On Becoming a Healer

Saul J. Weiner and Stefan Kertesz
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On Becoming a Healer

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. What can we learn from all those "Why I quit medicine" videos on YouTube?

    2月18日

    What can we learn from all those "Why I quit medicine" videos on YouTube?

    There are a lot of videos on YouTube that feature typically young physicians explaining why they decided to leave the profession after years of dedication and hard work.  For some it appears that they were so successful at building a social media presence and related businesses, that they quit medicine. Others seem to just want to share their experience in the hope it might help others. They describe how a sense of exhaustion, dreading work each day and discovering that it wasn’t what they imagined when they dreamed of becoming a doctor drove them away.  What they have to say feels quite convincing, and thousands of comments affirm them.   At the same time, there is something missing. They rarely talk about their relationships with patients or how medicine, no matter how corrupted it is by profit seeking, really is a special and unique profession that is worth fighting for. We reflect on what to make of this blind spot, trying very hard not to sound preachy.

    50 分鐘
  2. The New Medical School Graduation Competencies and Why One of the Them Stands Out

    1月21日

    The New Medical School Graduation Competencies and Why One of the Them Stands Out

    In December 2024, the three organizations that oversee medical school (MD and DO) and residency education released a set of “Foundational Competencies for Undergraduate Medical Education,” that represent a consensus on the observable abilities medical students should exhibit as they begin practicing medicine under supervision. Not surprisingly they include taking a relevant patient history, performing a relevant physical exam, and creating and prioritizing a differential diagnosis.  But a new one – and it’s the first one under Patient Care -- entails integrating patient context and preferences into patient care. Stefan interviews co-host Saul Weiner who has documented a strong correlation between contextualizing care and patient health care outcomes in thousands of encounters. Saul reflects on how contextualizing care is a deeply human but teachable process that AI can’t replicate and that makes care measurably more effective for patients, and more meaningful for doctors. The Institute for Health Care Improvement’s new online course on contextualizing care is accessed at Contextualizing Care 101. For bulk orders email OpenSchoolSubsribers@ihi.org

    51 分鐘
  3. A Conversation with Pediatric Surgeon John Lawrence MD, Past Board President of Doctors Without Borders, USA

    2024/12/17

    A Conversation with Pediatric Surgeon John Lawrence MD, Past Board President of Doctors Without Borders, USA

    At a moment of increasing isolationism and xenophobia and -- for physicians – burnout, in a highly bureaucratic and profit driven health system, service in low resource high needs settings can be an antidote for what ails America and American medicine, at least for the individual clinician. John Lawrence has spent decades serving all over the globe as a pediatric surgeon, most recently in war torn Gaza and South Sudan.  He explains how he headed to college with plans to become a mathematician and then got diverted from that career trajectory while teaching math to Native American youth in Montana and seeing the consequences of poor access to needed healthcare.  As cliched as it may sound, physicians are supposed to serve humanity rather than just the well insured, and John exemplifies that point of view on a global scale.

    56 分鐘
  4. Addressing Social Drivers of Health: What is the role of the clinician?

    2024/11/19

    Addressing Social Drivers of Health: What is the role of the clinician?

    In can be confusing and even demoralizing for a medical student or resident to understand what’s expected of them when caring for patients with social needs.  They already feel overwhelmed. Are they supposed to now also screen for housing insecurity? Is it their job to intervene to address social needs? And if someone else is doing the screening, what’s their role? And are they also supposed to be advocating for changes to social policies?  Finally, what’s special about social needs as opposed to all the other reasons that, for instance, a patient can’t control their diabetes? A patient may not be able to store their insulin because they are poor. Or they may not be able to administer it because they can’t read the bottle or their fingers are arthritic.  Our guest, Emily Murphy MD, an academic hospitalist, provides her perspective on teaching medical students and residents about SDOH. Co-host Saul Weiner, expresses concern that messages to trainees about their roles are confusing, that the SDOH movement is just the latest buzzword in medicine, like “patient-centered care,”, and that while getting a huge amount of attention the movement could ultimately have little impact on patient wellbeing. He, Dr. Murphy, and co-host Stefan Kertesz discuss these questions and concerns and consider what needs to change.

    53 分鐘
  5. “Simonisms”: Revisiting the uncommon wisdom of a physician and educator who shaped us deeply

    2024/10/15

    “Simonisms”: Revisiting the uncommon wisdom of a physician and educator who shaped us deeply

    To commemorate the start of our fifth season, we revisit a conversation we had almost two years ago about the wisdom of Simon Auster, MD. Simon was a family physician and psychiatrist who inspired the conversations we’ve been having with each other and with guests on every episode.  “Simonisms” embody Simon’s insights: pithy observations about the practice of medicine that are never cliché, challenge commonly held assumptions and offer fresh perspectives. We share -- and reflect on -- these pearls because we believe they can help many doctors, those in training, and those who train them, find joy and meaning in their work.  You can learn about Simon, who died in 2020, in an online (open access) essay about his life, published in The Pharos, the journal of the AOA medical honor society.

    34 分鐘
  6. Do the doctors who sold Matthew Perry ketamine indicate something rotten in mainstream medicine?

    2024/09/17

    Do the doctors who sold Matthew Perry ketamine indicate something rotten in mainstream medicine?

    The two doctors charged for their roles in the events leading up to actor Matthew Perry’s death were both involved in a “side hustle”: selling ketamine at a big mark-up to make extra money, above what they earned through legitimate practice. One was an internist-pediatrician and the other an emergency medicine physician.  Their cynicism was starkly evident in a text one sent the other about jacking up the price: “I wonder how much this moron will pay. Let’s find out.” It’s easy to write off these doctors as just bad apples; regrettable examples of how difficult it is to prevent a small number of unethical people from making it through medical school and residency.  But what about the profit-making that occurs when thousands of physicians perform procedures, including surgeries, for which there is strong evidence of NO benefit from randomized controlled trials, but with all the risks of pain and complications during recovery and over the long term? From a patient’s perspective is there really a difference between being subjected to predictable harm when you know your doctor is a drug dealer versus these practices within the mainstream of medicine where patients assume their physicians are acting in their best interests?   Which is the greater betrayal?

    57 分鐘
  7. Some Pitfalls of Narrative Medicine and How to Avoid Them

    2024/08/20

    Some Pitfalls of Narrative Medicine and How to Avoid Them

    The term “Narrative Medicine” (NM) refers to a range of activities, including close reading and reflective writing about literature, designed to improve the clinician-patient relationship. What could go wrong?  Our returning guest, English professor Laura Greene, lays out the case for narrative medicine, while co-host Saul Weiner highlights his concern that the challenges and rewards of interacting therapeutically with patients are categorically different from those of a physician interacting with a text.  Unless proponents of narrative medicine articulate these differences explicitly, they risk creating unrealistic expectations about what NM can achieve, particularly in regard to actual healing interactions in the exam room.

    56 分鐘
  8. The chasm between how doctors are taught to communicate and what they actually sound like

    2024/07/23

    The chasm between how doctors are taught to communicate and what they actually sound like

    There is an idealized version of physician-patient communication that is taught in medical schools, reinforced with acronyms like PEARLS, SPIKES, and LEARN, but what resemblance does it bear to how doctors actually sound in the exam room?  Co-host Saul Weiner leads a research team that has audio recorded and analyzed thousands of medical encounters. In this episode, he and Stefan read a transcript from a typical visit, portraying patient and doctor, respectively, breaking out of role periodically to reflect on what’s just happened. Throughout, the physician interacts with the computer, peppering their patient with questions while conducting data entry. On the one hand, the visit is unremarkable. The physician seems reasonably conscientious. On the other, it is disturbing for their lack of engagement even when the patient shows signs of distress or confusion. What can we learn and teach by studying transcripts of real doctor-patient interactions, warts and all?  Saul has posted over 400 of them, all de-identified, in a federal data repository.

    46 分鐘
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簡介

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).

資訊

  • 創作者
    Saul J. Weiner and Stefan Kertesz
  • 活躍年代
    2020年 - 2025年
  • 集數
    59
  • 年齡分級
    兒少適宜
  • 版權
    © Saul Weiner and Stefan Kertesz 2020
  • 節目網站
    On Becoming a Healer

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