity in how residency classes are selected Links Aimee’s Twitter feed: @aimeeGthePHD AAMC Best Practices for Conducting Residency Program Interviews: https://www.aamc.org/download/469536/data/best_practices_residency_program_interviews_09132016.pdf Society for Industrial & Organizational Psychology: https://www.siop.org/ SurgWise: https://surgwise.com/ #residency, #USMLE, #medicalschool, #education, #meded, #interviews

Ingrid Nembhard is an Associate Professor of Health Care Management at the University of Pennsylvania and she is the definition of a pluripotent researcher, teacher & mentor. She studies and coaches around how we can improve team-based culture  & organizational learning. We discuss the importance of feeling part of a high-performing team, how team-based culture forms, and how it translates into patient-centered care. This is riveting stuff & her insights are amazing! Key Learnings 1.  What gets Ingrid up in the morning and what brought her to healthcare 2.  Being a pluripotent scholar, what “Eureka” moments her down the path of healthcare? 3.  The experience of stepping into healthcare organizational improvement and the reception when she starts working with a new team 4.  Why it’s important to be at the front lines when she starts a project 5. The creativity that comes from “dissatisfied” people and the value of context 6. Understanding an organization’s culture to determine what’s possible, relevant, and useful 7. Organizational learning and the impact of new knowledge, especially in healthcare 8. How the intersection of organization culture and learning intersect to help drive progress 9. Why team-based culture is a common topic Ingrid is called to help with and a pivotal issue in the success of a healthcare organization 10. Hierarchy vs teamwork and the impact of how team members feel about their work 11. The challenge for a physician who trained in a hierarchical environment who now is joining an organization that focuses on teamwork 12. The vital nature of leadership in driving psychological safety and developing culture 13. Recurring strengths that healthcare organizations can build on 14. The central dogma of decision-making in healthcare 15. Ingrid’s goals for the future and places where her impact will be greatly felt Links Ingrid’s UPenn page: https://hcmg.wharton.upenn.edu/profile/ingridn/#research #leadership, #organizations, #healthcare, #hospitals, #culture, #learning, #education, #evidence, #hierarchy

Mark Hertling dedicated 37 years of service to the United States Army, serving in two wars before retiring as a Lieutenant General. He then stepped into developing physician leaders and has found tremendous success in this crossover. His book “Growing Physician Leaders” is superb and is applicable across many fields, not just medicine. We discuss his unique post-Army career, where the tension points exist within medical leadership, and how his curriculum works. Key Learnings 1   Transitioning from the United States Army into medical leadership development 2.  Why a retired General would be a good fit for medicine, according to Disney 3. First impressions looking under the hood & the importance of serendipity 4. The value of interdisciplinary learning to develop trust 5. First impressions of leadership in healthcare as he started his work, especially what is not working 6. Gaps and tension points in healthcare leadership and the reasons they exist 7. Overcoming “What the hell is the hospital trying to make us do?” 8. The value of continuing, lifelong leadership training 9. Helping physicians reclaim the aspirational part of their work as a component of leadership training 10. Examining tension between servant leadership (physicians) vs  transactional leadership (administration) 11. The importance of “We” 12. The granular components of learning and connecting in healthcare leadership training (I loved this part!) 13. The extraordinary opportunity medicine has to tap into a deep and broad well of potential leaders 14. How leadership training ripples into every component of life including relationships and burnout mitigation Links Florida Hospital page: https://www.floridahospitalpublishing.com/authors/detail/mark-hertling Mark’s book: “Growing Physician Leaders” Mark’s Twitter feed: @markhertling #leadership, #physician, #doctor, #usarmy, #general, #hospital, #administration, #nursing  

Peter Hotez is a Professor of Pediatrics at Baylor College of Medicine and Dean of the National School of Tropical Medicine. He is the world’s authority on vaccine science not simply because of scientific background, but because of his active and valuable advocacy work across many platforms. He joins us to discuss the measles explosions in the United States and Europe, the devastation wrought by the anti-vaccine movement Key Learnings 1.  Why your faithful host is angry 2.  The 3 vaccines that are being marginalized in the United States 3.  The 3 major forces behind the current public health crisis 4. The power of the anti-vaccine movement & the lack of clarity behind it’s goals and funding 5.  The impact of vaccine exemptions at the state level 6. The lack of a powerful & organized pro-vaccine advocacy 7.  Dr. Hotez’ evolution from scientist to advocate, finding his voice, & telling a very personal story 8. The pressing need for healthcare providers to become savvy with TV, writing, and social media 9. Realizing the incredible power that physicians have when they step forward on social issues 10. What’s it’s like to go up against the anti-vaccine lobby and the need for more support from physicians who may be either disinterested or afraid. 11.  The next steps needed to begin to stem the tide 12.  The value of educating the next generations of healthcare providers in policy, advocacy, media & importance of meeting them where they live. 13.  The alarming trajectory of measles and the concern it will move through Europe, Asia, Africa, and South America Links Dr. Hotez’ website: www.peterhotez.org Dr. Hotez on Twitter: @peterhotez New York Times article: https://www.nytimes.com/2019/02/06/us/measles-outbreak.html Crafting Your Scientist Brand: https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.3000024 Dr. Hotez’ book “Vaccines Did Not Cause Rachel’s Autism” : https://www.amazon.com/Vaccines-Did-Not-Cause-Rachels-Autism/dp/1421426609 #meded, #vaccine, #measles, #influenza, #antivaxx, #epidemic, #healthcare, #socialmedia, #doctors, #podcast, #autism, #politics, #advocacy

Laurie Garrett is a Pulitzer Prize-winning journalist who wrote an extraordinary article in The British Medical Journal on gender equity in healthcare called “The Trouble With Girls.” She joins us to discuss the deep inequities she describes, the drivers behind them today and the extraordinary response the paper engendered. Key Learnings 1.  The impetus behind writing “The Trouble With Girls” 2.  The steps required for advancement and the demonstrable gender bias associated with each one laid out in the article 3.  Applying historical context with the stories of Elizabeth Cady Stanton and Eunice Foote to an immediate & current problem 4.  The challenge of resistance in researching the article 5.  Experiencing a roller-coaster getting the article published in the annual BMJ satire issue 6.  The article goes viral… 7.  Ms. Garrett’s powerful and informative personal experience that underwrites this article 8.  Laying out the differing drivers for gender discrimination in healthcare & science in decades past and today 9. How gender bias and racial bias are closely linked in healthcare and what “assumed superiority” looks like 10.  The incredible responses and stories the article brought forth 11.  Calling out “Manels” 12.  What the tempo of change looks like 13. A word about Ebola, mineral mining, and cell phones from the world’s expert Links The article (open access) https://www.bmj.com/content/363/bmj.k5232.full @Laurie_Garrett on Twitter www.LaurieGarrett.com #healthcare, #gender, #genderinequity, #metoo, #racism, #science, #bias, #genderbias, #womensmovement, #genderequity, #ebola  

It’s Super Bowl week, so it’s time to discuss Chronic Traumatic Encephalopathy in NFL players. Visar Berisha is an Associate Professor of Engineering at Arizona State University, focusing on speech and hearing science. He and his team completed an amazing study looking at changes in language complexity in NFL players. We discuss the study, it’s findings, and the extraordinary potential for this work in neurodegenerative disease. Key Learnings 1. The cloud that hangs over the National Football League 2. Looking at neurological health and searching for biomarkers of cognitive decline through the complexity of speech generation 3. Creating a philosophy of lab as incubator for multidisciplinary neurodegenerative disease 4. Breaking down the study “Longitudinal Changes In Linguistic Complexity In Professional Football Players” 5. The two key markers: vocabulary size and idea density, what should happen over time, and what the study demonstrates happened to the NFL players.  (The study even looks at impact on language of number of times an NFL quarterback is sacked) 6. The findings… 7. Response to the paper since publication 8. Using these tools both as a predictive model for CTE and a return-to-play modality for concussion 9. Ongoing study with the NCAA and outreach from former NFL players 10. What comes next with this study template across multiple disease processes 11. How Dr. Berisha and I connected in the first place Links The study in “Brain and Language:” https://auralanalytics.com/wp-content/uploads/2018/09/Longitudinal-changes-in-linguistic-complexity-among-professional-football-players.pdf The New York Times article:  https://www.nytimes.com/2017/05/29/health/cte-brain-inuries-football.html Dr. Berisha’s website: http://www.public.asu.edu/~visar/ #CTE, #NFL, #SuperBowl, #chronictraumaticencephalopathy, #language, #neurodegenerative, #concussion, #science, #football

Kristin Wikelius is a Senior Policy Director with United States of Care and she joins us to discuss the vision of the organization, how illness and sickness can provide common ground for progress, and why Medicaid at the state level is a good place to start Key Learnings 1. What is United States of Care and what is the mission & vision 2. Health and illness as a societal leveler independent of any other considerations 3. Initial goals of shifting healthcare debate from something defined by a single policy or party to something mission-driven 4. Defining Medicaid as a cornerstone of American healthcare 5. Dispelling misconceptions and negative connotations of Medicaid through personal stories. 6. Why a focus on Medicaid at the state level is the right approach in the near-term 7. How states are responding to possibility of Medicaid buy-in approach 8. What does success look like in this first phase & what’s working so far 9. Where has pushback come from & how are physicians responding 10. Recognizing that partisan divides at state level are much less pronounced than federal level & how this is an accelerant for progress 11. The value of elevating the stories we all carry around healthcare as a driver of progress Links United States of Care: www.unitedstatesofcare.org Twitter: @usofcare #healthcare, #healthcarereform, #medicaid, #newmexico, #unitedstatesofcare, #meded, #physician,

Grace Farris is a Hospitalist, Chief of Division of Hospital Medicine at Mount Sinai West, and an accomplished cartoonist with works featured in Annals of Internal Medicine & Buzzfeed. She joins us to discuss the role cartooning plays in her career, the potential of graphic art as an accelerant to learning, and some serious comics discussion. A unique conversation with an incredibly talented physician! Key Learnings Unpacking a Calvin & Hobbes essay that freaked your host out Origins of the evergreen comics Dr. Farris creates Parenting as a stimulus for her work The colchicine experience and creating a comic around it Are cartoons more impactful than editorial articles? The power of  her pen to shape characters, events and ambiance The topics and characters she is creating and how she feels towards them The comics that influenced Dr. Farris throughout her life Reflecting on her superb series about handing off patients to a colleague What type of feedback she has received Cartooning as an educational tool, especially in medicine The coolest journal in medicine is coming Art as an accelerant to learning in medicine Follow Grace Farris here: Website: https://farrisgrace.com Instagram: coupdegracefarris Twitter: @gracefarris Hashtags #hospitalist, #cartoon, #graphicnovel, #calvinandhobbes, #farside, #education, #FOAmed, #medicaldirector, #learning, #mother

Robert Pearl is a physician leader in the United States of the highest order. He is widely published and frequently featured on multiple TV networks. He joins us in our first episode of 2019 to lay out the great challenges facing physicians and patients in America, his incredible passion to drive change, and how we can move the needle in the right direction. Key Learnings 1. How his personal experiences with the problems of American healthcare led  to the creation of his Forbes article 2. What it feels like to have doctors confessing their fears and frustrations to him in the wake of his book 3. Some of the limitations and barriers physicians deal with when trying to provide great care for patients 4. The passion and optimism that Dr. Pearl brings to the table and where he draws it from 5. The 5 fears doctors confess to other doctors 6. The great sense of loss that physicians have to deal with 7.  Describing the 3 historical eras of medicine as a central dogma 8. Feedback Dr. Pearl has received from people outside of medicine, and how it connects with his own personal experiences 9. What are the key functions and entities needed to drive meaningful change? Links Dr. Pearl’s book “Mistreated” Forbes article: What Doctors Confess To Other Doctors Tags #healthcare, #hospital, #physician #solutions #fear, #hospitalist #surgeon, #podcast, #leader, #leadership, #forbes, #patients, #doctors, #palliativecare, #compassion