The Podcast by KevinMD

"I propose Zooming while driving be added to the DSM criteria for ADHD. I have gotten a new glimpse into the world of some of my patients. One patient even mentioned it's hard for them to come to appointments, even with transportation, and we were able for the first time to talk at length about those psychological factors that prevent them from getting consistent follow up leading to lapses in effective treatment. Is this the first step toward more consistent care? Better outcomes? Some in my center therapists hate it as much as I do, but some really love it. Is this just not going to be everyone's color? There is room for yellows, blues, greens, reds, and all our mixtures. My experience is not representative of the entire tele field. Maybe there is even a place for it in my practice going forward, and our ability to bill for these encounters should continue. (Can you hear me, CMS!) But this cannot be my full-time practice. I hope there is a place for all of us. I hope when I retire, the money and screens haven't ultimately won over the best care for all patients. The optimist in me is hopeful, but the fast-talking irreverent realist in me says we will have to fight for our places." Allie Thomas-Fannin is a psychiatrist. She shares her story and discusses her KevinMD article, "A psychiatrist crashes into telemedicine during the pandemic." (https://www.kevinmd.com/blog/2020/05/a-psychiatrist-crashes-into-telemedicine-during-the-pandemic.html)

"I wrote a 55-word story in solidarity with my medical students and colleagues I had invited to share their lived experiences during COVID-19 on our Stories in Medicine blog. I wrote out of a need to "unmask" the guilt and angst of some of my colleagues and myself who, though practicing physicians, do not find ourselves directly on the front lines during these tumultuous times. Rather, we are dismayed to alternate between waves of anguish and guilt. Anguish for the suffering of our brothers and sisters in places like New York and New Orleans. Guilt, for not being shoulder to shoulder on the front lines. Guilt, because we are able to do things to take care of ourselves and our families in ways others are not. Our hearts break for our colleagues and families, their patients, and the families of their patients. We can only try to imagine a small portion of what they have gone through and will go through in the aftermath." Jennifer R. Hartmark-Hill is a family physician. She shares her story and discusses her KevinMD article, "Confessions in the time of COVID-19." (https://www.kevinmd.com/blog/2020/05/confessions-in-the-time-of-covid-19.html)

"With COVID-19, we have both the unique opportunity and need to deregulate buprenorphine prescriptions. The Substance Abuse and Mental Health Services Administration (SAHMSA) recently updated guidelines for buprenorphine prescriptions. There are new provisions for telephonic initiation of buprenorphine and scripts up to 28 days for stable patients. Unfortunately, this does not circumvent the major issue: redeployed providers will not be able to fill scripts. With just 7 percent of providers nationally able to even prescribe buprenorphine, this is a particularly vulnerable window for care. We must instead take the current crisis as an opportunity to reform and strengthen MAT access." Megana Dwarakanath is a pediatrician. She shares her story and discusses her KevinMD article, "With COVID-19, we have a unique opportunity and need to deregulate buprenorphine prescriptions." (https://www.kevinmd.com/blog/2020/05/with-covid-19-we-have-a-unique-opportunity-and-need-to-deregulate-buprenorphine-prescriptions.html)

"Children are being encouraged to take on the superhero persona and help protect others. They do this in true average-person-as-the-superhero style by wearing a facemask alone, without any superhero powers or words. Just as wearing a facemask in public has been the norm for years in many Asian countries, it may become the norm worldwide. For this to happen, we need buy-in by the younger generations who are less likely to wear a mask in public but are equally likely to unknowingly spread infection. In this group, the ability to make a fashion statement may motivate them to give up their laissez-faire view of their personal risk of harm in favor of the ethically favorable and trendy decision to protect others." Lauren Fine is an allergy-immunology physician and a medical educator. She shares her story and discusses her KevinMD article that she co-authored, "The superhero within during the time of COVID-19." (https://www.kevinmd.com/blog/2020/06/the-superhero-within-during-the-time-of-covid-19.html) She would like to thank her co-author and colleague, Dr. Vijay Rajput.

"We are health care workers. We are doctors, advanced care practitioners, nurses, pharmacists, social workers, and so much more. We are on the frontlines. We are our parents' children, and we are parents to our young children. For the first time, we are at an extremely high risk of being quarantined by the same beast we are trying to conquer. We are experiencing moral distress, guilt, and frustration, knowing our colleagues and patients need us when we can't be there. And now, for the first time, we feel like you need to know what we are truly feeling. For the first time, there is no you or I. No famous or average. There is no difference in race, sex, religion, or culture. We are one and the same, and for the first time, we all know what it feels like to be in each other's shoes. You are me, and I am you. We are you and I. For the first time, we are all equal in the eyes of this virus as it challenges us all physically, emotionally, socially, and spiritually." Simran Malhotra is a palliative care physician and can be reached on Instagram @drsimran.malhotra and on Twitter @simranm15. She shares her story and discusses her KevinMD article, "The many firsts of coronavirus." (https://www.kevinmd.com/blog/2020/03/the-many-firsts-of-coronavirus.html)

"It's maddening to see the differences in health outcomes between the rich and the poor. Even more unsettling is reflecting upon the psychological pain accumulated when living in a fad-obsessed materialistic comparison-creating society, the postponed dreams, and the day to day compromise that those with less have to endure – thoughts that may be far removed from the ruminations of the those who have abundance. I don't mean to stereotype, and this is not intended to be a polemic, but the country is divided, and many are living in two different worlds. The resultant health consequences should be contemplated upon, especially in the midst of a pandemic where the differences have the opportunity to be most blatantly highlighted." Harsh Bhavsar is an internal medicine resident. He shares his story and discusses his KevinMD article, "Coronavirus exposes the reality of income-driven health inequality." (https://www.kevinmd.com/blog/2020/04/coronavirus-exposes-the-reality-of-income-driven-health-inequality.html)

Since the coronavirus outbreak, reports of anxiety have increased, especially among physicians. Physicians face numerous stressors, including fears of contracting the coronavirus, concerns about potentially infecting loved ones, PPE shortages, testing delays, and frequently making quick decisions with limited information. Common symptoms of anxiety are increased worrying about one's self and/or loved ones, difficulty sleeping, difficulty eating, poor concentration, increased heart rate, hyperventilation, and struggling to control worrying. Christine Tran-Boynes is a psychiatrist. She shares her story and discusses her KevinMD article, "5 ways to manage anxiety during the coronavirus pandemic." (https://www.kevinmd.com/blog/2020/03/5-ways-to-manage-anxiety-during-the-coronavirus-pandemic.html)

"As the COVID-19 pandemic unfolds day by day at an exponential rate, we as doctors have been called to duty in unprecedented ways. Speak with any physician in the last few weeks, and you will be hard-pressed to find one who didn't feel an intrinsic obligation- indeed, wish- to rise to the occasion with an all-hands-on-deck attitude, despite the taxing and indefinite toll this will take. Speak with any physician mother, and you will quickly see that our intense drive to lead on the frontlines is matched with an equally intense anxiety about protecting and preserving the wellbeing of our families. Indeed, for most of us, the conflict between being a physician and mother has never felt greater." Tamara Goldberg is an internal medicine physician. She shares her story and discusses her KevinMD article, "The duality of being a physician-mom in the age of COVID-19." (https://www.kevinmd.com/blog/2020/04/the-duality-of-being-a-physician-mom-in-the-age-of-covid-19.html)

"Based on the evidence of the effects of trauma, we can predict that our health care teams, patients and families will exhibit signs of this assault through a variety of symptoms–sleeplessness, apathy, depression, and anxiety. The warning signs are already here. We read the desperate accounts and pleas of frontline workers describing the indescribable, holding the hands of patients dying alone, communicating with stunned and distraught families isolated away from death beds of their loved ones. Dr. Breen is symptomatic of a larger undercurrent of the fatal moral injury of the system currently at work. We need to face it head-on or risk additional losses as tragic as this." Mary R. Talen is a psychologist. Deborah Edberg is a family physician. They share their stories and discuss their KevinMD article, "Flattening the curve of COVID's emotional impact." (https://www.kevinmd.com/blog/2020/05/flattening-the-curve-of-covids-emotional-impact.html)

"Someday, I suspect I will recount this time of fear with mixed emotions. Sadly, there are people who have died and more to come, and this time will also lead us to reassess our way of life and make changes for the better. I work from home, juggling the management of patients by telemedicine with homeschooling my daughters, still working to find meaning and direction to do the right thing. With movie theaters all shuttered right now, and likely to struggle after this crisis, I hope the simple pleasure of watching these pictures in the theater can still be my escapist comfort. I yearn to go to the movies, and for me, streaming on Netflix can't match that theater experience. Still, I find purpose and meaning in reminding myself that we are characters in this movie, and just as in Hitchcock's thriller, the deeper meaning is in how we as people respond to extreme circumstances." Jules Lipoff is a dermatologist. He shares his story and discusses his KevinMD article, "Alfred Hitchcock, COVID-19, and the MacGuffin." (https://www.kevinmd.com/blog/2020/05/alfred-hitchcock-covid-19-and-the-macguffin.html)