The Podcast by KevinMD

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Anti-Asian racism and how bystander intervention training can save a life Jul 17, 2021

Show notes

"Doctors undergo mandatory training sessions in medical school to prepare for unexpected medical emergencies. Health care workers are mandated reporters who have to undergo specific training for the purpose of identifying child and elder abuse or neglect. Bystander intervention should also be on that continuum of responsibility and training.

I urge bystander intervention training to be widely adopted by health care workers, professional workplaces, and the broader community to end everyday harassment and racism, for microaggressions and violence, alike. In medical simulations, health care professionals are always taught to ask two questions first that can be useful to keep in mind in any situation: 1) Is the scene safe, and 2) Should I call for help?"

Michelle Lee is a resident physician and can be reached on Twitter @MichelleLeeMD.

She shares her story and discusses her KevinMD article, "Bystander intervention training can save a life." (https://www.kevinmd.com/blog/2021/05/bystander-intervention-training-can-save-a-life.html)

This episode is sponsored by the Substance Use Disorder Treatment and Recovery Loan Repayment Program. Would you like to help communities recover from the opioid epidemic? If you said yes, and you are a behavioral health professional or paraprofessional, then I have great news for you. Receive up to $250,000 in student loan repayment in exchange for service in a community disproportionately affected by the opioid crisis. Learn more and apply to join STAR LRP, the Substance Use Disorder Treatment and Recovery Loan Repayment Program (https://bhw.hrsa.gov/funding/apply-loan-repayment/star-lrp). Applications close on July 22.

What you need to know about the updated benzodiazepine boxed warning Jul 16, 2021

Show notes

"The FDA recommended an updated boxed warning and standardization of product labels across the drug class. They recommended judicious prescribing and a gradual taper to mitigate withdrawal reactions. While I am optimistic about these changes, the updated warning doesn't tell the whole story. After reviewing the newly updated Xanax Medication Guide, I have some concerns."

Christy Huff is a cardiologist and co-director, Benzodiazepine Information Coalition. She can be reached on Twitter @christyhuffMD.

She shares her story and discusses her KevinMD article, "The updated benzodiazepine boxed warning: What you need to know." (https://www.kevinmd.com/blog/2021/03/the-updated-benzodiazepine-boxed-warning-what-you-need-to-know.html)

A message to medical doctors who are unhappy with their careers Jul 15, 2021

Show notes

"This is a message to any medical doctor who is unhappy with their career. The individual reasons for this dissatisfaction will vary. Whatever the issue, it is important to ask, 'Is the problem correctable?' If yes, then you must act and secure your happiness. If no, you must consider other options. One uncomplicated choice is to stay in medicine and practice somewhere else. However, you may also be unhappy in your career because you don't like medicine. Maybe you are burnt out or no longer feel challenged. Then again, maybe you just don't want to do it anymore or explain (for the 7,000th time) why a patient doesn't need antibiotics. This means your options are now down to pursuing a nonclinical medical career or leaving medicine altogether. Regardless, if you don't like clinical medicine, then why are you still doing it? Perhaps reality is teaching you a lesson: that once you're in medicine, it's hard to leave it. This begs the question: Why is medicine so hard to quit?"

Elijah Sadaphal is an emergency physician.

He shares his story and discusses his KevinMD article, "Why quitting medicine is hard." (https://www.kevinmd.com/blog/2021/04/why-quitting-medicine-is-hard.html)

Is health care a right or privilege? The economic consequences of that answer. Jul 14, 2021

Show notes

"American medicine is facing an identity crisis. The COVID-19 pandemic brought renewed attention to socioeconomic health disparities and turned up the heat on the question of whether health care is a right or a privilege. The financial strain on hospitals resulting from the temporary postponement of scheduled surgeries exposed a vulnerability caused by an inherently flawed payment system.

The answer to the right versus privilege question has much more significant implications than the resolution of a philosophical debate. It determines which economic model — that of a public good, a private good, or a common good — makes the most sense for the delivery of medical services. For health care to be what we want it to be, broadly accessible, with no socioeconomic disparities, and long-term affordability, it must eventually be recognized as a common good, with all of the economic implications that come with such a recognition."

Tom Robertson is a health care economist.

He shares his story and discusses his KevinMD article, "Health care as an uncommon good." (https://www.kevinmd.com/blog/2021/04/health-care-as-an-uncommon-good.html)

What clinicians need to know about clinical trials Jul 13, 2021

Show notes

"Before COVID-19, clinical research was a little-known part of health care. Despite this process being responsible for determining the safety and efficacy of all the drugs, medical devices, vaccines, and other medical therapies available, less than 5 percent of the U.S. population actually participates in clinical research.

One reason why clinical research has little awareness and even lower participation is that, unlike other major industries, the pharmaceutical industry and many regulatory bodies never fully embraced technology to reduce the burdens of participation. We use our mobile devices to do our banking and place retail orders. Why can't we use similar technology in clinical research?"

Kent Thoelke is a science executive.

He shares his story and discusses his KevinMD article, "Accelerated by COVID-19, technology carves new pathways for everyone to access health care." (https://www.kevinmd.com/blog/2021/03/accelerated-by-covid-19-technology-carves-new-pathways-for-everyone-to-access-health-care.html)

Medical facilities: Please keep your immune-deficient patients safe Jul 12, 2021

Show notes

"I have a form of genetic primary immunodeficiency and several heart issues, among other things. I know that I need to be far more vigilant than someone with a fully armed and operational immune system, so I try to take as much responsibility for that as I can.

First tactic: Not going out at all. I've followed doctors' orders on this one and have only left my home for medical care since March 2020. Most medical appointments have been conducted online for the past year. More than a few conversations with my doctors have included some variation of the phrase "we'll schedule this when it's safer." But some, such as my infusions, imaging, and bloodwork, must be done in person.

Second: I try to get the first appointment in the morning, no matter how early that might be. I've been scheduled for MRIs at 6:30 in the morning. Being there early usually means that there are fewer people in the facility.

Third: I ask if there's an isolated place where I can wait. I'm not trying to cut the line. That needs to be understood. I'll wait as long as you need me to. 'Patient' is both a noun and an adjective. I just need to do that somewhere that is not a crowded waiting room. I have an immune deficiency, I pick up infections a bit more easily than some of your other patients, and we're in a pandemic."

Denise Reich is a patient advocate.

She shares her story and discusses her KevinMD article, "Medical facilities: Please keep your immune-deficient patients safe." (https://www.kevinmd.com/blog/2021/04/medical-facilities-please-keep-your-immune-deficient-patients-safe.html)

How to raise tenacious and resilient children Jul 11, 2021

Show notes

"For thousands of generations, parents, relatives, and the extended community raised and prepared children to become successful adults, to acquire knowledge, and strengthen the abilities needed to meet the challenges of their time. How did they do it? Until relatively recent times in human history there were no schools or organized institutions, nor were there self-help or parenting books. We believe the foundation of this process was accomplished by drawing upon seven important instincts that evolved over tens if not hundreds of thousands of years in ours and other hominid species.

In some species instincts are fixed patterns of behavior leading to a certain outcome such as a bird building a nest for the first time or a salmon returning upriver to its birthplace to spawn. We believe that in our species instincts represent an intuitive way of thinking and/or acting that increase the chances of survival and success. In viewing instincts in this way we appreciate that knowing what to do and doing what you know are not synonymous and are very much dependent on experience. These instincts are more important than ever in preparing today's children for tomorrow's successes.

Tenacity provides the power to build self-discipline and resilience. For these instincts to develop and flourish they require the nurturing and support of caring, knowledgeable adults. In short, it is our job to help children harness the power of their instincts."

Robert B. Brooks is a psychologist and co-author of Tenacity in Children: Nurturing the Seven Instincts for Lifetime Success.

He shares his story and discusses his KevinMD article, "Tenacity in children and the 7 instincts." (https://www.kevinmd.com/blog/2021/05/tenacity-in-children-and-the-7-instincts.html)

Huntington's disease and a patient's perspective on genetic testing Jul 10, 2021

Show notes

"When I was diagnosed as gene-positive for HD, just over ten years ago, there wasn't anything promising on the horizon in terms of a cure. It has only been since new clinical trials were announced in the past few years that I have allowed myself to feel a tiny bit of hope, that maybe there will be a treatment on time for me. How is it possible to be hopeful for a cure while still remaining realistic and preparing for my future with the disease?

Even though I do not have any disease symptoms yet, genetic testing has completely changed my life. Living with the knowledge that my future includes HD is a huge challenge. It has only been with time that I have learned how to balance many opposing views.

With the plethora of genetic testing available these days (even the mail-in kits), it is so important for people to consider the impacts such tests might have on their lives. Quite often, there are unforeseen consequences that one can struggle to come to terms with for years to come."

Erin Paterson is a writer.

She shares her story and discusses her KevinMD article, "A patient's perspective on genetic testing." (https://www.kevinmd.com/blog/2021/05/a-patients-perspective-on-genetic-testing.html)

How deep mindset work helped me find the courage to make my career transition Jul 09, 2021

Show notes

"I've been semi-retired in clinical medicine for almost four years now. Initially, I found myself coaching burned out physicians: Helping them recover, finding careers they love, and even starting their own businesses outside the box. However, as I listened to my inner voice, I was led back to my healing roots, and that opened up a career opportunity I would have never imagined to have.

Let me back up a bit. I'm a regular old family doc by training. Well, that's the way things began, anyway. I remember choosing the specialty the summer after the first year. I worked with a rural family doc who was a full spectrum doc. For those of you who are family medicine like me, you know what this means. He did everything! For me, that was fascinating. However, as you know, what we see as med students is often a sliver of the real world as it pertains to practice. As I progressed, I discovered integrative and functional medicine, and that is where my real love settled as a family physician. However, after seven years of having a private practice (even one where I set my own hours and ran my own ship) became less than fulfilling after a while. I felt like I had outgrown that purpose."

Maiysha Clairborne is an integrative family physician and is the co-author of Conscious Anti-Racism: Tools for Self-Discovery, Accountability and Meaningful Change.

She shares her story and discusses her KevinMD article, "How deep mindset work helped me find the courage to make my career transition." (https://www.kevinmd.com/blog/2021/04/how-deep-mindset-work-helped-me-find-the-courage-to-make-my-career-transition.html)

A plea for help from the front lines of the COVID-19 pandemic Jul 08, 2021

Show notes

"This plea for help is on behalf of every hospital worker who has been on the front lines of the COVID-19 pandemic — from the environmental services staff and medical assistants who are often not recognized, to the social workers and chaplains who are surrounded by distress, to the physicians and nurses who continue to stand and receive the sick — we need more time off in the coming year. Some hospital workers will need to continue to be paid; others will just need permission and people to back-fill their roles until they return. If you are a business leader who makes logistical, technological, charitable, and financial decisions every day: I am asking for your time, financial wherewithal, personal connections, commitment, and expertise in strategic planning in order to give every front line COVID-19 hospital worker more time off in the next year than they can and will be allotted by their health systems. Consider using your unique talents to radically change how our country's health care system moves on from this crisis.

Please help us. Help my friends and my colleagues. Help us do the thing we diligently, faithfully, and without hesitation tried to do for over half a million Americans this year. Help us survive."

Kristin Adams Forner is an anesthesiologist and palliative medicine physician who blogs at Mending the Fractured Story.

She shares her story and discusses her KevinMD article, "A plea for help from the front lines of the COVID-19 pandemic." (https://www.kevinmd.com/blog/2021/05/a-plea-for-help-from-the-front-lines-of-the-covid-19-pandemic.html)

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