The Podcast by KevinMD

"Disrupting weight stigma and bias in health care starts with calling it out. The power of stories and shared experiences highlights the collective voice. I'm coaching TikTok Followers to own their health power and start speaking up during clinic visits to make sure they get their questions answered. Future directions and next steps are to disrupt weight stigma and bias by speaking up, calling it out, and calling on doctors, nurses, and all of health care to do better. Back to TikTok!" Karla Lester is a pediatrician. She shares her story and discusses the KevinMD article, "Medical gaslighting due to weight stigma and bias is harmful: a viral TikTok study." (https://www.kevinmd.com/blog/2021/06/medical-gaslighting-due-to-weight-stigma-and-bias-is-harmful-a-viral-tiktok-study.html)

"No matter how extensive or well-developed your capacity for empathy may be, you cannot feel empathy for everyone all the time. Whether we're talking about doctors who have never been patients, or clinicians who have never faced discrimination, we know that people's ideas can change, when properly educated and supported. In a randomized, controlled trial, one of the most exciting findings within my own research into the malleability of empathy looked at physicians of six different medical and surgical specialties. Using the E.M.P.A.T.H.Y.(R) acronym and other techniques, physicians learned how to accurately "read" their patients' states of emotion and respond more empathically. Post-intervention, the training group received significantly higher patient satisfaction scores than the control group. The good news about our research is that it showed that we can be hopeful about changing the culture of medicine. We now have evidence-based tools to accomplish this. There is hope for a brighter future in health care and all relationships when empathic principles are learned and practiced at the local, regional, and societal levels." Helen Riess is a psychiatrist and author of The Empathy Effect: Seven Neuroscience-Based Keys for Transforming the Way We Live, Love, Work, and Connect Across Differences. She shares her story and discusses her KevinMD article, "How to preserve empathy in medicine." (https://www.kevinmd.com/blog/2021/10/how-to-preserve-empathy-in-medicine.html)

"I believe there is a formula that can reduce the risk of burnout and save primary care, rooted in one key objective: Remove work from primary care doctors and nursing staff's plates immediately. Easier said than done. And that's where technology and clinical navigation must be leveraged — to assist, facilitate, streamline, and support. Where EMR messages, not requiring doctor expertise, are responded to by clinical navigators harnessing technology to guide patients to the right outcome. Where these teams of clinical navigators are integrated into the clinical pyramid and delegated all tasks that do not require physician attention. Integrated technology + navigation = relief." Ronald Dixon is an internal medicine physician. He shares his story and discusses his KevinMD article, "As doctor burnout climbs, can we save primary care?" (https://www.kevinmd.com/blog/2021/09/as-doctor-burnout-climbs-can-we-save-primary-care.html)

"My brain is still struggling to comprehend the battle for the status quo a physician faces each day; one who must, by default, be cognizant of the lurking dangers of an opioid prescription, while also helping the patient on their swiftest way to recovery, led by the very same guidelines. But what happens when the patient slips on the road to recovery and out from underneath the physician's caring cloak towards substance abuse? Whether the patient's role changes at that very threshold is a different story. While it certainly is a part of this somewhat self-perpetuated epidemic, the struggle to keep a status quo has ancient roots and every physician has — if not knowingly so — sworn to abide by them when uttering the anecdotal resemblance of the Hippocratic Oath: 'I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism.' But what if we dare to question the application of this ancient commitment on this particular matter? Should we have already done so, or can we afford to wait until the death toll reaches an unspeakable capita? Should opioids for postoperative pain even be permitted to dance on this slippery spectrum between adequate analgesia and addiction? I wish the answer were that simple." Jesse Seilern und Aspang and Mara Schenker are orthopedic surgeons. They share their stories and discuss the KevinMD article, "America's prescription epidemic: Breaking an ancient promise." (https://www.kevinmd.com/blog/2021/07/americas-prescription-epidemic-breaking-an-ancient-promise.html)

"I am a woman of history who stands up and tells the truth, irrespective of what other people say. I remember the words of the late Representative John Lewis, 'Do not get lost in a sea of despair. Be hopeful, be optimistic. Our struggle is not the struggle of a day, a week, a month, or a year. It is the struggle of a lifetime. Never, ever be afraid to make some noise and get in good trouble, necessary trouble.' Black female physicians are not OK, but it is our collective duty to do something about it. It is our collective duty to go against the tide. It is time to take a stand and institute change that we need to initiate ourselves." Tomi Mitchell is a family physician. She shares her story and discusses her KevinMD article, "The unique agony of being a Black female doctor." (https://www.kevinmd.com/blog/2021/11/the-unique-agony-of-being-a-black-female-doctor.html)

"I am exhausted and sad and disappointed and discouraged. I am losing faith in humanity. Where is the 'love your neighbor as yourself'? Where is the willingness to help each other? Where is the solidarity of those first days? Physicians have gone from being heroes to being villains. We have dedicated decades of our lives to learning how to care for you, but now our knowledge and expertise are being thrown back in our faces as not good enough and not as believable as your cousin's friend who saw something on social media. It is hard to keep going. But we do. We keep going because we have dedicated our lives and careers to our patients. We follow our Hippocratic Oath, and we do the best we can for every patient no matter who they are, what they believe, or what choices they make. But many of us are barely clinging to our passion to serve. Each day, I get out of bed, swallow my frustration and disappointment, and pray for the fortitude and resilience to face another workday, because I know that if I can make a difference, however small, it means something. And I know that my patients and their families bring me joy! But each day, my heart breaks a little more. It shouldn't have to be this way, but this is the world we live in right now. I am exhausted." Lisa Cronk is a pediatrician. She shares her story and discusses her KevinMD article, "Physicians have gone from being heroes to villains." (https://www.kevinmd.com/blog/2021/09/physicians-have-gone-from-being-heroes-to-villains.html)

"The truth is, we were all drowning, alone, and hiding behind the image of perfection. Clearly, each of us secretly thought that the others had it all figured out. We were so afraid of admitting weakness or asking for help, so we kept it to ourselves and muddled through, burnt out and miserable, terrified of being judged for our vulnerability. When we negatively judge ourselves for needing help, we end up judging others who need our help too. Our patients feel this undercurrent of judgment when they ask for our help. They don't want to face that vulnerability because they too feel judged. Asking for help and facing our struggles with honesty is a sign of courage and compassion. It is human nature to need each other and to feel connection. Maybe if we'd all been a little less armored, more vulnerable, and shared our struggles with each other, our cohort of future doctors could have leaned on each other to cope better back during our intern year too." Jordana Rothschild is a preventive medicine physician. She shares her story and discusses her KevinMD article, "Doctors are humans, not heroes." (https://www.kevinmd.com/blog/2021/08/doctors-are-humans-not-heroes.html)

"What are altcoins, and should you be investing in them? I cannot speak to whether investing in altcoins is appropriate for you. Altcoins are a highly volatile and risky asset class that offers the potential for high returns. Every investor must decide whether they are willing to bear the associated risk. When evaluating thousands of coins to select the best opportunities, it is critical to have an appropriate framework to work from. That is why I am sharing my 5-step framework." John Stillson is a medical student and an investment manager. He shares his story and discusses his KevinMD article, "Alternative cryptocurrencies: 5 tips for physicians." (https://www.kevinmd.com/blog/2021/08/alternative-cryptocurrencies-5-tips-for-physicians.html)

"Go ahead, give yourself permission, summon the compassion and grace you'd bestow on your best friend, and tell yourself, "This is the breadth of the human experience, and I'm only human." There is immense beauty and strength in that vulnerability. I lied to myself for too long, couldn't see the road ahead through the cracked glass until it, and I, in turn, shattered. Once those broken shards that obscured and distorted the path forward have been swept away, only then can the clarity of a stronger, more resilient soul begin to emerge. I'm not back to normal, and it's possible I may never get there. But each day, there are glimmers of hope that I might be closer to my true self than before — and that's all I can ask for right now." Luyi Kathy Zhang is a palliative care physician and can be reached on Twitter @DrKathyZ. She shares her story and discusses her KevinMD article, "Maybe we're not all hanging in there. And that's OK." (https://www.kevinmd.com/blog/2021/02/maybe-were-not-all-hanging-in-there-and-thats-ok.html)

"When the medical profession—a career you have pursued for years, a career you love and trust to do no harm does something to shatter the foundations of your sense of trust and worldview, the resulting trauma can be severe resulting in loss of sense of self and life-altering betrayal grief that mirrors the stages of acceptance of one's own death (or the death of a piece of one's soul when swept up in the betrayal cascade)—denial, anger, bargaining, depression, and acceptance. As a witness to immense betrayal within the medical profession, I've felt them all." Pamela Wible is a family physician and author of Physician Betrayal: How Our Heroes Become Villains. She shares her story and discusses her KevinMD article, "Medicine's culture of betrayal." (https://www.kevinmd.com/blog/2021/09/medicines-culture-of-betrayal.html)