The Podcast by KevinMD

"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

"I thought of her with each miscarriage I saw in COVID+ mothers, and during each delivery of premature rupture of membranes due to infection. I thought of her every time I gave steroids, increased the oxygen flow for someone struggling to breathe, or held the hand of someone before their emergency delivery. I saw her face when I was frantically calling a pulmonologist to help me manage oxygen on a deteriorating patient on the unit. She stayed with me through each obstetric emergency. She probably never thought of me. I was the doctor who made her cry when she was most excited to tell me that she wanted children. I don't know if she'll be back, and I don't know if I am better or worse at explaining the urgency. All I know is that we all make choices. With COVID, some choices will save lives, whereas other choices might end with the unimaginable." Yuliya Malayev is an obstetrician-gynecologist. She shares her story and discusses her KevinMD article, "What does it even mean to work through the unimaginable?" 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 failed my Step 1 medical school board exam by 1 point. This was very hard for me to process, and I consistently wondered if I would have passed if I had just waited an additional week. This new challenge led me to reach out to a new resource: the disability office. Never before had I considered my medical diagnosis of endometriosis and anxiety as a 'disability.' I had obviously done well enough to graduate college and get into medical school. Although, I never seemed to be able to achieve top grades in my class. I had always believed this was an explanation for being less intelligent than my peers. However, the disability office helped me realize that the standardized testing system was not equitable and did not allow me to do my very best in these exams. Through this experience, I realized that I do have a disability. All a disability means is that one is not able to achieve what other people without the disability can achieve." Stephanie E. Moss is a medical student. She shares her story and discusses her KevinMD article, "Requesting disability accommodations in medical school." 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

"What makes soldiers and doctors good at their jobs are also the very things that make it hard to leave work at work. My former husband was, and is, very good at his job, especially when it comes to compassion and care for his patients. At work, he gives his all. He sits with grieving families, helping them understand what's happening with their loved ones and even crying with them as they die. To ask one more thing of him when he'd given every ounce of his soul all day seemed selfish and childish. So I tried to be civilized and grown-up, swallowing my need for love, to be seen and cared for the way his patients were. By the end of the day, he was so drained; he must have felt that no story he could tell me could bridge the huge divide between the battlefield of the hospital and the home we shared. This is what many doctors do: go back and forth between the battlefield and whatever "home" they've created. They are soldiers in everyday life." Susan Hart Gaines is an executive coach specializing in physician wellbeing. She shares her story and discusses her KevinMD article, "The difficulty in coming home: What doctors and soldiers have in common." 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

"Life can feel full of uncertainty when battling cancer, with few guarantees. 'Is there still cancer in my body?' and 'Will it come back?' are common questions that have long been difficult to answer confidently until recently. Advances in next-generation sequencing — and a growing understanding of how our bodies respond to illness and treatment — have brought us closer than ever to predicting our individual futures, at least when it comes to cancer. In recent years, cancer researchers have embraced new noninvasive technologies that can detect small amounts of DNA shed by tumors into the blood, also known as circulating tumor DNA (ctDNA). This is no easy feat, as ctDNA is extremely scarce after surgery and treatment — as low as a single molecule in a tube of blood. But by broadly sequencing one's tumor, we can identify its unique genetic signature, allowing for the creation of a highly sensitive and personalized assay that can track cancer in the body over time." Alexey Aleshin is a hematology-oncology physician and health care executive. He can be reached on Twitter @aaleshin. He shares his story and discusses his KevinMD article, "Tumor-informed residual disease testing can help inform cancer treatment." 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 what it feels like to be in the depths of depression and hopelessness. I have had a lifelong battle with stuttering, obsessive-compulsive tendencies, depression, and suicide. I continually fight these battles and have learned to heal and recover through family, friends, and ultra-running. Since attempting to take my life on September 12, 2009, I have developed wellness tactics to help me journey through life to achieve optimum performance and to have a better work-life balance to lead a more healthy, peaceful, and purposeful life." Anthony Avellino is a pediatric neurosurgeon. He shares his story and discusses his KevinMD article, "Coming back from the brink of burnout." 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 was diagnosed over 20 years ago, and looking back, I feel privileged that I did meet the stereotype for anorexia and be forced into treatment. However, along the way, I have gained insight that people of all bodies share my struggles. And the use of weight/BMI to determine whether someone is struggling and should have access to treatment results in delayed diagnoses, limitations in access to care, prolonged suffering, invalidation, and shame." Jillian Rigert is an oral medicine specialist and radiation oncology research fellow. She shares her story and discusses her KevinMD article, "Eating disorders thrive in secrecy, so let's talk about it. Starting with BMI." 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

Often, physicians only give minimal attention to their financial futures, but potential federal changes could make tax planning even more important. The proposed infrastructure bill would increase taxes, affecting those with an annual income higher than $400,000, which is not uncommon for physicians. These changes make it vital for physicians to sit down with their financial advisors and CPAs now to minimize their own tax burden. Syed Nishat is a partner, Wall Street Alliance Group. This article is sponsored by Wall Street Alliance Group, specializing in physician financial planning. 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

"The business of health care delivery differs markedly from other consumer and service industries in many ways. First and foremost, the economics differ. Specifically, the payers of medical care are often different from the customers, the government and third-party insurers are the primary payers, demand is inelastic, quality metrics are typically unavailable, and the industry consists largely of nonprofits that avoid taxes. And that's just the start of the economic differences. These profound economic differences vis-a-vis other industries lead to fundamental deficiencies in health care governance, leadership, organizational design, infrastructure, and operations. We believe economic exceptionalism is the root cause." Joe Mandato is a venture capitalist. Ryan Van Wert is a pulmonary physician and health care executive. They share their stories and discuss their KevinMD article, "Why health care delivery is an exceptionally different industry." 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 see lamenting the Great Resignation. I celebrate it. It's not so much about what people are leaving – but where are they going? What have they empowered themselves to become? The thought, 'There has to be something more,' has been pondered and fleshed out. We are stretching our wings, becoming educators, influencers, and entrepreneurs; creating movements and businesses; becoming the parents we always wanted to be. And I dare say that the writing is on the wall for organized medicine. We can lament that physicians are resigning and feverishly design retention programs. Or we can see that physicians do not want to be retained in this system. We are big thinkers, we are idealists, we are creative, and we are creating the future of medicine right now." Wendy Schofer is a pediatrician. She shares her story and discusses her KevinMD article, "Why we should celebrate the Great Resignation." 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