In Part 1 of this episode of The Pursuit of Health Podcast - in a co-branded session with Parent Heart Watch, the Louis J. Acompora Memorial Foundation and the Dominic Murray 21 Memorial Foundation - Dr. Fethke sits down with three thought leaders and pioneers who have spent the past two decades addressing the recognition and prevention of Sudden Cardiac Arrest and Death, particularly in the young. 

For the first time, Dr. Fethke welcomes three guests at once to inform our audience about this very important and often under recognized topic -  

-Martha Lopez-Anderson: Executive Director of Parent Heart Watch (PHW)    

-Karen Acompora: Founder & President of the Louis J. Acompora Memorial Foundation & Board Chair of PHW    

-Melinda Murray: Founder & President of the Dominic Murray 21 Memorial Foundation & Board Secretary of PHW     

(Together Melinda Murray’s and Karen Acompora’s Foundations combine their efforts as Heart Screen New York)

This episode’s discussion is motivated by several critical features of Sudden Cardiac Death (SCD) and Sudden Cardiac Arrest (SCA);

1. SCA is often the first clinical presentation of SCD
2. 1/300 youth live with an underlying heart condition that places them at risk for a SCA
3. SCA in the young claims 7,000-10,000 individuals/year which translates to 24 deaths/day or 1 life lost every 1-2 minutes
4. Amongst SCA Victims -
   1.  49% have had a family history of others with similar cardiac problems
   2. 60-72% have had preceding symptoms or other warning signs not recognized by their medical practitioners 
5. The American Academy of Pediatrics acknowledges that warning signs and risk factors are often missed by medical professionals, parents and youth
6. The current existing and recommended cardiac risk assessment tools are largely unused 
7. A History and Physical exam alone miss more youth at risk for SCA/SCD than when a properly performed and interpreted ECG is included as part of the screening process

PHW was founded in 2005 by 4 mothers of children who were victims of SCD. It has become a nationally-recognized entity that focuses on three main steps:

1. Cultivating Local Champions
2. Providing the Architecture for Collaborations at all levels
3. Motivating Parents

PHW work has now expanded in several areas;  

1. Sponsoring and promotion of research to fill the void of accurate and comprehensive data regarding SCA and SCD. 
2. Establishing Best Practices Models to address Prevention (Primary and Secondary) through Education. 
3. Impacting Educators, Sports leaders, and medical and policy-making stakeholders to recognize and address SCA/SCD Syndrome. 

Our guests share their personal journeys that allowed them to overcome one of the greatest tragedies a person can experience - the loss of a child - to ultimately undertake this Herculean task of changing the landscape of SCA and SCD. As they express in poignantly clear terms, they continue this work for others so “that the loss of their son or daughter is not in vain.”   

Next time, in Part 2, we will continue our discussion in which our guests describe their hurdles, successes and visions for the future in their work to combat SCA/SCD.   

To Learn More, Please Visit:  

https://parentheartwatch.org/
https://heartscreennewyork.com/
https://la12.org/
https://www.domheart21.org/

You can follow Dr. Eric Fethke on Facebook, Instagram, Twitter, and Tik Tok @drfethkemd
(This episode is also available in video format on Youtube @drfethkemd).   

Follow me on Instagram and Facebook @ericfethkemd and checkout my website at www.EricFethkeMD.com.

My brand new book, The Privilege of Caring, is out now on Amazon! https://www.amazon.com/dp/B0CP6H6QN4

On Episode 6 Part 2 we continue to explore the concept of Implicit Bias in Healthcare with the help of two brave and remarkable healthcare professionals, Dr. David M. Loeb, M.D., PhD, who is the Chief of the Division of Pediatric Hematology, Oncology and Marrow and Blood Cell Transplantation at the Children’s Hospital at Montefiore; and Denise Velazquez, a Senior Social Worker in the same division at Children’s Hospital at Montefiore. 

After deciding to tackle Implicit Bias regarding race, gender and other forms of non explicit discrimination in their own work environment, our guests explained in Part 1 how they teamed up to bring their own unique skill sets to bear in creating a special environment to begin this work with their colleagues.   

In Part 2 they go further into the operational details and how, after 8 months of persistence,  the participants have just begun to feel safe enough to share and contribute to the process. They discuss the role of new technology such as Zoom and the need for them to take the first steps into the waters of self analysis.   

Dr. Loeb expresses his desire to see this process as enduring and to incorporate it permanently into the culture of his medical division. Ms. Velazquez chimes in with full support for the benefits of this work that has just begun to change the dynamics of their team’s care provided to patients and their families.   

Ms. Velazquez would also like to again recognize others who are doing great work to combat racism, including The People’s Institute for Survival and Beyond and their Undoing Racism Community Organizing Workshop which can be found at www.racialequityresourceguide.org.  

We all finish by agreeing that science and technology in isolation, void of humanity and attention to the crucial role of the social sciences, falls short of the true healing we all desire for our patients and society.  

You can follow Dr. Eric Fethke on Facebook, Instagram, Twitter, and Tik Tok @drfethkemd
(This episode is also available in video format on Youtube @drfethkemd).

Follow me on Instagram and Facebook @ericfethkemd and checkout my website at www.EricFethkeMD.com.

My brand new book, The Privilege of Caring, is out now on Amazon! https://www.amazon.com/dp/B0CP6H6QN4

On Episode 6 Part 1 we begin to explore the concept of Implicit Bias in Healthcare with the help of two brave and remarkable healthcare professionals: Dr. David M. Loeb, M.D., PhD, who is the Chief of the Division of Pediatric Hematology, Oncology and Marrow and Blood Cell Transplantation at the Children’s Hospital at Montefiore; and Denise Velazquez, a Senior Social Worker in the same division at Children’s Hospital at Montefiore.  

Implicit Bias in Healthcare poses the very ominous risk of negatively impacting the patients we serve in several ways;

1. Creating a dissociation between the ethical norms- the expectations of professional impartiality- and the actual actions of healthcare providers.
2. Creating an unintended negative impact on patients, families and communities - such as the all too prevalent healthcare disparities - despite what may be an honest intent of healthcare professionals to help.
3. Negatively impacting clinicians’ diagnoses, treatment decisions and ultimately the quality of care we provide.   

Our discussion therefore starts by asking our guests to provide their own definition of Implicit Bias in Healthcare and to acknowledge that clinicians and healthcare workers share the same level of such biases as other members of society. Whether based on issues of racism, gender discrimination, or myriad other psychological and social factors, our guests agree that we all share some form of such bias and that the pandemic and other healthcare problems cry out for long overdue serious attention to this destructive force.   

Our guests share their very personal story of the situations that ultimately lead them to collaborate on the creation of a forum to address Implicit Bias in their own medical division. Through this journey of humility and self-discovery, their desire to place other colleagues and members of their community as equals with themselves in order to best serve their very vulnerable patient population - children with cancer - and their families, comes shining through bright and clear.   

As we finish Part 1 of this episode, we are keenly aware that they have created a very special space to begin this much needed soul searching in an already stressful environment.  Ms. Velazquez would also like to give a shout out to acknowledge others who are doing great work to combat racism, including The People’s Institute for Survival and Beyond and their Undoing Racism Community Organizing Workshop which can be found at www.racialequityresourceguide.org.  

In Part 2, we continue our discussion with Dr. Loeb and Ms. Velazquez as they invite us into the process, challenges, successes and future implications of their work in this area.

You can follow Dr. Eric Fethke on Facebook, Instagram, Twitter, and Tik Tok @drfethkemd
(This episode is also available in video format on Youtube @drfethkemd).

Follow me on Instagram and Facebook @ericfethkemd and checkout my website at www.EricFethkeMD.com.

My brand new book, The Privilege of Caring, is out now on Amazon! https://www.amazon.com/dp/B0CP6H6QN4

On Part 2 of this episode, Dr. Fethke continues his dialogue with Ernesto Chan on the effects of the COVID-19 Pandemic on our nation’s elderly.  Mr. Chan is a Director of Nursing at a Longterm Care facility in New Jersey. Mr. Chan shares his experiences and the broader implications they provide to all of us who may be caring for our vulnerable parents and grandparents.   

The discussion picks up from the Summer of 2020, when there continued to be a shortage of Personal Protective Equipment (PPE) and continued stresses on his staff. These issues took their toll, and Mr. Chan had to grapple with the deaths of several elderly residents in his facility. As in during the HIV epidemic, off came the gloves once again so that Mr. Chan could reach out and touch those who would otherwise be alone in their final moments of life.   

The discussion naturally led to the idea of a “Calling” to be a healthcare provider, especially in the most difficult times. Mr. Chan fondly remembers some of his residents who have passed away during the pandemic, and he urges us all to never forget our humanity.

Mr. Chan discusses the advent of the COVID-19 vaccine and his concerns about the effects of misinformation that led many to not receive the vaccine initially. He stresses that his experience and research indicates that the vaccine is safe.   

Like many facilities in the nation, he also experienced the spread of the virus through his essential staff - including doctors and nurse practitioners - that often had to work in several different facilities and jobs just to make ends meet. The access to reliable testing ultimately curbed this phenomena and, with the vaccine, the numbers of COVID-19 cases and deaths has recently started to decrease. Finally, Mr. Chan is able to return back to his prime directive: to keep everyone in his facility safe.   

Mr. Chan opens up about his concerns about how longterm care and assisted living facilities - both private and public - were designated as “extra beds” to unload the burden on the hospitals’ capacity to admit patients. As a clinician, he believes that this was a mistake which adversely effected the most vulnerable amongst us, and one that should not be repeated in the advent of future pandemics or environmental catastrophes.   

This again returns to the main discovery of this episode; these facilities were not treated as an actual legitimate part of the healthcare system, though they were still expected to be providing medical care to their residents.   

We finish the episode with an eerie foreshadowing of his experience back when Mr. Chan and his team had set up a mock emergency drill for a viral pandemic hitting his facility, back in February of 2019! He emphasizes that if it had not been for the lack of PPE, they would have been ready to avoid the poor outcomes they have sadly experienced.   

He also advocates for letting the families into the facilities so that they can help share the care of their loved ones. He advises that families go to longterm care and assisted living facilities to choose the right place for their elderly parents. He urges us all to remain a proactive part of our loved ones’ lives while they reside there.   

Throughout our discussion, Mr. Chan never gives up hope for the value of life at all stages.   

You can follow Dr. Eric Fethke on Facebook, Instagram, Twitter, and Tik Tok @drfethkemd
(This episode is also available in video format on Youtube @drfethkemd).   

**Research for this episode was conducted by Alyssa Shannon, a first-year medical student at Touro University.

Follow me on Instagram and Facebook @ericfethkemd and checkout my website at www.EricFethkeMD.com.

My brand new book, The Privilege of Caring, is out now on Amazon! https://www.amazon.com/dp/B0CP6H6QN4

On this episode of the Pursuit of Health Podcast, Dr. Fethke was honored and excited to invite a dear friend and colleague, Ernesto Chan, to discuss the effects of the COVID-19 Pandemic on our nation’s elderly. Mr. Chan is a Director of Nursing at a Longterm Care facility in New Jersey, which we have intentionally kept anonymous in order to not bias one facility or institution over another. Mr. Chan shares his experiences and the broader implications they provide to all of us caring for our vulnerable parents and grandparents.   

In this, the one year anniversary of COVID-19 entering our nation’s shores, Dr. Fethke starts this episode by providing the scope of the issue at hand:  

1.  According to data from the CDC as of 2016, there are 15,600 nursing homes (69.3% private equity-owned) with 1.3 million residents. (https://www.cdc.gov/nchs/fastats/nursing-home-care.htm) 
2. "Although there are only 1.3 million patients in US nursing homes, representing less than 0.4% of the country’s population, 43% of all COVID-19 deaths have been attributed to these facilities." (Braun et al). 

Mr. Chan describes his early years of education when he started to train as a male nurse through the example set by his mother, a career nurse. His first experiences with longterm care were during the HIV pandemic during the 1980’s, thus laying the groundwork for his experiences 35 years later with COVID-19.  

As he entered longterm care for the elderly, he sought out the preventative side of healthcare in order to keep his patients safe and foster their independence and quality of life. Ten years into his career, his focus on education led him to his administrative responsibilities as a Director of Nursing, and he became part of a movement to advance how the elderly are monitored and treated.  

Mr. Chan explains how he used his past experiences with caring for HIV patients to emotionally bolster his staff, residents, and their families through this pandemic - especially as they began to experience the nationally shared tragedy of significant death rates amongst the elderly they were charged with caring for. In early 2020, they could see the tidal wave of the pandemic heading from west to east, disproportionately affecting the elderly in facilities such as his. The guidelines at this time were vague and conflicting at best, and certainly not always appropriate for elder care. Mr. Chan fell back on his past training and experiences to get through this early time period of the COVID-19 pandemic, including Universal Precautions.  

Mr. Chan highlights the initial difficulties with obtaining Personal Protective Equipment (PPE) and alludes to the pre-existing budget deficit and revelation of all regarding Longterm Care facilities. They were not treated as an actual legitimate part of the healthcare system, though they were still expected to be providing medical care to their residents.  

We finish Part 1 of this timely and moving episode with Mr. Chan finding light in the darkness - stressing the power of community efforts to help his facility get through the pandemic. Under his leadership, they maintained hope.  

Next week, on Part 2 of this Episode, we finish our heartfelt discussion with Mr. Ernesto Chan as he recounts his COVID-19 experiences through the Summer of 2020 until today.   

You can follow Dr. Eric Fethke on Facebook, Instagram, Twitter, and Tik Tok @drfethkemd
(This episode is also available in video format on Youtube @drfethkemd).   

**Research for this episode was conducted by Alyssa Shannon, a first-year medical student at Touro University.  

Follow me on Instagram and Facebook @ericfethkemd and checkout my website at www.EricFethkeMD.com.

My brand new book, The Privilege of Caring, is out now on Amazon! https://www.amazon.com/dp/B0CP6H6QN4

On this episode of the Pursuit of Health Podcast, Dr. Fethke continues his discussion with colleagues and neighbors - Dr. Philip Wilken and Dr. Avi Silber -  who also happen to be practicing pediatric physicians and administrators in the Greater Hudson Valley of New York State. In this virtual fireside chat, they expand upon the role of finances in the quality and effectiveness of healthcare delivery in direct patient care.   

The doctors share their insights into the criteria that best defines the quality of a particular physician or medical facility. They ask us to look beyond the superficial window dressings and into the more relevant matters, such as the particular way that care is delivered by a provider, their team, or a facility.   

Dr. Silber discusses the disparities in healthcare access due to less available health insurance in his adult patients compared to children. He raises the very real concern that this disparity ultimately leads to a sicker population, which costs us all more than would be necessary if they just had upfront access to medical care in the first place.  

Dr. Wilkin emphasizes the need for a smoother transition between pediatric and adult care for his special needs patients.  He argues that better coordination of services with the Care Team can help make the complex patient and their families feel less stranded at this point in their lives. He suggests that Coordination of Care not only results in better health outcomes, but is actually more cost effective.   

The doctors comment favorably on the recent changes of the Federally-directed, overly-complex billing systems in healthcare. They are hopeful that in many ways the physicians’ collective concerns appear to be reaching the policy makers. They allude to a changing funding system that will soon reimburse for Quality of Care rather than Quantity of Care in the current Fee-for-Service model. Such preventative approaches may hopefully reduce care-related costs while improving our nation’s well-being and health.   

Next time on Episode 6 we tackle the very timely topic of Implicit Bias in Healthcare with two healthcare workers dealing with Childhood Cancer patients.   

You can follow Dr. Eric Fethke on Facebook, Instagram, Twitter, and Tik Tok @drfethkemd
(This episode is also available in video format on Youtube @drfethkemd). 

Follow me on Instagram and Facebook @ericfethkemd and checkout my website at www.EricFethkeMD.com.

My brand new book, The Privilege of Caring, is out now on Amazon! https://www.amazon.com/dp/B0CP6H6QN4

After a week-long break, The Pursuit of Health Podcast is back with another exciting episode. Dr. Fethke sits down with colleagues and neighbors - Dr. Philip Wilken and Dr Avi Silber -  who also happen to be practicing pediatric physicians and administrators in the Greater Hudson Valley of New York State. In this virtual fireside chat they delve into the role of finances in the quality and effectiveness of healthcare delivery in direct patient care.   

They tackle several important questions including; 

• Does paying more money for medical care result in better care?
• Is money being wasted in current healthcare that could be better directed to promote quality healthcare?
• How should we balance the commodity of “time” with the cost of medical care?  

Dr. Silber shares his personal career journey from education, to a private “boutique” practice and, finally, into a community practice for underserved people.  He explains why he made this very personal decision to refocus his professional goals to an environment where he could make a significant difference in people’s lives, even if it meant earning less.  

Dr. Wilken’s story takes us through a different path into the world of the severely disabled child.  He explains the valuable role of a strong medical team and a medical home model in facilitating the best possible care for some of the most vulnerable children and young adults in society.  

All three physicians finish Episode 5 Part 1 by reinforcing the need for legitimate trust in one’s doctors based upon a strong patient-physician relationship. They suggest that time spent in promoting this relationship is time well spent both in minutes and dollars.  

In Part 2 of this episode, Dr. Fethke continues this frontline financial analysis with Dr. Silber and Dr. Wilkin as they make further constructive criticisms and suggestions for improvements in how our nation funds healthcare.   

You can follow Dr. Eric Fethke on Facebook, Instagram, Twitter, and Tik Tok @drfethkemd
(This episode is also available in video format on Youtube @drfethkemd).  

Follow me on Instagram and Facebook @ericfethkemd and checkout my website at www.EricFethkeMD.com.

My brand new book, The Privilege of Caring, is out now on Amazon! https://www.amazon.com/dp/B0CP6H6QN4

In our first Take A Step Back episode, we take the opportunity to look back over and comment on Episodes 1 through 4.  Our host,  Dr. Fethke, is joined by a first year medical student, Alyssa Shannon, and an experienced practicing pediatrician, Dr. Emily Brown. Together, they reflect on the lessons learned from the first four episodes, including:  

Episode 1 - How healthcare has strayed from its original mission and an emphasis on the Patient-Physician relationship,   

Episode 2 - The value of Family-centered care and the need to promote creative solutions to address deficits in the healthcare system,     

Episode 3 - A need to establish Diagnosis-specific innovative and comprehensive solutions, legitimate Medical Home models, and advancement of care through Evidence-based research,      

Episode 4 - The need for consistency and a unified Team Approach in public health guidelines and the valuable role of Education as an entry point into the healthcare system.   

This hour long reflection from the frontlines was honest, revealing, and insightful, and the energy of this discussion was extremely captivating and constructive. Our inaugural Take A Step Back episode proved to be a great success. This retrospective format from physicians, young and old, promises to be the glue that will bind future episodes into a collection of works that will Empower our audience.   

Next week on Episode 5, Part 1, we are joined by two seasoned physicians to begin a commentary on Payment Models in the current U.S. Healthcare System.

You can follow Dr. Eric Fethke on Facebook, Instagram, Twitter, and Tik Tok @drfethkemd
(This episode is also available in video format on Youtube @drfethkemd).  

Follow me on Instagram and Facebook @ericfethkemd and checkout my website at www.EricFethkeMD.com.

My brand new book, The Privilege of Caring, is out now on Amazon! https://www.amazon.com/dp/B0CP6H6QN4

On this episode of The Pursuit of Health Podcast, we continue our visit with Dr. Elizabeth Sassi, a Nurse Practitioner on the front lines of the Covid-19 pandemic in a large public school system just outside New York City. As a nurse with 38 years of experience, including 20 years in critical care and a background in Epidemiology, she brings a unique perspective to the role that public education plays in balancing health and education in these difficult times.   

 
In Part 1, we followed Dr. Sassi and her colleagues through their arduous and compassionate efforts to cope with the Covid-19 pandemic. In Part 2 she provides keen insights on facing the pandemic through the Winter and into the Summer of 2021. She remembers some of the emotionally trying moments with her students, their families, and her colleagues.  

 
Dr. Sassi dives further into the role of public education as an entry point into the U.S. Healthcare System, particularly for the underserved such as America’s newest immigrants.  She shares the story of one particular young immigrant student who left a lasting impact on her life in response to a moment of kindness from Dr. Sassi and her family.  
 

We discuss the myriad obstacles that new Immigrants face as they try to reach for a better life. Dr. Sassi has seen the lack of access to medical services, inequities due to language barriers, the fear of losing a job at odds with the needs for accurate reporting of health status, and the effects on health due to limited housing.  

Dr. Sassi reminds us that we are a land of immigrants and that it takes a community to raise a child well.  She asks us all to prioritize our health above the fears that we face daily. She makes us believe again that together we can go beyond fear and build a better community and society.  
  

Dr. Elizabeth Sassi and the resources of her school system can be reached at www.mw.k12.ny.us.  
 
You can follow Dr. Eric Fethke on Facebook, Instagram, Twitter, and Tik Tok @drfethkemd
(This episode is also available in video format on Youtube @drfethkemd).  

Follow me on Instagram and Facebook @ericfethkemd and checkout my website at www.EricFethkeMD.com.

My brand new book, The Privilege of Caring, is out now on Amazon! https://www.amazon.com/dp/B0CP6H6QN4

On today's episode of The Pursuit of Health Podcast, Dr. Fethke sits down with Dr. Elizabeth Sassi, a Nurse Practitioner on the front lines of the COVID-19 pandemic in a large public school system just outside New York City. As a nurse with over 38 years of experience - including 20 years in critical care and a background in Epidemiology - she brings a unique perspective to the role that public education plays in balancing health and education in these difficult times.  

She took us through her team’s and community’s experience beginning in early 2020.  As information regarding the spread and dangerous effects of the virus, SARS-CoV-2, poured in through the Spring and Summer of 2020, she stepped in to protect her thousands of students and staff. We share her struggle and frustrations through this process, but she never gives in to fear in her role as caretaker, administrator, and healer.  

Through Dr. Sassi’s lens, we get a glimpse into the immense coordination required to tackle the COVID-19 pandemic while trying to maintain the high education standards of her school. She humbly admits that everyone was just doing their best in the face of this daunting event. Together, she and her colleagues break new ground as they try to hold their community together.  

As social and economic inequities became apparent, the school stepped in to help with access to technology so that learning can continue remotely. As the long Summer of 2020 ended, Dr. Sassi’s colleagues worked to bring the students safely back to school and reestablish activities such as sports and music programs. Utilizing the latest science behind the spread of illnesses, she implemented the tools of Contact Tracing, Quarantine, and Social Distancing.  

Dr. Sassi shares the lessons that she has learned along the way with our audience. She emphasizes the key roles of:   

1. Open communication
2. Consistency in approach amongst her team and surrounding communities, 
3. The impact of building architecture on creating a safe environment,
4. Compassion for those with less resources, and 
5. Learning to anticipate a problem such as a COVID-19 surge in advance so that appropriate protective measures can be implemented.  

We will continue our conversation with Dr. Sassi in Part 2 of Episode 4 next week. We look forward to her insights on dealing with the pandemic through the Winter and into the Summer of 2021.  She also dives further into the role of public education as an entry point into the U.S. Healthcare System, particularly for underserved communities such as America’s newest immigrants.

You can learn more about Dr. Sassi and the Monroe-Woodbury Central School District on their website, www.mw.k12.ny.us  

You can follow Dr. Eric Fethke on Facebook, Instagram, Twitter, and Tik Tok @drfethkemd
(This episode is also available in video format on Youtube @drfethkemd).  

Follow me on Instagram and Facebook @ericfethkemd and checkout my website at www.EricFethkeMD.com.

My brand new book, The Privilege of Caring, is out now on Amazon! https://www.amazon.com/dp/B0CP6H6QN4