On Becoming a Healer

Saul J. Weiner and Stefan Kertesz
  • 5.0 (44)
  • MEDICINE
  • UPDATED BIMONTHLY

Doctors and other health care professionals are too often socialized and pressured to become "efficient task completers" rather than healers, which leads to unengaged and unimaginative medical practice, burnout, and diminished quality of care. It doesn't have to be that way. With a range of thoughtful guests, co-hosts Saul Weiner MD and Stefan Kertesz MD MS, interrogate the culture and context in which clinicians are trained and practice for their implications for patient care and clinician well-being. The podcast builds on Dr. Weiner's 2020 book, On Becoming a Healer: The Journey from Patient Care to Caring about Your Patients (Johns Hopkins University Press).

  1. Preventing Suicide: How can we do better?

    2D AGO

    Preventing Suicide: How can we do better?

    Forty-five percent of patients who die by suicide saw a primary care physician in the prior month. Physicians screen for suicide risk just half the time when seeing patients under treatment of depression.  Meanwhile, suicide rates continue to rise in the United States and are the second leading cause of death among young people.  In this episode, Saul interviews co-host Stefan, who is leading a national study of suicide in patients on chronic opioids who take their own lives after their physician tapered or cut off their opioids without their consent. They discuss the rich literature, theoretical and empirical, on why people take their lives, what stops them, and what a caring health professional can do to make a difference. Please note: if you are in crisis, US-based crisis supports are available by calling 988, and at https://988lifeline.org. An international listing of hotlines is offered at https://blog.opencounseling.com/suicide-hotlines/.

    39 min
  2. Bad Leadership in Academic Medicine and Health Care: Let's Talk about It

    JAN 20

    Bad Leadership in Academic Medicine and Health Care: Let's Talk about It

    Unfortunately, bad leadership is common, with 50% of American's leaving a job because of a bad boss, and medicine is no exception.  Saul and Stefan, with a combined 60 years in academic medicine and clinical practice, share personal experiences and anecdotes that highlight the characteristics of dysfunctional and toxic leaders, and discuss their implications for health care training and practice environment, including the trickledown effect on patients. They consider why and how bad leaders end up in positions of power, and what to do about it, acknowledging the difficulties in identifying and promoting effective leaders.

    54 min
  3. Poems about the wretched illness experience when your doctor is"clinically detached"

    12/16/2025

    Poems about the wretched illness experience when your doctor is"clinically detached"

    Writing about the illness experience, medical sociologist Richard Frank described an unspoken agreement with his doctor that if he adopted their detached and clinical language when discussing his illness, "I would have at least a junior place on the management team." Initially it seemed like "not a bad deal," until he experienced the toll it took, concluding that, "No one should have to stay cool and professional while being told their body is breaking down, though medical patients always have to do just that."  Through three poems selected by our repeat guest, English professor Laura Greene of Augustana College, we see the pain and cost to patients when their doctors and nurses hold them at arm's length, unable or unwilling to see their humanity. We reflect on why, and what to do about it.

    50 min
  4. Assisted Dying: An End-of-Life Care Option or a Line Physicians Should Never Cross?

    11/18/2025

    Assisted Dying: An End-of-Life Care Option or a Line Physicians Should Never Cross?

    A growing number of US states and other nations are legalizing either voluntary euthanasia in which a physician (or designate) administers lethal drugs, or physician-assisted dying in which the drugs are given to the patient to self-administer. Our guest, Erica Baccus, tells us about her husband's determination to end his life rather than die of Alzheimer's disease, and the journey they took to Switzerland to make it possible (US laws don't apply to dementia).  His wishes were unquestionably honored. At the same time the procedure has implications we find troubling, especially for what it can mean for the doctor-patient relationship, such as in Canada where some physicians are now killing several of their patients a week.

    1h 3m
  5. Why are we addicted to talking about opioids rather than helping people with chronic pain?

    10/21/2025

    Why are we addicted to talking about opioids rather than helping people with chronic pain?

    For years, doctors and those learning to practice medicine were told pain is "the fifth vital sign" and to treat it aggressively – including with opioids, "if that's what it takes." A consequent rise in opioid prescribing contributed to the devastating opioid crisis. Then the pendulum swung in the opposite direction, hard, with physicians cutting off opioid prescribing to patients, often without their consent. That too led to suffering with many deaths by suicide. What do these two seemingly opposing trends share in common? Both reflect a failure to embrace current knowledge about chronic pain and to bring compassion and caring to people who are suffering. Co-hosts Saul Weiner and Stefan Kertesz discuss the implications from two perspectives: Medical learners are still taught to treat chronic pain like a simple bodily injury ("somatically") with the caveat to avoid opioids, spurring apathy and frustration. Stefan, an addiction medicine specialist who has been conducting a national study of suicides related to forced opioid tapers, argues that we have "become addicted to talking about opioids" rather than about all the good we could do if we applied current knowledge and compassion to help people who are suffering.

    52 min
  6. Despite It All: stories from women who found joy in medicine despite joining a less than welcoming profession

    09/16/2025

    Despite It All: stories from women who found joy in medicine despite joining a less than welcoming profession

    From the 1940 to the 1970's, medicine went from an almost exclusively male club to a profession in which women physicians were commonplace.  Our physician guest is Dr. Anne Walling, who has written a book about the experiences of 37 women who attended a Midwestern medical school, Women in Medicine: Stories from the Girls in White This was a time when pornographic images appeared in lecture slides, and sexual harassment and discrimination in the job market were ubiquitous.  Despite the misogyny, the women interviewed nearly all expressed gratitude that they were able to have such meaningful, rewarding, and stimulating careers. Our guest told us that her interviewees described reunions where male colleagues seemed burned out and cynical, while many of these women remained upbeat and excited about their medical work.  What can we learn from the story of women's entry into mainstream medicine? How has the profession been changed (or not) by their presence?

    42 min
  7. The biopsychosocial model: What would it take to really replace the biomedical model?

    08/19/2025

    The biopsychosocial model: What would it take to really replace the biomedical model?

    Medical educators generally acknowledge the importance of training doctors who care for the whole patient rather than just treat the disease. Most medical school curricula attempt to teach to that philosophy, but how successful are they, really?    Our guest, Robert C. Smith, is a physician and author, who trained with Dr. George Engel, founder of the biopsychosocial model. In his new book, Dr. Smith argues that medical education mostly pays "lip service" when it comes to training physicians who are ready and comfortable serving patients who struggle with unaddressed psychosocial and psychological needs.    He calls for a complete overhaul of medical education. What would that take? Is an overhaul feasible, or are the market forces that now drive medicine as big business too overpowering to allow for transformative change?

    46 min
  8. "Disability is part of the human experience": So why not treat it that way?

    07/15/2025

    "Disability is part of the human experience": So why not treat it that way?

    Soon after Lisa Iezzoni MD was diagnosed with multiple sclerosis during her first year at Harvard Medical School, from which she graduated in 1984, faculty and administrators discouraged her from practicing medicine.  And in her final year they made it impossible for her when the dean's office refused to write a recommendation letter (now called a Medical Student Performance Evaluation).  This week marks the 35th anniversary of the American Disabilities Act which was signed into law on July 26th, 1990. Much has changed since but -- as Dr. Iezzoni, who went on to become an eminent scholar and national policy leader on disability, has documented -- not nearly enough.  She and others have documented wide disparities in the quality of care patients with disabilities still receive, and in 2021 she published the findings of a national study of physician attitudes towards disability that document's persistent stigma and misinformation. Disabled patients were described as a "disruption to clinic flow" and a majority of physicians believed that patients with significant disability inherently have a worse quality of life.  Practices are also ill-equipped to care for them, Dr. Iezzoni, who chaired the U.S. Access Board's advisory committee on accessibility standards for medical equipment observed that "healthcare has been among the most backward environments, in terms of making itself accessible. Movie theaters are accessible, sports stadiums are accessible, transit is accessible. But healthcare facilities—no." In our conversation with her, we explore why.  How is it that physicians have such difficulty appreciating that disability is simply a part of the human experience? We explore the link between the culture within medical education and training, and the kind of people physicians become.  ------ References: Physicians' Perceptions of People with Disability and Their Health Care US Access Board

    57 min
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About

Doctors and other health care professionals are too often socialized and pressured to become "efficient task completers" rather than healers, which leads to unengaged and unimaginative medical practice, burnout, and diminished quality of care. It doesn't have to be that way. With a range of thoughtful guests, co-hosts Saul Weiner MD and Stefan Kertesz MD MS, interrogate the culture and context in which clinicians are trained and practice for their implications for patient care and clinician well-being. The podcast builds on Dr. Weiner's 2020 book, On Becoming a Healer: The Journey from Patient Care to Caring about Your Patients (Johns Hopkins University Press).

Information

  • Creator
    Saul J. Weiner and Stefan Kertesz
  • Years Active
    2020 - 2026
  • Episodes
    71
  • Rating
    Clean
  • Copyright
    © Saul Weiner and Stefan Kertesz 2020
  • Show Website
    On Becoming a Healer

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