The Podcast by KevinMD

Kevin Pho, MD
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May 18, 2025 • 18min

Addressing America's reliance on psychotropic medication

Practicing internist and psychiatrist Muhamad Aly Rifai discusses his article, "How America became overmedicated—and what we can do about it." He raises concerns about the high rate of psychotropic medication use in the U.S., citing CDC data suggesting nearly 1 in 4 adults may be taking these drugs, often without clear long-term plans or exit strategies. Muhamad contrasts this with U.K. NICE guidelines that emphasize structured deprescribing protocols, highlighting a significant gap in U.S. clinical guidance. He points to systemic issues like short medication management visits, lack of industry incentives for deprescribing, and the need for better physician training in distinguishing withdrawal symptoms from relapse. Dr. Rifai advocates for a national shift towards wellness, emphasizing medication optimization, integrated behavioral health (including therapy and trauma-informed care), addressing social determinants of health, and fostering recovery-oriented conversations that explore non-pharmacologic approaches like peer support, nutrition, and exercise. Actionable takeaways include the need for robust deprescribing guidelines, investment in holistic and integrated care models, and a conscious effort by clinicians to discuss not just starting medications, but also safely stopping them when appropriate. Our presenting sponsor is Microsoft Dragon Copilot. Microsoft Dragon Copilot, your AI assistant for clinical workflow, is transforming how clinicians work. Now you can streamline and customize documentation, surface information right at the point of care, and automate tasks with just a click. Part of Microsoft Cloud for Healthcare, Dragon Copilot offers an extensible AI workspace and a single, integrated platform to help unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise—and it's built on a foundation of trust. It's time to ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow. VISIT SPONSOR → https://aka.ms/kevinmd SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
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May 17, 2025 • 18min

An introduction to occupational and environmental medicine

Occupational medicine physician Robert Nathan Clapp discusses his article, "Why you should take a closer look at occupational and environmental medicine." Addressing the pervasive issue of physician burnout, Robert introduces occupational and environmental medicine (OEM) — a specialty under preventive medicine — as a compelling but often overlooked field boasting high job satisfaction and low burnout. He notes that despite its appeal, only about 20 percent of OEM residents knew about the specialty before finishing medical school, leading many to transition later in their careers. Robert explains that OEM focuses on preventing, diagnosing, and treating workplace and environmental injuries and illnesses, uniquely blending clinical care with public health principles. Key advantages drawing physicians to OEM include extremely diverse career paths (ranging from 100 percent clinical to 100 percent non-clinical in various settings like corporations, government, and academics), excellent work-life balance with minimal call or weekend work, a focus on functional outcomes rather than volume metrics, competitive salaries, and high demand. Furthermore, residency training is accessible (often two years, or even one year for those with prior GME) and includes a master of public health (MPH) degree, with prior specialty experience often being highly valued. Actionable takeaways encourage physicians feeling dissatisfied or burnt out, as well as medical students, to explore OEM as a pathway to a more sustainable and rewarding medical career. Our presenting sponsor is Microsoft Dragon Copilot. Microsoft Dragon Copilot, your AI assistant for clinical workflow, is transforming how clinicians work. Now you can streamline and customize documentation, surface information right at the point of care, and automate tasks with just a click. Part of Microsoft Cloud for Healthcare, Dragon Copilot offers an extensible AI workspace and a single, integrated platform to help unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise—and it's built on a foundation of trust. It's time to ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow. VISIT SPONSOR → https://aka.ms/kevinmd SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
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May 16, 2025 • 13min

Alzheimer's and the family: Opening the conversation with children

Journalist and patient advocate Carol Steinberg discusses her article, "Alzheimer's impact on the young should be an open book." She argues that while Alzheimer's disease and related dementias (ADRD) are known to affect the whole family, children under 18 are often excluded from conversations about a loved one's condition, leading to fear, confusion, and missed opportunities for connection. Carol details the emotional toll on children witnessing cognitive decline, the distinct difficulties for those with a parent with younger-onset ADRD, and the significant challenges faced by the 5.4 million caregiving youth in the U.S., who often experience adverse mental, physical, and academic outcomes. The discussion highlights a growing consensus among experts urging truthfulness and age-appropriate involvement for children, calling on the medical community and others to better recognize and support young carers. Carol introduces her children's book, Come Grandpa Meow, Let's Fly, as a tool to facilitate these difficult conversations and promote meaningful intergenerational activities, allowing families to connect and "meet in the moment" despite the disease's progression. Actionable takeaways emphasize the importance of candor, using resources to educate children, fostering continued relationships, and advocating for greater support systems for affected youth. Our presenting sponsor is Microsoft Dragon Copilot. Microsoft Dragon Copilot, your AI assistant for clinical workflow, is transforming how clinicians work. Now you can streamline and customize documentation, surface information right at the point of care, and automate tasks with just a click. Part of Microsoft Cloud for Healthcare, Dragon Copilot offers an extensible AI workspace and a single, integrated platform to help unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise—and it's built on a foundation of trust. It's time to ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow. VISIT SPONSOR → https://aka.ms/kevinmd SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
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May 15, 2025 • 18min

Why great patient outcomes don't protect female doctors from burnout

Pediatrician and holistic wellness expert Noemi Adame discusses her article, "Having a female doctor is better for your health, but not for hers." She highlights research indicating patients often experience better outcomes—including lower mortality, readmission, and post-surgical complication rates—when treated by female physicians, potentially linked to factors like longer visits and stronger adherence to guidelines. However, Noemi contrasts this with the significant personal toll on female doctors, who face higher burnout rates, a greater burden of uncompensated tasks like EMR messages (receiving 25 percent more requests), and a concerning lack of the longevity advantage seen in the general female population. She critiques the corporate medical system for failing to adequately support or compensate female physicians for the qualitative differences in their care delivery and the associated emotional labor. Noemi strongly advises female colleagues to protect their own well-being by considering alternatives to corporate employment, such as Direct Primary Care (DPC), independent contracting, or building a personal brand, while also acknowledging the unique challenges women face in setting boundaries within these models. Actionable takeaways emphasize the critical need for female physicians to prioritize self-care, implement sustainable practice systems, and advocate for themselves, whether inside or outside traditional employment structures. Our presenting sponsor is Microsoft Dragon Copilot. Microsoft Dragon Copilot, your AI assistant for clinical workflow, is transforming how clinicians work. Now you can streamline and customize documentation, surface information right at the point of care, and automate tasks with just a click. Part of Microsoft Cloud for Healthcare, Dragon Copilot offers an extensible AI workspace and a single, integrated platform to help unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise—and it's built on a foundation of trust. It's time to ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow. VISIT SPONSOR → https://aka.ms/kevinmd SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
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May 14, 2025 • 16min

Precision and personalization: Charting the future of cancer care

Hematology-oncology physician Yousuf Zafar discusses his article, "The personalization of cancer care in 2025." He traces the evolution of cancer treatment over the past two decades, moving through waves of cytotoxic chemotherapy, biologic therapies, immunotherapies including groundbreaking CAR-T therapy, and now precision oncology, which targets treatments to the specific molecular profile of a patient's cancer. While these advancements have significantly improved survival and quality of life, Yousuf highlights the resulting increase in care complexity and the widening gap in outcomes between specialized centers (where only 20 percent of U.S. patients are treated) and community practices (where 80 percent of care occurs), particularly impacting rural areas where 66 percent of counties lack an oncologist. The conversation explores how digital health solutions, such as remote case reviews connecting community oncologists with subspecialists, can help bridge this divide and improve access. Importantly, Yousuf stresses that personalized care extends beyond treatment to encompass vital patient support for financial burdens, mental well-being, and survivorship. Actionable takeaways emphasize the need for collaboration, resources for community oncologists, investment in digital health tools, and a continued focus on patient-centered support throughout the cancer journey. Our presenting sponsor is Microsoft Dragon Copilot. Microsoft Dragon Copilot, your AI assistant for clinical workflow, is transforming how clinicians work. Now you can streamline and customize documentation, surface information right at the point of care, and automate tasks with just a click. Part of Microsoft Cloud for Healthcare, Dragon Copilot offers an extensible AI workspace and a single, integrated platform to help unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise—and it's built on a foundation of trust. It's time to ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow. VISIT SPONSOR → https://aka.ms/kevinmd SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
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May 13, 2025 • 22min

Rethinking patient payments: Why billing is the new frontline of patient care

Health care executive Blake Walker discusses his article, "From caregivers to collectors: Navigating the new landscape of patient payments." He describes a perfect storm impacting provider groups: the significant rise in patient financial responsibility due to high-deductible health plans, the growth of health care consumerism where patients demand better experiences (with up to 50 percent willing to switch providers over billing issues), and the overwhelming administrative burden placed on staff using outdated systems not designed for patient collections. Blake argues that traditional practice management systems, prioritizing insurance reimbursement, are ill-equipped for today's landscape, leading to lost revenue and patient frustration. The conversation emphasizes the need to unbundle patient billing from these systems and adopt modern, consumer-friendly solutions offering automation, transparency, clear communication (like omnichannel options recovering 70 percent of payments quickly), and multiple payment methods. Actionable takeaways include recognizing patient billing as a critical touchpoint, investing in technology that improves the patient financial experience, and automating routine tasks to free up staff and improve collections. Our presenting sponsor is Microsoft Dragon Copilot. Microsoft Dragon Copilot, your AI assistant for clinical workflow, is transforming how clinicians work. Now you can streamline and customize documentation, surface information right at the point of care, and automate tasks with just a click. Part of Microsoft Cloud for Healthcare, Dragon Copilot offers an extensible AI workspace and a single, integrated platform to help unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise—and it's built on a foundation of trust. It's time to ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow. VISIT SPONSOR → https://aka.ms/kevinmd SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
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May 12, 2025 • 19min

Why funding cuts to academic medical centers impact all of us

Orthopedic surgeon Adil S. Ahmed discusses his article, "Academic medical centers under threat: the impact of funding cuts." He outlines the essential, multifaceted roles of academic institutions in educating future doctors, conducting vital biomedical research, and providing complex care, often for underserved populations—functions distinct from private equity-driven health care models. The conversation highlights the critical dependence of these centers on funding, grants, and donations, particularly from government sources like the NIH, HHS, and CDC, to sustain their tripartite mission. Adil argues that recent government funding cuts, driven by political shortsightedness and a potentially misleading focus on "efficiency," pose a direct threat to medical training opportunities, scientific advancement, and the capacity to care for the most complex patients. Actionable takeaways focus on recognizing the long-term societal value of academic medical centers and the potential dangers of reducing their funding, urging support for policies that bolster science and education. Our presenting sponsor is Microsoft Dragon Copilot. Microsoft Dragon Copilot, your AI assistant for clinical workflow, is transforming how clinicians work. Now you can streamline and customize documentation, surface information right at the point of care, and automate tasks with just a click. Part of Microsoft Cloud for Healthcare, Dragon Copilot offers an extensible AI workspace and a single, integrated platform to help unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise—and it's built on a foundation of trust. It's time to ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow. VISIT SPONSOR → https://aka.ms/kevinmd SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
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May 11, 2025 • 20min

Navigating physician non-competes: a strategy for staying put

Cardiologist Stanley Liu discusses his article, "5 steps to ride out a non-compete without uprooting your family." He shares his personal experience of being bound by an 18-month, 20-mile non-compete clause after leaving an academic cardiology position and outlines the strategic steps he took to navigate this period without relocating his family. Key points include the critical importance of building a substantial worst-case scenario fund for financial security during negotiations or unemployment, defining clear personal and professional goals for the career transition to maintain focus, and exploring diverse income streams like locum tenens work or non-clinical roles that align with those goals. Stanley also emphasizes the necessity of creating contingency plans (Plan B and C) for potential setbacks and the importance of maintaining professional goodwill by managing the departure process gracefully. Actionable takeaways involve proactive financial planning, intentional career design focused on personal well-being, and strategic navigation of contractual limitations. Our presenting sponsor is Microsoft Dragon Copilot. Microsoft Dragon Copilot, your AI assistant for clinical workflow, is transforming how clinicians work. Now you can streamline and customize documentation, surface information right at the point of care, and automate tasks with just a click. Part of Microsoft Cloud for Healthcare, Dragon Copilot offers an extensible AI workspace and a single, integrated platform to help unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise—and it's built on a foundation of trust. It's time to ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow. VISIT SPONSOR → https://aka.ms/kevinmd SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
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May 10, 2025 • 22min

Mindful negotiation: practical strategies for physician self-advocacy

Pediatrician and certified coach Jessie Mahoney discusses her article, "Why physicians find negotiating challenging—and what they can do to negotiate better." She explores why negotiation often feels stressful for physicians, linking it to medical training that emphasizes service, self-sacrifice, and conflict avoidance over self-advocacy, particularly impacting women. Drawing from her own experiences and coaching work, Jessie shares eleven actionable strategies designed to help physicians negotiate more effectively and mindfully. These tips include using breathwork to stay calm, clearly asking for what you want, conducting thorough research, understanding your value and bottom line (including the willingness to walk away), framing requests as mutual solutions, leveraging patience and silence, managing emotions like resentment, and celebrating successful outcomes without guilt. The conversation reframes negotiation not just as a business necessity but as a vital skill for physician well-being, energy protection, and building a sustainable career. Our presenting sponsor is Microsoft Dragon Copilot. Microsoft Dragon Copilot, your AI assistant for clinical workflow, is transforming how clinicians work. Now you can streamline and customize documentation, surface information right at the point of care, and automate tasks with just a click. Part of Microsoft Cloud for Healthcare, Dragon Copilot offers an extensible AI workspace and a single, integrated platform to help unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise—and it's built on a foundation of trust. It's time to ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow. VISIT SPONSOR → https://aka.ms/kevinmd SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
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May 9, 2025 • 21min

Understanding therapy beyond crisis management

Anesthesiologist and psychotherapist Maire Daugharty discusses her article, "Why real therapy isn’t just about crisis." She challenges the common misconception that therapy is only necessary or effective during acute crises ("crisis-hopping"), explaining that this view can lead to premature termination—a "flight to health"—when underlying work remains. Maire emphasizes that periods of calm in therapy are essential for integrating positive changes, processing accomplishments, and solidifying shifts in perspective and self-structure. The conversation also explores the critical importance of respecting patient autonomy and boundaries in both therapeutic and medical settings, acknowledging that clinicians cannot fully know a patient's inner world. Furthermore, Maire clearly distinguishes the deep, exploratory work of psychotherapy, which often involves confronting difficult truths ("approaching the shattered mirror") and altering implicit assumptions, from the explicit skill-building and goal-oriented approach of coaching, which works with the existing self-structure. Our presenting sponsor is Microsoft Dragon Copilot. Microsoft Dragon Copilot, your AI assistant for clinical workflow, is transforming how clinicians work. Now you can streamline and customize documentation, surface information right at the point of care, and automate tasks with just a click. Part of Microsoft Cloud for Healthcare, Dragon Copilot offers an extensible AI workspace and a single, integrated platform to help unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise—and it's built on a foundation of trust. It's time to ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow. VISIT SPONSOR → https://aka.ms/kevinmd SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

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