The Podcast by KevinMD

"Their absence makes me feel sad, I look around at my peers, envious and curious, Obsessing over when they will show up. When they do, they never seem to live up to expectations, Too small, too uneven, but what's sure is it's a sign I'm no longer a child. It adds to my wardrobe in a hushed way, I don't know whether to be proud or embarrassed that they're finally here. I look at magazines; should I display them more? Or will my whole essence be reduced to how big they appear under my shirt. I'm confused but feel alone with no one to talk to about these new guests." Poonam Merai is an internal medicine physician. She shares her story and discusses her KevinMD article, "There is no other body part that has filled me with such a roller coaster of emotion." Did you enjoy today's episode? Rate and review the show so more audiences can find The Podcast by KevinMD. Subscribe on your favorite podcast app to get notified when a new episode comes out. Reflect and earn 1.0 AMA PRA Category 1 CME for this episode. Also available in Category 1 CME bundles. Powered by CMEfy - a seamless way for busy clinician learners to discover Internet Point-of-Care Learning opportunities that reward AMA PRA Category 1 Credit(s)™. Learn more at about.cmefy.com/cme-info

"I understand that the biggest fear you have about going through chemotherapy is losing your hair. I just want to tell you. You will be fine. Trust me. I know it's barbaric. Why don't we have medicines to treat cancer that will not make you lose your hair in this day and age? Strange, right? But science has its limits. Work is being done on finding such drugs, but we are not there yet. If you Google "forced standing," a black and white picture of a girl from a couple of hundred years ago pops up who is being forced to stand, by tying her neck and arms with ropes to the ceiling and walls. Her head is slightly slumped over to one side as if she does not want to stand. The caption will inform you that this is actually how clinical depression was treated at that time. Perhaps if someone is depressed and is lying in bed all day, forcing them to stand up would somehow cure depression. When we look at that picture today, it seems like a scene out of a horror movie. Whoever I have shown that picture to has gasped. But at that time, this treatment was likely endorsed by some, if not all, psychiatrist societies of the world. Human history, after all, has no deficit of theories and rituals that were popular at the time but later considered abhorrent.' Farhan S. Imran is a hematology-oncology physician who blogs at Did I Ask? He shares his story and discusses his KevinMD article, "To my patient who is going to lose her hair from chemotherapy." Did you enjoy today's episode? Rate and review the show so more audiences can find The Podcast by KevinMD. Subscribe on your favorite podcast app to get notified when a new episode comes out. Reflect and earn 1.0 AMA PRA Category 1 CME for this episode. Also available in Category 1 CME bundles. Powered by CMEfy - a seamless way for busy clinician learners to discover Internet Point-of-Care Learning opportunities that reward AMA PRA Category 1 Credit(s)™. Learn more at about.cmefy.com/cme-info

"Our patients go through some very predictable fears and responses to illness and injury. In turn, medical students and residents also think and respond with some thought distortions and misunderstandings about their patients and themselves. Armed with awareness and familiarity with the typical patterns, we learn more about what to expect. We anticipate when we will get push-back and we are better prepared to act calmly and confidently. Additionally, we can get curious and ask better questions during those challenging interactions. What else is true about that grumpy old man? Is he someone's father or grandfather? Could some of the patient's behavior be a symptom of his disease? If we remember that, don't those facts make the patient's actions a lot more understandable? Is there another way to approach a problem to which you see only one solution? Can you reach some collaborative plan that satisfies both the patient and you?" Joan Naidorf is an emergency physician and author of Changing How We Think about Difficult Patients: A Guide for Physicians and Healthcare Professionals. She shares her story and discusses her KevinMD article, "Changing how we think about difficult patients." Did you enjoy today's episode? Rate and review the show so more audiences can find The Podcast by KevinMD. Subscribe on your favorite podcast app to get notified when a new episode comes out. Reflect and earn 1.0 AMA PRA Category 1 CME for this episode. Also available in Category 1 CME bundles. Powered by CMEfy - a seamless way for busy clinician learners to discover Internet Point-of-Care Learning opportunities that reward AMA PRA Category 1 Credit(s)™. Learn more at about.cmefy.com/cme-info

"Overall, the health system in the United States is still not tilting its axes in favor of either primary care or family doctor. What is worse, family doctors as a collective are more balkanized and less cohesive than ever. There is a sense among those in the field that something is not right about the specialty. Some feel there is a bait-and-switch aspect to becoming a family doctor. It ends up being something much different than what they were initially told. Others feel it is an impossible job to do well. The ask is too big for them. Still others believe sincerely in the ideal definition of the role, that of the generalist or comprehensive doctor, but find themselves working too hard or sacrificing too much to get it done. They find other niche-oriented ways to convince themselves they are doing "true" family medicine work. Family doctors everywhere are searching out more sustainable career paths for themselves, leading to so much career variety that the very label family doctor starts losing its preferred connotation." Timothy Hoff is a professor of management and author of Searching for the Family Doctor: Primary Care on the Brink. He shares his story and discusses his article, "Family medicine and the fight for the soul of health care." Did you enjoy today's episode? Rate and review the show so more audiences can find The Podcast by KevinMD. Subscribe on your favorite podcast app to get notified when a new episode comes out. Reflect and earn 1.0 AMA PRA Category 1 CME for this episode. Also available in Category 1 CME bundles. Powered by CMEfy - a seamless way for busy clinician learners to discover Internet Point-of-Care Learning opportunities that reward AMA PRA Category 1 Credit(s)™. Learn more at about.cmefy.com/cme-info

"Our children are not OK. Our pediatricians are not OK. Please, let us not further ignore and jeopardize the future health of our society. Pediatrics needs a transformational change to direct primary care and other models that transition from transactional care to relational care. Encourage your employer to embrace direct primary care for children. The future health of our children is at stake." Andrew Hertz and Keili Mistovich are pediatricians. They share their stories and discuss the KevinMD article, "Kids are not OK: Health care is failing them." Did you enjoy today's episode? Rate and review the show so more audiences can find The Podcast by KevinMD. Subscribe on your favorite podcast app to get notified when a new episode comes out. Reflect and earn 1.0 AMA PRA Category 1 CME for this episode. Also available in Category 1 CME bundles. Powered by CMEfy - a seamless way for busy clinician learners to discover Internet Point-of-Care Learning opportunities that reward AMA PRA Category 1 Credit(s)™. Learn more at about.cmefy.com/cme-info

"I had sent an email to some key people in my organization about managing patients' expectations and how that needed to be addressed differently on an organizational level. The truth of the matter is that I am powerless to change the way the system handles a lot of things. The more personally relevant issue is managing my expectations, both how I relate to the needs/expectations of those in front of me and my own personal needs and expectations of myself in delivering that care. Since we truly only have control over ourselves, the key question becomes how do I manage my own expectations better as a way of managing my own inner resources, namely, time, energy, and mental/emotional output?" Anne M. Miller is a psychiatrist. She shares her story and discusses her KevinMD article, "Managing expectations in the face of COVID-19." Did you enjoy today's episode? Rate and review the show so more audiences can find The Podcast by KevinMD. Subscribe on your favorite podcast app to get notified when a new episode comes out. Reflect and earn 1.0 AMA PRA Category 1 CME for this episode. Also available in Category 1 CME bundles. Powered by CMEfy - a seamless way for busy clinician learners to discover Internet Point-of-Care Learning opportunities that reward AMA PRA Category 1 Credit(s)™. Learn more at about.cmefy.com/cme-info

"There is a small amount of literature about secondary trauma. This means that the people who respond to trauma (firefighters, police, doctors, EMTs, etc.) experience PTSD from experiences they were not the primary victims of. I haven't read the literature, and I don't know what qualifies. I do know that this is the single worst experience with humanity that I have ever had, and the images from that night are as clear in my head today as they were when I first saw them. I know I will never forget that night, nor will I ever cease to feel my heart drop and stomach churn when I think about the few steps that Amanda took from her bed to the bathroom. The last few of her life. Rehaan Shaffie is a hospitalist. He shares his story and discusses his KevinMD article, "The worst code I ever ran." Did you enjoy today's episode? Rate and review the show so more audiences can find The Podcast by KevinMD. Subscribe on your favorite podcast app to get notified when a new episode comes out. Reflect and earn 1.0 AMA PRA Category 1 CME for this episode. Also available in Category 1 CME bundles. Powered by CMEfy - a seamless way for busy clinician learners to discover Internet Point-of-Care Learning opportunities that reward AMA PRA Category 1 Credit(s)™. Learn more at about.cmefy.com/cme-info

"If you knew we are like the 'Two Fridas,' that our hearts are connected, would you change your mind? Would you stop as you are about to cut the artery feeding your heart and mine? If you knew that when you cry because of your loneliness, because of your longing for your family, that I cry, too, (though behind your back, after I have comforted you) would you change your mind? If you knew that your isolation, with the tubes and gadgets coming from you or going into you, extend to me would you change your mind then?" Rosemary Eseh-Logue is an internal medicine physician. She shares her story and discusses her KevinMD article, "Unrequited: love in the time of COVID-19." Did you enjoy today's episode? Rate and review the show so more audiences can find The Podcast by KevinMD. Subscribe on your favorite podcast app to get notified when a new episode comes out. Reflect and earn 1.0 AMA PRA Category 1 CME for this episode. Also available in Category 1 CME bundles. Powered by CMEfy - a seamless way for busy clinician learners to discover Internet Point-of-Care Learning opportunities that reward AMA PRA Category 1 Credit(s)™. Learn more at about.cmefy.com/cme-info

"For the most highly educated and specialized professional on the health care totem pole, physicians put up with a ridiculous amount of nonsense in the workplace. You are pressured to see high volumes of patients in a rapid-fire fashion (15 minutes per visit) even when it interferes with the quality of care. You are expected to complete mundane and excessive administrative tasks and generally are not directly compensated for this time. You are given very little flexibility from your employers when it comes to rearranging your schedule and taking personal time off. For the average physician, the working conditions are intolerable at best and inhumane at worst. So the question is, why is this poor treatment tolerated?" Chelsea Turgeon is a former OB/GYN resident and can be reached at Coach Chels MD. She shares her story and discusses her KevinMD article, "Why do physicians stay in toxic work environments?" Did you enjoy today's episode? Rate and review the show so more audiences can find The Podcast by KevinMD. Subscribe on your favorite podcast app to get notified when a new episode comes out. Reflect and earn 1.0 AMA PRA Category 1 CME for this episode. Also available in Category 1 CME bundles. Powered by CMEfy - a seamless way for busy clinician learners to discover Internet Point-of-Care Learning opportunities that reward AMA PRA Category 1 Credit(s)™. Learn more at about.cmefy.com/cme-info

"Unfortunately, when negotiating with hospitals I am frequently forced to deal with individuals who need to 'explain' the importance of maintaining flexibility in their workforce (a wonderful business school phrase that appropriately dehumanizes the people who are accomplishing the purported mission of the hospital to treat the sick and injured). The hospital personnel frequently tell me that limiting patient contact hours to 'only' 32 or 36 hours per week is considered part-time. Many contend that keeping the electronic health record boxes all appropriately checked should be done on the physician's own time. I assume the hospital administrators would be pleased if a physician avoided any personal contact with the patient during whatever brief moments are allocated for a visit so that the electronic health record can be put into a condition that allows billing for the visit. Physicians, of course, spend their visits treating the patient as a human being rather than a unit on the assembly line that is their schedule. Doing so requires significant outside time polishing the record so that the hospital may bill. Hospital executives apparently view this as an inefficient use of resources, and therefore frequently insist upon 40 patient contact hours per week." Dennis Hursh is a physician contract lawyer. He blogs at Physicians Contracts Blog. He shares his story and discusses his KevinMD article, "Are hospitals evil? A physician contract lawyer explains." Did you enjoy today's episode? Rate and review the show so more audiences can find The Podcast by KevinMD. Subscribe on your favorite podcast app to get notified when a new episode comes out. Reflect and earn 1.0 AMA PRA Category 1 CME for this episode. Also available in Category 1 CME bundles. Powered by CMEfy - a seamless way for busy clinician learners to discover Internet Point-of-Care Learning opportunities that reward AMA PRA Category 1 Credit(s)™. Learn more at about.cmefy.com/cme-info