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Investing in the Future of Medicine | Justin Norden, MD, MBA Nov 08, 2022

Show notes

While digital technologies now permeate nearly every aspect of our lives, their application to improve medicine remains limited. Still, recent advances in artificial intelligence, telecommunications, and other technologies hold enormous potential to transform how healthcare is delivered. At the forefront of exploring this potential is Justin Norden, MD, MBA, a physician and investor at the venture capital firm GSR Ventures, where he focuses on investments in digital health companies. With a background in computer science, Dr. Norden previously worked on the healthcare team at Apple and helped launch the Center for Digital Health at Stanford University. He joins us in conversation to discuss how he discovered investing and entrepreneurship as a way to tackle problems in medicine, clarify misconceptions about digital health and venture capital, and explore how technologies are shaping the future of medicine.

In this episode, you will hear about:

A brief introduction to venture capital - 1:48
How Dr. Norden’s experiences during medical training led him explore entrepreneurship and healthcare investing - 3:22
How Dr. Norden’s passion for computer science influenced his medical education - 7:30
What it was like to leave a clinical career - 10:18
The past and current state of technological advancement in medicine - 20:28
Co-host Dr. Johnson’s concerns over the ways technology has, at times, impeded the delivery of health care - 28:38
Dr. Norden’s vision for the ideal balance between humanism and technology in medicine - 34:31
How Dr. Norden considers the reconciliation between the profit motive of companies and the preservation of what makes medicine meaningful - 38:28
How Dr. Norden decides which digital health companies to invest in - 44:57
Advice to young clinicians who are curious about healthcare innovation - 50:09

Follow Dr. Norden on Twitter @JustinNordenMD.

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.

On Moral Injury and Emotions in Medicine | Danielle Ofri, MD, PhD Nov 01, 2022

Show notes

As one of the most prolific and acclaimed physician writers today, Danielle Ofri, MD, PhD is the author of seven books on the intricacies of modern medical practice and the doctor-patient relationship. Her other writings have appeared in The New York Times, The Atlantic, The New Yorker, in addition to various leading medical journals. She is also the co-founder and editor-in-chief of the Bellevue Literary Review, a literary journal that publishes works focusing on the human body, illness, and health. In her writings, Dr. Ofri uses vivid narratives to shed light on the highs and lows of being a doctor. In this episode, she joins us to share her path to medicine, how doctors can mitigate the moral injury they experience in their work, and how storytelling can comfort us in times of suffering.

In this episode, you will hear about:

How Dr. Ofri was initially drawn to internal medicine through the patient stories she encountered - 1:54
A discussion of the tension between the business and art of medicine - 6:07
Dr. Ofri’s advice on how clinicians can combat the moral corrosion that broken medical systems can induce - 11:29
How Dr. Ofri’s medical residency during the AIDS epidemic led to her passion for writing - 16:33
Dr. Ofri’s writing process - 23:30
A discussion of the moral philosophy of medicine and why doctors do what they do - 27:09
Dr. Ofri reflections on how her writing has impacted her clinical practice - 31:47
The wisdom that physicians who encounter suffering every day can share with a world experiencing collective grief from the COVID-19 pandemic - 34:38
A discussion of the emotional toll on clinicians of delivering bad news and confronting grief, and an exploration of guilt and shame - 42:25
Dr. Ofri’s advice to clinicians on how to stay connected to meaning in medicine - 48:44

Dr. Danielle Ofri is the author of the following books on being a doctor:
Singular Intimacies: Becoming a Doctor at Bellevue

What Doctors Feel: How Emotions Affect the Practice of Medicine

When We Do Harm: A Doctor Confronts Medical Error

What Patients Say, What Doctors Hear

Medicine in Translation

Intensive Care: A Doctor’s Journey

Incidental Findings

Follow Dr. Ofri on Twitter @DanielleOfri.

This episode included an excerpt from Jacqueline du Pré and Daniel Barenboim’s performance of the Cello Sonata No. 2 in F major, Op. 99 by Johannes Brahms, recorded live in West Berlin in 1968.

Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.

Finding Meaning After Loss | David Kessler Oct 25, 2022

Show notes

In 1969, Elisabeth Kübler-Ross identified the five stages of dying in her book On Death and Dying. Her work has radically transformed the way we think and talk about grief and loss, giving us a shared vocabulary and understanding of a previously murky, yet universal, human experience. Towards the end of her life, Kübler-Ross worked closely with David Kessler, with whom she co-authored several books and formally adapted the stages of dying into the stages of grief. Today, David is the world’s foremost expert on grief and has taught health care workers, counselors, and first responders on facing death and loss. His writings and his website Grief.com have reached millions of people. In this episode, David joins us to share his personal experiences with loss and what his decades of helping those on the edge of death have taught him about finding meaning amid suffering, and happiness after tragedy.

In this episode, you will hear about:

Thanatology — the study of death and dying — and what drew David to this field - 2:10
Kessler’s friendship with Elisabeth Kübler-Ross, the psychiatrist best known for developing the five stages of dying - 6:06
How physicians are often ill-equipped to face death and how hey might better engage with dying patients - 11:22
David’s advice to physicians on finding meaning amid loss and tragedy - 19:05
A review of the five stages of dying/grief - 28:58
On Meaning, the sixth stage of grief that David developed - 33:38
How the pandemic saw a renewed interest in grief management, and how his interview with the Harvard Business Review entitled “The Discomfort You Are Feeling is Grief” went viral - 38:04
How David manages the overwhelming sadness he sometimes experiences in his line of work - 43:54
David’s advice to physicians on comforting grieving patients - 48:31

David Kessler is the author of several books, including The Needs of the Dyingand Finding Meaning: The Sixth Stage of Grief, as well as Life Lessons and On Grief and Grieving with Elisabeth Kübler-Ross, who is herself the noted author of On Death and Dying.

Follow David Kessler on Twitter @IamDavidKessler.

Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.

If you know anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion or send an email to info@thedoctorsart.com.

Reimagining Aging and Later Life | Louise Aronson, MD, MFA Oct 18, 2022

Show notes

Advances in modern medicine mean a greater proportion of people today than ever before will live well into old age. Despite the seemingly encouraging trend, geriatrician Louise Aronson, MD, MFA argues that we have made old age into a disease, a condition to be dreaded, denigrated, neglected, and denied. Dr. Aronson has made it her life's work to help us reimagine the rich possibilities of human longevity and of later life. Her bestselling book, Elderhood, was a finalist for the 2020 Pulitzer Prize for general nonfiction. In this episode, Dr. Aronson explains what makes geriatrics a meaningful career for her, discusses the faults in our society’s conception of elderhood, and shares her humane and hopeful vision for the future of aging.

In this episode, you will hear about:

An overview of what geriatrics entails - 1:47
The need to recognize elderhood as distinct a life stage - 4:42
Dr. Aronson’s reflections on what drew her into caring for older patients - 6:15
The ways goals of care change in elderhood - 8:24
Dr. Aronson’s approach to caring for her patients holistically - 13:27
How physicians can change the “losers and winners” paradigm in healthcare - 17:34
A discussion of structural and cultural ageism and the insidious ways it harms our society - 23:03
How American culture and medicine elevates patient autonomy and how this can sometimes be harmful to older patients - 30:59
A discussion of Dr. Aronson’s writing and what motivated her to become an author - 38:49
How Dr. Aronson experienced and overcame burnout - 42:57
Advice to new clinicians on how to connect with patients and create a more meaningful career path - 46:08

Dr. Aronson is the author of the nonfiction book Elderhood and the short story collection A History of the Present Illness, as well as several essays and articles on ageism and aging and a blog.

Follow Dr. Louise Arondson on Twitter @LouiseAronson, Instagram @LouiseAronsonSF, and LinkedIn.

Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.

Caregiving at the End | Andy Clinnin Oct 11, 2022

Show notes

On June 28, 2022, we released an episode featuring Ellen Dunphy, a 35-year old patient with a terminal diagnosis of gastric cancer who had been under the care of co-host Dr. Tyler Johnson. Ellen passed away a week later. Accompanying every step on her cancer journey was her husband, Andy Clinnin. In this episode, Andy joins us to share his experiences as Ellen’s caregiver and primary source of emotional support. Over the course of our conversation, we explore Andy and Ellen’s relationship from its beginnings all the way to her final days and after. Andy’s reflections on these challenging moments, perhaps paradoxically, has much to teach us about what it looks like to courageously make the most of life, however much of it remains.

In this episode, you will hear about:

A synopsis of how Ellen came to be in Dr. Johnson’s care - 1:03
How Andy and Ellen met, and their relationship leading up to her diagnosis - 6:44
Andy’s perspective on Ellen’s diagnosis - 10:15
What it was like for Andy to learn about Ellen’s diagnosis and how he adjusted to being her caregiver - 16:26
Andy’s reflections on the experience of having Dr. Johnson as Ellen’s oncologist - 21:39
How Andy helped Ellen think through her priorities at the end-of-life - 27:15
How being with his partner until the end has changed the way Andy sees life - 35:46
How California’s End of Life Treatment Act allowed Ellen to control how her life story ended - 43:14
Andy’s advice for other caregivers on how to best take care of themselves so they may best provide care to their loved ones - 51:33

Ellen Dunphy’s one-woman play “Imaginary Endings” about facing her cancer diagnosis can be viewed on YouTube.

Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.

Expanding Healthcare at the Margins | Toyin Ajayi, MD, MPhil Oct 04, 2022

Show notes

What should we do about the fact that a person's health is affected in large part by social factors beyond the confines of the hospital? For a long time, traditional health care institutions have been inadequate in answering this question. Joining us in this episode is Toyin Ajayi, MD, MPhil, co-founder and chief executive officer of Cityblock Health, a tech-driven health care provider for communities with complex health and social needs. With a focus on Medicaid and lower income Medicare beneficiaries, Cityblock Health has been widely recognized as an exemplar of a sustainable model of care delivery for marginalized populations. We are pleased to be joined by Dr. Ajayi to discuss Cityblock Health as well as her clinical work, which centers on patients with chronic complex and end-of-life needs.

In this episode, you will hear about:

Dr. Ajayi’s personal journey from growing up in Kenya to leading Cityblock Health - 1:57
Why Dr. Ajayi chose to focus her career on patients with complex and chronic health needs - 4:11
The social determinants of health and its impact on a patient’s ability to seek appropriate medical care - 5:21
Dr. Ajayi’s story of a chronically-ill patient who appeared ‘difficult’ but in truth was suffering from social inequities that limited his access to health care - 10:35
A discussion of Cityblock Health, the value-based healthcare provider that Dr. Ajayi co-founded to provide care to the Medicaid patient population - 18:07
The stigmas around Medicaid patients and why Dr. Ajayi sees opportunities instead of barriers - 22:02
An in-depth exploration of the services Cityblock Health provides - 27:00
The challenges of the fee-for-service model of American healthcare, and how Cityblock seeks to address them - 32:36
Dr. Ajayi’s advice to medical practitioners on how to build trust and rapport with their patients - 37:50
The future of Cityblock Health and the health equity movement - 40:05

Follow Dr. Toyin Ajayi on Twitter @ToyinAjayiDoc and Cityblock Health @CityblockHealth

Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.

Man of Science, Man of Faith | Francis Collins, MD, PhD Sep 27, 2022

Show notes

The Human Genome Project was a 13 year long international effort to map and sequence all of the genes in the human genome. Leading this ambitious endeavor was Francis Collins, MD, PhD, who was also Director of the National Institutes of Health from 2009 to 2021. His work has had a far-reaching impact on our understanding of diseases and the development of new therapies. In addition to being one of the foremost physician scientists of our time, Dr. Collins is also well known for his bold defense of his Christian faith and for his steadfast promotion of dialogue between science and religion. His book, The Language of God, was an international bestseller. In this episode, Dr. Collins joins us to share his remarkable path in medicine, the origins and evolution of his faith, and his perspectives on the moral mission of medicine.

In this episode, you will hear about:

A close personal look at Dr. Collins’ career, leading to his directorship of the Human Genome Project - 1:56
The mission and implications of the Human Genome Project - 10:02
The cultural upheaval that has occurred during Dr. Collins’ lifetime and the way popular culture tends to pit science and faith against each other - 15:25
The origin of BioLogos and its mission to foster a community that strives to harmonize science and Christian faith - 24:47
A brief discussion of Intelligent Design, a movement that aims to prove the existence of God through science, and how it differs from BioLogos - 28:26
Dr. Collins’ reflections on the reconciliation between his faith in God and the human suffering he has witnessed throughout his career - 32:42
Advice on finding meaning and fulfillment in both life and work, and how community can help combat burnout - 40:38

Dr. Francis Collins is the author of The Language of God and the founder Biologos.org.

Dr. Collins references The Problem of Pain by C.S. Lewisas being particularly enlightening to his personal worldview

Dr. Collins was recently interviewed by Science.org about his time leading the National Institutes of Health

Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.

On Leading Medicare | Meena Seshamani, MD, PhD Sep 20, 2022

Show notes

With around 63 million beneficiaries, Medicare is the single largest provider of health insurance in the United States, serving Americans aged 65 or older, as well as some younger patients who have certain disabilities. Directing this massive program is Meena Seshamani, MD, PhD, an otolaryngologist and former Vice President of Clinical Care Transformation at MedStar Health, a large health care organization primarily operating in the Baltimore-Washington metropolitan area. There, she led initiatives in palliative care, geriatrics, and community health. She has also served as Director of the Office of Health Reform at the US Department of Health and Human Services. In this episode, Dr. Seshamani discusses her path from surgeon to health policy leader, what draws her to caring for older adults, and her vision for a better, more sustainable health care of the future.

In this episode, you will hear about:

Dr. Seshamani’s enthusiasm for medicine at a young age and the diverse career trajectory that followed - 2:08
A discussion of Dr. Seshamani’s past leadership roles, including those at the Office of Health Reform under the Obama administration and at MedStar Health - 6:27
Balancing the need for clinicians to work collaboratively and the inclination of physicians to value autonomy - 10:20
An explanation of Medicare’s role in the US healthcare ecosystem - 14:51
What draws Dr. Seshamani to focus on the care of older adults - 17:39
The crisis of burnout in the medical profession and Dr. Seshamani’s vision for how this can be addressed - 21:00
The fee-for-service mechanism of healthcare reimbursement, accountable care relationships, and the value of preventative care - 25:33
The pay disparity between specialists and primary care physicians, and the role Medicare can play - 30:40
How the growing population of aging Americans impacts the future sustainability of the Medicare program - 38:41
How Medicare is reforming its allocation of resources to promote health equity - 42:02
Dr. Seshamani’s advice to students and clinicians on engaging in meaningful work as they advance in their careers - 48:24

In this episode, we discuss the speech “Cowboys and Pit Crews” by Atul Gawande, published in the New Yorker.

You can follow Dr. Seshamani on Twitter @DrMeenaSesh

Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.

The Brain and All That Makes Us Human | Jay Wellons, MD Sep 13, 2022

Show notes

Pediatric neurosurgeons manage some of the most complex diseases in children, operating on the delicate and precious organ that makes us essentially human. Jay Wellons, MD is Chief of the Division of Pediatric Neurosurgery at Vanderbilt University Medical Center and the author of All That Moves Us, a memoir that offers an intimate and gripping account of the triumphs, terrors, joys, and pathos he encounters on a daily basis. In this episode, Dr. Wellons joins us to discuss his path to neurosurgery by way of English literature and family medicine, his faith as an anchor amidst his challenging work, and reflections on what the human dramas involving the most vulnerable children he has cared for has taught him about resilience, courage, and grace under pressure.

In this episode, you will hear about:

A discussion of the range of procedures pediatric neurosurgeons perform - 1:58
How a fascination with neuroanatomy drew Dr. Wellons into neurosurgery, and how his literary studies have impacted his patient care - 3:58
The origin of Dr. Wellons’ book All That Moves Us and his experiences with a personal health crisis - 8:59
What it is like to operate on one of the most intricate and delicate parts of the human body - 18:00
How Dr. Wellons deals with the weight of unsuccessful procedures, and how he carries on - 27:51
Forming relationships with the families of very young and often very ill patients - 31:12
A discussion of spiritual faith and its place in the life of a surgeon who sees so much tragedy - 35:27
Dr. Wellons’ advice to students, trainees, and clinicians on how to stay connected and hopeful in the face of seemingly insurmountable challenges - 40:52

Dr. Wellons is the author of a book All That Moves Us: A Pediatric Neurosurgeon, His Young Patients, and Their Stories of Grace and Resilience, as well as the article “How the Summer Camp Doctor Earned His Stripes ” for Garden & Gun magazine.

You can follow Dr. Jay Wellons on Twitter @JayWellons5

Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.

Facing the Rarest of Cancers | Katie Coleman Sep 06, 2022

Show notes

On New Year's Eve of 2020, at the age of 29, Katie Coleman was diagnosed with metastatic renal oncocytoma, a type of kidney cancer so rare that she is the only known case in the United States and one of only a handful around the world. The sheer uniqueness of her situation resulted in a prolonged course of prognostic and therapeutic uncertainty. Thanks to the work of oncologists at the National Cancer Institute and MD Anderson Cancer Center, Katie is now in remission. Today, she is a patient advocate who passionately supports other patients through their cancer journeys. In this episode, Katie joins us to share her incredible story, her experiences with grief, uncertainty, and hope, and her lessons learned on finding joy and meaning in life.

In this episode, you will hear about:

Katie’s backstory and the events leading up to her diagnosis - 1:50
The experience of being diagnosed with one of the rarest cancers in the world - 3:58
How Katie’s oncologists discussed this unusual diagnosis with her - 10:42
The experience of receiving treatment with the goal of prolonging life, rather than curing the disease - 13:06
How co-host Dr. Tyler Johnson communicates issues of serious illness with his patients - 15:38
How the uncertainty around a terminal cancer prognosis impacts the way patients approach living their lives - 22:21
How Katie’s changing prognoses have altered her life plans - 28:53
The wisdom on living well one gains from facing a life-limiting illness - 34:32
Lessons on hope in the face of uncertainty - 39:55
The various ways clinicians can open up and connect with their patients on a human level - 44:14

Katie’s story has been profiled by the National Cancer Institute, NBC News, and the Today Show.

You can follow Katie on Twitter @KayDAustin

Katie is also an active content creator and patient advocate on Youtube, TikTok, and Instagram.

Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.

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