On Becoming a Healer

Saul J. Weiner and Stefan Kertesz
  • 4.9 (37)
  • MEDICINE
  • UPDATED MONTHLY
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. Physicians and Authoritarians: Are We Too Obedient?

    APR 8

    Physicians and Authoritarians: Are We Too Obedient?

    The record of physicians standing up for their values as healers under authoritarian regimes is not good, whether it’s Nazi Germany, the former Soviet Union, or Iraq, with behaviors ranging from assisting in torture, to psychiatric hospitalization for political reasons. And sadly, it’s often without any coercion. More subtly, physicians may go along with authoritarian regimes' demands, thinking they can just "stay above the fray."  But is that possible? Already, other professional institutions, including academia and law, have struck deals in the hope they they can move on, rather than defend academic freedom or long-standing legal principles.   What’s in store for medicine? Some might say “not much” -- physicians must simply continue to take good care of their patients. But some are already acceding to orders to abandon care to certain populations, including trans people and refugees; or to compromise privacy. And professional organizations are saying little about looming cuts that would curtail access to care for millions of Americans. One scholar of authoritarianism, Timothy Snyder has written, “When political leaders set a negative example, professional commitments to just practice become more important. Authoritarians need obedient servants.” In this episode, two physicians wrestle with what those commitments are, and how we hold on to them.

    47 min
  2. Caring for Patients or Policing Them? Prescription Drug Monitoring, Doctors and Opioids

    MAR 18

    Caring for Patients or Policing Them? Prescription Drug Monitoring, Doctors and Opioids

    Prescription Drug Monitoring Programs (PDMPs) were originally designed for law enforcement to monitor patients and physicians for criminal behavior before it became available to health care professionals. Physicians and pharmacists often find PDMPs helpful because they can verify what a patient tells them and will often decide not to prescribe or dispense opioids if they discover their patient has been going to multiple providers and pharmacies. But is that health care or policing? Who benefits and who is harmed? Those are questions we consider with our guest, Elizabeth Chiarello, PhD, sociology professor and author of Policing Patients: Treatment and Surveillance on the Frontlines of the Opioid Crisis. The themes we discuss are not unique to PDMPs. This is at least our fifth episode exploring how the criminal justice mindset has crossed into medical practice with harmful effects. Prior ones include: ·       Opioids and the physician-patient relationship: What are we getting wrong? March 2022 ·       Urine Drug Screening: How it can traumatize patients and undermine the physician-patient relationship without helping anyone August 2022 ·       My patient’s in shackles: Can we take these off? April 2023 ·       Drug testing at time of birth: How physicians are co-opted into harming families while thinking they are doing the right thing. Nov 2023

    1h 9m
  3. What can we learn from all those "Why I quit medicine" videos on YouTube?

    FEB 18

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

    JAN 21

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

    12/17/2024

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

    11/19/2024

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

    10/15/2024

    “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 min
  8. Do the doctors who sold Matthew Perry ketamine indicate something rotten in mainstream medicine?

    09/17/2024

    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 min
See All (61)

Trailer

4.9
out of 5
37 Ratings

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 - 2025
  • Episodes
    61
  • Rating
    Clean
  • Copyright
    © Saul Weiner and Stefan Kertesz 2020
  • Show Website
    On Becoming a Healer

You Might Also Like

To listen to explicit episodes, sign in.

Stay up to date with this show

Sign in or sign up to follow shows, save episodes, and get the latest updates.
Select a country or region

Africa, Middle East, and India

Asia Pacific

Europe

Latin America and the Caribbean

The United States and Canada