The Podcast by KevinMD

Endocrinologist Michael Morkos discusses his article "Mastering the art of efficient patient encounters: tips for physicians." Michael shares practical strategies for optimizing the patient encounter to enhance both efficiency and patient satisfaction. He delves into effective documentation techniques, emphasizing the importance of maintaining eye contact while touch-typing in the exam room, and adapting clinic setups with adjustable carts and laptops. Michael explains his system for ordering future labs during visits in lab-heavy specialties like endocrinology, ensuring all necessary data is available for follow-up appointments. He also outlines his streamlined EHR workflow, including pre-charting, side-by-side review of outside records, and transparent patient communication during the visit. Michael highlights how these methods enable him to complete all notes and charges by the end of the day, significantly reducing after-hours work and contributing to burnout prevention. Our presenting sponsor is Microsoft Dragon Copilot. Microsoft Dragon Copilot, your AI assistant for clinical workflow, is transforming how clinicians work. Now you can streamline and customize documentation, surface information right at the point of care, and automate tasks with just a click. Part of Microsoft Cloud for Healthcare, Dragon Copilot offers an extensible AI workspace and a single, integrated platform to help unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise—and it's built on a foundation of trust. It's time to ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow. VISIT SPONSOR → https://aka.ms/kevinmd SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

Nurse practitioner Surani Hayre-Kwan discusses her article "Are you protecting your career? 5 essential questions about your NP liability insurance." Surani discusses the critical need for nurse practitioners to secure their own professional liability insurance, highlighting how relying solely on employer-provided coverage can leave significant gaps. She provides insights into common pitfalls, such as employer policies often excluding licensing board complaints or having shared liability limits. Surani explains the crucial differences between occurrence and claims-made coverage and the importance of understanding "tail" and "nose" coverage to ensure continuous protection when switching jobs or carriers. She also offers actionable advice on how robust documentation, including adherence to SOAP note standards and careful patient engagement, can serve as a powerful defense against legal challenges. Surani emphasizes that comprehensive malpractice coverage is vital for protecting an NP's license, career, and financial stability. Our presenting sponsor is Microsoft Dragon Copilot. Microsoft Dragon Copilot, your AI assistant for clinical workflow, is transforming how clinicians work. Now you can streamline and customize documentation, surface information right at the point of care, and automate tasks with just a click. Part of Microsoft Cloud for Healthcare, Dragon Copilot offers an extensible AI workspace and a single, integrated platform to help unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise—and it's built on a foundation of trust. It's time to ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow. VISIT SPONSOR → https://aka.ms/kevinmd SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

Internal medicine and pediatric physician Charles LeBaron discusses his article "How the CDC's opioid rules created a crisis for chronic pain patients." Charles discusses the 2016 CDC opioid guideline, initially framed as a solution to over-prescription and overdose deaths, and critically examines its actual impact. He reveals how the guideline, despite being based on "low quality of evidence," led to widespread restrictions on opioid prescriptions by states, federal agencies, insurance companies, and pharmacies. Charles highlights the severe, unintended consequences for chronic pain patients, including increased pain, worsened quality of life, and a rise in suicides and overdoses among those whose opioid dosages were reduced or discontinued. He also touches on the devastating impact on cancer patients experiencing undertreated pain and discusses criticisms from pain specialists and the damning report by Human Rights Watch, which characterized the de facto denial of pain relief as a potential human rights violation. Our presenting sponsor is Microsoft Dragon Copilot. Microsoft Dragon Copilot, your AI assistant for clinical workflow, is transforming how clinicians work. Now you can streamline and customize documentation, surface information right at the point of care, and automate tasks with just a click. Part of Microsoft Cloud for Healthcare, Dragon Copilot offers an extensible AI workspace and a single, integrated platform to help unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise—and it's built on a foundation of trust. It's time to ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow. VISIT SPONSOR → https://aka.ms/kevinmd SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

Otolaryngologist Kevin C. McMains discusses his article "The hero's journey: Understanding professional identity formation in graduate medical education." Kevin discusses the ongoing crisis of burnout and mental health issues in medical training, critically examining traditional educational and environmental interventions. He identifies a gap in the current narrative surrounding work-life balance, suggesting that framing work and life as dichotomous can inadvertently diminish the intrinsic rewards of caring for others. Kevin proposes an alternative, more emotionally powerful narrative for professional identity formation: the hero's journey. He explains how this framework, rooted in universal storytelling traditions, can help medical trainees find deeper meaning in their sacrifices and engage more profoundly with their patients, fostering a more resilient and compassionate generation of health care professionals. Our presenting sponsor is Microsoft Dragon Copilot. Microsoft Dragon Copilot, your AI assistant for clinical workflow, is transforming how clinicians work. Now you can streamline and customize documentation, surface information right at the point of care, and automate tasks with just a click. Part of Microsoft Cloud for Healthcare, Dragon Copilot offers an extensible AI workspace and a single, integrated platform to help unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise—and it's built on a foundation of trust. It's time to ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow. VISIT SPONSOR → https://aka.ms/kevinmd SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

Osteopathic medical student Scarlett Saitta discusses her article "The school cafeteria could save American medicine." Scarlett discusses the profound connection between childhood nutrition and long-term health outcomes, drawing from her personal experiences and observations in her hometown. She highlights how current food systems contribute to chronic illnesses like type 2 diabetes and hypertension, and how misleading food marketing exacerbates the problem. Scarlett shares her proposed solution: The American Farm and School Nutrition Support Act, a federal policy amendment aiming to expand Farm-to-School programs by reallocating existing funds to support whole, locally sourced foods in schools. She emphasizes that this initiative not only improves child health but also supports rural economies and addresses health disparities. Scarlett explains the political process of advocating for such a bill, stressing the importance of listening and building bridges across political divides. She also shares data supporting the efficacy of improved school nutrition standards and discusses how this work is a part of the future of medicine, focusing on holistic well-being beyond clinical settings. Our presenting sponsor is Microsoft Dragon Copilot. Microsoft Dragon Copilot, your AI assistant for clinical workflow, is transforming how clinicians work. Now you can streamline and customize documentation, surface information right at the point of care, and automate tasks with just a click. Part of Microsoft Cloud for Healthcare, Dragon Copilot offers an extensible AI workspace and a single, integrated platform to help unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise—and it's built on a foundation of trust. It's time to ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow. VISIT SPONSOR → https://aka.ms/kevinmd SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

Licensed clinical psychologist and health care ethicist Jenny Shields discusses her article, "DSM-5 doesn’t name it, but moral distress is everywhere in medicine." Jenny illuminates the pervasive issue of moral distress among clinicians, defining it as the psychological toll exacted when they know the ethically appropriate action but are systematically prevented from taking it by institutional constraints such as hospital policies or insurer mandates. She carefully distinguishes moral distress from burnout or trauma, characterizing it as a chronic erosion of professional identity that occurs when daily work consistently conflicts with the core values that drew clinicians to their profession. Examples cited include understaffing in the face of rising executive compensation and adherence to insurer-driven care plans over sound medical judgment. Jenny describes the accumulation of "moral residue"—a lasting emotional injury—and a form of institutional gaslighting where systemic issues are presented as improvements, causing clinicians to doubt their own perceptions. She argues that by not naming moral distress, diagnostic manuals like the DSM-5 contribute to medicalizing symptoms like burnout, thereby avoiding the underlying ethical fractures in a health care system primarily designed around revenue and efficiency, which consistently deprioritizes ethics. The article calls for a shift away from focusing on individual clinician resilience towards demanding fundamental systemic changes to address this profound ethical crisis. Our presenting sponsor is Microsoft Dragon Copilot. Want to streamline your clinical documentation and take advantage of customizations that put you in control? What about the ability to surface information right at the point of care or automate tasks with just a click? Now, you can. Microsoft Dragon Copilot, your AI assistant for clinical workflow, is transforming how clinicians work. Offering an extensible AI workspace and a single, integrated platform, Dragon Copilot can help you unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise and it's part of Microsoft Cloud for Healthcare–and it's built on a foundation of trust. Ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow. VISIT SPONSOR → https://aka.ms/kevinmd SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

Psychiatrist, internist, and addiction medicine specialist Muhamad Aly Rifai discusses his article, "When rock bottom is a turning point: Why the turmoil at HHS may be a blessing in disguise." Muhamad offers a counterintuitive perspective on the recent wave of layoffs and leadership changes sweeping through federal health agencies like the NIH, CDC, and FDA. He argues that this "rock bottom" moment, rather than signaling collapse, presents a critical opportunity for a fundamental overhaul of a system that has lost public trust. He points to events like the perceived disengagement of many HHS employees during the COVID-19 pandemic's peak in 2021 and the 2021-2022 baby formula crisis as catalysts for this erosion of faith. Muhamad contends that the U.S.'s status as the "sickest wealthy nation," plagued by high maternal mortality, rampant chronic diseases, an addiction crisis, and falling life expectancy, demonstrates the failure of the old guard and conventional approaches. He suggests that the criticism of newly appointed "unconventional" leaders overlooks the desperate need for new thinking. The article calls for these institutions to become truly human-serving, prioritizing patient-centered care, transparency, and direct community engagement over bureaucratic inertia and data-driven detachment, ultimately aiming to rebuild a health system that genuinely protects and serves the American public. Our presenting sponsor is Microsoft Dragon Copilot. Want to streamline your clinical documentation and take advantage of customizations that put you in control? What about the ability to surface information right at the point of care or automate tasks with just a click? Now, you can. Microsoft Dragon Copilot, your AI assistant for clinical workflow, is transforming how clinicians work. Offering an extensible AI workspace and a single, integrated platform, Dragon Copilot can help you unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise and it's part of Microsoft Cloud for Healthcare–and it's built on a foundation of trust. Ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow. VISIT SPONSOR → https://aka.ms/kevinmd SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

Physician and clinical researcher Chris Apfel discusses his article, "Functional precision oncology: a game changer in cancer therapy." Chris explains that functional precision oncology takes a highly personalized approach by testing a patient's live tumor cells outside the body (ex-vivo) against a panel of cancer drugs to directly observe which treatments are most effective against that specific cancer. This method, he argues, can significantly improve cancer response rates and survival while reducing costs and unnecessary side effects, by moving beyond the limitations of standard pathology (which identifies cancer type but not optimal treatment) and genomic sequencing (which identifies mutations but provides actionable targets for only a minority of patients). Chris recounts the history of functional testing, its initial promise, its decline with the rise of next-generation sequencing, and its current resurgence, supported by studies demonstrating its high predictive accuracy for clinical outcomes. Despite its potential to complement genomics and truly personalize care, he notes that functional precision oncology faces slow adoption due to its general absence from standard NCCN treatment guidelines, hospital restrictions on external tissue testing, and a systemic preference in health care for standardization over innovative, individualized approaches. Chris strongly encourages patients, particularly those facing difficult or unresponsive cancers, to educate themselves about functional precision oncology and actively advocate for access to these tests. Our presenting sponsor is Microsoft Dragon Copilot. Want to streamline your clinical documentation and take advantage of customizations that put you in control? What about the ability to surface information right at the point of care or automate tasks with just a click? Now, you can. Microsoft Dragon Copilot, your AI assistant for clinical workflow, is transforming how clinicians work. Offering an extensible AI workspace and a single, integrated platform, Dragon Copilot can help you unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise and it's part of Microsoft Cloud for Healthcare–and it's built on a foundation of trust. Ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow. VISIT SPONSOR → https://aka.ms/kevinmd SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

Health care attorney Dennis Hursh discusses his article, "What independent and locum tenens doctors need to know about fair market value." Dennis explains why understanding fair market value (FMV) is crucial for independent and locum tenens physicians, not only for securing appropriate payment but also for ensuring compliance with federal laws like the Stark Law. He breaks down the Stark Law's definition of FMV as compensation arising from bona fide bargaining between well-informed parties not in a position to generate business for each other, and introduces the vital concept of "commercial reasonableness"—meaning an arrangement should make sense for the parties' goals, even if not directly profitable for the hospital regarding that specific physician's services. Dennis provides a practical method for locum physicians to estimate their minimum acceptable rate by calculating the total hourly cost of an equivalent employed physician, factoring in salary, benefits (typically 20 to 30 percent of compensation), paid time off, and amortized bonuses, offering a family medicine physician example where this cost exceeds $216 per hour. He advises locums to consider situational factors like a hospital's urgent need or difficulty in recruitment as leverage, and to proactively research and ask insightful questions to ensure their contributions are properly valued. Our presenting sponsor is Microsoft Dragon Copilot. Want to streamline your clinical documentation and take advantage of customizations that put you in control? What about the ability to surface information right at the point of care or automate tasks with just a click? Now, you can. Microsoft Dragon Copilot, your AI assistant for clinical workflow, is transforming how clinicians work. Offering an extensible AI workspace and a single, integrated platform, Dragon Copilot can help you unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise and it's part of Microsoft Cloud for Healthcare–and it's built on a foundation of trust. Ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow. VISIT SPONSOR → https://aka.ms/kevinmd SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

Physician executive Jay Anders discusses his article, "Health care's data problem: the real obstacle to AI success." Jay asserts that the transformative potential of artificial intelligence in health care is fundamentally dependent on the quality of the underlying clinical data. He explains that while tools like large language models and conversational AI show promise in synthesizing information and easing documentation, their reliability is compromised when fed with data from repositories often filled with inconsistencies, errors, and gaps. This can lead to an "increased workload paradox," where clinicians spend more time verifying and correcting AI-generated outputs, and a failure to produce the structured data vital for regulatory compliance, quality metrics, and analytics. Jay emphasizes that the "garbage in, garbage out" principle severely hampers interoperability and contributes to significant financial and clinical risks, including medical errors and inefficient workflows. To counter this, he advocates for robust data validation and normalization, enhancement of clinical terminologies, and the use of AI paired with evidence-based algorithms to rectify historical data issues, stressing that establishing trusted data sources is paramount before AI can truly revolutionize health care delivery. Our presenting sponsor is Microsoft Dragon Copilot. Want to streamline your clinical documentation and take advantage of customizations that put you in control? What about the ability to surface information right at the point of care or automate tasks with just a click? Now, you can. Microsoft Dragon Copilot, your AI assistant for clinical workflow, is transforming how clinicians work. Offering an extensible AI workspace and a single, integrated platform, Dragon Copilot can help you unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise and it's part of Microsoft Cloud for Healthcare–and it's built on a foundation of trust. Ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow. VISIT SPONSOR → https://aka.ms/kevinmd SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended