The Podcast by KevinMD

What are the challenges facing psychiatry? How does psychiatry need to innovate the continue to thrive? What is the future of psychiatry What's your #1 tip for those considering the profession? What advice can you give to primary care clinicians as it relates to behavioral health issues? Owen Muir is a psychiatrist and host of the podcast, Pandemic Check In. (https://podcasts.apple.com/us/podcast/pandemic-check-in/id1503107429) He shares his story and discusses the present state and future of psychiatry as a profession.

"Death is not meant to be rushed. Saying goodbye shouldn't be rushed. Celebrating a life once lived cannot be rushed. And yet, we must. Taking a moment, a minute, an hour, maybe a day to feel something that normally takes far longer. Because we must. And in our hearts, the grief remains. Frozen in time in this state of mourning that we are all experiencing. We say the same words to our friends, to the families of patients that we ourselves have been the recipient of. The awkward moment when we realize that offering our condolences, again and again, has begun to lose meaning. There is a certain degree of numbing that occurs, perhaps protective, when faced with traumatic situations day in and day out. What do you when the tears no longer fall?" Julie B. Trivedi is an infectious disease physician. She shares her story, explores the pandemic from the perspective of a Texas-based infectious disease physician, and discusses the KevinMD article, "How do you grieve when you are still mourning?" (https://www.kevinmd.com/blog/2020/04/how-do-you-grieve-when-you-are-still-mourning.html)

"Over the last 100 years, the U.S. has had to respond to five avian flu pandemics. The most severe was the 1918 avian influenza infecting 1/3 of the world's population and killing 650,000 Americans. It was also the last time wide-spread containment, mitigation, and isolation strategies were used in the U.S. Seldom mentioned about the 1918 pandemic are the three 'waves' or cycles of resurgence and the subsequent deaths associated with them, especially in cities and towns that failed to implement timely mitigation restrictions or rescinded them too quickly. When considering the rescindment of mitigation restrictions, a bottom-to-top approach (local-state-federal governments) must be followed precisely to account for the kinetics of the virus. It is the virus that will truly dictate when American lives can return to some semblance of normal. The goal is to taper restrictions to avoid a cycle of new COVID-19 outbreaks and thus minimize the similar cycle of deaths, which followed in the 1918 pandemic." Nicolas K. Fletcher is a public health student. He shares his story and discusses his KevinMD article, "Strategies for lifting COVID-19 mitigation restrictions." (https://www.kevinmd.com/blog/2020/04/strategies-for-lifting-covid-19-mitigation-restrictions.html)

"The unparalleled and pervasive nature of the evolving COVID-19 pandemic has touched all of us in some way. There is limited, albeit growing, research on the mental health effects of disasters. A recent review article pointed out the potentially negative consequences of prolonged quarantine, while other research from Wuhan, China, highlighted the impact of COVID-19, particularly amongst healthcare personnel. Psychiatrists and mental health professionals will play a critical role in the aftermath of the pandemic, but this requires a shift in perception of who a psychiatrist is and what they have to offer." Chinenye Onyemaechi is a psychiatrist. She shares her story and discusses the KevinMD article that she co-wrote, "Redefining the role of psychiatrists in the time of COVID-19." (https://www.kevinmd.com/blog/2020/04/redefining-the-role-of-psychiatrists-in-the-time-of-covid-19.html)

"Recent articles have accused some physicians of hoarding medications for themselves during our international medical crisis. Authors such as these should be ashamed of their coverage and wasted ability on sensationalism when they could be spending their time informing the public about the dangers of COVID-19 and the actions communities, hospitals, physicians, businesses, and public servants are taking on a daily basis to protect our great nation and the world from the perils of this invisible enemy. As a physician, I urge my colleagues to keep fighting to help restore order and health in our nation and to remember the promise we made in our Hippocratic Oath: 'So long as I maintain this Oath faithfully and without corruption, may it be granted to me to partake of life fully and the practice of my art, gaining the respect of all men for all time. There is hope we will defeat this invisible enemy and return to the normal way of American life: travel, commerce, vacation, celebrations, and sports. I ask that we help each other and not spread fear and disinformation during this period. Many people are in need, so reach out to your local hospital or medical school and ask how you can help by donating food or funds to help medical students, physician trainees, and other health care workers. This is a time of national unity and to rise as one and to share resources with each other, help the elderly, and listen to the advice of medical experts." Shady Henien is an interventional cardiology fellow and CEO, Physician Promise. (https://www.physicianpromise.com/) He shares his story, explores the cardiology-coronavirus connection, and discusses KevinMD article, "This is a time for national unity, not sensationalism." (https://www.kevinmd.com/blog/2020/03/this-is-a-time-for-national-unity-not-sensationalism.html)

"This pandemic presents a unique opportunity for senior anesthesiologists to see the benefit of accommodating the health care needs of our workforce. Just as I tried to avoid the teratogenic effects of certain cases when pregnant, we should consider the most effective ways to protect senior anesthesiologists from a life-threatening infection. When the pandemic has passed, anesthesiologists of all ages can take into account times when each of us is more susceptible than others. I hope that we will work to accommodate the age dynamics of our profession and protect each other. For now, while we still have a full roster of healthy anesthesiologists, an effort should be made to spare older colleagues who are at higher risk. After all, this is at the heart of what we do as physicians: care for and protect those who are in need." Becky Wong is an anesthesiologist and can be reached on Twitter @BeckyWongMD. She shares her story and discusses her KevinMD article, "Spare older anesthesiologists COVID-19 coronavirus risk." (https://www.kevinmd.com/blog/2020/03/spare-older-anesthesiologists-covid-19-coronavirus-risk.html)

"Being present is a wonderful thing. It relieves stress caused by focusing on failures of the past and worries of the future. Both realms are unreachable, largely unchangeable. But at the same time, they both entice and tease our minds such that we often find ourselves everywhere, but at the moment as we focus on changing what has already passed or what may (or may not) come to be. Living as our children model so well, at the moment, has an immediate influence on our health and wellness. Tuning out the constant barrage of news about coronavirus and tuning into what is before you will bring calm, serenity, and a sense that all is okay. It will allow you to enjoy the moment, the small pleasures our senses offer us, things that pass us by when we are lost somewhere else on the time continuum. The touch of an elder, the smell of a blossoming fruit tree, the way the wind feels against our cheek – open up to the present, and it is all there for you. Just ask the two year olds." Anthony Fleg is a family physician who blogs at Writing to Heal. He shares his story and discusses his KevinMD article, "Take a gratitude perspective on coronavirus" (https://www.kevinmd.com/blog/2020/05/take-a-gratitude-perspective-on-coronavirus.html) and "The superpower of being present." (https://www.kevinmd.com/blog/2020/05/the-superpower-of-being-present.html)

"Recently, I realized that something needed to change in my family life. With three busy daughters at three different schools who participate in multiple activities along with my full-time job as an anesthesiologist, my life depended on accurate and concise communication. However, this was the third time in a week that a ball had been dropped between my husband and me. This time it resulted in my middle daughter, Laini, being left at practice, and the coach calling to figure out who was picking up this last straggler. It was enough to make me realize that something had to change. The previous day, I had run a code in the GI suite at the hospital where I work. Everything had gone smoothly with team members, all understanding each other perfectly. If I could communicate effectively with a team of five health care members, why couldn't I use these strategies to communicate with my own husband more effectively?" Maria Michaelis is a pediatric anesthesiologist. She shares her story and discusses her KevinMD article, "Closed-loop communications: Good for codes and for marriage." (https://www.kevinmd.com/blog/2020/03/closed-loop-communications-good-for-codes-and-for-marriage.html)

"All too often, physicians and other health care providers have tried to do the right things for our patients to ultimately have had our hand slapped. So pause for a second, get the questions answered, know what future implications are for today's actions. Make the right choice for your patient, and for yourself, especially if it means amending your contract before you start something that may limit your talent/potential as a health care provider. We are taught to feel powerless, which is why our burnout rate is so high. Words are disguised to mean another: patient volume/productivity disguised as patient access, EHR checkboxes that are clinically meaningless disguised as quality measures, your bedside manner, and ability to relate disguised as patient satisfaction surveys. And yet, as we see, despite being made to feel powerless, at the end of the day, we are the only ones with the ability to provide medical care when people need it. An anesthesia machine, scalpel, laboratory, and stethoscope are all useless without the person with it. So get out there and wear your warrior uniform and help your patients! But don't have it be a disguise for being made to wear shackles tomorrow." Vasanth Kainkaryam is an internal medicine-pediatrics physician. He shares his story, explores his direct primary care decision, and discusses KevinMD article, "Advice to employed physicians plunging into telemedicine." (https://www.kevinmd.com/blog/2020/03/advice-to-employed-physicians-plunging-into-telemedicine.html)

"Obesity is a topic that literally hits home for me. For the past two years, the website WalletHub has voted the McAllen-Edinburg-Mission TX metroplex as the 'fattest city in America.' As a health care provider, this is deeply disturbing because it puts my community at high risk for a wide variety of health problems, including but not limited to coronary artery disease, diabetes, stroke, and several cancers such as liver, kidney, breast, endometrial, prostate, and colon. Not surprisingly, we also rank third for the highest percentage of diabetic (type 2) adults. In a local news article published just after our unceremonious coronation, city officials were quoted as saying that WalletHub's findings were, '… extremely misleading about the actual activities and health and wellness and well-being of our community.' I've seen all of the strides that this area has taken to make exercise more accessible, with increasing healthy food options, gyms seemingly everywhere, and miles of paved paths for running and biking. Each city hosts a number of races yearly, including marathons. We even live an hour from South Padre Island, where there's a wide variety of water sports available to enjoy. Yet, the fact remains that our obesity rates still rank at the very top in the country. So, what's to blame for this health epidemic? The plate is full when it comes to contributors, but we are missing out on the main dish." Henry Herrera is a gastroenterologist. He shares his story and discusses his KevinMD article, "What's to blame for the obesity epidemic?" (https://www.kevinmd.com/blog/2020/03/whats-to-blame-for-the-obesity-epidemic.html)