Dr. Patient

Date: 6/13/22
Name of podcast: Dr. Patient
Episode title and number: 10 Pushback, Part 2

Episode summary:
How did we get to where we are today, where health insurance companies dictate how medicine should be practiced between a doctor and their patient? This episode reviews the origins of Medicare, and reviews Medicare For All as an alternative to the over-privatization of current Medicare plans. This is yet another way that physicians (and patients) can pushback on a dysfunctional system.

Guest(s):
Dr. Susan Rogers, President of Physicians for National Health Program 

Key Terms:
Medicare – federal insurance for people 65 and older, some younger people with disabilities
Medicare Parts A, B, C, D – A provides inpatient/hospital care, B is for outpatient coverage, C offers an alternative way to get your benefits, D provides prescription drug coverage
Medicare For All – a single payer, national health insurance program concept; would provide everyone in the US with comprehensive health care coverage
Medicare Advantage – Part C plans; private companies provide the care
Fee For Service, FFS – system of health insurance payment where a doctor or other health care provider is paid a fee for each service rendered
Single Payor System – health care system where one entity (a single payer) collects all health care fees and pays for all health care costs
Affordable Care Act, ACA – legislation from 2010 that provided more affordable health insurance to more people, expanded the Medicaid program and supports innovative medical care delivery methods to reduce costs. Also called “Obamacare”
Direct Contracting Entity, DCE – Private 3rd parties that provide an alternative payment model for healthcare. They act as the intermediatry between the government and the beneficiary
Capitation – the payment of a fee to a doctor per patient; often is about $10k per year per patient whether the doctor sees that patient 1 time or 20 times during the year 

References:

Physicians for National Health Program
How do Medicare Advantage Plans work?          
Social Determinants of Health
US Health Insurance System (overview)
A Brief history of Medicare in America
History of Health Insurance in the United States
Medicare and the Affordable Care Act
There goes your Medicare: The trouble with DCEs
Single-Payer Healthcare vs. Universal Coverage

Podcast website: www.drpatientpodcast.com

Podcast email, become a guest: [email protected]

Date: 6/7/22
Name of podcast: Dr. Patient
Episode title and number: 9 Pushback Part 1
Episode summary:
Part 1 of stories about doctors and patients who are pushing back on a broken healthcare system. Learn about concierge care and direct primary care, from two doctors that left traditional fee for service practice models for these alternatives. 

Guest(s):
Dr. Charles Dillon, University Associates in Chicago
Dr. Cindy Rubin, In Touch Pediatrics & Lactation in Chicago 

Key Terms:
[11:42] - physical extender - someone certified in basic medical training - Physician Assistant, Nurse Practitioner, Nurse Midwife
[14:47] - Guillan-Barre Syndrome - immune disorder where your body's immune system attacks itself

References:

Dr. Dillon site:  https://www.doximity.com/pub/charles-dillon-md
Dr. Rubin site:  https://intouchpediatrics.com
Direct Primary Care Coalition:  https://www.dpcare.orgDCP Nation:  https://dpcnation.org

https://www.medicaleconomics.com/view/difference-between-concierge-and-direct-care

Podcast website: www.drpatientpodcast.com

Podcast email, become a guest: [email protected]

Date: 5/31/22
Name of podcast: Dr. Patient
Episode title and number: 8 Medical Errors 

Episode summary:
This is a three part episode: part 1 is a story about a medical error with devastating consequences, part 2 is a minor medical records error that has much larger ripple effects and part 3 is my own story of a medical error.  Medical errors are unfortunately not that uncommon, and range from medication errors, hospital acquired infections, missed diagnoses, delays in treatment and more. 

 Guest(s):
Eve from Chicago
Randi from Florida 

Key Terms:
[01:27] Preeclampsia – complication of pregnancy characterized by high blood pressure, protein in the urine and more
[01:39] HELLP syndrome – life threatening pregnancy complication which is a variant of preeclampsia, defined by the breakdown of red blood cells, low platelets (easy bruising and bleeding) and elevated liver tests
[05:29] – Braxton Hicks – mild, irregular contractions during pregnancy, not the same as actual labor contractions

 References:
Study Suggests Medical Errors Now Third Leading Cause of Death in the U.S. – study by Johns Hopkins
Medical errors may stem more from physician burnout than unsafe health care settings – study by Stanford Medical Center

Podcast website: www.drpatientpodcast.com

Podcast email, become a guest: [email protected]

Date: 5/24/22
Name of podcast: Dr. Patient
Episode title and number: 7 Doctor Burnout and Moral Injury

Episode summary:
Physician burnout is very prevalent in the US, and is predicted to rise in the coming years as the pandemic lingers, the doctor shortage intensifies, and the population of elderly shoots up. In addition, adolescents and young adults today are reporting all time high rates of depression and anxiety, and they’re not even in medical school yet. Raising awareness about burnout and it’s partner, moral injury, is crucial to beginning to prevent, instead of treat, this workplace phenomenon. My guest is Dr. Karen Leitner, a medicine-pediatrics doctor and now coach to women physicians.

Guest(s): Dr. Karen Leitner of Karen Leitner MD Coaching

Key Terms:
[08:11] - PA process; prior authorization - the process medical offices need to go through with insurance companies when something they want their patient to have is not covered by the patient's insurance company
[22:07] - MA; Medical Assistant

References:
AMA article What Doctors Wish Patients Knew About Physician Burnout - no longer available
World Health Organization’s definition of burnout
2019 article by Wendy Dean MD, Simon Talbot MD and Austin Dean ‘Reframing Clinicial Distress: Moral Injury Not Burnout’ and their organization, Fix Moral Injury
Article on the history of burnout
Articls ‘50+ Shocking Physician Burnout Statistics You’ll Never Believe’
Karen Leitner MD Coaching

Podcast website: www.drpatientpodcast.com

Podcast email, become a guest: [email protected]

Date: 5-17-22
Name of podcast: Dr. Patient
Episode title and number:  6 How Doctoring Used to Be

 Episode summary:
In the old days of medicine, doctors had more time and more freedom to practice their art as they saw fit. Nowadays many doctors are affiliated with big hospitals or groups, and have lost the freedom to design their day so to speak. Many don’t have a say over how much time they get with patients, how billing works and more. In this story you’ll hear a few stories about how things used to be, and also how those older healthcare providers see today’s healthcare delivery.

Guest(s): Anne Johnston, Dr. Jack Martin

 Key Terms:
[08:30] EKG – short for Electrocardiogram, it’s a test that looks at the electrical activity of your heart. 
[09:37] pacemaker – a device that’s implanted into the chest to regulate your heartbeat and rate
[10:05] – PVCs – Premature ventricular contraction, considered an “extra” heartbeat that originates in one of the lower chambers, ventricles, and leads to the feeling of fluttering or an extra heart beat
[10:08] – pacemaker in situ – a pacemaker that’s “in place”
[10:54] – echocardiogram, basically an ultrasound of your heart, it checks how blood is pumping in all parts of your heart and the main vessels
[29:28] – CME – Continuing Medical Education. Doctors need to log a certain number of hours per year to retain their medical license

Podcast website: www.drpatientpodcast.com

Podcast email, become a guest: [email protected]

Date: 5/10/22
Name of podcast: Dr. Patient
Episode title and number: 5 Doctoring Above & Beyond

Episode summary:
Doctors' lives are so insanely busy, that it stands out even more when someone takes the time to go beyond the expectation of basic care. It could be something small, like simply following through on a mystery illness, or it could be the appointment that you make for a patient that basically saves their life.

Key terms:
OB [01:06] - Obstetrician-Gynecologist
Hodgkins [01:41] - a type of blood cancer; full name is Hodgkins Lymphoma
ENT [02:36] - Ear, Nose & Throat doctor
Pulmonology [10:12] - lung doctor
CT scans [10:22] - short for computed tomography scan; medical imaging technique
Cardiologist [10:40] - heart doctor
Echocardiogram [10:45] - an ultrasound of the heart and its vessels and blood flow
Right heart catheterization [10:48] - a procedure where a thin, flexible catheter is guided through a blood vessel to the heart to diagnose certain heart conditions
Rheumatologist [10:58] - specialist doctor that sees inflammatory disorders
Idiopathic Subglottic Stenosis - a disorder of unknown origin that causes narrowing of the part of the airway just under the vocal cords

Podcast website: www.drpatientpodcast.com

Podcast email, become a guest: [email protected]

Date: 5/3/22
Name of podcast: Dr. Patient
Episode title and number: 4 Doctors As Patients

Episode summary:
What happens when the doctor has to take off the stethoscope and lie down in the hospital bed? You’ll hear 3 stories today: A pediatrician hospitalist whose own child is in the hospital, a provider that does telehealth with her clients all the time but stumbles through her own telehealth appointment, and me talking about what exactly is so hard about being a doctor-patient.

Guests:
Dr. Barrett Fromme, University of Chicago
Sharon Dornberg-Lee, LCSW

Key Terms:
Hospitalist [00:41] - a physician who works exclusively in the hospital caring for inpatients
Jon Snow [14.58] -  reference to the character from Game of Thrones who is often told, "you know nothing, Jon Snow"

Podcast website: www.drpatientpodcast.com

Podcast email, become a guest: [email protected]

What can you do to get the most out of your visit with a doctor? There actually are a few things that you can do! Bringing your list with you, asking questions the right way, and being totally honest are a few. 

Podcast website: www.drpatientpodcast.com

Podcast email, become a guest: [email protected]

Date: 4/26/22
Name of podcast: Dr. Patient
Episode title and number: 3 Finding Humanity in the Hospital

Episode summary:
Hear Grace Lombardo’s stories about a role-reversal in the hospital, the blog that she maintains to share about her experiences, and how she got one doctor to think twice about how she practices medicine.

Guest:
Grace Fauls Lombardo

Key Terms:
Doula [00:40] - a trained professional who provides continuous physical, emotional and informational support to a mother before, during and shortly after childbirth.
Mastectomy [02:09] - a way of treating breast cancer by removing all of one or both breasts

References:
Grace's blog: www.grancerblog.com
Short documentary about Grace's breast tattoo: https://www.self.com/video/watch/grace

Podcast website: www.drpatientpodcast.com

Podcast email, become a guest: [email protected]

Date: 4/19/22
Name of podcast: Dr. Patient
Episode title and number: 2 A Day in the Life, Doctor

Episode summary:
Let me take you through a day in the life of a busy primary care doctor. Hear about his main challenge of the day, time, and what he needs to do to fit everything in.

Guest:
Andrew Johnston MD, Site Director, Open Door Fortuna Community Health Center (yes, he's my brother)

Key Terms:
MyChart [17:07] - an example of an electronic medical record system's messaging section

FQHC [17:46] -  Federally Qualified Health Center, community-based health care providers that receive funds from the HRSA Health Center Program to provide primary care services in underserved areas

HMO [17:52] -  Health Maintenance Organization, a type of health insurance plan that limits coverage to certain doctors and hospitals that work for or contract with the HMO. It's usually a little cheaper, but more restrictive.

References:
A study conducted in late 2021 by locumstory.com and Hanover Research of 1000 physicians across the country found that:
-- nearly 2/3 of doctors feel more overworked now than when they started their career
-- about 40% feel their jobs don’t allow them to lead well-balanced lives
-- almost 1/4 spend more than an hour per day on paperwork only
-- 58% spend less time now with patients than when they started
-- 59% want more time to communicate with their patients in person
-- 53% think digital communication distracts from patient care
-- Over half (55%) said they had considered quitting or leaving medicine in the prior few years

Podcast website: www.drpatientpodcast.com

Podcast email, become a guest: [email protected]