The Podcast by KevinMD

"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)

"I was first diagnosed with major depressive disorder as a preteen after my teenage sister died. I attempted suicide three years later. This would be the first of several attempts and the first of countless times I felt my life was not worth living. But I am not unique. According to the Centers for Disease Control (CDC), 1 person dies by suicide every 11 minutes. My depression is like a chronic autoimmune disease — constitutively present at a low level with flares. But there's no Humira for depression. At baseline, I am exhausted, anxious, lacking motivation, and full of self-doubt. When severely depressed, I am at the bottom of the sea, struggling to breathe and unable to swim. I am paralyzed by a high-pressure, heavy and humid darkness. Through physical or mental isolation, I may not see another living creature for hours, days or weeks. I can look up and see the sun shining beyond the water surface, but the surface is miles beyond my reach. I must physically force myself to breathe as my mind tells me to stop. Trying to take a test, see patients or study can prove impossible." This anonymous medical student shares her story and discusses her KevinMD article, "Surviving medical school with depression." (https://www.kevinmd.com/blog/2021/06/surviving-medical-school-with-depression.html)

"I am here to testify that it is possible, and I am not alone in this specialist direct care market. There are other specialists' practices like mine, hidden gems for patient care. During my journey, I learned specialists are thriving to remove the "middlemen" and reconnect with patients. Patients are eager to shop for their health, discover transparent pricing and excellent quality. Patients and physicians desire mutual accountability. Since the direct primary care movement started approximately ten years ago, many patients that signed up to this model quickly realized the benefit of having access, affordability, and price transparency. Specialists in direct care now exist across the country. In the last two years, I have been in contact with many thriving physicians providing a direct care model. However, it was so hard to find and connect. Our hope – and our patients' need – is that connecting patients with direct care specialists gets easier. We are working on that now – we are working to change the system because our patients need it – and practicing good health care depends on it. This is just the beginning of a new era in medicine, where patients and physicians reunite." Diana M. Girnita is a rheumatologist and founder and CEO, Rheumatologist OnCall. She can also be reached on Facebook, Instagram, and YouTube. She shares her story and discusses her KevinMD article, "The emergence of direct specialty care." (https://www.kevinmd.com/blog/2021/09/the-emergence-of-direct-specialty-care.html)

"At the hospital, the nurse is the one who is at the patient's bedside around the clock. When the patient has to go to the bathroom or needs help to sit up in a chair, he or she calls the nurse. The nurse is the one who is changing the diapers for the elderly; she is the one cleaning the sputum and the spilled urine; she is the one holding the patient's hand and stroking his hair while he is having a painful procedure done. She is the one arranging the flowers and picture frames in the room. She is the one administering the medications when the patient is in pain or nauseous. She is the foremost advocate for the patient. She is at the bedside when the patient is taking his last breath, and she is the one to call the doctor to pronounce him dead after having first witnessed and confirmed it herself." Farhan S. Imran is a hematology-oncology physician who blogs at Did I Ask? He shares his story and discusses his KevinMD article, "A nurse is to a patient what a mother is to a child." (https://www.kevinmd.com/blog/2021/05/a-nurse-is-to-a-patient-what-a-mother-is-to-a-child.html)

"Many patients, doctors, nurses, and health care administrators appear to have a seat on the blimp with little concept of how the game has evolved over the years and is being played now. They may have attended the game in the past, but they likely haven't seen the action from 5,000 feet above the field—and seeing the health care picture from the big picture distance can create some impetus for adapting to the new rules. We need to not only explain the new rules of the game but also show how passion of the team can overcome adverse conditions and ultimately prevail. Everyone on the blimp needs to become engaged, including those who have been riding involuntarily. The health care game has changed. We will find season ticket holders. And those of us on the field will get messy, no doubt. But who knows? Our game might just become a national pastime." 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, "Getting messy in the game of health care." (https://www.kevinmd.com/blog/2021/08/getting-messy-in-the-game-of-health-care.html)

I did not realize I was a perfectionist. I was far from perfect. It was not until I listened to a master class on perfectionism from a physician coach that I had my "aha moment." I am now working extremely hard on training my brain to be an imperfectionist. To do that means to let go of the mental constructs that I have created for myself. In particular, I had to let go of the narrative that said to me: You are not someone unless you look like the epitome of success. I was a young African-American doctor full of "firsts." However, these firsts did not protect me from the hurt of failure or the heartache associated with imperfection. For sure, it did not provide me with what I longed for most, self-worth and validation." Frieda Millhouse-Jones is an internal medicine physician. She shares her story and discusses her KevinMD article, "A Black physician's perfectionism." (https://www.kevinmd.com/blog/2021/05/a-black-physicians-perfectionism.html)

"We have observed that delays in screenings and intervention for patients with certain common chronic conditions can contribute to claims. Now, clinicians have the opportunity to identify patients whose conditions merit priority contact, such as those with cardiac conditions, those on blood pressure medication, or those with diabetes, and request they come in for delayed screenings or checkups. Explicitly recommending that those without medical contraindications get vaccinated not only helps slow the spread of COVID-19, but may also stop a patient from claiming that they remained unvaccinated for lack of counsel from their physician. Whether or not a practice or institution is distributing vaccines, it should communicate to patients that COVID-19 vaccines are extremely safe, remarkably effective, and vital to ending the pandemic. Invite patients who have questions about vaccines to communicate their concerns. Since risks exist even if patients did not present for care, documenting the practice's efforts to reach patients who have delayed care will reduce litigation risks. If a patient is considering filing a claim, a review of the patient's medical record will be among a plaintiffs' attorney's first steps. Therefore, documenting patient communications is a defense against suits before they are filed." Richard E. Anderson is chairman and chief executive officer, The Doctors Company and TDC Group. He shares his story and discusses his KevinMD article, "Mitigating risks from care during COVID-19." (https://www.kevinmd.com/blog/2021/05/mitigating-risks-from-care-during-covid-19.html)

"The diagnosis is well-established. A cure is within our reach, and the wisest among our practitioners of the healing arts are offering valuable counsel. When the U.S. government and science, in its most principled form, work together, insulated from a culture of insidious and invidious profiteering, they can put a man on the moon, and launch a helicopter on Mars. They can also deliver better health care in a much more equitable and cost-effective way. It is time for the patient to listen to her best doctors. They are giving it to her straight." Jeffrey Fraser is a neurologist. He shares his story and discusses his KevinMD article, "Diagnosis: malformation of a health care system." (https://www.kevinmd.com/blog/2021/07/diagnosis-malformation-of-a-health-care-system.html)

"After much searching, I was fortunate to find a fellowship that though inexperienced in LGBTQ health recognized an opportunity. Faculty and mentors worked from a growth mindset rooted in finding what I needed to succeed rather than what they knew they had to offer at that moment. With their and others' support, despite the discouragement and fears of being "superficial," I now try to serve as an example to other students and trainees who wish to pursue a career that weaves their personal and professional interests in LGBTQ health. Carl Streed, Jr. is an internal medicine physician. He shares his story and discusses his KevinMD article, "Professional gay: Charting a career in LGBTQ health." (https://www.kevinmd.com/blog/2021/08/professional-gay-charting-a-career-in-lgbtq-health.html)

"We physicians must come to terms with the trauma caused by the financial insecurity built into our training and the ripple effect it has even after we finish training, both as a way to repair ourselves individually and as a way to assure that our profession survives. The cost of medical education is high, but the cost of the financial lessons learned in the course of obtaining that education is even higher. It may be a price too high for future doctors to bear." Elizabeth Hughes is a dermatologist. She shares her story and discusses her KevinMD article, "How medical training teaches doctors to be financially unhealthy." (https://www.kevinmd.com/blog/2021/08/how-medical-training-teaches-doctors-to-be-financially-unhealthy.html)