The Podcast by KevinMD

"The victims of this now distorted concept of liberty are ones that we physicians encounter every day. The one that inspired this essay for me is an 11-year-old boy that I saw three weeks ago. He is a patient of mine in my pediatric practice who came to see me with typical respiratory symptoms that led to a diagnosis of COVID-19. While he recovered uneventfully, his father got sick the next day and died from the same illness five days later. Like the vast majority of people who die from COVID-19 now, he was unvaccinated, believing that getting vaccinated was unnecessary and part of a greater effort to undermine his personal liberty. His son is now dealing with the unimaginable grief of losing a parent at such a tender age and asking his mother if he killed his father by getting sick and causing his death. This happens every day now in our communities across our nation. These are wounds that will never heal for this generation of kids." Jason V. Terk is a pediatrician. He shares his story and discusses his KevinMD article, "The dimming of the shining city." (https://www.kevinmd.com/blog/2021/10/the-dimming-of-the-shining-city.html)

"The U.S. Department of Education recently announced some major changes to the rules and qualifications around the Public Service Loan Forgiveness (PSLF) Program. Now, for a limited period of time, borrowers may receive credit for past payments made on loans that would otherwise not qualify for PSLF. The good news is that public service loan forgiveness is now available to more people. The bad news is that there will be more people waiting in line to have their federal student loans waived. This issue impacts anyone from medical residents to physicians who are making payments on loans for at least ten years." Will Koster is a financial planner. He shares his story and discusses his KevinMD article, "The Public Service Loan Forgiveness waiver and its impact on physicians." (https://www.kevinmd.com/blog/2021/10/the-public-service-loan-forgiveness-waiver-and-its-impact-on-physicians.html)

"Finding out I was gene-positive had hit me harder than I could ever have imagined. How was I to know that my decision to get tested would have such an impact on my life? All of the rehearsing I had done in the weeks leading up to my results appointment proved useless. At the genetics clinic that day, the doctor told me most people feel better after about three months. As I sat on the hard plastic hospital chair, staring at the creased piece of paper containing my test results, I thought, That doesn't seem so bad. Three months isn't that long. The problem was it had been longer than that and I still didn't feel better, not even a little bit. I was starting to think something was wrong with me, that I was the cause of my own misery. Am I wallowing in my own self-pity? Do I like feeling this way? I didn't understand why I couldn't make myself better. I had never experienced a depression as deep or as long-lasting as this. I had recently begun to realize that anything I had felt previous to my HD diagnosis that I thought was depression was just sadness. Every day, every moment, was a struggle. There was no more joy in my life. I hadn't smiled in weeks. I had more unanswerable questions now than before I got tested. How am I supposed to live with this? I can't stop it from happening, so how am I ever going to feel OK?" Erin Paterson is a writer and the author of All Good Things: A Memoir About Genetic Testing, Infertility and One Woman's Relentless Search for Happiness. She shares her story and discusses her KevinMD article, "The emotional side of genetic testing." (https://www.kevinmd.com/blog/2021/10/the-emotional-side-of-genetic-testing.html)

"I'm not brave. I'm just me. Full of light and lifted by my light. You see, when you strip away the darkness and lies that others surround you with, you're left only with your light. The genuine you. Moving forward in life in ways that are authentically you. Not because it's brave to rise above and be disconnected from your humanity, but rather because when you become un-brave, you step into your own courage. Courage has understanding of what you're doing and who or what you're doing it for. Courage gives you permission to feel the feels, and connect not only with others, but also with yourself. Whether you're a nurse, an abuse survivor, or whatever has led to your belief that brave is the face you need to show, I hope you give yourself permission to become un-brave. Step into the courage that allows you to embrace the fears that are the keys to your strength, compassion, and humanity. May you show that courage first to yourself and the parts of you that are hurting, so that you can be genuinely and authentically courageous for others." Traci Powell is a nurse practitioner. She shares her story and discusses her KevinMD article, "If you're a nurse or an abuse survivor, you don't have to be brave." (https://www.kevinmd.com/blog/2021/11/if-youre-a-nurse-or-an-abuse-survivor-you-dont-have-to-be-brave.html)

"Some policymakers may be wary of not using case numbers as the primary metric to guide public behavior and policy. As cases become more complex, however, health departments should still monitor infection numbers, but guidance should be tied to hospitalization metrics. When rising cases do not reliably predict hospitalization surges, hitching Covid policies to cases alone is no longer effective policy — or good public health." Monica Gandhi is an infectious disease physician and co-author of the New York Times opinion article, "Why Hospitalizations Are Now a Better Indicator of Covid's Impact."

"We orthopedic surgeons are disappointed with the growing lack of enthusiasm in your reports. When I began in practice almost 15 years ago, it wasn't unusual to see a report of a post-reduction or post-surgical X-ray that read, 'alignment is now anatomic' or, at a minimum, 'near anatomic.' What happened? What did we do to deserve reports like, 'Overlying cast obscures fine bony detail. Alignment is improved from pre-reduction imaging,' after we closed reduced a mangled looking extremity and got it back anatomically? Or better yet, '54 seconds of fluoroscopic time was provided for ORIF of femur. Correlate with operative report,' when we ORIF'd the hell out of it." Samara Friedman is a pediatric orthopedic surgeon. She shares her story and discusses her KevinMD article, "An open letter to radiologists from a jilted orthopedic surgeon." (https://www.kevinmd.com/blog/2021/11/an-open-letter-to-radiologists-from-a-jilted-orthopedic-surgeon.html)

"Right now, I think that people need to understand that this virus is clearly mutating to become more contagious, and that is in its evolutionary best interest. That's what viruses do. That is not the same thing as a virus having an advantage by making us more sick or breaking through our vaccines. There's no advantage there. So we don't yet know about that. So what I really want your audience to know and to think is, do I care about infection or do I care about outcomes? Sometimes those things are totally interchangeable, like an infection is an outcome. You get infected. You have a long-term consequence. But as time goes on, I want people to really think about whether we've uncoupled that with our vaccines, with our therapeutics. And if we have, then we should really be watching a different set of outcome metrics. So I want people to be willing to stand up their level of concern when something new and unknown comes along. But I want them to also be able to deescalate that when we learn more. Because look, we've been humbled by this many times in many directions, and I think that watching those issues in real-time and responding to the data is really our best chance to keep getting better at this." Jeremy Faust is an emergency physician who can be reached on Twitter @JeremyFaust and on Instagram @JeremySamuelFaust. He also publishes the newsletter, Inside Medicine.

"Physicians can exert their influence in a health care environment to put the patient-physician relationship at the center of the enterprise. Working with middle-market employers (between 200-2,000 employees), some companies pair bold doctors with innovative employers to bring exceptional value to employee health benefits. There are no pre-authorizations for medical decisions, but doctors are held accountable for best practices. Customized health benefits offered within the ERISA framework allow employers to tailor programs and coverage to their employee population. A purpose-built tech solution allows all the players to see more, see it sooner, and maximize health. Nurses serve as the point of contact for employees and as trusted guides for any health concerns, facilitating appointments with doctors and other healthcare professionals. In this model, doctors are equal partners with employers, reducing avoidable costs while delivering higher quality care. Instead of a fragmented journey, patients are supported through three phases of care—navigation, facilitation, and resolution." Paul Pender is an ophthalmologist and can be reached at his self-titled site, Dr. Paul Pender. He is the author of Rebuilding Trust in Healthcare: A Doctor's Prescription for a Post-Pandemic America. He shares his story and discusses his KevinMD article, "'Take it or leave it' is not negotiation but coercion." (https://www.kevinmd.com/blog/2021/11/take-it-or-leave-it-is-not-negotiation-but-coercion.html)

In this special episode of The Podcast by KevinMD, I'm on the other side of the podcast mic. It was an honor to be interviewed by Jonathan Baktari, MD on his show, the Baktari MD Show. In this hour-long episode, Life as an MD Online, I discuss how I got started, online reputation and social media, the KevinMD platform, my medical career, physician burnout, online misinformation, how COVID impacts medicine, and much more. Thanks again to Jonathan Baktari who can be reached at BaktariMD.com (https://baktarimd.com/) on Twitter @baktarimd and YouTube.

"By denigrating midwifery care, pathologizing the natural process of birth, and instilling fear of complications and pain, doctors persuaded women to give birth at the hospital under their care. By touting the benefits of anesthesia, forceps delivery, episiotomy and promoting in-hospital birth, doctors and hospitals were able to capitalize on the new specialty. Interventions of increasing risk and complexity, and their routine use — without proof of benefits for the 80 percent of birthing people who are low risk — have caused harm not just because of their invasive nature, but because the birthing person is subjected to various forms of persuasion and coercion (without informed consent) to do what doctors believe is best for them and their babies. Many of the practices employed on labor and delivery interfere with the natural process of birth. When patients ask to avoid those interventions (which often make life easier for the staff or more money for the hospital), they are told they are not allowed to do what they want for their labor and birth. In a 2019 survey of women who gave birth in U.S. hospitals, 28 percent reported mistreatment. Black people report discrimination in about one-third of their medical encounters." Leslie Farrington is an obstetrician-gynecologist. She shares her story and discusses her KevinMD article, "This obstetrician recommends midwifery care." (https://www.kevinmd.com/blog/2021/07/this-obstetrician-recommends-midwifery-care.html)