The Podcast by KevinMD

"Attending physicians struggling with a mental health issue should consider contacting a counselor first, rather than a department head or employer resource. A counselor can assess the mental health issue, offer treatment recommendations, and provide therapy that meets the physician's needs – all while protecting that person's privacy. Mental health providers are legally obligated to maintain confidentiality except under the most narrow of circumstances. Despite the concerns that licensing boards and employers have about the risk to patients or impairment, there is little evidence that simply having a mental health issue, or receiving treatment for one, imperils patients. We have abundant evidence, however, that avoidance of treatment imperils physicians. Many physicians have successfully undergone counseling while continuing to work without ever notifying their employer or department, imperiling patient care, or incurring licensing consequences. Until changes occur that mitigate the causes of burnout, depression, anxiety, and substance use disorders among physicians, our priority must be increasing access to and engagement in treatment. Physician-specialized private counseling practices are one way to accomplish that." Vickie Mulkerin is a family physician and owner, White Coat Counseling, LLC. She shares her story and discusses her KevinMD article, "Why physician-specialized private counseling practices are important." (https://www.kevinmd.com/blog/2021/08/why-physician-specialized-private-counseling-practices-are-important.html)

"I called my wife of 31 days, anxious and dazed. I told her that the pace I was on was crushing me. I told her I had done seven admits since 5 p.m. and taken floor calls, too. It was not yet midnight. I told her I don't know if I can do this job. But I soldiered on. It was the first of July. I picked up my first chart of the shift and began to walk to see the patient. Felt some apprehension. I looked at the chart and noticed the name printed in the box for the attending physician. The name was mine. I felt awe. I felt pride. I felt fear." Duane Corsi is an emergency physician. He shares his story and discusses his KevinMD article, "An emergency medicine life." (https://www.kevinmd.com/blog/2021/07/an-emergency-medicine-life.html)

"Chiefs, remember, one of those interns is going to fill your shoes in a few years. They may model you in that role, so you want to raise them well! As a former chief resident, I have lots of pearls for those entering residency. However, what I will tell you now is different from what I would have told you then. I have since learned that there are possibilities to create the results that we want and not just follow the path we are told to take. Recently, a former intern of mine — who went on to be a chief resident and subsequently a program director — tweeted that he received advice from another chief: "If you are unhappy in residency, you need to adjust your expectations." He pondered that this suggestion was a mixed bag. Can you see both sides? Residents, who is responsible for your happiness? Is it the institution, the program, the program director, the chief resident — or you?" Marion McCrary is an internal medicine physician and can be reached at Marion McCrary Wellness. She shares her story and discusses her KevinMD article, "A word of advice from one chief resident to another." (https://www.kevinmd.com/blog/2021/07/a-word-of-advice-from-one-chief-resident-to-another.html)

"In January of 1991, at twenty-two months old, Nick had another heart catheterization. Andy and I had started thinking about the next stage of surgery to finish the heart repair. Just before Nick was discharged, I discussed it briefly with Dr. Kanter. 'Tell me when you would like to do the surgery,' he said. 'Never, if it's up to me.' We were in no hurry for Nick to go into the OR again. The older Nick grew, the more difficult it became to agree to procedures. At least this operation would be one of the planned surgeries. By now, heart surgeons were doing an additional repair, completing the surgery in two stages instead of one. The positive side was that at least we would be taking a step forward. Andy and I wanted the surgery date to be sooner rather than later, but we still had questions. I asked Dr. Kanter to call me. He and I discussed the pros and cons of the repair. There was a pause in the conversation, and then Dr. Kanter asked, 'Susan, are you sitting down?'" Susan May is a writer and author of Nick's New Heart: 30 Years and Counting. She shares her story and discusses her KevinMD article, "The story of a heart transplant in a 1-year-old, as told by his mother." (https://www.kevinmd.com/blog/2021/05/the-story-of-a-heart-transplant-in-a-1-year-old-as-told-by-his-mother.html)

"After my last promotion, my institution adopted new guidelines and criteria for incorporating social media into promotion. I understand several other academic institutions have taken similar approaches, and it is enlightening to learn that academic medicine is evolving to match the current state of medical education. I encourage anyone considering promotion to become familiar with your institution's criteria and consider how to leverage that with your work. I also encourage you not to discount the work you do on social media and consider how you can translate into more traditional checkboxes such as teaching, advocacy, and national reputation. Social media has fundamentally changed how the world receives information. Science, medical expertise, and fundamental facts are under constant assault. Thousands of medical professionals are engaged online and interacting in positive ways to help combat misinformation. It's time for this important work to be recognized and rewarded by academic institutions. Good luck, colleagues, and please feel free to reach out on social media if I can help in any way." David R. Stukus is a pediatric allergist and can be reached on Twitter @AllergyKidsDoc. He shares his story and discusses his KevinMD article, "How I used social media to get promoted to professor." (https://www.kevinmd.com/blog/2021/07/how-i-used-social-media-to-get-promoted-to-professor.html)

"Imagine this scenario: a busy mom struggles to balance work and parenting during the pandemic when suddenly her teenage son begins to anger. He gets out of control, screams threats, and kicks a hole in the wall. Neighbors call the police, who recommend the family go to the emergency department (ED). When the family arrives at the ED, the stresses of enforced isolation show on their exhausted, tearful faces. And unfortunately, in these extraordinary times, they're far from alone." Gregg Miller and Seth Thomas are emergency physicians. They share their stories and discuss their KevinMD article, "As the pandemic winds down, another crisis may be looming." (https://www.kevinmd.com/blog/2021/05/as-the-pandemic-winds-down-another-crisis-may-be-looming.html)

How does a physician become a thriller author? Where do his stories come from? How long does it take to go from idea to finished product? How did his experience as a physician influence his books? John Bishop is a retired orthopedic surgeon. He shares his story and discusses his transition from physician to medical thriller author.

"Feedback in the assessment stage is always useful for improving the design of a device — especially as it relates to improving long-term aspects, such as patient outcomes or cost-effectiveness. This kind of feedback can only come after a device has been on the market and in use for a while, and after doctors have had a chance to see the long-term effects that use of a product has for their patients — for example, in the recovery period following procedures. The involvement of doctors is of utmost importance in all stages of the development of any medical technology. Doctors should recognize the value their feedback holds for improving the technologies they will ultimately use. When it comes to understanding the problems in need of solutions, doctors should see themselves as partners in the development of medical technologies that will serve the ultimate goal — better care of and outcomes for patients." Lena Levin is a health care executive. She shares her story and discusses her KevinMD article, "Here's how doctors can support medtech innovation." (https://www.kevinmd.com/blog/2021/06/heres-how-doctors-can-support-medtech-innovation.html)

"As I approach this last stretch of residency, still entrenched in the rigors of training and the intensity of raising three young children under five years old, I am in a unique position of being able to reflect on the years and look ahead at what I want to build at the same time. It has been a lonely, emotional, seemingly endless journey at times. We mothers and doctors are barraged with messages that we do not belong here, straddling both roles. The work of dismantling these messages will be impossible for any single person, but cumulatively we can. And for future young women who are budding doctors and hopeful mothers, I hope their search for answers and advice results in them finding a large community of support and belongingness. And I will continue my part to advocate, to mentor, to fight this cycle of self-blame that our training system perpetuates, to continually question these messages of what priorities 'belong' in medicine, until finally, we expand this radius of belonging. Despite all that I have encountered, my spirit is not broken. I have work to do." Eunice Stallman is a psychiatry resident. She shares her story and discusses her KevinMD article, "So, are you committed to medicine — or your baby?" (https://www.kevinmd.com/blog/2021/07/so-are-you-committed-to-medicine-or-your-baby.html)

"While the COVID-19 pandemic exposed and normalized the need for increased mental and behavioral health services over the last year and a half, addressing mental health issues as a regular form of their wellness will persist beyond the pandemic. However, as the adoption of virtual technologies continues to open up more access to care, the potential to successfully meet the rising demand for these services is promising. The last 18 months have shown us that providers are making huge strides in helping patients from all walks of life facilitate their own care virtually. Even with the challenges we are still experiencing in the current pandemic, it's an exciting time for the evolution of mental health care." Sara Smucker Barnwell is a licensed clinical psychologist and clinical director of behavioral health, 98point6. She can be reached on LinkedIn and at her self-titled site, Sara Smucker Barnwell PhD. She shares her story and discusses her KevinMD article, "Debunking common virtual therapy myths and 4 tips for new patients." (https://www.kevinmd.com/blog/2021/08/debunking-common-virtual-therapy-myths-and-4-tips-for-new-patients.html)