The Podcast by KevinMD - podcast cover

The Podcast by KevinMD

Kevin Pho, MDwww.kevinmdpodcast.com
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. 15 minutes a day. 7 days a week. Welcome to The Podcast by KevinMD.
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Episodes

Inside the race to conquer the COVID-19 pandemic

"That year, 2020, Uğur told the crowd, would be the year BioNTech proved the doubters wrong. There was no time to lose. Soon after he’d finished his talk, Uğur hopped on a plane to Seattle, where he met with a team at the Bill & Melinda Gates Foundation, which had recently signed a $100 million agreement with BioNTech to develop a slew of new drugs. Hours later, he moved on to Boston, to stop by a small cancer immunotherapy company that BioNTech was about to purchase in a $67 million deal. T...

Mar 30, 202225 min

Support desperate health care workers now, before your life counts on them

"America’s health care workers are on the brink of collapse. If we want them to hold on and be there for us when we are too sick to walk, stand or breathe, we must act now. Cast aside political opinions. Follow CDC guidelines. Wear masks when you are in a group of people. Remain properly vaccinated. Maintain social distances. And please extend extra consideration to health care workers. Is that too much to ask to do for someone trying to save your life or the life of your loved one?" Julie Colli...

Mar 29, 202215 min

How to close gaps in social determinants of health

"As a doctor, it is pretty humbling to reflect on the fairly minimal impact our health care system has on individuals’ overall health. One study I find particularly intriguing shows that socioeconomic factors (e.g., education and income), and physical environment (e.g., security and safety at home and reliable access to transportation), affect a person’s health outcomes just as much as their behaviors (e.g., mental health, diet, and physical activity) and the clinical care they receive. The data...

Mar 28, 202219 min

A physician's new rules of time management

"Pediatric cardiac anesthesiologist, woman, mother, wife, friend, mentor. I can’t remember a time when I wasn’t trying to “work smarter, not harder” to get it all done and feel good about myself, only to begin climbing the mountain with a fresh list the next day. My goals were simple: peace of mind and a sense that I was in control of my life and doing a good job for all the people who needed me. Just a little more effort, better organization, and I would be there. As a physician coach, I find t...

Mar 27, 202216 min

Health care and the Latinx experience

"Knowing that an important number of Latinx are not yet fully vaccinated and understanding the health care gaps and social disparities that affect this group, it is reasonable to assume that the Latinx community will be disproportionately affected by the pain and sorrow of the new wave of the COVID-19 pandemic. More efforts and resources need to be designated to continue educating and empowering the Latinx community to comply with vaccination and other well-proven preventive measures that will p...

Mar 26, 202227 min

Patients need palliative care to manage the pain of sickle cell disease

"Sickle cell disease (SCD) affects about 100,000 Americans as an inherited genetic disorder with intermittent exacerbations requiring hospitalization. SCD is also a painful and complicated disease with no single physician specialist that can provide pain relief. While SCD pain is similar in severity to cancer pain, patients struggle to find adequate pain relief because they are often labeled as 'doesn’t appear in pain' as the imaging scans may not show actual pathology. Some palliative colleague...

Mar 25, 202217 min

We're failing people with opioid use disorder

"We know regulators can move quickly to confront a health crisis because we have seen it in action. During COVID, the nation eased regulatory burdens at all levels of government to help health systems and doctors leverage technology and change the way they deliver care and to drive vaccine innovation. During the AIDS epidemic, we saw how effectively we could mobilize across the public and private sector to really change the course of the fight. Now is the time to harness the same energy for the ...

Mar 24, 202223 min

A body part that fills me with a roller coaster of emotion

"Their absence makes me feel sad, I look around at my peers, envious and curious, Obsessing over when they will show up. When they do, they never seem to live up to expectations, Too small, too uneven, but what’s sure is it’s a sign I’m no longer a child. It adds to my wardrobe in a hushed way, I don’t know whether to be proud or embarrassed that they’re finally here. I look at magazines; should I display them more? Or will my whole essence be reduced to how big they appear under my shirt. I’m c...

Mar 23, 202216 min

To my patient who is going to lose her hair from chemotherapy

"I understand that the biggest fear you have about going through chemotherapy is losing your hair. I just want to tell you. You will be fine. Trust me. I know it’s barbaric. Why don’t we have medicines to treat cancer that will not make you lose your hair in this day and age? Strange, right? But science has its limits. Work is being done on finding such drugs, but we are not there yet. If you Google “forced standing,” a black and white picture of a girl from a couple of hundred years ago pops up...

Mar 22, 202221 min

Changing how we think about "difficult" patients

"Our patients go through some very predictable fears and responses to illness and injury. In turn, medical students and residents also think and respond with some thought distortions and misunderstandings about their patients and themselves. Armed with awareness and familiarity with the typical patterns, we learn more about what to expect. We anticipate when we will get push-back and we are better prepared to act calmly and confidently. Additionally, we can get curious and ask better questions d...

Mar 21, 202215 min

Family medicine and the fight for the soul of health care

"Overall, the health system in the United States is still not tilting its axes in favor of either primary care or family doctor. What is worse, family doctors as a collective are more balkanized and less cohesive than ever. There is a sense among those in the field that something is not right about the specialty. Some feel there is a bait-and-switch aspect to becoming a family doctor. It ends up being something much different than what they were initially told. Others feel it is an impossible jo...

Mar 20, 202227 min

Kids are not OK: Health care is failing them

"Our children are not OK. Our pediatricians are not OK. Please, let us not further ignore and jeopardize the future health of our society. Pediatrics needs a transformational change to direct primary care and other models that transition from transactional care to relational care. Encourage your employer to embrace direct primary care for children. The future health of our children is at stake." Andrew Hertz and Keili Mistovich are pediatricians. They share their stories and discuss the KevinMD ...

Mar 19, 202220 min

Managing expectations during COVID-19

"I had sent an email to some key people in my organization about managing patients’ expectations and how that needed to be addressed differently on an organizational level. The truth of the matter is that I am powerless to change the way the system handles a lot of things. The more personally relevant issue is managing my expectations, both how I relate to the needs/expectations of those in front of me and my own personal needs and expectations of myself in delivering that care. Since we truly o...

Mar 18, 202222 min

How a code profoundly affected this physician

"There is a small amount of literature about secondary trauma. This means that the people who respond to trauma (firefighters, police, doctors, EMTs, etc.) experience PTSD from experiences they were not the primary victims of. I haven’t read the literature, and I don’t know what qualifies. I do know that this is the single worst experience with humanity that I have ever had, and the images from that night are as clear in my head today as they were when I first saw them. I know I will never forge...

Mar 17, 202221 min

Unrequited: love in the time of COVID-19

"If you knew we are like the 'Two Fridas,' that our hearts are connected, would you change your mind? Would you stop as you are about to cut the artery feeding your heart and mine? If you knew that when you cry because of your loneliness, because of your longing for your family, that I cry, too, (though behind your back, after I have comforted you) would you change your mind? If you knew that your isolation, with the tubes and gadgets coming from you or going into you, extend to me would you cha...

Mar 16, 202216 min

Why do physicians stay in toxic work environments?

"For the most highly educated and specialized professional on the health care totem pole, physicians put up with a ridiculous amount of nonsense in the workplace. You are pressured to see high volumes of patients in a rapid-fire fashion (15 minutes per visit) even when it interferes with the quality of care. You are expected to complete mundane and excessive administrative tasks and generally are not directly compensated for this time. You are given very little flexibility from your employers wh...

Mar 15, 202218 min

Are hospitals evil? A physician contract lawyer explains.

"Unfortunately, when negotiating with hospitals I am frequently forced to deal with individuals who need to 'explain' the importance of maintaining flexibility in their workforce (a wonderful business school phrase that appropriately dehumanizes the people who are accomplishing the purported mission of the hospital to treat the sick and injured). The hospital personnel frequently tell me that limiting patient contact hours to 'only' 32 or 36 hours per week is considered part-time. Many contend t...

Mar 14, 202221 min

COVID and obstetrics: a physician shares her story

"I thought of her with each miscarriage I saw in COVID+ mothers, and during each delivery of premature rupture of membranes due to infection. I thought of her every time I gave steroids, increased the oxygen flow for someone struggling to breathe, or held the hand of someone before their emergency delivery. I saw her face when I was frantically calling a pulmonologist to help me manage oxygen on a deteriorating patient on the unit. She stayed with me through each obstetric emergency. She probabl...

Mar 13, 202217 min

Requesting disability accommodations in medical school

"I failed my Step 1 medical school board exam by 1 point. This was very hard for me to process, and I consistently wondered if I would have passed if I had just waited an additional week. This new challenge led me to reach out to a new resource: the disability office. Never before had I considered my medical diagnosis of endometriosis and anxiety as a 'disability.' I had obviously done well enough to graduate college and get into medical school. Although, I never seemed to be able to achieve top...

Mar 12, 202218 min

What doctors and soldiers have in common

"What makes soldiers and doctors good at their jobs are also the very things that make it hard to leave work at work. My former husband was, and is, very good at his job, especially when it comes to compassion and care for his patients. At work, he gives his all. He sits with grieving families, helping them understand what’s happening with their loved ones and even crying with them as they die. To ask one more thing of him when he’d given every ounce of his soul all day seemed selfish and childi...

Mar 11, 202217 min

Cancer treatment and tumor-informed residual disease testing

"Life can feel full of uncertainty when battling cancer, with few guarantees. 'Is there still cancer in my body?' and 'Will it come back?' are common questions that have long been difficult to answer confidently until recently. Advances in next-generation sequencing — and a growing understanding of how our bodies respond to illness and treatment — have brought us closer than ever to predicting our individual futures, at least when it comes to cancer. In recent years, cancer researchers have embr...

Mar 10, 202221 min

Coming back from the brink of burnout

"I understand what it feels like to be in the depths of depression and hopelessness. I have had a lifelong battle with stuttering, obsessive-compulsive tendencies, depression, and suicide. I continually fight these battles and have learned to heal and recover through family, friends, and ultra-running. Since attempting to take my life on September 12, 2009, I have developed wellness tactics to help me journey through life to achieve optimum performance and to have a better work-life balance to l...

Mar 09, 202217 min

Eating disorders thrive in secrecy, so let’s talk about it

"I was diagnosed over 20 years ago, and looking back, I feel privileged that I did meet the stereotype for anorexia and be forced into treatment. However, along the way, I have gained insight that people of all bodies share my struggles. And the use of weight/BMI to determine whether someone is struggling and should have access to treatment results in delayed diagnoses, limitations in access to care, prolonged suffering, invalidation, and shame." Jillian Rigert is an oral medicine specialist and...

Mar 08, 202219 min

Tax planning tips for physicians

Often, physicians only give minimal attention to their financial futures, but potential federal changes could make tax planning even more important. The proposed infrastructure bill would increase taxes, affecting those with an annual income higher than $400,000, which is not uncommon for physicians. These changes make it vital for physicians to sit down with their financial advisors and CPAs now to minimize their own tax burden. Syed Nishat is a partner, Wall Street Alliance Group . This articl...

Mar 07, 202223 min

Why health care delivery is an exceptionally different industry

"The business of health care delivery differs markedly from other consumer and service industries in many ways. First and foremost, the economics differ. Specifically, the payers of medical care are often different from the customers, the government and third-party insurers are the primary payers, demand is inelastic, quality metrics are typically unavailable, and the industry consists largely of nonprofits that avoid taxes. And that’s just the start of the economic differences. These profound e...

Mar 06, 202221 min

Why we should celebrate the Great Resignation

"I see lamenting the Great Resignation. I celebrate it. It’s not so much about what people are leaving – but where are they going? What have they empowered themselves to become? The thought, 'There has to be something more,' has been pondered and fleshed out. We are stretching our wings, becoming educators, influencers, and entrepreneurs; creating movements and businesses; becoming the parents we always wanted to be. And I dare say that the writing is on the wall for organized medicine. We can l...

Mar 05, 202218 min

Digital apps and sustaining mental health

"Digital mental health apps have increased access to mental health care for people around the world. You can find services that fit your specific needs, often on a 24/7/365 basis, so if you need support in the middle of the night, it’s there. Digital apps can include resource libraries, artificial intelligence-driven chatbots that tailor the treatment they provide to your responses, and digital coaching from credentialed mental health professionals at any hour of the day or night from the privac...

Mar 04, 202216 min

A nuanced look at the Tuskegee syphilis study

"The Tuskegee Syphilis Study is widely acknowledged as a violation of ethics today, but the social conditions of the time allowed the grave injustices to happen in plain sight. In the 1930s, social Darwinism emerged as justification for racist practices. The perceived inevitability of African Americans’ natural “extinction” was used to justify many unethical practices within the study, including the decision to withhold known treatment from participants. The USPHS earned the approval of the Unit...

Mar 03, 202214 min

High deductible health insurance is bankrupting Americans

"Regulators should push health savings accounts (HSA) and businesses should offer them. While HSAs are growing, they are still only available to 30 percent of workers — more likely for larger companies than smaller ones. This, of course, is a way to help pay for extra medical costs almost always incurred under a high deductible health plan. Perhaps a better option is to require all health insurance plans come with free primary care office visits. That can encourage patients to seek care earlier ...

Mar 02, 202224 min

Stop health care’s great resignation

"As the next COVID-19 variant hits our country, I feel a renewed sense of urgency. We need to move faster to invest in an infrastructure that protects our nation’s health care workforce before we lose more nurses, doctors, and other care team members. Every day they risk their own safety for ours and our loved ones. It is time to reimagine safety and take action to make lasting change. That means investing in new policies, processes, resources, and solutions that ease the burden of team members ...

Mar 01, 202218 min
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