The Doctor's Art

The American Medical Association (AMA) is the largest professional association of physicians in the United States, comprising more than 270,000 clinicians across all medical specialties. It is involved in all aspects of American medicine, from establishing standards of care, to reforming medical education, to lobbying for health care policies. Our guest in this episode is Jack Resneck Jr., MD, chair of the department of dermatology at the University of California San Francisco and President of the AMA from 2022 – 2023. In this conversation, we explore Dr. Resneck's personal journey in medicine, how the AMA is addressing physician burnout, how the AMA is coming to terms with its own history with race relations, how digital health is transforming medicine, how health care reimbursement rates are determined, and how doctors can play a more active role in advocating for their own work.In this episode, you will hear about:Dr. Resneck’s early years as a self-described ‘policy nerd’ and growing up in a physician family - 2:10How Dr. Resneck first became involved with the AMA - 6:01A brief review of the history and mission of the AMA - 8:23A discussion of the epidemic of burnout and how the AMA is addressing it - 12:45A survey of the AMA’s current policy priorities - 23:42A conversation around the incentive discrepancies around primary care medicine and how the AMA’s Relative Value Update Committee (RUC) is addressing this - 29:26How artificial intelligence and other new technologies are shaping the future of medicine, and why physicians must take an active role in their development - 36:25Reflections on the history of the AMA’s race relations and what the modern medical establishment must do to remedy health discrepancies, including The AMA’s Strategic Plan to Embed Racial Justice and Advance Health Equity - 47:15Dr. Resneck’s optimistic view of the future of the profession - 55:08In this episode we discussed several reports and articles, including:The Flexner Report, a 1910 survey of the medical profession that was used to standardize medical education.How Being a Doctor Became the Most Miserable Profession by Daniela Drake.The Lorna Breen Health Care Provider Protection Act, a recently-passed legislation aimed at helping physicians.Follow Dr. Resneck on Twitter @JackResneckMD.Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.Copyright The Doctor’s Art Podcast 2023

Matters of faith and spirituality are seldom openly discussed in medicine. But for our guest in this episode, pediatric palliative care doctor Elisha Waldman, MD, these issues are a daily fixture of his work. Dr. Waldman is former associate chief of the Division of Pediatric Palliative Care at Ann and Robert H. Lurie Children's Hospital of Chicago and former medical director of pediatric palliative care at Columbia University Irving Medical Center. He is the author of the memoir This Narrow Space, in which he describes his seven years working as a pediatric oncologist at Hadassah Hospital in Jerusalem, Israel, while grappling with the ethical and political complexities that came with treating his Muslim, Jewish, and Christian patients. Over the course of our conversation, Dr. Waldman discusses his formative religious upbringing, delves deep into what it means to be present with patients in moments of suffering and existential anguish, and examines what his experiences have taught him about the enigmas of life, death, faith, and identity.In this episode, you will hear about:How Dr. Waldman’s early interest in religious studies influenced his pursuit of a career caring for children with cancer - 2:12Dr. Waldman’s religious upbringing as the son of a conservative Jewish rabbi - 7:00A discussion of spiritual care in medicine and what it means to be a “spiritual generalist” versus a “spiritual specialist” - 13:49Reflections on what brought Dr. Waldman to Jerusalem and what it was like to practice medicine in such a diverse and politically complex city - 23:01How Dr. Waldman finds the emotional fortitude to continue giving care and comfort to children who are seriously ill - 26:11A discussion of powerful and beautiful moments in accompanying patients through suffering - 33:40How pain differs from suffering and what physicians can do once they recognize that difference - 48:13Dr. Waldman’s advice to young clinicians on being present and curious with patients - 57:25Dr. Elisha Waldman is the author of This Narrow Space: A Pediatric Oncologist, His Muslim, Jewish, and Christian Patients, and a Hospital in Jerusalem.Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.Copyright The Doctor’s Art Podcast 2023

The National Academy of Medicine (NAM) is an independent organization that provides expert evidence-based guidance on issues of health, biomedical science, and health policy. Election to the NAM is considered one of the highest honors in the fields of health and medicine, recognizing individuals who have shown exceptional professional achievement and commitment to service. In this episode, we are joined by Victor Dzau, MD, who has been president of the NAM since 2014. He previously served as President of the Duke University Health System, Chairman of Medicine at Brigham and Women's Hospital of Harvard Medical School, and Chairman of Medicine at Stanford Health Care. As a leading scholar in cardiovascular medicine, his pioneering research laid the foundation for the development of blood pressure medications widely used today. Over the course of our conversation, Dr. Dzau discusses his challenging upbringing as a refugee of the Chinese Civil War, describes his dedication to health equity and global health; explores the work of the NAM, and passionately shares why clinicians should be more involved in public discourse.In this episode, you will hear about:How growing up as a refugee of the Chinese Civil War shaped Dr. Dzau’s path and practice as a physician - 2:27How Dr. Dzau’s became a physician-scientist - 7:06The circumstances that led Dr. Dzau to take on issues of global health - 11:03Reflections on how Dr. Dzau stays in touch with the deeper meaning of medicine - 13:05A discussion of the values Dr. Dzau holds in his various roles - 17:41The difficulties Dr. Dzau faced during his education and career and how he recovered from burnout - 20:04A description of the purpose and mission of the National Academy of Medicine - 28:36How new members are elected to the NAM - 32:26A survey of the current issues the NAM focuses on and how Dr. Dzau thinks about the political dimensions of his work - 36:25The need for medical professionals to better communicate scientific facts with the broader public - 41:25Advice to early-career clinicians on leadership - 45:32Dr. Dzau delivered the Boston University Class of 2020 Commencement Speech, in which he discussed his own experience of burnout.You can follow Dr. Dzau on Twitter @VictorDzau.Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.Copyright The Doctor’s Art Podcast 2023

While this podcast has largely featured clinicians sharing the joy they have found in medicine, in this episode—breaking with tradition—we speak with a physician left disenchanted by her experiences working in medicine. Our guest is Arghavan Salles, MD, PhD, a minimally-invasive and bariatric surgeon who conducts research on gender equity and implicit bias in medicine. At Stanford Hospital, she advises initiatives to promote physician well-being and diversity. During the COVID-19 pandemic, her frontline experiences were featured in Newsweek, NBC, CBS, and other press outlets. Over the course of our conversation, Dr. Salles shares fiercely honest accounts about the difficulties she has faced as an immigrant, minority, and woman in medicine. Her stories are by turns saddening, shocking, and amusing, but ultimately invoke us to reflect on the part we can all play to create a more just and inclusive path for current and future physicians.In this episode, you will hear about:Dr. Salles’  path to medicine and her regrets along the way - 2:11The social pressures within medicine to overlook the downsides and hardships of a medical career - 7:11Why Dr. Salles chose surgery as a specialty - 11:02How, upon accepting her first academic position , Dr. Salles found herself in an environment that did not adequately support her surgical practice and her research - 14:12The systemic and cultural factors that led to the lack of support Dr. Salles faced - 23:03Dr. Salles’ research on gender equity in medicine - 29:57A discussion of the challenges of life as an academic physician - 32:13How Dr. Salles made the decision to put herself over her career and leave her academic position - 36:47Why it can sometimes seem that hospitals are exploiting physicians - 41:12Advice on how institutions can better promote diversity, equity, and inclusion in their culture - 47:32Learn more about Dr. Salles’ work on her website and follow her on Twitter @Arghavan_Salles.Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.Copyright The Doctor’s Art Podcast 2023

In the first half of 2020, New York City quickly became the American epicenter of the COVID-19 pandemic, with over 200,000 cases reported in the first few months. The city came to a standstill as thousands of people died alone in hospitals and bodies piled up in freezer trucks that could not transport them away fast enough. In August 2020, amid this cataclysm, Dave Chokshi, MD assumed position as New York City's Health Commissioner and began the arduous task of repairing a broken city and restoring public trust among its residents. Prior to this work, Dr. Chokshi led the NYC Health and Hospitals Corporation and was a White House Fellow at the US Department of Veterans Affairs. In this episode, Dr. Chokshi joins us to share the core values that drive his public health work and how he navigated the challenges of leading New York City through COVID-19.In this episode, you will hear about:How Dr. Chokshi, early in his life, came to understand the association between health and opportunity - 3:52A discussion of how privilege impacts the opportunities available to individuals and how this recognition affects Dr. Chokshi’s medical work - 7:40How Hurricane Katrina revealed to Dr. Chokshi the flaws in our existing health systems - 15:48Dr. Chokshi’s involvement with Universities Allied for Essential Medicine - 19:34An account of Dr. Chokshi’s tenure as New York City Health Commissioner during the height of the COVID-19 pandemic - 24:31Dr. Chokshi’s principles of effective leadership - 32:31Reflections on the first wave of the COVID-19 pandemic and how indebted society is to nurses and hospital house staff - 37:15Dr. Chokshi’s personal philosophy on maintaining a balanced sense of humility - 53:48Five lessons for medical trainees and clinicians on staying connected to what makes medicine meaningful - 57:38Dr. Chokshi briefly discussed his early work with the Committed Communities Development Trust in Mumbai, India.You can follow Dr. Dave Chokshi on Twitter @DaveChokshi.Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.Copyright The Doctor’s Art Podcast 2023

In 2015, New York Times journalist John Leland set out to follow the lives of six people over the age of 85. What John learned shattered his preconceived notions about aging, loneliness, and loss. The resulting 2018 book, Happiness is a Choice You Make, became an international bestseller and delved into how these older individuals found wisdom and joy in the later stages of life. In this episode, John joins us to discuss the transformational exploration he undertook and lessons on living well he has discovered from this journey. In this episode, you will hear about:How a college music reviewer came to write for The New York Times - 1:41How John’s exploration of aging began when he was initially—reluctantly—assigned to write a series of articles on old age and retirement - 5:04Reflections on how John’s expectations of aging — including loss, sadness, loneliness — were transformed over the course of this writing project - 9:01How John discovers his interview subjects - 11:38 A discussion of John’s book, Happiness is a Choice You Make, and the lessons he learned from his subjects -14:44Advice to young clinicians on finding moments of happiness in their careers - 26:19John’s surprising realization that elders are not “depressed all the time” - 33:53A discussion of John’s recent article, in which he was documents the last days of Shatzi Weisberger, a nurse and prominent death educator - 36:53Reflections on how John’s relationships with older adults have changed his perception of death - 40:07Advice to clinicians on how they can better help older patients connect with what makes their lives meaningful - 45:03John Leland is the author of the book Happiness is a Choice You Make: Lessons from a Year Among the Oldest Old.He is also a staff writer at the New York Times. In this episode we discussed his articles How Loneliness is Damaging Our Health, and She Preached About Death Without Fear. Could She Practice it?You can follow John Leland on Twitter @JohnLeland.Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.Copyright The Doctor’s Art Podcast 2023

One of medicine's thorniest ethical questions concerns the lengths to which a physician should go to ameliorate suffering, including the use of medical means to hasten death. Yet, particularly for those who care for patients with, or for those who live with, serious illness, this question is all but inevitable. In this episode, Stefanie Green, MD, the current president of the Canadian Association of Medical Assistance in Dying Assessors and Providers, shares her experiences helping patients die and how she views this branch of medicine. Dr. Green has been at the forefront of the change in legal regulation and clinical practice around medical assistance in dying (MAiD) in Canada. In her 2022 book, This is Assisted Dying, she shares the delicate, challenging, and humane moments she has witnessed while navigating this unique work.Disclaimer: This episode does not advocate for or against medical assistance in dying. Rather, it seeks to understand why a clinician may choose to perform this work. If you are experiencing suicidal thoughts or a crisis, please call or text 988 to reach the Suicide & Crisis Lifeline, available 24 hours a day, 7 days a week.In this episode, you will hear about:How Dr. Green transitioned from a career in maternity care to medical assistance in dying (MAiD) - 5:14A brief legal history of MAiD in Canada, beginning with Rodriguez v British Columbiaand including the sea change that came with Carter v. Canada - 6:39An overview of how MAiD works today in Canada - 12:14How MAiD works in the United States, specifically in California, and the role of prognosis in a patient’s eligibility for MAiD - 15:43Dr. Green’s reflections on how two decades working in maternity prepared her for MAiD - 20:45The specific process by which Dr. Green helps her patients die - 24:13The first patient encounter in which Dr. Green provided MAiD - 27:53Reflections on the frame of mind Dr. Green must adopt in order to perform this work - 35:04How Dr. Green processes the difficult emotions arising from her work - 43:22Dr. Green’s reflections on her role as a patient advocate when handling family conflicts at end of life - 47:50Advice for clinicians about connecting with patients through empathetic presence - 51:35Dr. Stefanie Green is the author of This is Assisted Dying.You can follow Dr. Stefanie Green on Twitter @DocSGreen.Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.Copyright The Doctor’s Art Podcast 2023

What does it take to lead a health department with a budget of more than $50 billion, overseeing the health of nearly 20 million Americans? Here to tell us about that is Nirav R. Shah, MD, MPH, who was the 15th New York State Commissioner of Health from 2011 to 2014. Today, Dr. Shah is a nationally recognized advocate of patient safety, health care innovation, and high-quality, low-cost care. He has variously served as Chief Operating Officer of Kaiser Permanente in Southern California, Advisor to the CDC Director, Senior Fellow of the Institute of Health Improvement, and Senior Scholar at Stanford University's Clinical Excellence Research Center. In this episode, Dr. Shah joins us to share his philosophy of healthcare leadership and how meaningful relationships anchor his work.In this episode, you will hear about:How Dr. Shah’s upbringing and the influence of Jainism steered him away from a lucrative career in finance and into medicine - 1:53Two patient stories in which seemingly simple mistakes led to moments of awakening for Dr. Shah in recognizing his purpose in medicine - 6:21A brief overview of Dr. Shah’s career path - 13:47Lessons on empathetic leadership that Dr. Shah picked up along the way - 19:21How forging strong relationships helped Dr. Shah find solutions on big issues during his time as New York State’s Health Commissioner - 21:57Dr. Shah’s current pursuits, including those focused on making a business case for supporting the unpaid caregivers of patients - 31:23Why transparency and bureaucratic structure are critical components of healthcare reform in the United States - 37:46Advice to clinicians on what makes effective leaders and collaborators, and how to find passion for meaningful projects - 41:43Dr. Shah is a trustee of the John A. Hartford Foundation, a board member of STERIS, and an advisor to GSR Ventures.You can follow Dr. Nirav R. Shah on Twitter @NiravRShah or on LinkedIn.Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.Copyright The Doctor’s Art Podcast 2023

Storytelling, pain, rage, and cultural competency are just some of the themes we will explore in this episode. Our guest, Haider Warraich, MD, grew up and went to medical school in Pakistan before completing residency at Harvard Medical School and fellowship in cardiovascular medicine at Duke University Medical Center. Today, he is an assistant professor at Harvard Medical School and the associate director of the Heart Failure Program at the VA Boston Health Care System. A prolific writer, he contributes regularly to the New York Times, Washington Post, and others. He is the author of three books on medicine for the general audience, most recently 2022’s The Song of Our Scars: The Untold Story of Pain, which examines the nature of pain not only as a physical, but also a historical and cultural experience. Over the course of our conversation, Dr. Warraich compares his medical experiences in Pakistan and in the US, discusses why he strives to incorporate palliative care into his cardiology work, and offers an impassioned critique of how modern medicine fails to address patients' suffering.In this episode, you will hear about:How Dr. Warraich went from thinking of his medical training as an “arranged marriage” to loving the career - 2:10How Dr. Warraich stays connected to his patients and his work despite the intense pressure and responsibility he experiences on a daily basis - 7:03What drew Dr. Warraich to cardiology and end-of-life care - 13:22Dr. Warraich’s reflections on the gaps in the care of patients with heart disease and how he now strives to reform the practice of cardiology - 17:33A discussion of how the medical culture of Pakistan differs from the United States and how they can be shockingly similar - 22:06How Tom Brady, the football quarterback, inspires Dr. Warraich to stay connected to the emotional core of his practice - 28:49Why it’s important to stay in a field if you care about it, especially if you hope to change and improve it - 35:37Dr. Warraich’s reflections on the nature of pain and how he hopes to change our cultural conversation around it - 41:38How acute pain and chronic pain are very different processes and how we can address suffering as a subject and deeply personal experience - 45:17You can follow Dr. Warraich on Twitter @haiderwarraich.Dr. Haider Warraich is the author of several books, including The Song of Our Scars: The Untold Story of Pain, Modern Death: How Medicine Changed the End of Life, and State of the Heart: Exploring the History, Science, and Future of Cardiac Disease.In this episode, we discuss the article “At the Edge of the Inside” by David Brooks, for the New York Times, and the book Just Mercy by Bryan Stevenson.Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.If you enjoyed this episode, please subscribe, rate, and review our show, and feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.Copyright The Doctor’s Art Podcast 2023

What if we could scientifically prove that compassion improves our well-being, our cognitive function, our longevity, and societal welfare? Here to explore these questions is our guest on this episode, James Doty, MD, a neurosurgeon, inventor, entrepreneur and writer. As the founding director of Stanford's Center for Compassion and Altruism Research and Education, his academic focus is the neurobiological effects of meditation, compassion, and altruistic behavior. His bestselling 2017 memoir, Into the Magic Shop, details his path from a troubled childhood to becoming an internationally-renowned surgeon and philanthropist. He has served on the board of a number of nonprofit organizations, including as former Chairman of the Dalai Lama Foundation, and is on the International Advisory Board of the Council of the Parliament of the World's Religions. In this episode, we discuss his unlikely journey to medicine and the incredible insights on compassion he has collected over the years.In this episode, you will hear about:Dr. Doty’s difficult childhood experiences and how the kindness of strangers pulled him to medicine - 2:10How Dr. Doty dealt with the fish-out-of-water experiences in medical school - 11:00A discussion of negative self-talk and how to overcome it - 17:30How Dr. Doty went from developing a neuroscience center in impoverished Mississippi to establishing an altruism research lab at Stanford University - 20:19A discussion of the eponymous incident of Dr. Doty’s book Into the Magic Shop and how it profoundly shifted his view on compassion - 26:06A review of some of the exciting findings of Stanford’s Center for Compassion and Altruism Research and Education - 32:36Reflections on how Dr. Doty practices compassion in his daily life - 38:29A brief discussion of the power of belief and how it shapes our reality - 44:00A discussion of how the dehumanizing bureaucracy and profiteering of the medical field is failing physicians - 49:55Dr. James Doty is the author of the best-selling memoir Into the Magic Shop: A Neurosurgeon’s Quest to Discover the Mysteries of the Brain and the Secrets of the Heart.He is the senior editor of the Handbook of Compassion Science published by Oxford University.Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.Copyright The Doctor’s Art Podcast 2022