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Flourishing in Medicine: From Surviving to Thriving
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Flourishing in Medicine: From Surviving to Thriving

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Flourishing in Medicine: From Surviving to Thriving explores ways that health professionals- physicians, nurses and nurse practitioners, physician assistants, mental health providers, therapists, and others- can truly flourish in the complex and challenging world of health care.

The ability for physicians and other health professionals to practice high quality care and attain professional satisfaction and meaning in their work has been under continued challenge. These critically important members of our communities experience ongoing threats to their well-being and hence to the quality of care they deliver. The recent pandemic has only exacerbated changes that have occurred over the preceding years in the practice of medicine, exposing even further the fragility of our imperfect health care systems. This podcast explores the many ways that physicians can and do flourish, including a deeper exploration of what it means to work at the frontier of human frailty and suffering, while applying biomedical science and compassionate care to address the complexities of the human condition. It is the hope that this podcast can help support these health professionals and ultimately translate into improved care of themselves, their patients, and our communities.

Your host, Mick Krasner M.D., F.A.C.P, is a Professor Emeritus of Medicine at the University of Rochester School of Medicine and Dentistry. Dr. Krasner has been teaching Mindfulness-Based programs to patients, medical students, and health professionals for more than 23 years, involving over 4000 participants and more than 2000 health professionals, and continues to facilitate Mindfulness-Based Stress Reduction for employees and dependents of the University of Rochester. He was the project director of Mindful Communication: Bringing Intention, Attention, and Reflection to Clinical Practice, sponsored by the New York Chapter of the American College of Physicians, funded by the Physicians Foundation for Health Systems Excellence, with results reported in JAMA in September 2009. This program led to the establishment of Mindful Practice in Medicine Programs at the University of Rochester which he co-directs, offering continuing educational programs to health professionals and educators locally and internationally for the past 13 years, and includes a multi-year teacher training program for future facilitators of Mindful Practice. He has been engaged in a variety of research projects including the investigations of the effects of mindfulness practices on the immune system in the elderly, on chronic psoriasis, and on caregivers of Alzheimer’s patients. His most recent project, The Healer’s Journey, is a documentary film in production that explores the professional identity formation of our newest health professionals, the medical students.

Dr. Krasner graduated from the University of California, Berkeley in 1983 and received the Doctor of Medicine degree from the University of California, San Diego School of Medicine in 1987, completing residency in both Internal Medicine and Pediatrics at the University of Rochester School of Medicine and Dentistry where he continued as a full-time faculty member, engaging in medical student and residency education, post-graduate medical education, and research. He has shared his work in peer-reviewed publications, scientific assemblies, workshops, visiting professorships, and intensives throughout the world, focusing primarily on the roots of Hippocratic medicine through the cultivation of attention, awareness, and reflection on the health professional- healing relationship. Having recently left clinical practice, he now devotes all his time to the pursuit of helping physicians and other health professionals flourish.

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Today, we are joined by Dr. Catherine Pound, MSc, MPH, MD, FRCPC, Director of Physician Support and Wellness at the Canadian Medical Protective Association.Dr. Pound joined CMPA as a Physician Advisor in Safe Medical Care Learning in 2021 and became the Director of Physician Support and Wellness in 2023. She is also a pediatrician and researcher, and was an Associate Professor in the Department of Pediatrics at the University of Ottawa until 2024. Dr. Pound holds master's degrees in epidemiology as well as in public health, with a focus on health policy. Dr. Pound has obtained multiple research grants, and has been published extensively in the areas of medical education, health promotion, and clinical medicine. She has also implemented and led multiple physician wellness programs, both in clinical and administrative settings.In the conversation, Dr. Pound shares her personal journey from experiencing burnout early in her career to recognizing the widespread silent suffering among physicians and dedicating her work to systemic change that helps healthcare professionals thrive.We also cover:How her values of connection, compassion, and curiosity led her from pediatrics through public health to physician wellness leadershipCMPA's innovative programs including peer support, longitudinal coaching, and the national Physician Wellbeing Index assessmentThe critical connection between healthcare professional wellbeing and patient safety as a public health issueDr. Pound concludes by envisioning a healthcare system where professionals give themselves permission to acknowledge when they need help, creating environments of trust, collaboration, and compassionate care.Links:Dr. Catherine Pound LinkedIn: https://www.linkedin.com/in/catherine-pound-b22a921/ CMPA: https://www.cmpa-acpm.ca/en/home CMPA Practically Speaking podcast: https://www.cmpa-acpm.ca/en/education-events/cmpa-podcasts EmPro Website: https://www.myempro.com/ EmPro Peer Support Program: https://www.myempro.com/peer-support/ Physician Support Line: +1(888) 409-0141 Physician Support Line Website: https://www.physiciansupportline.com/ Dr. Krasner's Website: https://mickkrasnermd.com/ Mindful Practice in Medicine Website: https://mindfulpracticeinmedicine.com/Chapters:(00:00) Introduction(03:00) Why Medicine: Connection and Compassion(08:00) Personal Journey to Physician Wellness Work(11:00) Public Health Approach to Prevention(14:00) Physician Wellbeing as Public Health Crisis(15:00) Joining CMPA and Building Programs(17:00) Developing Evidence-Based Support Systems(22:00) Theater-Based Training and Team Approaches(25:00) Research-Driven Program Development(27:00) Envisioning the Future of Healthcare(32:00) Conclusion
Today, we are joined by Dr. Donald E. Moore, MD, MPH, a Yale-trained physician, longtime Brooklyn primary care doctor and hospital attending educator at Weill Cornell, Downstate and Pace.Dr. Donald E. Moore earned his M.D. and M.P.H. from Yale in 1981. He is an Adjunct Professor of Biology at Pace University and a Clinical Assistant Professor at Weill Cornell Medicine and Downstate Health Sciences University. For more than 30 years, Dr. Moore served as an Attending Physician at New York Presbyterian Brooklyn Methodist Hospital while also managing a primary care practice in Brooklyn for over 35 years. He is the former President of the Provident Clinical Society of Brooklyn and currently holds leadership positions in the Medical Society of the State of New York (MSSNY), including Chair of the Wellness and Resilience Committee and Chair of the AI Taskforce. Additionally, he has served as the past Chair of the Committee on Physician Health. Dr. Moore advocates for a healthcare system focused on patient care, access to quality medicine, and ethical doctor-patient relationships rooted in trust and beneficence.In the conversation, Dr. Moore traces his calling to medicine from a transformative college biology class through his humanistic education at Yale, sharing how ethics, trust, and beneficence guide his practice.We also cover:Making over 20,000 house calls and what horizontal care taught him about doctor-patient relationshipsHis leadership in physician wellness and moving from downstream treatment to upstream prevention of burnoutArtificial intelligence in medicine and the essential role of curiosity in medical practiceDr. Moore concludes by reflecting on medicine as a calling rather than just a job, emphasizing that physicians are healers and teachers who must maintain curiosity and dedication throughout their careers.Links:Dr. Donald Moore Website: https://donaldmooremd.comDr. Donald Moore LinkedIn: https://www.linkedin.com/in/donald-e-moore-m-d-m-p-h-a3868868/Pace University Advisory Board: https://www.pace.edu/dyson/about-dyson/advisory-board/donald-moore-76EmPro Website: https://www.myempro.com/EmPro Peer Support Program: https://www.myempro.com/peer-support/Physician Support Line: +1(888) 409-0141Physician Support Line Website: https://www.physiciansupportline.com/Dr. Krasner's Website: https://mickkrasnermd.com/Mindful Practice in Medicine Website: https://mindfulpracticeinmedicine.com/Chapters:(00:00) Introduction(03:00) Dr. Moore’s Calling to Medicine(08:00) Yale's Humanistic Medical Education(12:00) Ethics, Trust, and Beneficence in Practice(21:00) The Art of Making House Calls(28:00) Horizontal Care and Patient Relationships(30:00) Leadership in Physician Wellness(36:00) Embracing Artificial Intelligence in Medicine(42:00) The Central Role of Curiosity(47:00) Conclusion
Today, we are joined by Colleen Camenisch, MBA, Executive Director of the Nevada Physician Wellness Coalition.Colleen Camenisch, MBA, is an experienced Chief Executive Officer with a demonstrated history of working with leaders in the mindfulness industry and in the higher education industry and Medicine. She has a wide range of skills that include Management, Strategic Planning, Marketing Strategy, Mindfulness Based Interventions, and Public Speaking. Her strong business development experience with a post graduate training in International Business and Trade Law from United Nations' International Labour Organization (ILO) in conjunction with the University Institute of European Studies adds depth and a worldview rarely found in leaders of a community organization like the NPWC. She is a certified Mindfulness Based Stress Reduction Teacher and Teacher Trainer who regular teaches programs for the University of Massachusetts and Brown University.In the conversation, Colleen shares the deeply personal story of how losing her father to a likely medical error led her on a healing journey through mindfulness and eventually into transformative work supporting healthcare professionals.We also cover:The grassroots evolution of the Nevada Physician Wellness Coalition from responding to physician suicides to a dynamic statewide organizationHow mindfulness practice informs her leadership in navigating uncertainty and holding space for difficult conversationsThe coalition's innovative programs including peer support networks, hospital leadership collaboratives, and medical student mentorshipColleen concludes by envisioning a future where healthcare professionals feel safe, valued, and have time for meaningful patient care, while sharing her hope to replicate the coalition model nationally.Links: Nevada Physician Wellness Coalition: https://www.nevadaphysicianwellnesscoalition.com/ Colleen Camenisch’s LinkedIn: https://www.linkedin.com/in/colleen-camenisch-mba/ TEDx Reno Talk: https://www.youtube.com/watch?v=hQo-CQzoW24EmPro Website: https://www.myempro.com/ EmPro Peer Support Program: https://www.myempro.com/peer-support/ Physician Support Line: +1(888) 409-0141 Physician Support Line Website:  https://www.physiciansupportline.com/ Dr. Krasner’s Website: https://mickkrasnermd.com/ Mindful Practice in Medicine Website: https://mindfulpracticeinmedicine.com/Chapters: (00:00) Introduction (03:00) Personal Origin Story and Loss (08:00) Finding Calling in Healthcare Support (11:00) Evolution of the Nevada Physician Wellness Coalition (15:00) Coalition Programs and Services (18:00) Collaborative Working Groups (24:00) Assessment and Net Promoter Score (25:00) Mindfulness and Leadership (30:00) Balancing Training with Broad Impact (33:00) Envisioning the Future of Healthcare (40:00) Conclusion
Today, we are joined by Dr. Todd Hill and Dr. Ward Flemons.Dr. Todd Hill is a clinical psychologist, professor and Director of Behavioral Medicine in the Dept of Family Medicine at the University of Calgary's Cumming School of Medicine (CSM). He is also the Director of the CSM's Centre for Mindfulness (C4M). Dr. Ward Flemons is a Professor Medicine, Cumming School of Medicine and Department of Medicine Vice-Chair, Health Analytics and Safety. He is the former Head of Respiratory Medicine at the University of Calgary and former Medical Director of the Foothills Medical Centre's Sleep Clinic. He was a Medical Director for the Health Quality Council of Alberta (HQCA) for over 10 years.In the conversation, Dr. Hill and Dr. Flemons share how their personal journeys and formative experiences led them to discover mindfulness as a vital tool for fostering compassionate care and culture change within medical education.We also cover:How childhood experiences and early mentors shaped their commitment to helping others flourishThe evolution from individual mindfulness practice to institutional culture change through breaking down silosTheir vision for cultivating a culture of compassionate caring where meaning in medical work is recognizedDr. Hill and Dr. Flemons conclude by envisioning a future where leaders embody mindful practice naturally, creating institutions where people care not because they have to, but because they want to.Website Links & Phone Numbers: Dr. Todd Hill’s LinkedIn: https://www.linkedin.com/in/todd-hill-56b61573/ Dr. Ward Flemon’s LinkedIn: https://www.linkedin.com/in/w-ward-flemons-740244121/ Centre for Mindfulness, Cumming School of Medicine: https://cumming.ucalgary.ca/centres/centre-mindfulness/home EmPro Website: https://www.myempro.com/ EmPro Peer Support Program: https://www.myempro.com/peer-support/ Physician Support Line: +1(888) 409-0141 Physician Support Line Website:  https://www.physiciansupportline.com/ Dr. Krasner’s Website: https://mickkrasnermd.com/ Mindful Practice in Medicine Website: https://mindfulpracticeinmedicine.com/Relevant Publications: Flemons WW, Feasby TE, Wright B. Building a safety and quality culture in healthcare: where it starts. Healthc Pap. 2011;11(3):41-7; discussion 79-83. doi: 10.12927/hcpap.2011.22552. PMID: 21952026.Chapters:(00:00) Introduction(03:00) Origin Stories in Healthcare(10:00) Todd's Path to Medical Education(13:00) Ward's Journey to Patient Safety(17:00) Discovering Mindfulness for Healthcare(22:00) Conceiving Culture Change(26:00) Building Leadership Support(35:00) Collaboration and Mindfulness(42:00) Envisioning Future Success(49:00) Conclusion and Reflection Exercise
Today, we are joined by Dr. Susy Stirling, a Public Health Physician and Associate Dean based in Yorkshire & Humber, and Dr. Sandy Miles, a GP and Medical Educator in Devon, both from the United Kingdom.Dr. Susy Stirling MBChB, MSc, MPH, DCH, FFPH trained in medicine and after early career jobs in hospital medicine in the NHS, worked as a General Medical Officer in rural South Africa for 2 years. She returned to the UK to train in Public Health and was previously Lead for Migrant, Asylum Seeker and Refugee Health across the Yorkshire & Humber region.Dr. Sandy Miles is a GP and Medical Educator in Devon. Alongside her clinical role as a GP, she works in Postgraduate GP training, was Clinical Director of Eastleigh Primary Care Network and, together with Dr. Sam Powell, established popular retreats for doctors. In the conversation, Dr. Miles and Dr. Stirling share their journeys from early medical careers through personal challenges and discoveries that led them to focus on supporting healthcare professionals through storytelling, coaching, and addressing shame in medical practice.We also cover:How personal experiences with inequality, family history, and burnout shaped their paths toward supporting healthcare professionalsThe transformative power of medical humanities education and its impact on professional identityTheir collaboration on the National Health Stories experience, creating platforms for healthcare workers to share narratives of hope and humanityDr. Sandy Miles’ LinkedIn: https://www.linkedin.com/in/sandy-miles-4552a294/ Dr. Susy Stirling’s LinkedIn: https://www.linkedin.com/in/susy-stirling-469976146/Relevant Publications:Miles S. Addressing shame: what role does shame play in the formation of a modern medical professional identity? BJPsych Bulletin. 2020;44(1):1-5. doi:10.1192/bjb.2019.49Podcast Interview:https://youarenotafrog.com/episodes/152/Website Links & Phone Numbers:EmPro Website: https://www.myempro.com/EmPro Peer Support Program: https://www.myempro.com/peer-support/Physician Support Line: +1(888) 409-0141Physician Support Line Website:  https://www.physiciansupportline.com/Dr. Krasner’s Website: https://mickkrasnermd.com/Mindful Practice in Medicine Website: https://mindfulpracticeinmedicine.com/Chapters:(00:00) Introduction(03:00) Origin Stories: Why Medicine?(08:00) Susy's Path from Medicine to Medical Education(11:00) Sandy's Journey Through Burnout and Recovery(17:00) The Transformative Power of Medical Humanities(31:00) Understanding Shame in Medical Identity Formation(38:00) The Genesis of National Health Stories(43:00) Using Shame as a Compass for Core Values(51:00) The Importance of Connection in Healthcare(59:00) Envisioning a Future Healthcare System(01:07:00) Conclusion
Today, we are joined by Dr. Will Bynum.Will Bynum, MD, PhD., is an Associate Professor of Family Medicine in the Duke University School of Medicine. Prior to arriving at Duke in October 2017, he served for seven years on Active Duty in the US Air Force. Will's military service included four years of faculty duties in the NCC Family Medicine Residency Program, a deployment to East Africa as the senior medical director of a special operations command, and multiple overseas trips providing medical support to traveling congressional delegations. Will currently serves as the Duke Family Medicine Residency Program Director and Faculty Advisor to the Duke School of Medicine Student Wellness Committee. Will's primary academic interest centers on the role of self-conscious emotions (shame, guilt, and pride) in the medical learning experience. He has conducted some of this research through his PhD work in health professions education at Maastricht University in the Netherlands.In the conversation, Dr. Bynum shares his journey from a service-oriented upbringing to becoming a leader in addressing shame in healthcare, exploring how authentic human connection forms the foundation of his work as both clinician and educator.We also cover:● His experiences in military service and the paradoxical psychological safety he found there compared to healthcare environments● The personal crisis that led him to study shame in medical education and healthcare● How storytelling and narrative serve as powerful tools for addressing shame● The concept of "shame competence" and shame-sensitive practices in healthcare● His vision for a more connected, authentic healthcare system that integrates humanities and creativityDr. Bynum concludes by reflecting on finding joy in his life through connecting with his family, building new experiences with his children, and creating work that feels meaningful enough to blur the line between profession and passion.Dr. Bynum’s LinkedIn: https://www.linkedin.com/in/william-bynum-698a1889/Website - Shame Space Consortium: https://www.theshamespace.com/Chapters:(00:00) Introduction(01:45) Dr. Bynum’s Background(04:00) Dr. Bynum's Path to Medicine(07:15) Service-Oriented Family Influence(10:30) Military Service Experience(16:00) Journey into Medical Education(18:45) Origin Story of Studying Shame in Medicine(24:15) Storytelling as a Tool for Addressing Shame(28:30) Comparing Military and Healthcare Environments(34:30) Shame Competence and Shame-Sensitive Practices(38:30) Creativity, Arts, and Humanities in Healthcare(42:00) Imagining a Transformed Healthcare Future(47:45) Personal Life and Finding Joy(50:15) ConclusionResources/References: The Shame Conversation Film: https://www.theshamespace.com/film Dr. Brene Brown Ted Talks on shame and vulnerability: https://www.youtube.com/watch?v=psN1DORYYV0https://www.youtube.com/watch?v=iCvmsMzlF7o Bynum WE 4th, Sukhera J. Perfectionism, Power, and Process: What We Must Address to Dismantle Mental Health Stigma in Medical Education. Acad Med. 2021;96(5):621-623. doi:10.1097/ACM.0000000000004008 Bynum WE 4th, Varpio L, Lagoo J, Teunissen PW. 'I'm unworthy of being in this space': The origins of shame in medical students. Med Educ. 2021;55(2):185-197. doi:10.1111/medu.14354 Bynum WE 4th, W Teunissen P, Varpio L. In the "Shadow of Shame": A Phenomenological Exploration of the Nature of Shame Experiences in Medical Students. Acad Med. 2021;96(11S):S23-S30. doi:10.1097/ACM.0000000000004261
Today, we are joined by Charles Pfeffer.Charles is an organizational consultant and executive coach with over 30 years of experience helping leaders harness their own and their organization's inherent ability to create change through learning and adaptation. He guides partly through his listening skills, honed through a life-long engagement with self-awareness approaches and group dynamics training, guiding his clients to clarify what they want – for their enterprise, their teams, themselves, and the world. Has assisted executives across many varied industries and organizations, including FedEx, Xerox, DuPont, and Medifast, to align teams, develop leaders, communicate rigorously, and produce results, and has coached teams with assignments ranging from bringing the world's first production digital color printer to market to safely closing the NASA Space Shuttle program. Collaborating with Nvolv Partners, Charles worked with Starbucks and Save the Children to align leadership, strategy, and talent, and has teamed with Brimstone Consulting on strategic change initiatives at the New York Times, ExpressScripts, and the State of Maine. Working with the pioneering DEI firm, The Kaleel Jamison Consulting Group, Charles helped to bring the power of inclusion to accelerate strategy deployment at Merck, United Airlines, and EcoLab.In the conversation, Charles shares insights from his "accidental" journey into personal growth work and executive coaching, highlighting how he helps leaders navigate complexity and change while maintaining authentic purpose.We also cover:The fundamental question he poses to clients: "What do you want?" and how this simple inquiry can unlock deeper purposeHow organizations navigate change through disruption and the role of leaders in transforming systemsThe parallels between executive leadership challenges and healthcare professionals' experiencesThe connection between oath, authenticity, and purpose in professional identityHis vision for healthcare environments that provide calm, competent care through better alignment of capacity and demandCharles concludes by sharing his personal approach to flourishing, which includes time in nature - walking in the woods, kayaking, and skiing - as restorative practices that help him maintain balance while supporting leaders through complex challenges.Website: https://www.charlespfeffer.com/LinkedIn Page: https://www.linkedin.com/in/charlespfeffer/-Chapters:(00:00) Introduction(01:15) Charles Pfeffer’s Background(04:15) Charles' Journey into Personal Growth and Coaching(08:00) Early Influences and Moving Beyond Blame(10:30) The Concept of Polarities: Freedom and Responsibility(13:00) How Executive Coaching Works(17:00) Understanding Leadership and Organizational Complexity(22:45) The Challenge of Integration in Healthcare Systems(26:45) Complexity, Disruption, and Organizational Change(33:45) Flourishing Through Authentic Purpose(37:30) What Allows Charles to Flourish in His Work(41:00) Imagining a Better Healthcare Future(45:15) Personal Wellness Practices(46:15) Conclusion
Today, we are joined by Dr. Carter Lebares.Dr. Lebares is an Associate Professor of Surgery in the Division of General Surgery and the Director of the Center for Mindfulness in Surgery at the University of California, San Francisco. She is a gastrointestinal and bariatric surgeon who specializes in treating gastrointestinal disease, using minimally invasive surgery, such as robotics and surgical endoscopy. Her expertise includes treatments for reflux disease, obesity, early esophageal or gastric cancer, esophageal motility disorders, hernias, gallbladder disease and some kinds of biliary disease.Lebares' research interests include resilience and mindfulness in surgery, mindfulness and nutrition in metabolic syndrome and obesity, the neuroendocrine and cognitive effects of stress on learning and performance. She has developed and studied a customized curriculum specifically designed for surgeons, the Enhanced Stress Resilience Training (ESRT), which has been demonstrated to improve burnout and global executive function.In the conversation, Dr. Lebares shares her journey from biochemistry to academic surgery, driven by a deep commitment to advocacy and empowering others through resilience-building approaches.We also cover:Her early experiences advocating for disadvantaged youth that ultimately led her to medicineThe evolution of surgical training environments and challenges to physician wellbeingDevelopment of the Enhanced Stress Resilience Training (ESRT) specifically designed for surgeonsHer vision for systemic changes in healthcare to preserve medicine as a "pillar of civilization"Dr. Lebares concludes by reflecting on finding joy in the simplicity of everyday life - being outdoors, connecting with people outside medicine, and appreciating ordinary moments that meditation helps bring into focus.Guest: Carter Lebares, MDAssociate Professor of Surgery, Division of General SurgeryDirector, Center for Mindfulness in SurgeryPrincipal Investigator, The Lebares Resilience LabUniversity of California, San FranciscoFaculty webpage: https://generalsurgery.ucsf.edu/faculty/acute-care-surgery/carter-lebares,-md.aspxLebares Resilience Lab Website: https://carterlebares.org/LinkedIn Page: https://www.linkedin.com/in/carter-lebares-a3970b8/Selected Resources/References:About Ann Masten PhD: https://en.wikipedia.org/wiki/Ann_MastenLibby Zion Law: https://en.wikipedia.org/wiki/Libby_Zion_LawLuton OW, James OP, Mellor K, Eley C, Hopkins L, Robinson DBT, Barlow E, Lebares CC, Lewis WG, Egan RJ; Welsh Surgical Research Initiative (WSRI) Collaborative. Enhanced Stress Resilience Training for UK Surgical Trainees; Effect and Evolution Evaluated. J Surg Educ. 2023 Oct;80(10):1395-1402. doi: 10.1016/j.jsurg.2023.07.017. Epub 2023 Aug 9. PMID: 37567800.Luton OW, James OP, Mellor K, Eley C, Hopkins L, Robinson DBT, Lebares CC, Powell AGMT, Lewis WG, Egan RJ. Enhanced stress-resilience training for surgical trainees. BJS Open. 2021 Jul 6;5(4):zrab054. doi: 10.1093/bjsopen/zrab054. PMID: 34323917; PMCID: PMC8320339.Lebares CC, Coaston TN, Delucchi KL, Guvva EV, Shen WT, Staffaroni AM, Kramer JH, Epel ES, Hecht FM, Ascher NL, Harris HW, Cole SW. Enhanced Stress Resilience Training in Surgeons: Iterative Adaptation and Biopsychosocial Effects in 2 Small Randomized Trials. Ann Surg. 2021 Mar 1;273(3):424-432. doi: 10.1097/SLA.0000000000004145. PMID: 32773637; PMCID: PMC7863698.Lebares CC, Guvva EV, Ascher NL, O'Sullivan PS, Harris HW, Epel ES. Burnout and Stress Among US Surgery Residents: Psychological Distress and Resilience. J Am Coll Surg. 2018 Jan;226(1):80-90. doi: 10.1016/j.jamcollsurg.2017.10.010. Epub 2017 Oct 26. PMID: 29107117.
Today, we are joined by Dr. Maura Kenny.Dr. Kenny is a psychiatrist with Southern Australian Health and a mindfulness teacher, trainer and researcher with 20 years of experience teaching mindfulness courses in both clinical and organizational settings. Her special interest is the wellbeing and resilience of healthcare staff, and she's developed a six week mindfulness course that has been delivered for several years in South Australia's public health settings and in other healthcare and university settings around Australia, the United Kingdom, Singapore and Taiwan.Maura is also the inaugural director of Staff Wellbeing at the largest healthcare network of over 17,000 employees in South Australia Health.In the conversation, Dr. Kenny traces her journey from aspiring domestic science teacher to psychiatry, driven by her fascination with biology and a desire to alleviate suffering.We also cover:Her pivotal encounter with Professor Mark Williams that introduced her to mindfulnessAdapting mindfulness practices specifically for exhausted healthcare professionalsThe limitations of individual interventions without system-level changesHer role as Director of Staff Wellbeing and the challenges of connecting different parts of the healthcare systemThe importance of peer support and camaraderie in medicineDr. Kenney concludes by reflecting on finding joy amid the inherent challenges of healthcare and the privilege of being present for patients during significant moments in their lives.Chapters:(00:00) Introduction(03:00) Dr. Kenny's Path to Medicine(11:40) Introduction to Mindfulness in Practice(15:20) Pivotal Workshop with Professor Mark Williams(19:40) Adapting Mindfulness for Healthcare Professionals(24:20) Healthcare Staff Wellbeing in Australia(31:00) Social Justice in Australian Healthcare(34:00) Leadership Challenges and "No Villains" Mantra(37:20) Importance of Peer Support and Camaraderie(41:00) "A Brief for the Defense" Poem Reading(44:20) Finding Joy Amidst Challenges(48:00) Conclusion and The Guest House PoemGuest: Maura Kenny, MBChB, MRCPsych, FRANZCPDirector, Staff Wellbeing, SA Health (South Australia Health)LinkedIn Page: https://www.linkedin.com/in/dr-maura-kenny-b5bb1b53/Website for the Mindful Self Care Course: https://www.mindfulscp.com/Resources/References:Kenny M, Luck P, Koerbel L. Tending the Field of Mindfulness-Based Programs: The Development of International Integrity Guidelines for Teachers and Teacher Training. Glob Adv Health Med. 2020 May 7;9:2164956120923975. doi: 10.1177/2164956120923975. PMID: 32426180; PMCID: PMC7218322.Amishi Jha, PHD and her work and research: https://amishi.com/Guest House Poem, Rumi: https://www.scottishpoetrylibrary.org.uk/poem/guest-house/Mindful Self-Compassion, Kristen Neff PhD, and Chris Germer PhD: https://centerformsc.org/about/A Brief for the Defense, Poem by Jack Gilbert: https://genius.com/Jack-gilbert-a-brief-for-the-defense-annotated
Today, we are joined by Dr. Janine Kirby, an integrative medical doctor, homeopath and mindfulness teacher based in East London.After completing her medical degree, she obtained a Diploma in Child Health, a Diploma in Obstetrics and a Masters in Family Medicine. She worked in the public sector for many years before starting her own integrative medical practice and acquiring professional qualifications in Homeopathy. She has a passion for helping her patients understand the importance of the intimate connection between the body, thoughts and emotions in healing.Janine enjoys teaching, having facilitated both under- and post-graduate Family Medicine training. She has been teaching the 8-week Mindfulness Based Stress Reduction Program (MBSR) with psychologist Barbara Gerber since 2010. She also co-facilitates mindfulness-informed programs for healthcare practitioners dealing with stress and burnout, and is the current Chairperson of IMISA, the Institute for Mindfulness South Africa, involved on national and international levels in promoting mindfulness programs and developing teacher training standards.In the conversation, Dr. Kirby shares the profound impact of her early life experiences and the environment of apartheid South Africa on her journey into medicine and mindfulness.We also cover:How her brother's illness shaped her holistic understanding of healingThe challenges of integrating traditional and modern medical practicesHer work with the Institute for Mindfulness of South Africa (IMISA)Dr. Kirby’s mindfulness programsThe balance between professional challenges and personal fulfillmentShe concludes by sharing her desire to expand mindfulness programs and contribute to the global mindfulness conversation and reflecting on the balance between professional challenges and personal fulfillment.-Chapters:(00:00) Introduction(03:31) Dr. Kirby’s Medical Journey(04:39) Janine's Experiences with Her Brother’s Illness(08:52) Traditional Healing in South Africa(14:19) Challenges in South African Healthcare(22:54) Burnout and Mindfulness in Medicine(26:33) Janine's Personal Journey with Mindfulness(38:17) Future of Mindfulness in South Africa(43:14) ConclusionGuest: Janine Kirby, MBChBFamily Practitioner / Homeopath in private practice; Chairperson of IMISA (Institute of Mindfulness SA)LinkedIn Page: https://www.linkedin.com/in/janine-kirby-525b595a/Institute for Mindfulness South Africa website: https://mindfulness.org.za/Facebook Page, Institute for Mindfulness South Africa: https://www.facebook.com/instituteformindfulnesssouthafrica/Resources/References:Kirby JM, Milligan PD, Conradie HH, McIntosh BM. A mindful approach to physician self-care. S Afr Fam Pract (2004). 2024;66(1):e1-e4. Published 2024 Jan 30. doi:10.4102/safp.v66i1.5836
Our guest today is Sara C. Charles, MD, a psychiatrist, and professor emerita at the University of Illinois College of Medicine. In 1976, Dr. Charles endured a six-week trial for medical malpractice in federal court which resulted in a defense verdict. The experience of the trial so profoundly affected her that she began to study the mental, emotional, and physical effects of malpractice litigation on physician defendants. Her pioneering research published in the 1980s and 90s is relied on today by physicians, clinicians, and experts in physician wellness. A prolific writer, books co-authored by Dr. Charles include Defendant, A Psychiatrist on Trial for Medical Malpractice (written with her husband, Dr. Eugene Kennedy), and Adverse Events, Stress and Litigation (written with her dear friend and attorney, the late Paul Frisch).Retired from active practice, Dr. Charles remains engaged in promoting the wellness of all healthcare professionals who become involved in malpractice litigation and in this conversation, she shares her journey into medicine, shaped by her upbringing in a large Irish Catholic family that valued education. Despite initial thoughts of pursuing social work, she pursued a path in biology and chemistry, ultimately finding her calling in psychiatry due to her ability to connect with patients. She recounts a pivotal event in their career when a patient sued her, sparking an interest in addressing the emotional toll of malpractice litigation on physicians. Her experiences during the lengthy malpractice proceedings highlighted the lack of support and isolation physicians face, driving her advocacy for cultural change within the medical community to better address the psychological impact of litigation. Her interest, research, and investigations about this topic led to the publications of several seminal books about the experience of physicians of being sued and the establishment of the Physician Litigation Stress Organization.Emphasizing the importance of peer support and cultural change within medicine, Dr. Charles advocates for a deeper appreciation of the moral and existential nature of medical work in medical education, aiming to address the emotional toll of malpractice litigation and improve physician well-being. Her varied interests and deep social connections underscore the role of community, the importance of medical work, and the cultivation of an integrated social fabric in finding flourishing in medicine and in life. Guest: Sara Charles, MD Founder, The Physician Litigation Stress Resource Center Website: https://physicianlitigationstress.org/ Resources/References: Charles SC and Frisch PR.Adverse Events, Stress, and Litigation: A Physician’s GuideNew York. Oxford University Press, 2005. Charles SC, Kennedy EC.Defendant: A Psychiatrist on Trial for Medical Malpractice New York. Random House, (Vintage Books), 1986. Plumb EJ. World changing. Ann Intern Med. 2015 Apr 21;162(8):594-5. doi: 10.7326/M14-2076. PMID: 25894031.
Our guest today is Dr. Jane Fogg, a physician leader and executive with broad experience leading health care delivery, focusing on primary care, systems redesign, and value-based delivery models and a Senior Physician Advisor for the division of Professional Satisfaction & Practice Sustainability at the American Medical Association. Prior to this, she was the Executive Chair of Internal Medicine Family Medicine at Atrius Health, an innovative value-based healthcare leader in Massachusetts, and a member of Optum, responsible for the care delivery and outcomes of a practice with 350 physicians and advanced practice clinicians caring for 400,000 patients. She implemented advanced primary care redesign for reliable systems that are team-based, patient-centered, innovative, and return joy to the practice of medicine. Dr. Fogg is a Lecturer at Harvard Medical School, Affiliate Faculty at the Center for Primary Care, and speaks internationally and locally on value-based care delivery, innovation in health care, physician wellbeing, and in basket reduction.During this conversation, Dr. Fogg recounts her interest in a medical career that was spurred by experiences as a medical assistant in oncology, where she experienced the pivotal role of relationships in healthcare. Reflecting on her over three-decade career hence, she has grown increasingly aware of systemic deficiencies in the organization of healthcare, especially in primary care, which have fueled her commitment to addressing these issues in her many leadership roles. While grappling with physician burnout and systemic challenges, Dr. Fogg advocates for fundamental changes in healthcare deliver, in particular promoting and implementing value-based care which aligns financial incentives with quality patient care. She emphasizes quite persuasively that the transition to value-based care and data-driven decision-making while optimizing clinical operations can enhance physician wellbeing as well as practice efficiency. She shares actionable strategies such as in-basket workload reduction while championing honesty, gratitude, and joy in healthcare practice and leadership.Guest: Jane Fogg, MD, MPH, Lecturer on Global Health and Social Medicine, Harvard Medical School, Affiliate Faculty, Center for Primary Care, Harvard Medical SchoolLinkedIn Page: https://www.linkedin.com/in/jane-f-fogg-md-mph-52a61349/Resources/References:AMA STEPS Forward® practice innovation strategies offer real-world solutions to the challenges that your practice is confronting today. Gain the tools you need to overcome barriers and restore the joy in your practice of medicine: https://www.ama-assn.org/practice-management/ama-steps-forwardJane Fogg, MD, MPH, and Christine Sinsky, MD: In-Basket Reduction: A Multiyear Pragmatic Approach to Lessen the Work Burden of Primary Care Physicians Published April 19, 2023, NEJM Catal Innov Care Deliv 2023;4(5)DOI: 10.1056/CAT.22.0438 https://catalyst.nejm.org/doi/pdf/10.1056/CAT.22.0438?download=true“Participant joyfully in the world…” a quote by Campbell from the book This guidance occurred in the 1991 book Reflections on the Art of Living: A Joseph Campbell Companion which consisted of material selected and edited by Diane K. Osbon.Anthropologist Angeles Arrien re the four questions a healer would ask (YouTube video of Dr. Arrien): https://www.youtube.com/watch?v=HUJQlVeGZzY&t=34s
The guest today is Pat Croskerry, MD, PhD, is a professor in emergency medicine at Dalhousie University in Halifax, Nova Scotia, Canada. Trained as an experimental psychologist, Dr. Croskerry went on to become an emergency medicine physician and found himself surprised by the relatively scant amount of attention given to cognitive errors. He has become one of the world's foremost experts in safety in emergency medicine and diagnostic errors. Dr. Croskerry is currently Director of the Critical Thinking Program within the Division of Medical Education, Dalhousie University. His interests lie primarily in clinical decision making, diagnostic failure, and the role of cognitive and affective bias in decision making. Recent work is aimed at cognitive bias mitigation.During this fascinating conversation, Pat shares his unique path to medicine, stemming from a background in psychology that instilled a focus on critical thinking and cognitive biases, and the discipline to study medicine, informed by his brief rowing career during which, as a member of the Canadian National Team he competed in the Olympic Games. He delves into specific biases affecting medical decision-making, such as emotional affective, anchoring, and search satisficing biases, stressing the need to mitigate these biases for accurate diagnoses. Furthermore, he explores the impact of cognitive load and decision fatigue on physician well-being, advocating for a reconsideration of critical thinking's role in modern medical practice to ensure optimal performance and professional satisfaction.Guest: Pat Croskerry, MD, PhD, FRCPLinkedIn Page: https://www.linkedin.com/in/pat-croskerry-199a8132/Wikipedia page: https://en.wikipedia.org/wiki/Patrick_CroskerryNEJM Interview: https://www.nejm.org/action/showMediaPlayer?doi=10.1056%2FNEJMdo002218&aid=10.1056%2FNEJMp1303712&area=Other references:Croskerry P, Clancy M. Advancing diagnostic excellence: the cognitive challenge for medicine. BMJ. 2022 Mar 29;376:o799. doi: 10.1136/bmj.o799. PMID: 35351777.Olson A, Rencic J, Cosby K, Rusz D, Papa F, Croskerry P, Zierler B, Harkless G, Giuliano MA, Schoenbaum S, Colford C, Cahill M, Gerstner L, Grice GR, Graber ML. Competencies for improving diagnosis: an interprofessional framework for education and training in health care. Diagnosis (Berl). 2019 Nov 26;6(4):335-341. doi: 10.1515/dx-2018-0107. PMID: 31271549.Croskerry P. From mindless to mindful practice--cognitive bias and clinical decision making. N Engl J Med. 2013 Jun 27;368(26):2445-8. doi: 10.1056/NEJMp1303712. PMID: 23802513.
The guest today is Justin Klamerus, MD, MMM, Executive Vice-President and Chief Clinical Officer for McLaren Health, a fully integrated, nonprofit health care delivery system committed to quality, evidence-based patient care and cost efficiency. The McLaren system includes 14 hospitals in Michigan, ambulatory surgery centers, imaging centers, a 490-member employed primary and specialty care physician network, commercial and Medicaid HMOs covering approximately 700,000 lives in Michigan and Indiana. McLaren operates Michigan’s largest network of cancer centers and providers, anchored by the Karmanos Cancer Institute, one of only 51 National Cancer Institute-designated comprehensive cancer centers in the U.S. McLaren maintains academic affiliations with medical schools at Wayne State University, Michigan State University and Central Michigan University. McLaren’s GME campuses offer residencies and fellowship programs that train over 650 future physicians annually.A medical oncologist by training who joined McLaren in 2009, he went on to hold numerous positions at McLaren including president of McLaren Cancer Institute and principal investigator of the McLaren Center for Research and Innovation. Following the acquisition of Karmanos Cancer Institute by McLaren in 2014, Klamerus served as chief quality officer and later president of the Karmanos Cancer Hospital and Network. in 2020, he was appointed to the Public Health Advisory Commission by Michigan Governor Gretchen Whitmer, and in 2022 he became Chief Clinical Officer for all of McLaren Health.During this conversation, Dr. Klamerus discusses his leadership in McLaren Health, highlighting the organization's dedication to its medical staff as well as to many diverse communities, while navigating financial constraints and significant public challenges such as the Flint Michigan water crisis, gun violence, and maternal health delivery issues. He shares a vision for how large and complex healthcare systems can improve workforce stability and community engagement through fostering an environment where staff receive the support needed to excel in complex patient care delivery and to address social issues. He underscores the importance of transparent, authentic, and engaged leadership, mindfulness, and personal connections, alongside emerging technologies, in driving positive changes in healthcare delivery, community health outcomes, and physician and health professional well-being. I found his candor, humor, genuineness and warmth to be comforting, helping me to better understand the connection we can all have with true leaders.Guest: Justin F. Klamerus, MD, MMMExecutive Vice President and Chief Clinical Officer, McLaren HealthcareFaculty Profile: about Dr. Klamerus- https://www.mclaren.org/main/news/mclaren-health-care-appoints-justin-f-klamerus-md-3906LinkedIn Page: https://www.linkedin.com/in/justin-klamerus-md-mmm-a42b293b/About McLaren Health: https://www.mclaren.org/3 Minute Meditation Session with Dr. Mick Krasner
Our guest today is Rita Charon is a general internist and literary scholar and one of the founders of the field of narrative medicine. She completed the MD at Harvard Medical School and the PhD in English at Columbia University. She is the Bernard Schoenberg Professor of Social Medicine, Professor of Medicine, and founding chair of the Department of Medical Humanities and Ethics at Columbia University Vagelos College of Physicians & Surgeons. Her research in narrative medicine has been supported by the NIH, the NEH, and many private foundations. She authored, co-authored, or co-edited four books on narrative medicine. She lectures and teaches internationally and publishes extensively in leading medical and literary journals. In this interview, Dr. Rita Charon discusses how early experiences with her father's medical practice inspired her to pursue a career in medicine. She also reflects on her love of literature that led to her deep dive into that field, connecting profoundly with narrative theory. This instantly enriched her medical practice by enhancing her listening skills and her ability to unearth deeper meanings in patient interactions. She highlights the importance of narrative medicine in helping health professionals cope with the emotional challenges of their work, particularly during crises like the COVID-19 pandemic, and reflects on the broader implications of narrative competency, the importance of listener trust, and the systemic challenges in healthcare that impact equitable access to care. The close reading of non-medical texts she maintains can help health professionals recognize and address structural inequities within the healthcare system. Rita emphasizes the importance of activism among clinicians and the need for providing models of activism for students of medicine while protecting clinicians from systemic pressures that erode the patient-clinician relationship. This fascinating, lively, and connecting conversation with Dr. Charon makes a compelling and inspiring call for all of us in medicine to consider a deeper literary engagement to enhance empathy and understanding in medical practice. Guest: Rita Charon, MD, PhDBernard Schoenberg Professor of Social Medicine, Professor of Medicine, and founding chair of the Department of Medical Humanities and Ethics at Columbia University Vagelos College of Physicians & Surgeons Faculty Page, Columbia University: https://sps.columbia.edu/faculty/rita-charon-md-phd Resources/References: Dr. Charon’s Jefferson Lecture for the National Endowment for the Humanities: https://www.youtube.com/watch?v=7yI0rdQEAj8 About Luke Fildes painting The Doctor, 1891: https://en.wikipedia.org/wiki/The_Doctor_(painting) David Rothman Strangers at the Bedside: A History of How Law and Bioethics Transformed Medical Decision https://www.taylorfrancis.com/books/mono/10.4324/9781315130286/strangers-bedside-david-rothman About Henry James: https://en.wikipedia.org/wiki/Henry_James About Hans-Georg Gadamer, philosopher: https://en.wikipedia.org/wiki/Fusion_of_horizons Emily Dickinson:“A word is dead when it is said…” https://www.americanpoems.com/poets/emilydickinson/a-word-is-dead/“Tell all the truth but tell it slant…” https://www.poetryfoundation.org/poems/56824/tell-all-the-truth-but-tell-it-slant-1263
Our guest today is Helen Riess, M.D. is Chief Scientist and Chairman of Empathetics. Dr. Riess is Associate Clinical Professor of Psychiatry at Harvard Medical School and Director of the Empathy and Relational Science Program at Massachusetts General Hospital. In addition, Dr. Riess is the author of The Empathy Effect and a core member of the Consortium for Research on Emotional Intelligence in Organizations (CREIO) and faculty of the Harvard Macy Institute. Dr. Riess is a psychiatrist who developed an empathy training approach based on research in the neurobiology and physiology of empathy that has been rigorously tested in pilot studies and a randomized, controlled trial at MGH. She completed her residency and Chief Residency at MGH and Harvard Medical School. Dr. Riess has devoted her career to teaching and research in the art and science of the patient-doctor relationship. Dr. Riess received her M.D. from Boston University School of Medicine and her B.A. From Wesleyan University. In this conversation Dr. Riess shared the influence of her family's experiences as refugees from war-torn Europe, which sensitized her to trauma and resilience. Her interest in psychiatry began during medical school when she was drawn to understanding the mind and healing through narrative and empathy. While a small percentage of people lack the neural mechanisms for empathy, for most, empathy is a mutable trait influenced by their environment and mental state, and burnout among healthcare professionals diminishes their capacity for empathy, not because empathy is inherently harmful, but due to the overwhelming demands and flawed systems they work within. To address this, Dr. Riess speaks of the importance self-regulation and self-care skills, recognizing the human needs of healthcare workers, and creating supportive, empathetic organizational cultures. Helen discusses four pillars of what she describes as institutional resilience- supporting healthcare workers with safe environments, caring communication, community cohesion, and mental health normalization. The personal anecdotes she shared illustrate the profound impact of empathetic interactions, both professionally and personally, and the importance of meaningful connections for self-care and fulfillment, all reflections of her infectious passion and inspiration as well as her deep humanity. Guest: Helen Reiss MDChief Scientist and Chairperson of Empathetics, Director, and Associate Clinical Professor of Psychiatry at Harvard Medical School and Director of the Empathy and Relational Science Program at Massachusetts General Hospital LinkedIn Page: https://www.linkedin.com/in/helen-riess/Website for Empathetics: https://www.empathetics.com/ Resources/References: Dr. Riess’ TEDX Talk: https://www.youtube.com/watch?v=baHrcC8B4WM The Empathy Effect: https://rb.gy/96awc2 The Consortium for Research on Emotional Intelligence in Organizations (CREIO): https://eiconsortium.org/ Riess, Helen. Institutional Resilience: The Foundation for Individual Resilience, Especially During COVID-19. Glob Adv Health Med. 2021 Apr 6;10:21649561211006728. doi: 10.1177/21649561211006728. PMID: 33889440; PMCID: PMC8040559. About Heinz Kohut and Self-Psychology: https://en.wikipedia.org/wiki/Self_psychology
The guest for this podcast Ellen Langer, PhD, Professor of Psychology at Harvard University, a Fellow of The Sloan Foundation; The American Psychological Association, the American Psychological Society, The American Association for the Advancement of Science; Computers and Society; The Society for the Psychological Study of Social Issues; The Society of Experimental Social Psychologists. She has been awarded a Guggenheim and the Liberty Science Genius Award among many others. In addition to her many honors, she has been a guest lecturer in Japan, Malaysia, Germany, and Argentina.Langer has had a significant influence on the positive psychology movement. Along with being known as the “mother of positive psychology” her contributions to the study of mindfulness have earned her the moniker of the "mother of mindfulness." Her work helped to presage mind/body medicine, which has been regarded by many scientists to be an important intellectual movement and one that now has "considerable evidence that an array of mind-body therapies can be used as effective adjuncts to conventional medical treatment." She has co-authored experimental research indicating a connection between time perception and wound healing.She has published over 200 articles and academic texts, was published in The New York Times, and discussed her works on Good Morning America. Additionally, in many introductory psychology courses at universities across the United States, her studies are required reading. She is the author of numerous books including her most recent one, The Mindful Body. In this conversation, a rich exploration unfolds of the intersection between mindfulness and healthcare, beginning with Dr. Langer’s personal journey into health studies, catalyzed by a miraculous recovery in their family. This narrative weaves through the profound influence of the mind-body connection, drawing on examples like the "Counterclockwise Study" to underscore the potential for psychological factors to significantly impact physical health. She advocates for a healthcare approach that recognizes the unity of mind and body, emphasizes the importance of mindfulness beyond meditation, and addresses the dynamic nature of health with a flexible, engaged attitude towards patient care. The discussion also highlights the challenges of conventional medicine's problem-focused approach, proposing a shift towards leveraging patients' strengths and capacities through mindful observation to variability. By illustrating how mindfulness can transform both personal experiences and professional practices, the conversation champions a healthcare paradigm that values meaningful connections and fosters an environment of non-judgment and safety, suggesting a communal shift towards a more mindful, holistic view of health and well-being. Guest: Ellen Langer, PhDProfessor of Psychology, Harvard University Faculty Profile: https://scholar.harvard.edu/langer/homeWebsite: https://www.ellenlanger.me/LinkedIn Page: https://www.linkedin.com/in/ellenjlanger/Book titles by Dr. Langer: see https://www.ellenlanger.me/home#book-s
This episode’s guest, Dr. Gail Gazelle, with 25 years as a practicing internist and hospice physician, combines practical, evidence-based strategies with her extensive medical and mindfulness expertise. She is a recognized figure in the media, featured in outlets like CNN, NPR, Oprah Magazine, and has been published twice in the New England Journal of Medicine as well as other leading medical journals.Her latest book, “Mindful MD: 6 Ways Mindfulness Restores Your Autonomy and Cures Healthcare Burnout,” underscores her significant contributions to wellness. Utilizing mindfulness to become the master of the mind, she shares the keys to reducing reactivity, decreasing burnout, and restoring the true autonomy that we can all retain. Using dozens of real-life stories, she helps readers see that they don’t have to hand over their happiness to a complex and dysfunctional healthcare system.In this podcast Dr. Gazelle shares insights into her work addressing physician burnout and fostering flourishing. Reflecting on her own journey, she discusses her initial interest in end-of-life care, shaped by complex family experiences. The conversation explores burnout roots in medical training, discussing self-critical thoughts, perfectionism, and the imposter syndrome among physicians. Dr. Gazelle advocates for mindfulness as a key tool in regaining autonomy, reconnecting with purpose, and challenging negative thought patterns. She introduces a coaching model incorporating mindfulness to help physicians find meaning and acknowledge positives, emphasizing individual empowerment and systemic healthcare challenges.Gail defines mindfulness in terms of awareness and mind training. In addressing health professional burnout, she stresses the need to focus on present moment experiences and work with what is-how things actually are- accepting the current state in healthcare as lived reality as an honest and workable starting point for transformation. She also explores the impact of stories in our professional lives, differentiating between helpful stories that add meaning and purpose to our work and unhelpful narratives that keep us stuck with an unrealistic and unworkable view of ourselves and our situations. Finally, the conversation touches on the transformative power of flourishing in healthcare, both as a recipient of healthcare and as a provider of care to others.Guest:Gail Gazelle, MDWebsite: www.gailgazelle.comEmail: drgazelle@gailgazelle.comLinkedIn: @gailgazelleFacebook: facebook.com/groups/539466187211003X: @gailgazellemdOther resources:Mindful MD: 6 Ways Restores Your Autonomy and Cures Healthcare Burnout- available at Amazon and free chapter download available at Dr. Gazelle’s website.Other resources available on Dr. Gazelle’s website: The Daily Dose of Calm; Imposter Syndrome Guide; Everyday Resilience Book; Leading in a Time of Crisis; and 10 Steps to Avoid Physician Burnout3 Minute Guided Meditation with Dr. Mick Krasner
This episode continues an investigation of medical education that began with last episode’s interview with Dr. Bonvin, now with a 4th Year Medical Student, Malayna Hocker, who shares her journey into medicine as a career and evolution as a teacher. Initially resistant to the idea of pursuing medicine due to negative childhood experiences in hospitals, she explored various paths but eventually found her way back to medicine through teaching. Inspired by her love for science and a desire to serve the community, Before entering medical school Malayna taught in challenging environments, facing issues like student violence and family difficulties.As she navigated this non-traditional path to medical school, Malayna's teaching experiences continued to shape her perspective, as her teaching focus has evolved into an advocacy role, addressing discomfort and questioning aspects of medical culture. Malayna emphasizes the need to break the stereotypes in medicine, challenging the notion of perfection and the acceptance of toxic aspects within the profession. She believes that open conversations about challenges, doubts, and well-being are essential in reshaping the culture of medicine. Malayna also sees teaching as a means to advocate for both patients and fellow trainees, fostering a culture of empathy, understanding, and collaboration.Malayna emphasizes the need to break the cycle of isolation and shame ingrained in medical training and advocates for fostering a culture of support and openness. She believes that finding connection and breaking out of isolation are crucial for addressing burnout in the future. Malayna expresses joy in learning, helping patients live the lives they want, and engaging in teaching. She highlights the importance of maintaining one's personhood and finding fulfillment both in and outside of the medical profession.Guest:Malayna Hocker, 4th Year Medical StudentUniversity of Rochester School of Medicine and DentistryOther resources:America Reads Program: existing in amny institutions of higher education, this website describes the program at Arizona State University: https://communityengagement.education.asu.edu/programs/america-readsShame in Medical Education:Bynum WE 4th, Varpio L, Lagoo J, Teunissen PW. 'I'm unworthy of being in this space': The origins of shame in medical students. Med Educ. 2021 Feb;55(2):185-197. doi: 10.1111/medu.14354. Epub 2020 Sep 13. PMID: 32790934.The Shame Conversation: A short documentary film created by Dr. Will Bynum depicting conversations about experiences with shame in healthcare.https://www.theshamespace.com/film
This episode’s guest is Dr. Raphäel Bonvin, Vice President of Education, Section of Medicine at Université de Fribourg - Universität Freiburg and Professor of Medical Education, Fribourg, Switzerland. Raphäel discusses his journey into medicine, highlighting his initial interest in physics, biochemistry, and medicine, ultimately choosing medicine for its humanistic dimension. His early training in traditional Chinese medicine and parallel training in acupuncture and homeopathic medicine influenced his decision to continue his studies, as he recognized early on a disconnect between how he was being taught and the educational elements and approaches necessary to become a skilled physician. His interest in this topic deepened, and through a series of events, his career path turned toward a central focus on medical education. He has been an influential and effective leader in shifting the focus of assessments in medical education from knowledge-centric assessments to a system of formative assessments, ones that are designed as truly learning tools, and emphasizing the role of student reflection and the development of critical competencies beyond only knowledge and skills.In his work at the University of Fribourg medical school, Raphäel discusses the programmatic assessment approach in medical education, emphasizing the importance of considering multiple sources of information rather than relying solely on grades. The speaker explains the concept of measuring points as pieces of information, like how we use multiple data sources in the clinical setting such as lab data, clinical interpretation, and personal experience to influence clinical decision-making. Here, multiple data points and sources are used to provide a holistic view of a student's progress. The program aims to move away from traditional grading and focus instead on providing this assessment information openly to students, with the expectation that they reflect on those data and use them to build learning plans to address key competencies necessary to be successful as a physician, including self-awareness skills and self-care.Guest:Raphäel Bonvin MDProfessor, Faculty of MedicineVice President of Education, Section of MedicineUniversity of Fribourg, SwitzerlandPHD Candidate, Maastricht University, The NetherlandsFaculty Page, University of Fribourghttps://www.unifr.ch/med/de/section/staff/prof/people/229455/d8deaOther resources:Bonvin R, Bayha E, Gremaud A, Blanc PA, Morand S, Charri I, Mancinetti M. Taking the Big Leap: A Case Study on Implementing Programmatic Assessment in an Undergraduate Medical Program.Educ. Sci. 2022, 12:425. https://doi.org/10.3390/educsci12070425Rey A, Bonvin R, Cantin B. Étudiant-e-s en médecine face à la mort: chassez le spectre, il revient au galop [Medical students facing death: death is the only certainty in life]. Rev Med Suisse. 2023 Dec 20;19(855):2399-2401. French. doi: 10.53738/REVMED.2023.19.855.2399. PMID: 38117109.Walker M, Grandmaison G, Bonvin R, Mancinetti M. Pédagogie de l’incertitude en médecine [How To Teach Uncertainty Management]. Rev Med Suisse. 2023 Feb 8;19(813):264-266. French. doi: 10.53738/REVMED.2023.19.813.264. PMID: 36753342.Gustin MP, Abbiati M, Bonvin R, Gerbase MW, Baroffio A. Integrated problem-based learning versus lectures: a path analysis modelling of the relationships between educational context and learning approaches. Med Educ Online. 2018 Dec;23(1):1489690. doi: 10.1080/10872981.2018.1489690. PMID: 29966510; PMCID: PMC6041782.
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