The Podcast by KevinMD

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Ignoring jaw pain comes at too high a price Nov 24, 2021

Show notes

"The COVID-19 pandemic challenged health care systems and patients' personal economic capacity, leading to approximately six million adults losing their dental insurance. Additionally, the World Health Organization and the American Dental Association recommended dentists to limit their practices to emergency and urgent dental care.

In the list of these diagnoses requiring emergency care, jaw pain (temporomandibular disorder (TMD) that includes several clinical problems involving the temporomandibular joint and group of muscles that help with chewing and other associated structures), was not included.

This is not acceptable."

Soumya Padala is a craniofacial orthodontist.

She shares her story and discusses her KevinMD article, "Delta surge warning: Ignoring jaw pain comes at too high a price." (https://www.kevinmd.com/blog/2021/08/delta-surge-warning-ignoring-jaw-pain-comes-at-too-high-a-price.html)

A doctor turned Hollywood actor on physicians who struggle with suicidal ideation Nov 23, 2021

Show notes

"Thanks for gathering today in this anonymous detached space. Since it's unlikely that we'll ever publicly convene in a circle on metal folding chairs, I'm reaching out through this letter. You can peruse this in private and perhaps see a piece of yourself here.

As a non-practicing physician who speaks openly about my decades of suicidal ideations, I know there's a thirst for connection on this topic. Colleagues pull me aside to whisper that they, too, have felt "that way." See this letter as my way of firing a flare into the dark cavernous topic of physician suicide in order to faintly shed light and, above all, signal that you are not alone."

Eliza Shin is an actor and former radiologist.

She shares her story and discusses her KevinMD article, "To my fellow physicians who are struggling with suicidal ideation." (https://www.kevinmd.com/blog/2021/09/to-my-fellow-physicians-who-are-struggling-with-suicidal-ideation.html)

Should you stay or leave medicine? Nov 22, 2021

Show notes

"I left my primary care practice earlier this year to focus on life coaching. Why did I leave? Because I wanted to do more and make a bigger impact. I remember how eager I was to complete medical training as I approached the light at the end of the tunnel. I thought I could finally relax and enjoy life as an attending after all the delayed gratification from becoming a doctor. All I ever wanted was to help people feel better and live a life of ease myself.

However, I was disappointed and frustrated by our broken health care system and how care coordination could impact patient outcomes negatively. Working as a PCP in the pandemic didn't make it any easier. I saw so many patients suffer and felt helpless that I couldn't do more. I wanted to offer healing on a deeper level by examining the root cause in order to change things for good and care for the person as a whole. But I was feeling stuck. I was afraid to leave my stable job. Medicine was all I knew. What else could I do?"

Cindy Tsai is an internal medicine physician and can be reached on Twitter @cindytsaimd.

She shares her story and discusses her KevinMD article, "Should you stay or leave medicine?" (https://www.kevinmd.com/blog/2021/09/should-you-stay-or-leave-medicine.html)

Why economics is the best pre-med major Nov 21, 2021

Show notes

"Economics taught me that I didn't have to culture cells in a dish to do interesting and life-changing work. I built a habit of being inquisitive and intellectually curious about the world around me because I learned in undergrad that our human, flawed world contains elegant experiments, puzzling oddities, and fertile ground for inquiry. That profound change in mindset is the most important lesson I could have learned from my undergraduate major, and I'll always be a grateful ex-economist."

Dan Donoho is a pediatric neurosurgeon and can be reached on Twitter @ddonoho.

He shares his story and discusses the KevinMD article, "An ode to econ: the best major for a would-be MD." (https://www.kevinmd.com/blog/2021/03/an-ode-to-econ-the-best-major-for-a-would-be-md.html)

Medical gaslighting due to weight stigma and bias: a viral TikTok study Nov 20, 2021

Show notes

"Disrupting weight stigma and bias in health care starts with calling it out. The power of stories and shared experiences highlights the collective voice. I'm coaching TikTok Followers to own their health power and start speaking up during clinic visits to make sure they get their questions answered. Future directions and next steps are to disrupt weight stigma and bias by speaking up, calling it out, and calling on doctors, nurses, and all of health care to do better. Back to TikTok!"

Karla Lester is a pediatrician.

She shares her story and discusses the KevinMD article, "Medical gaslighting due to weight stigma and bias is harmful: a viral TikTok study." (https://www.kevinmd.com/blog/2021/06/medical-gaslighting-due-to-weight-stigma-and-bias-is-harmful-a-viral-tiktok-study.html)

How to preserve empathy in medicine Nov 19, 2021

Show notes

"No matter how extensive or well-developed your capacity for empathy may be, you cannot feel empathy for everyone all the time. Whether we're talking about doctors who have never been patients, or clinicians who have never faced discrimination, we know that people's ideas can change, when properly educated and supported.

In a randomized, controlled trial, one of the most exciting findings within my own research into the malleability of empathy looked at physicians of six different medical and surgical specialties. Using the E.M.P.A.T.H.Y.(R) acronym and other techniques, physicians learned how to accurately "read" their patients' states of emotion and respond more empathically. Post-intervention, the training group received significantly higher patient satisfaction scores than the control group.

The good news about our research is that it showed that we can be hopeful about changing the culture of medicine. We now have evidence-based tools to accomplish this. There is hope for a brighter future in health care and all relationships when empathic principles are learned and practiced at the local, regional, and societal levels."

Helen Riess is a psychiatrist and author of The Empathy Effect: Seven Neuroscience-Based Keys for Transforming the Way We Live, Love, Work, and Connect Across Differences.

She shares her story and discusses her KevinMD article, "How to preserve empathy in medicine." (https://www.kevinmd.com/blog/2021/10/how-to-preserve-empathy-in-medicine.html)

How can technology innovation save primary care? Nov 18, 2021

Show notes

"I believe there is a formula that can reduce the risk of burnout and save primary care, rooted in one key objective: Remove work from primary care doctors and nursing staff's plates immediately.

Easier said than done. And that's where technology and clinical navigation must be leveraged — to assist, facilitate, streamline, and support. Where EMR messages, not requiring doctor expertise, are responded to by clinical navigators harnessing technology to guide patients to the right outcome. Where these teams of clinical navigators are integrated into the clinical pyramid and delegated all tasks that do not require physician attention.

Integrated technology + navigation = relief."

Ronald Dixon is an internal medicine physician.

He shares his story and discusses his KevinMD article, "As doctor burnout climbs, can we save primary care?" (https://www.kevinmd.com/blog/2021/09/as-doctor-burnout-climbs-can-we-save-primary-care.html)

A new approach to orthopedic post-operative pain Nov 17, 2021

Show notes

"My brain is still struggling to comprehend the battle for the status quo a physician faces each day; one who must, by default, be cognizant of the lurking dangers of an opioid prescription, while also helping the patient on their swiftest way to recovery, led by the very same guidelines. But what happens when the patient slips on the road to recovery and out from underneath the physician's caring cloak towards substance abuse? Whether the patient's role changes at that very threshold is a different story. While it certainly is a part of this somewhat self-perpetuated epidemic, the struggle to keep a status quo has ancient roots and every physician has — if not knowingly so — sworn to abide by them when uttering the anecdotal resemblance of the Hippocratic Oath: 'I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism.'

But what if we dare to question the application of this ancient commitment on this particular matter? Should we have already done so, or can we afford to wait until the death toll reaches an unspeakable capita? Should opioids for postoperative pain even be permitted to dance on this slippery spectrum between adequate analgesia and addiction?

I wish the answer were that simple."

Jesse Seilern und Aspang and Mara Schenker are orthopedic surgeons.

They share their stories and discuss the KevinMD article, "America's prescription epidemic: Breaking an ancient promise." (https://www.kevinmd.com/blog/2021/07/americas-prescription-epidemic-breaking-an-ancient-promise.html)

Black female physicians and the bias against them Nov 16, 2021

Show notes

"I am a woman of history who stands up and tells the truth, irrespective of what other people say. I remember the words of the late Representative John Lewis, 'Do not get lost in a sea of despair. Be hopeful, be optimistic. Our struggle is not the struggle of a day, a week, a month, or a year. It is the struggle of a lifetime. Never, ever be afraid to make some noise and get in good trouble, necessary trouble.'

Black female physicians are not OK, but it is our collective duty to do something about it. It is our collective duty to go against the tide. It is time to take a stand and institute change that we need to initiate ourselves."

Tomi Mitchell is a family physician.

She shares her story and discusses her KevinMD article, "The unique agony of being a Black female doctor." (https://www.kevinmd.com/blog/2021/11/the-unique-agony-of-being-a-black-female-doctor.html)

Physicians have gone from being heroes to villains Nov 15, 2021

Show notes

"I am exhausted and sad and disappointed and discouraged.

I am losing faith in humanity. Where is the 'love your neighbor as yourself'? Where is the willingness to help each other? Where is the solidarity of those first days? Physicians have gone from being heroes to being villains. We have dedicated decades of our lives to learning how to care for you, but now our knowledge and expertise are being thrown back in our faces as not good enough and not as believable as your cousin's friend who saw something on social media.

It is hard to keep going. But we do. We keep going because we have dedicated our lives and careers to our patients. We follow our Hippocratic Oath, and we do the best we can for every patient no matter who they are, what they believe, or what choices they make. But many of us are barely clinging to our passion to serve.

Each day, I get out of bed, swallow my frustration and disappointment, and pray for the fortitude and resilience to face another workday, because I know that if I can make a difference, however small, it means something. And I know that my patients and their families bring me joy! But each day, my heart breaks a little more. It shouldn't have to be this way, but this is the world we live in right now.

I am exhausted."

Lisa Cronk is a pediatrician.

She shares her story and discusses her KevinMD article, "Physicians have gone from being heroes to villains." (https://www.kevinmd.com/blog/2021/09/physicians-have-gone-from-being-heroes-to-villains.html)

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