The Podcast by KevinMD

"I write this as a caregiver, patient educator, and clinical researcher. The coronavirus pandemic has shone a spotlight on intensive care units (ICUs). Due to the rapid and continued increase in critical illness from COVID-19 infection, discussions about capacity and specialized equipment have become commonplace. Terms such as ventilators, ECMO, PPE, emergency use authorization, and proning have entered into the lingua franca. Critical care happens in the ambulance, the emergency department, and across the hospital. Ultimately the sickest and most severely injured patients end up in the ICU, or their medical providers are assisted virtually by trained clinicians (e-ICU). Before the pandemic, there were nearly 100,000 ICU beds across the U.S. COVID-19 has necessitated the creation of de facto ICUs, in repurposed operating rooms, in tents, and on ships. Non-critical care medical personnel have been deployed to meet the demand to render care for acutely ill patients." Sara L. Merwin is the co-author of The Informed Patient: A Complete Guide to a Hospital Stay. (https://amzn.to/2K8nzqY) She shares her story and discusses her KevinMD article, "Understanding critical care in the ICU: then and now." (https://www.kevinmd.com/blog/2020/10/understanding-critical-care-in-the-icu-then-and-now.html)

"If I had $100 for every time I walked into a patient's room, introduced myself as the doctor, and was immediately asked, 'Hey, how old are you?' I might be able to retire right now — at the age of 28. Of course, I am exaggerating, and yet this question echoes for my baby-faced colleagues and me constantly. Whether it's simple curiosity or blatant reverse-ageism, I find this question erodes trust before it is built. I haven't yet found an agreeable way to bypass it. I usually just state my age before quickly moving on. Rarely, some congratulate me on my accomplishments given 'such a young age.' But these felicitations are like writing in the sand, which quickly wash away in the waves of emotions I begin to feel the moment they ask me that question." Sneha Shah is an internal medicine chief resident who blogs at Insights on Residency Training, a part of NEJM Journal Watch. She shares her story and discusses her KevinMD article, "Does your doctor's age matter?" (https://www.kevinmd.com/blog/2020/09/does-your-doctors-age-matter.html)

"With the rapid growth of modern medicine and awareness in lifestyle and environmental influences, individuals can live longer and healthier lives. Approximately 15.2 percent of the U.S. population consists of individuals 65 years and older. To make the added years of life expectancy fulfilling, older adults need to stay socially connected and involved. One key method is through the development of meaningful relationships. Through the intergenerational paradigm, researchers have recognized a mutually beneficial relationship for both older and younger generations. The focus on relationships between the young and the old has been centered around the historical and cultural bond. Traditionally, family dynamics were structured to allow elders to share their wisdom and experiences with the younger generations while also establishing the family's norms and values. However, the social and economic changes have led to family structures to be transformed from single units to more complex and involved relationships. With the different family dynamics of single-working parents and two-working parents, there has been an increase in job opportunities. For this reason, many families move to newer cities and areas where there is higher job availability to support the family's financial needs. These changes have separated the two generations and have left them both missing key relationships of life that can improve their overall well-being." Satya Moolani is a premedical student. He shares his story and discusses his KevinMD article, "The value of intergenerational relationships." (https://www.kevinmd.com/blog/2020/11/the-value-of-intergenerational-relationships.html)

"Studies have repeatedly demonstrated a vast majority of pain physicians don't feel like they have adequate training in meeting the unique needs of this patient population, though most agree that such efforts are very necessary. This disconnect between demand and supply is a problem, a big one. With the current pandemic stretching many people thin financially, the last thing that needs to happen is people avoiding the hospital out of fear, not of the virus, but of the health care field itself, much like what my patient seemed ready to do. In some instances, this could be the difference between life and death. There needs to be a much larger emphasis placed on training students and even residents on how to become more aware of micro-aggressions, biases, and the struggles of the LGBTQ community. I'm not saying the changes will be evident overnight, but they won't ever happen if we aren't willing to even try." Indraneel Prabhu is a medical student. He shares his story and discusses his KevinMD article, "Issues faced by LGBTQ individuals in the operative setting." (https://www.kevinmd.com/blog/2020/08/issues-faced-by-lgbtq-individuals-in-the-operative-setting.html)

"The behavior of managers and supervisors in organizations affects the mental health of their employees. This is especially true during times of uncertainty, such as a global pandemic. Does a leader's health and well-being change how they lead? Early evidence shows that when leaders are experiencing challenging conditions, they are more likely to become resource depleted and exhibit negative behaviors, such as passive leadership or abusive supervision. You know the kind of boss who doesn't give you any credit, puts you down in front of others, or is simply never around? When leaders are resource depleted and are experiencing poor health (e.g., lack of, or poor quality sleep; excessive use of alcohol), they are more likely to act abusively. The good news is that leaders are often well-equipped to deal with stressors that affect us all, like the impacts of COVID-19, and can take steps to prevent passing their difficulties on to their employees. Three styles of leadership can help support employee well-being during difficult times." Kara Arnold is a professor of organizational behavior, Memorial University, St. John's, NL, Canada. Jennifer Dimoff is an assistant professor of organizational behavior and human resources, Telfer School of Management, University of Ottawa. They share their stories and discuss their KevinMD article, "How to be a transformational, supportive leader during COVID-19." (https://www.kevinmd.com/blog/2020/08/how-to-be-a-transformational-supportive-leader-during-covid-19.html)

"What has kept me comprised during this entire time has been the realization that this whole situation is not normal. It's not normal for me; it's not normal for millions of other people. This is not how pregnancy is supposed to go. This is a pandemic and an uncertain time for everyone. Many of us have caved under pressure, either it is financial, or the risk of exposure to a high-risk individual at home, or the fear of losing your friends and family. Each of us has reasons to be afraid. Being pregnant is just one of them and should be considered that way. It is important to acknowledge the unfamiliarity of this all and be thankful for what we have. I am thankful for supportive family, friends, and colleagues who have supported me (virtually) and practically in so many ways. I am thankful for the many work from home days, where I have felt so exhausted to get out of bed. I am thankful for health and food on my table, and my heart goes out to those who haven't been fortunate enough. And with that, I am also hopeful for better days, and a healthy child." Saba Fatima is a pediatric hospitalist. She shares her story and discusses her KevinMD article, "What it's like to be pregnant in a pandemic." (https://www.kevinmd.com/blog/2020/07/what-its-like-to-be-pregnant-in-a-pandemic.html)

"We can clearly see that exponential technologies are disrupting cars and phones. So why wouldn't these technologies find their way into health care and gastroenterology? What do stool tests have to do with self-driving cars? We'll soon find out. But let's first go back to the discussion we had earlier on the shift to digital. Screening for cancer through colonoscopy, while a gold standard, reminds me of a field that's at the crossroads of disruption—much like music or photography was before iTunes or smartphones. If you consider the argument for a moment, a colonoscopy is largely limited to one doctor and one patient at a time. When a doctor performs a colonoscopy, he or she can't scale beyond the procedure. With each procedure, the learning happens within the capacity of that one doctor. To put that into context, only a very small percentage of doctors become endoscopists. And an even smaller percentage achieve mastery in endoscopy. Statistically speaking, we are talking of a very few highly qualified individuals who can reliably screen for cancer using sophisticated methods. Ask yourself what could make the field of cancer screening go digital? Something that can accelerate cancer screening and give control to the nonexperts. I'm sure you might have arrived at DNA testing or artificial intelligence." Praveen Suthrum is president and co-founder, NextServices and blogs at redo | healthcare. He shares his story and discusses his KevinMD article, "What does colon cancer screening have to do with self-driving cars?" (https://www.kevinmd.com/blog/2020/08/what-has-colon-cancer-screening-got-to-do-with-self-driving-cars.html)

"Hiring locum tenens clinicians often proves to be more efficient, and when a position goes unfilled, health care organizations are potentially leaving millions of dollars on the table in unrealized revenues. Once in place, locum tenens clinicians can help organizations expand their service lines, provide access to specialists, relieve existing staff workload, keep the operating room running, manage throughput in the emergency department, and cover call. They are also part of a growing natural progression in health care — telemedicine. Locum tenens clinicians are being used in telehealth settings, allowing the flexibility to simply video chat with a patient for a consult or provide a second opinion to another physician. Utilizing locum tenens clinicians ultimately benefits patient care while positively impacting the bottom line. Among the available strategies to deal with the current challenges in clinician recruitment, the locum tenens model can undoubtedly evolve into a viable and attractive long-term strategy for the provision of everyday health care access." Sridhar Rajamani is a pulmonary physician and member of the advisory board, LocumTenens.com. He shares his story and discusses his KevinMD article, "How can we redefine locum tenens?" (https://www.kevinmd.com/blog/2020/03/how-can-we-redefine-locum-tenens.html)

"In my work with physicians and physician leaders in academic medicine, I learned that physicians are highly self-reflective and aware of the pressures they face; however, they are frequently the last to ask for help, and the first to deprioritize their own self-care. This has led to high suicide rates in the overall physician population. For coaches partnering with physicians on wellness, leading with mindfulness first could cause an adverse reaction. A colleague and I held a workshop on physician wellness and began the session with mindfulness. Several left the room, and a few others spoke up, indicating that what they needed was not mindfulness, but solutions for inefficient processes and increased demands from their medical coding departments. We did not make that mistake again! These professionals are overwhelmed; they are just trying to get through the day and meet their goals. Oh, and take care of their patients. Mindfulness can be seen as "another thing to do" in an already packed schedule or can make physicians feel angry or "guilty" for not already trying something that seems so simple and cause them to close down to exploring other solutions." Cory Colton is an executive coach. He shares his story and discusses his KevinMD article, "When coaching physicians with wellness, don't lead with mindfulness." (https://www.kevinmd.com/blog/2020/09/when-coaching-physicians-with-wellness-dont-lead-with-mindfulness.html) This episode is sponsored by Elsevier Health (https://www.us.elsevierhealth.com/). Looking to update your personal or professional medical library? Shop Elsevier Health's Holiday Sale and save up to 35% on your purchase of medical books! Plus, you can take an extra 5% off your order with code KEVINMD at checkout. Take advantage of the biggest sale of the year from Elsevier, the world-leading provider of medical books and reference materials. Shop us.elsevierhealth.com now through December 31.

"A few months ago, I signed up for a virtual conference for women in medicine. It's a group of women, over 10,000 of us, who have watched me and supported me through the past two years of my career. Two years of struggle. Two years of personal and professional pain. Two years of opportunity for growth, and two years of numerous setbacks that were only overcome with all of their assistance. At the close of each interview with women leaders in various industries, the organizer asks them what 2020 has taught them. A friend of mine from the group reached out to a few of us and asked us what 2020 had taught us. In my response, I referenced so much of what we have touched on in this class and things that have been brought to the surface by the turmoil of this year. The only way to save medicine, save our country, and to save ourselves is to pivot." Nicole M. King is an anesthesiologist. She shares her story and discusses her KevinMD article, "The only way to save medicine, save our country, and to save ourselves is to pivot." (https://www.kevinmd.com/blog/2020/09/the-only-way-to-save-medicine-save-our-country-and-to-save-ourselves-is-to-pivot.html) This episode is sponsored by Elsevier Health (https://www.us.elsevierhealth.com/). Looking to update your personal or professional medical library? Shop Elsevier Health's Holiday Sale and save up to 35% on your purchase of medical books! Plus, you can take an extra 5% off your order with code KEVINMD at checkout. Take advantage of the biggest sale of the year from Elsevier, the world-leading provider of medical books and reference materials. Shop us.elsevierhealth.com now through December 31.