The Podcast by KevinMD
The Podcast by KevinMD
Kevin Pho, MD
Social media's leading physician voice, Kevin Pho, MD, shares the stories of the many who intersect with our health care system but are rarely heard from. Welcome to The Podcast by KevinMD.
Imagining a pandemic as a physician novelist
"There are some things that we are living through as a result of COVID-19 that I did not imagine in my fictional account. For example: the timeline. As we are now four full months into this pandemic in the U.S., some experts estimate that we are still early in the game. As one doctor put it, we are only at about the twenty-yard line of the football field. My imagined timeline was much shorter. Another thing I didn’t foresee was the perception of danger dividing along political lines. In fact, I imagined the opposite: that people would, in the name of self-preservation, view with suspicion any political down-playing of the danger of a global pandemic and insist on any means possible of protecting themselves. And among the most devastating consequences of this pandemic that I hadn’t imagined for my novel was the situation of people dying alone in hospitals without their loved ones. Not being able to hold the hand, give a final hug, say goodbye. Undoubtedly, penning an imaginary pandemic is much less stressful than living through one. Living through a pandemic day by day has carried with it a chronic anxiety that I did not anticipate: not just the fear of contracting the illness, but the constant worry of pre-symptomatically transmitting it, thus second-guessing every errand, every visit to loved ones. As we all work through this unprecedented medical crisis, I hope we continue to make steady progress in treatment and prevention of this devastating illness. Stay safe." Teresa Fuller is a pediatrician. She shares her story and discusses her KevinMD article, "Imagining a pandemic as a physician novelist." (https://www.kevinmd.com/blog/2020/07/imagining-a-pandemic-as-a-physician-novelist.html)
Nov 7
12 min
Moral injury and practicing oncology during COVID-19
"As our office begins to return to pre-COVID operations, it has been uplifting to have a relative sense of normalcy, even though morale seems to be reduced. It is difficult to promote team building and improve morale when everyone has to maintain social distancing. I would love to go out for a meal with my staff, hug my patients, and lecture our trainees face-to-face in a classroom. While the hope is that all of these distancing measures are temporary, avoiding despair is another layer added onto an already heightened level of stress. I think all of us in medicine who have survived the pandemic thus far are grateful, even as we mourn the tremendous loss of life. There are signs that we can overcome this new normal moral injury involving fear, stress, and work-life imbalance. Several things that were burdensome pre-COVID such as licensing regulations, charting requirements, being unable to do telemedicine, for example, all were revised in some positive way as a result of the pandemic. In the same way that protests for social justice are rising, so are voices in medicine that will hopefully use this time of uncertainty to potentially change and improve health care systems. As we continually provide hope to our patients, perhaps there is hope for our profession to improve when we come out of this challenging time." Marc Braunstein is a hematology-oncology physician and can be reached on Twitter @docbraunstein. He shares his story and discusses his KevinMD articles, "My new normal moral injury" (https://www.kevinmd.com/blog/2020/07/my-new-normal-moral-injury.html) and "Practicing oncology during COVID-19." (https://www.kevinmd.com/blog/2020/03/practicing-oncology-during-covid-19.html)
Nov 6
16 min
Examining the duty of physician officials in the government
"The duty of physician officials in the government exceeds that of other officials. As physicians, they have a unique moral obligation to do more than protect the constitution from enemies, foreign and domestic. They have a duty to be unambiguously truthful, to use their power to do good, and to avoid harm. If they fail in any of those regards, they must be held accountable by their peers, and by society. This is especially urgent when those who appointed them to these positions of authority fail to manifest in their actions the moral necessity of telling the truth, doing good, and avoiding harm. In that case, peer and public accountability are all that is left to uphold these essential ethical standards. If this level of peer accountability seems extreme, imagine the consequences if the most powerful and public-facing physicians in the country continue to erode public trust in their own profession. Physicians have always held one another accountable to the highest ethical standards of medicine. The need is more urgent than ever. The potential for great human suffering demands that the unified voice of medicine muster its moral courage and act as though its life depends on it." Charles E. Binkley is a bioethicist and general surgeon. He shares his story and discusses his KevinMD article, "The failure of the U.S. government’s physicians to do good, avoid harm, and tell the truth." (https://www.kevinmd.com/blog/2020/09/the-failure-of-the-u-s-governments-physicians-to-do-good-avoid-harm-and-tell-the-truth.html)
Nov 5
15 min
An Indian doctor with vitiligo shares his story
"Growing up, my family sheltered and protected me with everything related to vitiligo. People never really asked me what happened to my skin. And, if I did get questions, I honestly did not know how to answer them, so I would say 'oh, they’re just sunburn scars' or some version of that story, and moved on. Thinking back, I probably was too supported and busy to really have an opportunity to be bothered by it. That, in itself, was a blessing. I pursued many years of schooling and training to ultimately become a practicing physician. Now that I’ve been in medicine for many years, I primarily value and cherish the connection with my patients, as I sincerely believe medicine is fundamentally about the human experience. But, when I hear statements like 'you don’t look Indian' from patients, I am constantly reminded each time that I have vitiligo. Reflecting on how best to answer this question, I ask myself if I should react and explain the skin condition, or just let it go. The truth is that the majority of the time, I do 'let it go' when it comes to discussing my skin condition with patients. I simply don’t want to explain to patients that I have vitiligo." Dhaval Desai is a hospitalist. He shares his story and discusses his KevinMD article, "The story of an Indian doctor with vitiligo." (https://www.kevinmd.com/blog/2020/06/the-story-of-an-indian-doctor-with-vitiligo.html)
Nov 4
10 min
COVID-19 amplifies health disparities
"The daily email update on COVID-19 affecting our hospital system is a glaring reflection of the health disparities amongst those in marginalized groups. The farther south you go, generally in San Diego, the higher the number of socioeconomically disadvantaged persons, and that tends to include a disproportionate number of persons of color.  These populations may be unable to physically distance due to living conditions and job conditions.  Perhaps there is a higher number of persons living together per household, in a smaller space, along with the inability to work from home.  And the mortality rates of those from COVID-19 amongst these persons is higher than white counterparts. Sometimes there is an inherent distrust in the medical system.  COVID-19 and racism intersect. However, this is not a unique situation in health care—many chronic illnesses portend worse outcomes for those in marginalized groups.  Marginalization means just that: glaringly apparent in health outcomes and socioeconomic disparities." Ni-Cheng Liang is a pulmonary physician and founder, the Mindful Healthcare Collective. She shares her story and discuss her KevinMD article, "COVID-19 becomes a magnifying glass for health disparities." (https://www.kevinmd.com/blog/2020/07/covid-19-becomes-a-magnifying-glass-for-health-disparities.html) Resources mentioned in the show: Implicit bias test: https://implicit.harvard.edu/implicit/takeatest.html Health Disparities Widget: https://www.healthypeople.gov/2020/data-search/health-disparities-data/health-disparities-widget Strategies for Reducing Health Disparities: https://www.cdc.gov/minorityhealth/strategies2016/index.html Conscious Anti-Racism: https://www.jillwener.com/consciousantiracism
Nov 3
13 min
How improv helps physician leaders
"Signing up for an improv class was unchartered territory. It was far beyond my comfort zone, like skydiving, for a little thrill. I’m not an adrenaline junkie interested in the ultimate adventure nor an aspiring actress hoping for a guest appearance on SNL. I’m a physician and a physician leader. Learning improvisational theatre wasn’t on my comprehensive, personal to-do list. But I’m also a physician coach. I sense what others feel in the moment without interpretation or judgment. However, when I tried to turn the same discerning sage on myself, I was faltering. The voice of compassion that I once used during patient visits and that I now use during client sessions, is sometimes muted by an inner critic that tells me to keep self-awareness out of awareness. It is this voice that I wanted to stifle when I hit the submit button." Terri Malcolm is an obstetrician-gynecologist and founder, Master Physician Leaders. She shares her story and discusses her KevinMD article, "How improv helps physician leaders." (https://www.kevinmd.com/blog/2020/08/how-improv-helps-physician-leaders.html)
Nov 2
15 min
Health misinformation from a patient perspective
"What on earth are we doing here, folks? To try to save a tanking economy, workers were sent back to their jobs much too early, causing again a spike in cases of the virus. I realize that the loss of a paycheck is a major traumatic situation for any breadwinner, but so is the loss of life. Our doctors and nurses are doing their best to treat COVID-19 patients under their care. Many are putting themselves in harm’s way and risking their health to care for those hospitalized. Some have been separated from their own families so as not to potentially carry the virus to them. And how do we repay them for their valiant efforts? By ignoring the guidelines put forth by the CDC and all other medical institutions. That doesn’t make sense." Michele Luckenbaugh is a patient advocate. She shares her story and discusses her KevinMD article, "The loss of a paycheck is a major traumatic situation. The loss of life is worse." (https://www.kevinmd.com/blog/2020/07/the-loss-of-a-paycheck-is-a-major-traumatic-situation-the-loss-of-life-is-worse.html)
Nov 1
18 min
Depression vs. burnout: A physician goes through both
"I have been depressed. I have been burned out. I have been both. I have been neither. How do you know if you are depressed vs. burned out when your chief complaint is, “I feel like crap?” It’s time to call a consult. I don’t mean curbsiding your colleagues to fill your medications off the record without evaluation. I mean, ask for real help, from someone who can objectively help you define your diagnosis and the best path forward. If you “feel like crap” and think you may be depressed or burned out, please reach out to a trusted physician, therapist, or coach. You are not alone, and there is hope and help waiting for you." Kara Pepper is an internal medicine physician and can be reached at her self-titled site, Physician Life Coach: Kara Pepper, MD. She shares her story and discusses her KevinMD article, "Call a consult: depression vs. burnout." (https://www.kevinmd.com/blog/2020/09/call-a-consult-depression-vs-burnout.html)
Oct 31
11 min
Telemedicine in COVID-19: Disparities still exist
"An increasing number of institutions are relying on telemedicine to continue delivering care to patients in lieu of typical outpatient visits in response to the COVID-19 pandemic. Telemedicine has been lauded as a potential equalizer in health care access. Indeed, it allows for safe and easy access to medical professionals. It especially benefits patients with transportation issues or those seeking specialty care from far away. Some pitfalls such as reimbursement issues and lack of physical exam notwithstanding, telemedicine overall is a helpful service at a time like this. However, telemedicine does not benefit all patients equally. In fact, it exposes and amplifies the existing health care disparity in a subgroup of patients." Wenjing Zong is a pediatric gastroenterology fellow. She shares her story and discusses her KevinMD article, "Telemedicine in COVID-19: Disparities still exist." (https://www.kevinmd.com/blog/2020/05/telemedicine-in-covid-19-disparities-still-exist.html)
Oct 30
12 min
#MedBikini and medical professionalism
"While our bodies have been a bastion of the heart and soul of medicine, a group of our peers thought it was acceptable to diminish the capabilities of our bodies to pictures on social media. They thought our ability to be exceptional physicians was inversely proportional to the number of pictures that showed us holding a drink or wearing a bikini. Our bodies do so much more than just practice medicine. What we choose to do with our bodies in our own free time should not become part of an investigation that is packaged as peer-reviewed research. Our bodies may have tattoos, ride motorcycles, or compete in pole fitness competitions for sport. None of that impacts our practice of medicine negatively. It’s past time we start celebrating the strength of our bodies and hold accountable those who try to negate our accomplishments with an ill-perceived attitude of sexism and misogyny." Jessica Pearce is an obstetrician-gynecologist. She shares her story and discusses her KevinMD article, "Let us talk about the underlying situation of #medbikini." (https://www.kevinmd.com/blog/2020/07/let-us-talk-about-the-underlying-situation-of-medbikini.html)
Oct 29
14 min
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