BackTable ENT & Allergy

Is the advice you’re getting from your mentor really what you need, or is the real breakthrough hidden in your own answers? In this episode of the BackTable ENT podcast, Dr. Gopi Shah welcomes Dr. Stacey Ishman, a chief medical officer, pediatric ENT, real estate investor, syndicator, and career coach for physicians, to discuss transitioning from academic medicine to utilization management.
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SYNPOSIS
Dr. Ishman emphasizes the significance of mentorship and coaching in academic medicine, the difference between the two, and how understanding one's values is crucial for career fulfillment. The conversation addresses common challenges faced by physicians such as setting boundaries, managing time effectively, and achieving work-life balance. Dr. Ishman also shares practical tips for personal and professional growth, encourages networking, and highlights how coaching can help physicians realign their careers with their values. The episode concludes with resources and strategies for physicians feeling burnt out and advice on navigating career transitions.
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TIMESTAMPS
00:00 - Introduction
03:56 - Mentoring vs. Coaching
11:10 - Time Management and Setting Boundaries
17:38 - Gender and Equity in Academic Medicine
22:18 - Exploring Personal Values
23:41 - Time Management Tips for Physicians
26:17 - Mid-Career Physician Challenges
28:28 - Networking and Self-Promotion
30:12 - Translational Skills in Medicine
32:04 - Knowing When to Make a Change
39:02 - Coaching Programs and Resources
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RESOURCES
Dr. Stacey Ishman
https://www.childrensdayton.org/doctors/stacey-ishman-md-mph
https://www.medicalmentorcoaching.com/

How do we integrate biologics into the existing stepwise treatment model for chronic rhinosinusitis with nasal polyps (CRSwNP)? In this episode, Dr. Reena Mehta, an allergist from Uptown Allergy and Asthma in New Orleans, discusses the use of biologics for treating chronic rhinosinusitis with nasal polyps.
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SYNPOSIS
Dr. Mehta elaborates on the common presentations of patients, the role of biologics such as dupilumab and tezepelumab, and the nuances of patient management post-sinus surgery. Dr. Mehta also covers the workup process, the significance of patient comorbidities like asthma and allergies, and the future perspectives on biologic treatments. Practical aspects of biologic therapy, including insurance hurdles, patient compliance, and the effectiveness of various biologics are thoroughly examined.
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TIMESTAMPS
00:00 - Introduction
02:27 - Understanding Chronic Rhinosinusitis with Nasal Polyps & Presentation
05:22 - Workup and Management of Nasal Polyps
07:31 - Treatment Options: Steroids and Biologics
15:28 - Tezepelumab: A New Tool in the Toolkit
25:03 - Side Effects and Safety of Biologics
28:59 - Insurance and Approval Challenges
36:14 - Long-Term Safety and Efficacy
38:47 - Pediatric Considerations and Future Directions
41:37 - Collaboration Between ENT and Allergy Specialists
45:07 - Conclusion and Final Thoughts
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RESOURCES
Dr. Reena Mehta
https://uptownallergyasthma.com/allergist-dr-reena-mehta/

What happens when a high-achieving physician trades perfectionism for purpose? In this episode of the BackTable ENT podcast, Dr. Tiffany Moon, an anesthesiologist, mom, entrepreneur, former Real Housewives of Dallas cast member, and author of the book 'Joy Prescriptions' joins host Dr. Ashley Agan.

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SYNPOSIS

Tiffany shares her journey from a driven, high-achieving academic physician to exploring new passions outside of medicine. She discusses her midlife crisis, the inspiration behind her book, and the importance of finding joy through gratitude and letting go of perfectionism. They delve into the challenges of balancing a medical career with motherhood, the decision to go part-time, and the impact of her social media presence. Also, Tiffany introduces her upcoming Lead Her Summit, aimed at empowering female entrepreneurs. The episode wraps up with practical insights on maintaining joy and navigating career transitions.

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TIMESTAMPS

00:00 - Introduction
01:37 - Tiffany’s Journey in Medicine
03:15 - Writing Joy Prescriptions
05:32 - Balancing Medicine and Personal Life
12:21 - The Decision to Go Part-Time
17:34 - Navigating Career and Personal Goals
20:42 - Understanding Joy Interrupted
23:05 - Practicing Gratitude in Daily Life
25:14 - The Struggle with Control
29:57 - Navigating Social Media Fame
34:57 - Upcoming Lead Her Summit
37:48 - Final Thoughts and Farewell

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RESOURCES

Tiffany Moon
https://www.tiffanymoonmd.com/

LeadHer Summit 2025 (use code BACKTABLE300 for $300 off):
https://www.leadhersummit.com/

A 47 year old male presents with intermittent, unilateral nasal drainage and headache. What do you do? In this episode of the BackTable Podcast, Dr. Satyan Sreenath, a rhinologist at Indiana University, and Dr. Sanjeet Rangarajan, a rhinologist at Case Reserve University, examine complex cases involving CSF leaks and encephaloceles.

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SYNPOSIS

The doctors discuss diagnostic approaches, imaging techniques, and innovative surgical methods, using endoscopic and minimally invasive strategies. The conversation highlights the difficulties of diagnosing and surgically repairing these leaks, focusing on their personal experiences and preferred techniques. Through detailed case studies with imaging and surgical videos, they explore the importance of meticulous planning, interdisciplinary collaboration, and adaptive strategies to manage these challenging conditions effectively. A must watch on Youtube!

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TIMESTAMPS

00:00 - Introduction
02:17 - Patient Case 1: “Headache and Drippy Nose..”
02:58 - Diagnostic Imaging and Findings
07:55 - Surgical Approach and Postoperative Care
16:52 - Patient Case 2: “Drippy nose and nasal congestion… just allergies right?”
17:32 - Diagnostic Imaging and Findings
20:21 - Surgical Approach and Postoperative Care
29:03 - Patient Case 3: “Runny nose after my MVC 3 years ago…”
29:21 - Imaging and Surgical Approach Discussion
31:46 - Post-Operative Challenges and Patient Follow-Up
42:46 - Patient Case 4: “Continuous nasal drainage BOTH sides”
43:31 - Imaging and Findings
44:43 - Surgical Approach for Bilateral Defects
56:39 - Final Thoughts

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RESOURCES

Dr. Satyan Sreenath profile:
https://iuhealth.org/find-providers/provider/satyan-b-sreenath-md-1821999

Dr. Sanjeet Rangarajan’s profile:
https://www.uhhospitals.org/doctors/Rangarajan-Sanjeet-164956839

A patient walks in with a persistent runny nose. Is it allergies, or something more dangerous? In this episode of the BackTable ENT Podcast, two renowned rhinologists, Dr. Satyan Sreenath
and Dr. Sanjeet Rangarajan, delve into the evaluation and management of cerebrospinal fluid (CSF) leaks at the anterior skull base with host Dr. Gopi Shah.

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SYNPOSIS

The discussion encompasses patient presentations, differential diagnosis, physical examination, and imaging techniques for localization. They also explore the impact of underlying conditions such as idiopathic intracranial hypertension (IIH) and obstructive sleep apnea (OSA) on CSF leaks. Dr. Sreenath and Dr. Rangarjan offer insight into diagnostic strategies, patient management, and surgical planning, providing a comprehensive overview of best practices in managing this complex condition.

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TIMESTAMPS

00:00 - Introduction
02:48 - Patient Presentation and Initial Evaluation
04:45 - Common Symptoms and Diagnostic Challenges
06:02 - Risk Factors and Etiologies of CSF Leaks
10:59 - Management and Treatment Approaches
16:55 - Physical Examination and Diagnostic Techniques
22:35 - Patient Instructions for Sample Collection
24:29 - Differentiating CSF Leaks from Other Conditions
26:12 - Endoscopic Examination Techniques
30:21 - Imaging and Diagnostic Approaches
33:14 - Surgical Planning and Considerations
45:23 - Concluding Thoughts

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RESOURCES

Satyan Sreenath
https://iuhealth.org/find-providers/provider/satyan-b-sreenath-md-1821999

Sanjeet Rangarajan
https://www.uhhospitals.org/doctors/Rangarajan-Sanjeet-1649568395

Let’s talk about what it really means to show up for your patients—and yourself—as a surgeon. In this episode of Backtable ENT, Dr. Mel Thacker, an otolaryngologist and founder of The Empowered Surgeon and the Surgeons with a Purpose Podcast, joins hosts Dr. Gopi Shah and Dr. Ashley Agan to discuss humanity in surgery, and how to stay grounded in a profession that demands so much of us.

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SYNPOSIS

Dr. Thacker shares her journey from experiencing anxiety and panic attacks in the operating room to becoming a coach who helps surgeons discover their purpose and practice medicine with greater humanity. They discuss the significance of self-awareness, the importance of protecting oneself as a valuable asset, and how to serve patients with compassion and empathy. Practical advice is offered on shifting mindset, engaging in meaningful connections with patients, and fostering a collaborative, rather than hierarchical, approach in medical practice.

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TIMESTAMPS

00:00 - Introduction
03:04 - Discovering Coaching
10:52 - Residency Reflections
23:06 - Improving Patient Relationships
29:48 - Coaching Surgeons and Addressing Emotional Growth
37:49 - Serving vs. Fixing: A New Perspective on Patient Care
44:09 - Daily Practices for Empathy and Self-Awareness
44:40 - Three Essentials for Success in Medicine
46:31 - Conclusion and Final Thoughts

How hard is it to move your medical practice across the globe? In this episode of BackTable ENT, otolaryngologist Dr. Ananya Majumder discusses her transition from practicing in Fort Worth, Texas to becoming a consultant otolaryngologist at North Shore Hospital in Auckland, New Zealand with host Dr. Gopi Shah.

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SYNPOSIS

They explore Dr. Majumder’s career journey, the factors that led her to move abroad, the process of obtaining medical licensing and a visa in New Zealand, and the differences in medical practice and work culture between the U.S. and New Zealand. Dr. Majumder also shares insights into her daily routine, the challenges she faced during the transition, and the benefits of international experience in the medical field.

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TIMESTAMPS

00:00 Introduction
01:40 Journey to New Zealand & Navigating Medical Licensing
08:26 Understanding the Healthcare System
15:24 Residency and Training Differences
21:37 Visa Process and Moving
28:49 Daily Practice in New Zealand
29:44 Clinic Workflow Differences & Operating Room Culture
37:14 Patient Relationships and Challenges
42:42 Professional and Personal Growth
48:02 Final Thoughts and Advice

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RESOURCES

Dr. Ananya Majumder
https://www.enthealth.org/find-ent/ananya-majumder/

The sour candy myth: why it’s not always the right Rx for salivary gland obstruction. In this episode, Dr. Wais Rahmati, a board-certified otolaryngologist at Mass Eye and Ear and Harvard Medical School, discusses the development of a comprehensive salivary gland center and the focus on office-based sialendoscopy with host Dr. Ashley Agan.

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SYNPOSIS

The doctors explore the benefits of incorporating salivary endoscopy in the office setting, including minimally invasive and gland-sparing approaches to treat obstructive salivary gland diseases. Dr. Rahmati shares the criteria for patient selection, techniques in the procedure, and post-operative care. They also touch upon the challenges and strategies for reimbursement and the significance of tracking codes to eventually establish dedicated CPT codes for sialendoscopy.

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TIMESTAMPS

00:00 - Introduction
02:40 - History and Evolution of Office-Based Endoscopy
05:32 - Understanding Obstructive Salivary Gland Disease
09:36 - Patient Selection and Office-Based Procedures
14:45 -Imaging and Diagnostic Approaches
20:50 - Office Setup and Procedure Details
30:38 - Injecting Mucosa for Better Access
31:10 - Using Sour Candy to Stimulate Saliva
32:29 - Dilation and Anesthesia Techniques
37:05 - Handling Stones and Stents
40:44 - Treating Stenosis in the Office
47:16 - Post-Procedure Care and Instructions
49:42 - Billing and Reimbursement Challenges
54:43 - Future of Salivary Gland Endoscopy

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RESOURCES

Wais Rahmati MD:
https://doctors.masseyeandear.org/details/447/rahmatullah-wais_rahmati-rahmati-otolaryngology-head_and_neck_surgery-boston

Sinusitis or migraine? Understanding the difference between rhinogenic and primary headaches could change your treatment algorithm. In this episode of Backtable ENT, Dr. Jessica Lee, an otolaryngologist from Charleston ENT and Allergy, discusses the prevalence and treatment of sinus headaches with hosts Dr. Gopi Shah and Dr. Ashley Agan.

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SYNPOSIS

The doctors discuss how half of sinus infection diagnoses are often misdiagnosed, with many patients having normal CT scans and nasal endoscopies. Dr. Lee emphasizes the importance of distinguishing between sinus-related headaches and migraines, noting that 80% of sinus headache complaints meet migraine criteria. The conversation covers the use of lifestyle medicine, supplements, medications, and the role of neurologists in managing chronic headaches. Dr. Lee also touches on the role of mycotoxins, drawing from evidence-based practices while stressing patient education and collaboration in treatment.

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TIMESTAMPS

00:00 - Introduction
04:10 - Differentiating Sinus Headaches from Other Conditions
10:07 - Lifestyle Factors and Migraine Management
25:45 - Supplements and Treatments for Migraine
30:01 - Iron Supplementation and Dietary Adjustments
31:42 - Medication Management for Migraines
34:52 - Botox as a Treatment Option
44:50 - Mycotoxins and Mold Illness
50:11 - Non-Pharmacologic Options for Headaches
54:00 - Final Thoughts and Recommendations

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RESOURCES

Dr. Jessica Lee
https://charlestonent.com/bio/jessica-lee/

Leadership isn’t just about saying yes—it’s about knowing when to say no too. In this episode of Backtable ENT, Dr. Carol Bradford, Dean of the Ohio State University College of Medicine and Vice President for Health Sciences at the Ohio State University Wexner Medical Center, shares her leadership journey with hosts Dr. Gopi Shah and Dr. Sunil Verma.

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SYNPOSIS

Dr. Bradford shares insights into her journey in otolaryngology, emphasizing the importance of feedback, emotional intelligence, and leadership development. She discusses her experiences in various leadership roles, the significance of maintaining clinical practice, and strategies for fostering future leaders. The conversation touches on the challenges and rewards of leadership in academic medicine, the impact of change, and the enduring mission to improve patient care and education.

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TIMESTAMPS

00:00 - Introduction
04:32 - Role and Responsibilities of a Dean & Balancing Clinical Practice
10:25 - Leadership Development & Mentorship
21:41 - Building and Leading Effective Teams
28:23 - Challenges in Leadership Roles
30:40 - Balancing Academic and Clinical Missions
33:41 - Leadership Style and Meeting Management
39:07 - Emotional Intelligence in Medicine
47:12 - Navigating Change and Future Goals
51:45 - Final Advice for Aspiring Leaders

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RESOURCES

Dr. Carol Bradford:
https://wexnermedical.osu.edu/about-us/our-people/carol-bradford

Dr. Sunil Verma:
https://www.ucihealth.org/clinicians/sunil-verma-1124279344