The Podcast by KevinMD

"I would encourage you to see amazing women on social media for who they are in the future. Maybe figure out where they have been and what they are working toward. Maybe even figure out how ways to help each other solve the problems this country faces. Instead of looking at someone's appearance, listen to their story. You got unlucky with me; you can't intimidate someone who has lived through the war. I'm hoping that you choose to go in a more professional direction with the next woman you message because of these words. We are not transactions. We are intelligent, determined, passionate, and persistent people. It's far better to be our ally than our foe." Kellie Lease Stecher is an obstetrician-gynecologist. She shares her story and discusses her KevinMD article, "When a colleague asks you for nude photos." (https://www.kevinmd.com/blog/2021/01/when-a-colleague-asks-you-for-nude-photos.html)

"Yearly physicals are usually afforded a longer time than regular visits. If I can use most of that time focusing the discussion on what a healthy life means to each of my patients and what they need to achieve it, I feel that I've accomplished more than doing palpation, range of motion, and auscultation. Discussing medications and finding opportunities for de-prescribing, and discussing annual routine labs' futility is also an equally important and welcome part of my yearly rituals. As our population ages and we are faced with more chronic diseases, our goal is to maximize our patients' abilities to function, relate to family and community, and live a life of purpose. Expanding the visit to discuss health status, strengths, weaknesses, and goals is a good time investment in achieving healthier people and enriching our relationship with patients. For my part, it also adds joy and purpose to my life." Alina Urriola is a family physician. She shares her story and discusses her KevinMD article, "What are your health goals for the coming year?" (https://www.kevinmd.com/blog/2021/01/what-are-your-health-goals-for-the-coming-year.html)

"For a vaccination campaign to be highly effective, we need to be open to having difficult conversations with people who disagree with our perspective. If we don't, the result will be a polarization of philosophical ideas and not an unbiased and unemotional assessment of the data where maybe we can meet in the middle. As we share our pictures and experiences regarding getting our vaccines, let's try to admit what we know and, more importantly, what we don't know. Let's not speak down to those who have questions. And let's not be afraid to say that maybe we are a little afraid ourselves of some of these unknowns but that we are willing to take the potential risk of getting a vaccine because over the past then months, there are a few more knowns about the actual virus that scare us even more. Happy conscientious and kind posting." Alicia Billington is a plastic surgeon. She shares her story and discusses her KevinMD article, "The COVID vaccine selfie: The caption matters as much as the picture." (https://www.kevinmd.com/blog/2020/12/the-covid-vaccine-selfie-the-caption-matters-as-much-as-the-picture.html)

"In addition to being a pediatrician, I am Jewish and the granddaughter of a sole Holocaust survivor. My grandfather's family perished in Auschwitz, a concentration camp in Poland. My grandfather alone escaped, skiing through the night, to his safety and ultimate survival. The request from my hospital, the presidential debate, and the seeming dismissal of parentless children reminds me of a quote from Elie Wiesel, a Nobel Prize-winning writer, and Holocaust survivor. "What hurts the victim most is not the cruelty of the oppressor, but the silence of the bystander." I will not tone it down. I will not be silent. I believe a medical institution that is dedicated to the well-being of all people would not ask me to do otherwise." Ariana Witkin is a pediatrician. She shares her story and discusses her KevinMD article, "Why politics has a place in medicine." (https://www.kevinmd.com/blog/2020/10/why-politics-has-a-place-in-medicine.html)

"There is a unique non-clinical consulting opportunity any physician can learn to do full-time, as part of your existing practice, or in lieu of retiring. I'm Dr. Armin Feldman, and I'm a full-time medical-legal consultant in legal cases. A little over 13 years ago, I started and now, through the years, have been refining a new subspecialty of forensic medicine. I've trained over 1,600 physicians to do this consulting work. When doctors and lawyers think about lawyers hiring doctors, they only think of one thing: Hiring doctors to be expert witnesses. It's important to know, you won't act as a medical expert, and you won't participate in medical malpractice cases. There is a big difference between a medical-legal consultant and a medical expert witness in legal matters. In fact, they are two completely different things." Armin Feldman is a medical consultant to attorneys. He shares his story and discusses his KevinMD article, "An introduction to medical-legal consulting." (https://www.kevinmd.com/blog/2020/12/an-introduction-to-medical-legal-consulting.html)

"Children cannot afford to wait, especially our youngest learners who have difficulty engaging on a screen. We need to all work together to help schools reopen, especially in low-income communities that are disproportionately suffering and may lack the resources. I stand with the AAP, CDC, European CDC, WHO, and UNICEF to support safe school re-opening." Lekha M. Rao is a pediatric neurologist. She shares her story and discusses her KevinMD article, "Children cannot afford to wait: We need to all work together to help schools reopen." (https://www.kevinmd.com/blog/post-author/lekha-m-rao)

"We, as a profession, must accept some blame for many of the developing problems in health care delivery. No, I am not suggesting that we caused the problem. I am stating that we have had ample opportunities to manage the debacle and even to reverse some of the disturbing trends, yet we rarely allow our voices to be heard. Is health care reform impossible? It certainly isn't. But we, as doctors, need to step up to the plate, to stand up to the growing bureaucracy in the system, and make sure our voices are heard. The change will be long, slow, and painful, but we can't allow the system to continue to swallow us whole. The change must come from us." Alejandro Badia is an orthopedic surgeon and author of Healthcare from the Trenches. He can be reached at Healthcare from the Trenches and on Facebook and Instagram @badiahandtoshouldercenter. He shares his story and discusses his KevinMD article, "Health care from the trenches: Change must come from us." (https://www.kevinmd.com/blog/2020/10/health-care-from-the-trenches-change-must-come-from-us.html)

"Many friends have asked for my perspective on the COVID vaccine. Answering this requires both an explanation of clinical trials and an understanding of what normally slows down pharmaceutical development. Importantly, COVID vaccines are required to go through the same process as every other pharmaceutical. Vaccination is a personal choice, but I 100 percent recommend it. Personally, I can't wait to get vaccinated and am so grateful to the thousands of heroes who made this possible." Alexandra Fairchok is a medical student. She shares her story and discusses her KevinMD article, "Why can I trust the COVID vaccine?" (https://www.kevinmd.com/blog/2020/12/why-can-i-trust-the-covid-vaccine.html)

"With 2020 behind us and the pandemic still raging, it is incumbent upon us to take a close look in the rear-view mirror. While the vaccines' approval gives us all hope, the vaccination initiative's slow rollout should worry us. Physicians, health care providers, nurses, and essential workers, and patients and family members have borne the brunt of the pandemic. On the last count, about 3,000 health care workers had lost their lives due to COVID-19. The toll that the pandemic is wrecking on the health care community's emotional and mental health is only starting to become apparent. Health care systems, local, state, and federal governments have responded in different ways to ease the pandemic burden. While we can debate the level and adequacy of the response, we may have a larger problem on our hands if we fail to learn lessons and make the necessary changes going forward. I want to offer my perspective on the changes that physicians and health care providers should pursue that would allow us to emerge stronger." Manish Thapar is a gastroenterologist. He shares his story and discusses his KevinMD article, "2020 in hindsight: What we can learn." (https://www.kevinmd.com/blog/2021/01/2020-in-hindsight-what-we-can-learn.html)

"There is a frenzy of trying to use technology to re-establish the healing human connection in the doctor-patient interaction. These efforts range from advanced transcription of voice-to-record, scribes who do the data recording during a patient encounter, and so on. The IT department at NYU Grossman Medical School, where I teach, worked with the dominant and much-loathed electronic medical record to create a patient-focused dashboard for each doctor. The dashboard both improved quality of outcomes and reduced costs. These attempts are useful, but they don't address the root cause of this inhuman encounter: billing, the link of patient data to cash. In each of these tech improvements, the doctor is still forced by the money-people to massage the bill for the highest private insurance payments. There is a war across the screen — and like all wars, it's about money. On one side, doctors are forced by the accountants to bill the most. On the other side, insurance people are striving to pay the least. No 'program' or 'bot' could do this job. It's trapping doctors in the epidemic called burnout, moral injury, or just plain abuse. Forcing us to lie, to provide maximum payment. So long Hippocratic Oath. I think the solution is obvious. Why are VA hospitals' electronic medical record systems widely preferred to any of the other ones out there? Because they are not-for-profit billing machines. All across the U.S., each VA diagnosis and treatment has approximately the same reimbursement. No war across the screen. No Hippocratic hypocrisy." Samuel Shem is a psychiatrist. He shares his story and discusses his books, the House of God (https://amzn.to/3cVEOZc) and Man's 4th Best Hospital. (https://amzn.to/3rFUhAH)