The Podcast by KevinMD

"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)

"We are in the midst of a crisis in humanity. While we are still dealing with COVID pandemic and its deleterious health, economic and societal consequences, our troubling past of racism and inequality is rearing its ugly head. The senseless killings at the hands of police, the shameful subjugation of persons of color, the systemic prejudice of a person based upon gender, sexual orientation, or disability have placed us at a tipping point in society. We are vulnerable as a community, as a state, and as a nation. As I am writing this, I am disheartened, disillusioned, and spiritually broken. Our children are witnesses and possibly victims of this inequity. So we as persons of all ways of life and ethnicity must do right for our current generation of highly impressionable minds. As I pen this 'call to care,' I ask you all to consider the following important actions." Nicolo Geralde is a neonatologist. He shares his story and discusses his KevinMD articles, "We are in the midst of a crisis in humanity" (https://www.kevinmd.com/blog/2020/06/we-are-in-the-midst-of-a-crisis-in-humanity.html) and "A different perspective on PPE during the COVID-19 crisis." (https://www.kevinmd.com/blog/2020/04/a-different-perspective-on-ppe-during-the-covid-19-crisis.html)

"With my passion for writing and connecting digitally with others in health care and the general public, this 'downtime' has allowed for an expansion of these interests. I've begun recording on my podcast, a multidisciplinary conversation between women who thrive in fields that traditionally they haven't thought to be able to (or shouldn't). I've spent more time than I ever could have imagined with my son – a wonderful by-product of the distancing measures. And I've found that I love to make my friends – and even strangers – find their laughter during this dark time. My family and friends will often attest to this, how I get joy from getting a smile, a smirk, or even a head shake (I can see you trying not to laugh under there though). As I've grown as a clinician, I've become more comfortable with infusing humor – appropriately – with my patients, and I know that a shared laugh even as they are going through a time that isn't the best in their lives is appreciated." Nancy Yen Shipley is an orthopedic surgeon and can be reached at her self-titled site, NancyMD, and on Twitter @_nancymd and Instagram @_nancymd. She shares her story and discusses her KevinMD article, "How a physician finds laughter during this dark time." (https://www.kevinmd.com/blog/2020/04/how-a-physician-finds-laughter-during-this-dark-time.html) We also discuss her #1 tip for women physicians interested in traditionally male-dominated fields, and her new podcast, The 6% with NancyMD. (https://www.nancymd.com/podcast/)

"I had been trained to be this way. No panic, just a calm journeyman's approach to any affliction, like a mathematician working an equation. Years of preparation, acquiring a skill set, building up my vault, had readied me to stand in the lounge like a zebra. And so, I stared at my hands to see if I was actually here, to see who I was. Maybe I was hoping to see something different. Anything, really. A tremble, a shake. But I saw nothing. Just my hands. Steady. Solid. Quiet. The clock clicked, 8:21. It was one of those old-school clocks, like you'd see on the wall back in grade school. I had zoned out looking at a similar clock at my son's last parent-teacher conference. The second hand was rigid and jerky, making a big move forward, then a small move back. Big forward, small back. Everything fits together, like the pieces of a giant puzzle. The picture becomes clear only when the dark colors blend with the bright. The picture is revealed because of the unity of pieces. I felt the seconds ticking, moving forward from 8:21. Even though it didn't look like it, deep down, the last thirty minutes had kicked my ass. From the outside I was calm, but somewhere inside, the hideous reality of death and suffering screamed and rattled in my well-guarded cage." Shannon Sovndal is an emergency physician and author of Fragile: Beauty in Chaos, Grace in Tragedy, and the Hope That Lives in Between. (https://amzn.to/30SyL1C) He shares his story and discusses his KevinMD article, "Calm in the face of the hideous reality of death." (https://www.kevinmd.com/blog/2020/05/calm-in-the-face-of-the-hideous-reality-of-death.html)

How do racial issues affect patients' physical and mental health, and how do we address them during regular visits? For those without the lived experience of the black community, how can we learn and educate ourselves? How are the current protests different from those in the past? In order for us to make enduring changes that arise from the protests, what needs to happen? C. Nicole Swiner is a family physician and can be reached at Docswiner and on Twitter @docswiner. She shares her story and her perspective on the country's racial climate and how it affects both doctors and patients.

"Physicians have struggled and sacrificed to develop the clinical judgment and skill needed to provide competent clinical care. They have undergone over a decade of schooling and training, taken on excessive student loan debt, worked backbreaking hours for low pay during residency, and risked their lives during the process. Yet when they have completed their training, they often times have to pay excessive malpractice premiums, having to answer to bureaucrats, administrators, insurance companies, politicians, and lawyers. Many times they get the short end of the stick, and are completely expendable by the system. Their incomes are tied to a job, boss, corporate, and regulatory entities that do not have their best interests in mind. More frequently, these entities are failing physicians. Look at what happened with COVID-19, and ask yourself, "What if that source of income was eliminated by no fault of your own?" What is needed is a paradigm shift, and breaking out of traditional modes of linear thinking that our profession is so accustomed to. Now, more than ever, it's not just about having a single high-income wage. Too many physicians are living paycheck-to-paycheck, have large liabilities, little-to-no savings, and families to support. Today's physicians must be able to use asset and income diversification to mitigate economic risks." Christopher H. Loo is a physician and author of How I Quit My Lucrative Medical Career and Achieved Financial Freedom Using Real Estate. (https://amzn.to/37MiPPB) He shares his story and discusses his KevinMD article, "How COVID-19 is forcing physicians to rethink the concept of job security." (https://www.kevinmd.com/blog/2020/05/how-covid-19-is-forcing-physicians-to-rethink-the-concept-of-job-security.html) This episode is brought to you by Money Insights. Please visit Moneyinsights.net/KevinMD (https://moneyinsights.net/KevinMD/) for a unique financial strategy to help physicians across the country grow and protect their wealth.

"Sitting in front of my laptop with both of us on the screen, I can maintain decent eye contact even if I look something up or type something into the medical record. The patient sees me as paying more attention than when I couldn't effectively both maintain eye contact and look at the screen while talking to him or her (because I'm not that good at typing). Without the ability to do a physical exam, I have more time to listen and ask questions, and my patient is speaking to me from their home environment without the distractions of getting to my office, sitting in the waiting room and perhaps waiting in a sterile exam room longer than they should have. We are now perhaps a little more at ease as we begin our encounter. Without the trappings of the medical office, we are face to face, and our surroundings are less obvious and less able to distract us. We feel more on an equal playing field, each one of us in our own environment. At the same time, if the patient chooses to, they can show me a glimpse of theirs. Just the other day, a tough-looking ex-convict showed me his new cat, a surprising side of him that deepened my understanding of his new life and new level of responsibility and respectability." Hans Duvefelt, also known as "A Country Doctor," is a family physician who blogs at A Country Doctor Writes: and is the author of A Country Doctor Writes: CONDITIONS: Diseases and Other Life Circumstances. (https://amzn.to/30Kl0BT) He shares his story and why he writes, explores how the pandemic change primary care, and discusses his KevinMD article, "Will telemedicine make us better diagnosticians?" (https://www.kevinmd.com/blog/2020/05/will-telemedicine-make-us-better-diagnosticians.html) This episode is brought to you by Money Insights. Please visit Moneyinsights.net/KevinMD (https://moneyinsights.net/KevinMD/) for a unique financial strategy to help physicians across the country grow and protect their wealth.

Physicians are finding out that their jobs aren't as secure as they thought. Many have taken salary acts, are furloughed, or worse, laid off completely. It comes as a financial shock to many doctors. In this episode, gastroenterologist and certified financial coach Brent Lacey shares his tips and advice on how physicians can navigate these uncertain financial times. Brent Lacey is a gastroenterologist and certified financial coach and can be reached at the Scope of Practice. He shares his story and discusses finance tips for physicians in the year 2020. This episode is brought to you by Money Insights. Please visit Moneyinsights.net/KevinMD (https://moneyinsights.net/KevinMD/) for a unique financial strategy to help physicians across the country grow and protect their wealth.