Rotations

Wow, I took a hiatus…well not really. In this 3rd and final segment with Melissa Thomas, PhD we start with mindfulness. That’s apropos because the Amish deal with time in a different fashion than do the “English”.

BTW, I am “mindfully” giving you an extra-long episode…

Dr. Thomas also clearly lets us know that she can “unplug” with the Amish. She leaves the phone in the car. That’s an important concept in an age when more and more people seem to be incapable of actually being without their phone for more than 5 minutes.

The other thing we discuss is assumptions. For the Amish, their concept of what is “healthy” may be a different concept from that of “English” society. Healthy for the Amish may mean “I can provide for my family.”.

Amish patients may not even ask a question thinking a physician’s time is valuable and if there was something to say, the doctor would tell them. Well we find out that time is again a critical factor and Western needs for “getting it done” might not be the best medicine. It might be letting a patient have some time to sort out how disease impacts their lives.

It’s also challenging to the average American that thinks that you can’t have free market health care to hear that the Amish will shop around for open heart surgery. They will ask questions to save money. Bottom line the Amish remind all of us that we have a fiduciary duty to our patients.

They deserve to know what they are paying for what they are getting. Kudos to Pomerene Hospital. I loved working there 18 years ago in the ER. Had I lived closer to Millersburg I would still be working there.

Slow TV. https://youtu.be/EXKATEeB64U (Look for the Queen of Norway in this compressed version)

Joel Pomerene Hospital https://www.pomerenehospital.org/

The Behalt: The Amish and Mennonite Heritage Center https://behalt.com/

I’d be woefully wrong not to include a link to Leemans https://www.lehmans.com/

Life Through Their Lens http://appalcare.org/life-through-their-lens-photo-book/

Buy a copy, all proceeds go back into the research and programs to help the Amish Communities.

Holmes County Ohio https://en.wikipedia.org/wiki/Holmes_County,_Ohio

Microfiche https://en.wikipedia.org/wiki/Microform

I am going to keep the reggae through this. Its happy and it’s upbeat and the irony of it, given that I will never see an Amishman in dreads, is too rich to avoid…plus I haven’t had the time to go out to Danny’s place and asking him if he minds if I use his family’s singing…I’ll get there.

[email protected]

But honestly, we seldom check it. Use the Social Media links…

Catch us on twitter at @RotationsPcast

Todd @MedicalCinema. Brian @Profplow and Nisarg @NisargBakshi

You can also send comments to Todd at TR Fredricks on Facebook.

Look for more Rotations Content at mediainmedicine.com/Rotations

and on

Soundcloud and

iTunes at Rotations Podcast.

Intro and Outro Music: Darb by the Tarante Groove Machine

Courtesy of Artlist.io

Produced by: Todd Fredricks DO and Brian Plow MFA

Edited by: Todd Fredricks DO

Cohost: Sarah Adkins PharmD…Pi was still there. Look for her on Facebook…

Disclaimers: Todd Fredricks, DO

Cut Clip: Nope

Rotations is part of the Media in Medicine family of medical storytelling and is copyrighted.

Rotations is made possible by Ohio University and by the Ohio University Heritage College of Osteopathic Medicine and Scripps College of Communications. The comments and ideas expressed on Rotations are those of the content creators alone and may not reflect official policy or the opinion of any agency of the Ohio University.

So…forgive this upload but frankly after 3 weeks of nothing you deserve an explanation...so here it is. Blame the COVID...

That said, I have the content and I will finish Melissa Thomas' series in the next week but this COVID thing has really put the demands on time and that is across all of my jobs.

Then I went to see my family out west.

So here is my school excuse and hopefully in the next week we will have the schedule working better.

As far as Napoleon's march into Russia here is the map...study this...

https://en.wikipedia.org/wiki/Charles_Joseph_Minard

Shoot me any comments or questions @TR Fredricks on Facebook

Look for more Rotations Content at mediainmedicine.com Rotations

and on

iTunes at Rotations Podcast.

Intro and Outro Music:

Up To The Sky & Discovery both by Roman P

Courtesy of Artlist.io

Produced by: Todd Fredricks DO and Brian Plow MFA

Edited by: Todd Fredricks DO

Cohost:

Disclaimers:

Cut Clip

Rotations is produced using (and we always accept donations from any gear folks):

Rode Podcaster Pro

Rode NT1-A mics

Polsen Studio Headphones

Kopul XLR cables

SanDisk media

iPhone 6

Final Cut Pro X

iMac

Tama mic stands

Rotations is part of the Media in Medicine family of medical storytelling and is copyrighted.

Rotations is made possible by the generous understanding and accommodation of our beloved institution, Ohio University and by the Ohio University Heritage College of Osteopathic Medicine and Scripps College of Communications. The comments and ideas expressed on Rotations are that of the content creators alone and may not reflect official policy or the opinion of any agency of the Ohio University.

The continuation of our interview with Melissa Thomas PhD and her experiences with the Amish people of Ohio and studying their health care. Melissa has 20+ years of working with the Amish of Ohio and she has gathered so many experiences that she has also published an extremely unique boom of photographs that the Amish gave her permission to create to help people see into their lives.

Melissa makes nothing from this project and all proceeds go back into the care of Amish women and preventing deaths from breast cancer. Please consider donating to her project and you can find details here:

http://appalcare.org/project-hoffnung/

We also ask that you share this on Facebook and with your friends to get the word out.

So the interview takes us from the LSU Tigers and Joe Burrow through a description of the history of the History of the Amish and the values of their community.

I’d be remiss in this age of treacherous youth narcissism if I didn’t mention Joe Burrow (who is frankly pretty well-liked around here) and his initial action with fame. He chose not to discuss himself but to focus on the needs of the poor in his community. In the process he helped raise $500,000 for the food bank right before COVID-19 hit the area. That was not an act. Joe is genuinely a good man, and a Bengal, so if you want to follow his lead, consider helping the food bank.

Athens Food Bank

https://www.facebook.com/athenscountyfoodpantry/

https://www.foodpantries.org/ci/oh-athens

Rumspringa

https://en.wikipedia.org/wiki/Rumspringa#:~:text=Rumspringa%20(Pennsylvania%20German%20pronunciation%3A%20%5B,used%20in%20some%20Amish%20communities.

Joseph F. Donnermeyer, PhD MA, Professor Emeritus, OSU

https://oaa.osu.edu/donnermeyer-joseph

For new listeners you might be curious about “The School whose Name Shall not be Mentioned”. Let’s be clear, I bleed Green and White and that other school gets all of the press in Ohio, so I am not going to promote them anymore. But if you really want to know who I am referring to…

https://www.youtube.com/watch?v=vxyWj4DMo-8

Finally, I am going to keep the reggae. Having actually been to Bob Marley’s House and not having rights to use any of Madness’ music I am going to continue to introduce everyone to some of the very talented artists on artlist.io

[email protected]

But honestly, we seldom check it. Use the Social Media links…

Catch us on twitter at @RotationsPcast

Todd @MedicalCinema. Brian @Profplow and Nisarg @NisargBakshi

You can also send comments to Todd at TR Fredricks on Facebook.

Look for more Rotations Content at mediainmedicine.com/Rotations

and on

Soundcloud and

iTunes at Rotations Podcast.

Intro and Outro Music:

Tired by the Young Lords

Courtesy of Artlist.io

Produced by: Todd Fredricks DO and Brian Plow MFA

Edited by: Todd Fredricks DO

Cohost: Sarah Adkins PharmD, again, because nobody else was in the building and her minion Pi wanted to participate in a podcast…

Disclaimers: Todd Fredricks, DO

Cut Clip: I should get there in the next few weeks.

Rotations is produced using (and we always accept donations from any gear folks):

Rode Podcaster Pro

Rode NT1-A mics

Zoom H4N

Rode Lavalier Go

Polsen Studio Headphones

Kopul XLR cables

SanDisk media

Final Cut Pro X

MacBook Pro

Tama mic stands

Rotations is part of the Media in Medicine family of medical storytelling and is copyrighted.

Rotations is made possible by the generous understanding and accommodation of our beloved institution, Ohio University and by the Ohio University Heritage College of Osteopathic Medicine and Scripps College of Communications. The comments and ideas expressed on Rotations are that of the content creators alone and may not reflect official policy or the opinion of any agency of the Ohio University.

Sorry, but I do like reggae. Soooo, I gave you an ample dose of it. Frankly with all of the current kerfluffle I think a good chunk of one drop rhythm will make almost anyone happy…and cousin, we need some happy right now. So, there you are.

In this series we find out that would-be meteorologists can fall into things like health care disparity research in Amish communities in Geauga and Holmes County, Ohio. Melissa Thomas PhD has a doctorate in science (public health) and is super smart and as non-threatening as anyone you will ever meet. She is just a very pleasant person and she has a very sophisticated sense of humor. That means that you can have a real conversation with her without feeling like you need a vacation afterward.

Melissa has a heart for the Amish. Specifically understanding breast cancer in their communities and helping them not die from a disease that has a pretty good survival rate if patients just know what to do. She works tirelessly at trying to help a substantial portion of the population of Ohio.

The talk is definitely about the Amish but it is also about cultural competency and how health care folks can move into and out of cultures that are very different from their own and not do damage in the process. She has a lot of wisdom to share and we hope you find something new to think about.

Fun Fact, I edited this in July 2020 and I just went to Amish country and it was vibrant and working and sunny and greatly enjoyable. You should go. As well they have a lot of eBikes. Yes, the Amish do use technology but they are very concerned about how anything they use affects their humility and their relationship with God so they consider carefully the impact of any new thing on their way of life. Go to Amish country, learn and see some wonderful folks who represent some of the awesomeness of our great state.

Melissa Thomas PhD

https://www.ohio.edu/uc/thomasm5

Avon Corporation

https://about.avon.com/us-about/corporate-responsibility/avon-breast-cancer-crusade

Daniel Skinner PhD

https://www.ohio.edu/experts/expert/daniel-skinner

Dan also produces a podcast called “Prognosis” https://podcasts.apple.com/us/podcast/prognosis-ohio/id1438757698

Berkeley Franz PhD

https://www.ohio.edu/experts/expert/berkeley-franz

Todd’s Three Rules of Civil Affairs:

1. All people want to grow old and die peacefully in their sleep.

2. All people want to see their grandchildren.

3. All people want ice cream on Sunday.

In 29 years of working across any number of populations across cultures on 7 continents I have operated with these three rules as the starting point for any discussion and/or negotiation and they have never failed me. Always start with what is common to all of us and you will find the dialogue goes a lot better.

As far as wonkish tschotchkies I have now given Melissa a baby Yoda…seriously. If you ever visit her she will probably have him on her desk…

Catch us on twitter at @RotationsPcast

Todd @MedicalCinema. Brian @Profplow and Nisarg @NisargBakshi

Todd at TR Fredricks on Facebook.

Look for more Rotations Content at

iTunes at Rotations Podcast.

Intro and Outro Music:

Autumn Breeze by Roger Rivas

Courtesy of Artlist.io

Produced by: Todd Fredricks DO and Brian Plow MFA

Edited by: Todd Fredricks DO

Cohost: Sarah Adkins PharmD (Because she was bored) her minion “Pi” had no choice in the matter.

Disclaimers: Todd Fredricks, DO

Cut Clip: None… we are getting there with production

Rotations is part of the Media in Medicine family of medical storytelling and is copyrighted.

Rotations is made possible by the generous understanding and accommodation of our beloved institution, Ohio University and by the Ohio University Heritage College of Osteopathic Medicine and Scripps College of Communications. The comments and ideas expressed on Rotations are that of the content creators alone and may not reflect official policy or the opinion of any agency of the Ohio University.

The last episode of our series with John Bishara DO. In this discussion we try and cover the most current developments in COVID and address some of the social media challenges in a public health crisis. It will probably run a little long but hey, you get what you pay for and in the case of Rotations you get a lot more than you pay for sometimes.

And as always…

Wear a mask in close and indoor public spaces. Period. Full stop.

Coagulopathy and COVID

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7225095/

Management of Pregnancy with COVID-19

https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/03/novel-coronavirus-2019

This seems like a perfectly good place to have Armando Hasudungan talk to us about cells…

https://www.youtube.com/watch?v=HjlWm3LudJs

How about Nucleus Medical Media as well?

https://www.youtube.com/watch?v=URUJD5NEXC8

And while we are at it lets review Drew Berry’s TED talk…

https://www.youtube.com/watch?v=WFCvkkDSfIU

WVU Medicine Charleston Area Medical Center

https://en.wikipedia.org/wiki/Charleston_Area_Medical_Center

[email protected]

But honestly, we seldom check it. Use the Social Media links…

Catch us on twitter at @RotationsPcast

Todd @MedicalCinema. Brian @Profplow and Nisarg @NisargBakshi

You can also send comments to Todd at TR Fredricks on Facebook.

Look for more Rotations Content at mediainmedicine.com/Rotations

and on

Soundcloud

and

iTunes at Rotations Podcast.

Intro and Outro Music:

Born Again by Michael Shynes

Courtesy of Artlist.io

Produced by: Todd Fredricks DO and Brian Plow MFA

Edited by: Todd Fredricks DO

Cohost: None, I did this after hours and you know work rules for students

Disclaimers: Sarah Adkins PharmD, The Phlegmatic Pharmacologist (It’s truly worth listening to her outro…you’re welcome)

Cut Clip: None

Rotations is produced using (and we always accept donations from any gear folks):

Rode Podcaster Pro

Rode NT1-A mics

Zoom H4N

Rode Lavalier Go mics

Countryman Lavalier mics

Polsen Studio Headphones

Kopul XLR cables

SanDisk media

Final Cut Pro X

MacBook Pro

Tama mic stands

Rotations is part of the Media in Medicine family of medical storytelling and is copyrighted.

Rotations is made possible by the generous understanding and accommodation of our beloved institution, Ohio University and by the Ohio University Heritage College of Osteopathic Medicine and Scripps College of Communications. The comments and ideas expressed on Rotations are that of the content creators alone and may not reflect official policy or the opinion of any agency of the Ohio University.

In this episode we continue with the discussion of moral injury. I can boil it down to a single concept:

If you are thinking that you are unsure of whether or not you can continue to remain moral and ethical in your current practice, you have moral injury.

The ideas in this episode are tough. How do we educate medical students to be aware of this concept? How do we empower physicians to deal with it? How do we work around administrations that are indifferent and only serve a spreadsheet? How do we work with sympathetic administrators who actually do want a healthy physician and clinician group but are constrained by insurance companies and regulations in their options to work toward that?

The cynic will shout “Nationalize all Health Care”. But here is a news flash, The VA is federalized medicine and moral injury is not a stranger in the VA. Large bureaucracies don’t work well toward the goal of building familiarity and common understanding of local group needs.

This is a very tough topic.

We end with a discussion on physician unions. The dialogue doesn’t make that a panacea either. Private practice folks cannot unionize for some reason but employed physicians can unionize. But keep in mind, what does a strike look like? The reality is that like air traffic controllers, you can have a union but do you strike when it means you are not caring for patients?

I ran this long because we had enough content for 2 episodes but not quite enough for 3, so forgive me.

Wendy Dean MD Twitter @WDeanMD

Simon Talbot MD https://physiciandirectory.brighamandwomens.org/details/1847/simon-talbot-plastic_surgery-boston

Moral Injury https://fixmoralinjury.org/

Burnout

https://www.aafp.org/fpm/2015/0900/p42.html

https://www.npr.org/2016/12/08/504864961/when-a-psychologist-succumbed-to-stress-he-coined-the-term-burnout

The Mini Z

https://www.vumc.org/health-wellness/sites/vumc.org.health-wellness/files/public_files/PDFs/wlc/wlcMiniZ.pdf

Malach Burnout Scale

https://en.wikipedia.org/wiki/Maslach_Burnout_Inventory

Fiduciary Responsibility

http://www.businessdictionary.com/definition/fiduciary-duty.html

Press-Ganey Scores

https://www.pressganey.com/About/News/Patient-Satisfaction-Scores-Optimizing-The-Patient-And-Clinician-Experience

Pay Parity

https://www.nursepractitionersoforegon.org/page/news20160225/Legislature-Votes-to-Make-NP-Payment-Parity-Law-Permanent.htm#:~:text=Oregon's%20nurse%20practitioner%20payment%20parity%20law%20is%20the%20first%20law,they%20perform%20the%20same%20services.

[email protected]

But honestly, we seldom check it. Use the Social Media links…

Catch us on twitter at @RotationsPcast

Todd @MedicalCinema. Brian @Profplow and Nisarg @NisargBakshi

You can also send comments to Todd at TR Fredricks on Facebook.

Look for more Rotations Content at mediainmedicine.com/Rotations

and on

Soundcloud and

iTunes at Rotations Podcast.

Intro and Outro Music:

Corals Under the Sun by Sivan Talmor

Courtesy of Artlist.io

Produced by: Todd Fredricks DO and Brian Plow MFA

Edited by: Todd Fredricks DO

Cohost: None, I did this after hours and you know work rules for students

Disclaimers: Todd Fredricks, DO

Cut Clip: None… we are getting there with production

Rotations is produced using (and we always accept donations from any gear folks):

Rode Podcaster Pro

Rode NT1-A mics

Zoom H4N

Rode Lavalier Go

Polsen Studio Headphones

Kopul XLR cables

SanDisk media

Final Cut Pro X

MacBook Pro

Tama mic stands

Rotations is part of the Media in Medicine family of medical storytelling and is copyrighted.

Rotations is made possible by the generous understanding and accommodation of our beloved institution, Ohio University and by the Ohio University Heritage College of Osteopathic Medicine and Scripps College of Communications. The comments and ideas expressed on Rotations are that of the content creators alone and may not reflect official policy or the opinion of any agency of the Ohio University.

The second of 3 episodes with John Bishara DO, Pediatric Pulmonologist. We get into the meat of COVID-19. Wonder why we are getting so concerned over this when we were not as concerned about SARS and MERS? We talk about it. Want to know how COVID-19 kills and maims people? We talk about it. Want to know the truth about this disease, specifically its affects on children? We talk about it.

Frankly I don’t mind the comments on social media about COVID-19, what I mind is that amateurs with a voice may influence people who then behave in a manner that leads to the infection of a nursing home or the death of a child. The bottom line is that COVID-19 is not a government conspiracy. Period. It is a real disease that is very mysterious in how it behaves and it has killed over 110,000 Americans in just 3 months.

So if you want to learn more, listen and while you do, ask yourself this; if it could save one life, is wearing a mask in Kroger for an hour worth it?

Wear a mask in close and indoor public spaces. Period. Full stop.

SARS

https://www.who.int/csr/sars/en/

https://www.cdc.gov/sars/index.html

https://en.wikipedia.org/wiki/Severe_acute_respiratory_syndrome

MERS

https://www.cdc.gov/coronavirus/mers/index.html

https://www.who.int/emergencies/mers-cov/en/

https://en.wikipedia.org/wiki/Middle_East_respiratory_syndrome

Incubation Period

https://en.wikipedia.org/wiki/Incubation_period

Case Fatality

https://en.wikipedia.org/wiki/Case_fatality_rate

High Flow Nasal Canula

https://rebelem.com/high-flow-nasal-cannula-hfnc-part-1-how-it-works/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6358040/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5406687/#:~:text=HFNC%2C%20like%20CPAP%2C%20is%20a,resistance%20%5B10%2C11%5D.

Cytokine Storm

https://www.cancer.gov/publications/dictionaries/cancer-terms/def/797584

https://www.nytimes.com/2020/06/11/health/coronavirus-cytokine-storm.html

https://www.youtube.com/watch?v=AXP9qQ_a0fw

COVID-19 and Coagulopathy/Thrombosis

https://ashpublications.org/blood/article/135/23/2033/454646/COVID-19-and-its-implications-for-thrombosis-and

COVID-19 and Cardiomyopathy

https://heartfailure.onlinejacc.org/content/8/6/512

Point of Care Ultrasound

https://www.acc.org/latest-in-cardiology/articles/2017/10/31/09/57/point-of-care-ultrasound

https://www.sonosite.com/about/what-pocus-point-care-ultrasound

[email protected]

But honestly, we seldom check it. Use the Social Media links…

Catch us on twitter at @RotationsPcast

Todd @MedicalCinema. Brian @Profplow and Nisarg @NisargBakshi

You can also send comments to Todd at TR Fredricks on Facebook.

Look for more Rotations Content at mediainmedicine.com/Rotations

and on

Soundcloud and

iTunes at Rotations Podcast.

Intro and Outro Music:

My Father’s Son by Jay Denton

Courtesy of Artlist.io

Produced by: Todd Fredricks DO and Brian Plow MFA

Edited by: Todd Fredricks DO

Cohost: None, I did this after hours and you know work rules for students

Disclaimers: Todd Fredricks, DO

Cut Clip: None… we are getting there with production

Rotations is produced using (and we always accept donations from any gear folks):

Rode Podcaster Pro

Rode NT1-A mics

Zoom H4N

Rode Lavalier Go

Polsen Studio Headphones

Kopul XLR cables

SanDisk media

Final Cut Pro X

MacBook Pro

Tama mic stands

Rotations is part of the Media in Medicine family of medical storytelling and is copyrighted.

Rotations is made possible by the generous understanding and accommodation of our beloved institution, Ohio University and by the Ohio University Heritage College of Osteopathic Medicine and Scripps College of Communications. The comments and ideas expressed on Rotations are that of the content creators alone and may not reflect official policy or the opinion of any agency of the Ohio University.

This series is a little different. Obviously, a pulmonologist has something to say about COVID-19 these days. So, John and I decided to break it up. Episode 1 will deal with becoming a pulmonologist and what that is like. Episode 2 is all about COVID-19 and what it does what it does. Basically, what do we know about this disease as of 8 June 2020. Episode 3 is the catchall of questions and how the incredible blessing of the internet is also a major headache for people trying to care for the critically ill and also prevent people from actually getting COVID-19 and dying because someone thinks a mask is not useful.

Dr. Bishara is also an officer in the United States Air Force and has been a principle advisor for public health policy within the West Virginia National Guard. He is about as humble as they come, and he deals with the sickest of sick people. He is someone that is approachable on any level and he loves what he does, mucus and all.

Finally, I want to reiterate that I am running John’s episode concurrently with Wendy Dean and Simon Talbot’s because while COVID-19 is not the same thing as Moral Injury in health care but they are related at this point in the disease. It is also really important that John’s words compete with all of the insanity that we see on the internet along the lines of masks don’t work. At the time of this recording 110,000 Americans are dead from COVID-19 and despite popular belief, this disease is hurting a lot more children than we thought at first.

Wear a mask in close and indoor public spaces. Period. Full stop.

Telemedicine

https://www.aafp.org/media-center/kits/telemedicine-and-telehealth.html

NICOM

https://www.nyit.edu/medicine

WVU Medicine Charleston Area Medical Center

https://en.wikipedia.org/wiki/Charleston_Area_Medical_Center

[email protected]

But honestly, we seldom check it. Use the Social Media links…

Catch us on twitter at @RotationsPcast

Todd @MedicalCinema. Brian @Profplow and Nisarg @NisargBakshi

You can also send comments to Todd at TR Fredricks on Facebook.

Look for more Rotations Content at mediainmedicine.com/Rotations

and on

Soundcloud and

iTunes at Rotations Podcast.

Intro and Outro Music:

Courtesy of Artlist.io

Produced by: Todd Fredricks DO and Brian Plow MFA

Edited by: Todd Fredricks DO

Cohost: None, I did this after hours and you know work rules for students

Disclaimers: Todd Fredricks, DO

Cut Clip: None… we are getting there with production

Rotations is produced using (and we always accept donations from any gear folks):

Rode Podcaster Pro

Rode NT1-A mics

Zoom H4N

Rode Lavalier Go

Polsen Studio Headphones

Kopul XLR cables

SanDisk media

Final Cut Pro X

MacBook Pro

Tama mic stands

Rotations is part of the Media in Medicine family of medical storytelling and is copyrighted.

Rotations is made possible by the generous understanding and accommodation of our beloved institution, Ohio University and by the Ohio University Heritage College of Osteopathic Medicine and Scripps College of Communications. The comments and ideas expressed on Rotations are that of the content creators alone and may not reflect official policy or the opinion of any agency of the Ohio University.

This series is a little different. Obviously, a pulmonologist has something to say about COVID-19 these days. So, John and I decided to break it up. Episode 1 will deal with becoming a pulmonologist and what that is like. Episode 2 is all about COVID-19 and what it does what it does. Basically, what do we know about this disease as of 8 June 2020. Episode 3 is the catchall of questions and how the incredible blessing of the internet is also a major headache for people trying to care for the critically ill and also prevent people from actually getting COVID-19 and dying because someone thinks a mask is not useful.

Dr. Bishara is also an officer in the United States Air Force and has been a principle advisor for public health policy within the West Virginia National Guard. He is about as humble as they come, and he deals with the sickest of sick people. He is someone that is approachable on any level and he loves what he does, mucus and all.

Finally, I want to reiterate that I am running John’s episode concurrently with Wendy Dean and Simon Talbot’s because while COVID-19 is not the same thing as Moral Injury in health care but they are related at this point in the disease. It is also really important that John’s words compete with all of the insanity that we see on the internet along the lines of masks don’t work. At the time of this recording 110,000 Americans are dead from COVID-19 and despite popular belief, this disease is hurting a lot more children than we thought at first.

Wear a mask in close and indoor public spaces. Period. Full stop.

Telemedicine

https://www.aafp.org/media-center/kits/telemedicine-and-telehealth.html

NICOM

https://www.nyit.edu/medicine

WVU Medicine Charleston Area Medical Center

https://en.wikipedia.org/wiki/Charleston_Area_Medical_Center

[email protected]

But honestly, we seldom check it. Use the Social Media links…

Catch us on twitter at @RotationsPcast

Todd @MedicalCinema. Brian @Profplow and Nisarg @NisargBakshi

You can also send comments to Todd at TR Fredricks on Facebook.

Look for more Rotations Content at mediainmedicine.com/Rotations

and on

Soundcloud and

iTunes at Rotations Podcast.

Intro and Outro Music:

Courtesy of Artlist.io

Produced by: Todd Fredricks DO and Brian Plow MFA

Edited by: Todd Fredricks DO

Cohost: None, I did this after hours and you know work rules for students

Disclaimers: Todd Fredricks, DO

Cut Clip: None… we are getting there with production

Rotations is produced using (and we always accept donations from any gear folks):

Rode Podcaster Pro

Rode NT1-A mics

Zoom H4N

Rode Lavalier Go

Polsen Studio Headphones

Kopul XLR cables

SanDisk media

Final Cut Pro X

MacBook Pro

Tama mic stands

Rotations is part of the Media in Medicine family of medical storytelling and is copyrighted.

Rotations is made possible by the generous understanding and accommodation of our beloved institution, Ohio University and by the Ohio University Heritage College of Osteopathic Medicine and Scripps College of Communications. The comments and ideas expressed on Rotations are that of the content creators alone and may not reflect official policy or the opinion of any agency of the Ohio University.

Sooooo...we are just gonna dive in. Some of you may remember our discussion with Pamela Wible MD about physician suicide. It was compelling. Well suicides don’t happen in a vacuum and so speaking about things that might drive a physician to despair is a pretty important. So we are gonna discuss moral injury.

You can google that and get a definition for moral injury but I think that it is better to just get a couple of the folks who are deeply involved in this topic and trying to raise awareness of it. SO I was about to get ahold of Wendy Dean MD and Simon Talbot MD and have a chat with them. I challenge you to think about burnout and moral injury in context and then of course, if you have questions, check out the associated links below.

It was a great interview and I want to thank both Wendy and Simon for carving out their time to spread the message of a very real thing that negatively affects physicians and sometimes, causes them to decide that ending their lives is the only solution.

Pamela Wible MD https://www.idealmedicalcare.org/

Wendy Dean MD Twitter @WDeanMD

Simon Talbot MD https://physiciandirectory.brighamandwomens.org/details/1847/simon-talbot-plastic_surgery-boston

Moral Injury https://fixmoralinjury.org/

Burnout

https://www.aafp.org/fpm/2015/0900/p42.html

https://www.npr.org/2016/12/08/504864961/when-a-psychologist-succumbed-to-stress-he-coined-the-term-burnout

The Mini Z

https://www.vumc.org/health-wellness/sites/vumc.org.health-wellness/files/public_files/PDFs/wlc/wlcMiniZ.pdf

Malach Burnout Scale

https://en.wikipedia.org/wiki/Maslach_Burnout_Inventory

Fiduciary Responsibility

http://www.businessdictionary.com/definition/fiduciary-duty.html

Press-Ganey Scores

https://www.pressganey.com/About/News/Patient-Satisfaction-Scores-Optimizing-The-Patient-And-Clinician-Experience

[email protected]

But honestly, we seldom check it. Use the Social Media links…

Catch us on twitter at @RotationsPcast

Todd @MedicalCinema. Brian @Profplow and Nisarg @NisargBakshi

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Intro and Outro Music:

Shallow Water by Sivan Talmor

Courtesy of Artlist.io

Produced by: Todd Fredricks DO and Brian Plow MFA

Edited by: Todd Fredricks DO

Cohost: None, I did this after hours and you know work rules for students

Disclaimers: Todd Fredricks, DO

Cut Clip: None… we are getting there with production

Rotations is produced using (and we always accept donations from any gear folks):

Rode Podcaster Pro

Rode NT1-A mics

Zoom H4N

Rode Lavalier Go

Polsen Studio Headphones

Kopul XLR cables

SanDisk media

Final Cut Pro X

MacBook Pro

Tama mic stands

Rotations is part of the Media in Medicine family of medical storytelling and is copyrighted.

Rotations is made possible by the generous understanding and accommodation of our beloved institution, Ohio University and by the Ohio University Heritage College of Osteopathic Medicine and Scripps College of Communications. The comments and ideas expressed on Rotations are that of the content creators alone and may not reflect official policy or the opinion of any agency of the Ohio University.