The Pursuit of Health Podcast

On this episode of the Pursuit of Health Podcast we return to the issue of healthcare economics with our guest, Ms. Andrea Zalusky. She brings over a decade of experience in the field of healthcare administration, with a particular focus as of late on the transition from a “Fee-for-Service” (FFS) to a “Value-based care” (VBC) approach to the financing of medical care. She explains that, like doctors, she has engaged in this work because she wanted to help as many people as possible become and stay healthy. With a Masters Degree in Public Health from Columbia after studying Global and Health Policy at Johns Hopkins University, Ms. Zalusky has worked in the northeast from New York to New Jersey to establish a consistent approach to healthcare. Through her work she remains intent on improving the health and well-being of the populations that live in these areas.

Ms. Zalusky is  currently leading value-based care operations for Optum Care in the New York and New Jersey region, focused on supporting physicians, hospitals, and post-acute care facilities be successful in these programs.  Prior to Optum, she worked at CareMount Health Solutions where she managed operational programs focused on reducing readmissions in partnership with major hospital systems. Prior to these operations focused roles, she also had time with both Evolent Health and other consulting firms, where she  gained experience with population health program implementation and Value-based care models all across the US - working with physician groups, hospitals and Accountable Care Organizations to help them be successful in this new model of care. 

Ms. Zalusky takes our audience through some of the details behind the concepts of Population Health and Value-based payment systems in a way that is enlightening and reassuring. She explains some of the hurdles and successes along the way and shares her ultimate goal of finding a balance that allows for the achievement of 4 crucial elements to a well functioning healthcare system in the U.S.. Along the way she emphasizes the sentiment that  “Our system is indeed broken and the people deserve better.”

Ms. Zalusky explains that this venture towards Value-based payments has been in the works for years. It has required persistence, legislation and time to finally get off the ground. Though she is honest that we have a long way to go, she contends that there is no turning back to a Fee-for-Service system. She reassures us that the key to a successful transition from FFS to VBC over the next several years is to work in partnership with clinicians so that they can best implement their evidence-based knowledge to the betterment of everyone.

We look forward to your feedback on this and any prior episodes. Dr. Fethke and the POH team can be reached on Facebook and Instagram @drfethkemd and our website at drfethkemd.com

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 is joined by a pediatrician leader and educator who has practiced for over half a century, Dr. Gilbert Simon. Dr. Simon started his pediatric career at Columbia University’s Babies & Children’s Hospital during the same era as many of Dr. Fethke’s most esteemed mentors. After years of working in the metropolitan northeast in a prestigious academic center, Dr. Simon made a life-changing career move to the west coast where he ultimately founded and served as the Medical Director and CEO of the Sacramento Family Medical Clinics. It was here that all his experience, including his military service in the 1960’s working for a branch of the U.S. Center for Disease Control, came in handy.

He ultimately ran the clinics for low income families in Sacramento California with virtually 100% Medicaid fixed resources which “lasted 26 years longer than anyone believed I could,” by identifying and decreasing wasteful healthcare expenses. In 2019 Dr Simon gathered all of his experience and lessons learned while running the California clinic and serving as a subcommittee member of California Medical Association’s Medi-Cal to write an amazing and must read book - RIPPED OFF! Overtested and Overcharged, the American Healthcare Mess.

During our discussion with Dr. Simon from his California home office, he shared some of the highlights from his book, including the overuse of Unnecessary Services, Inflated Prices, Fraud, Excess Administrative Costs, and the Lack of Coordination and Fragmentation. Along the way he provides some very clear and practical examples of each of these problems that combined have created the “Mess” that U.S. Healthcare finds itself in today.

As with many of the wonderful clinician leaders and visionary guests on our podcast, Dr. Simon provides solutions to the myriad problems he has identified and so clearly revealed in his book for lay people, policymakers and healthcare professionals alike. Most importantly, he can back up his vision and recommendations by years of his own success facing many of these issues in his pioneering career. Dr. Simon gives us a sense of sober hope that our healthcare system can be salvaged and benefit from the exceptional work of those who have come before us and will follow in the future. We would all do well to heed his advice before it is too late.

 As always, we at The Pursuit of Health Podcast look forward to our audience response to this and any of our episodes. We can be reached at drfeethkemd on Facebook and Instagram and our website-drfethkemd.com.

Book References:

1. RIPPED OFF! Overtested, Overtreated and Overcharged, the American Healthcare Mess. Paper Raven Books. March 3 2020.
2. www.gilbertsimonmd.com

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

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 is joined by a remarkable frontline colleague from the medical field of Obstetrics, Dr. Daniel Perkes. Dr. Perkes takes us through two decades of change and turmoil during which he remarkably remained focused on maintaining strong professional relationships with his patients. He emphasizes that such alliances with his patients were the backbone to his career that allowed him to navigate through all the shifts in healthcare from a private practice to corporate medicine. He shares some pearls of wisdom with us on how he was able to sustain such a remarkable following from his patients through his entire over two decades of practicing.

Despite many of the initial challenges, Dr Perkes gives us some hope that larger medical practices can still maintain a patient focus if their leadership ensures open communications with their frontline physicians and seeks regular patient feedback.

In a timely manner, Dr. Perkes addresses his concerns regarding the potential effects of legislative changes should Roe v. Wade be overturned. In a field already experiencing significant strains and cutbacks in access throughout many parts of the country, he worries that the situation will only get worse for women unless people advocate for women’s rights and their ability to seek medical advice from the doctors that they trust. He stresses that he is not a “Pro Choice” or a “Pro Life” physician, but rather has always been a “Pro Patient” doctor. This has allowed him to tailor his medical care to the specifics of each patient, rather than taking a blanket one-size-fits-all approach.

Dr. Perkes finishes this valuable discussion with advice and hope for future obstetricians. Though it has not always been easy, he emphasizes, “Knowing the challenges facing young obstetricians today, I would still  do it all over again”.

We look forward to your feedback on this and any of our episodes on The Pursuit of Health Podcast. We can be reached at drfethkemd in Facebook and Instagram, and our website- drfethkemd.com.

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

• Infrastructure - Resiliency and Sustainability as a goal 
• Know the people you serve and focus on their needs, not your perceptions of their needs

• Healthcare is a fundamental and critical factor in forming a new nation
• HIV experience highlighted inequities in healthcare
• Covid-19 - should have learned from past experiences and need to understand why we did not
• Politics can support of interfere with national healthcare 

• Structural Racism in US creates inequities in racial distribution of physicians
• People do better when their physician is someone they can identify with
• Outreach to under represented races is necessary and effective in improving the number and distribution of non-white physicians
• When we all do better - everyone wins.

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 return to our Case Studies From the Heart format. Our host, Dr, Eric Fethke, begins by sharing the stories of two patients - one lost tragically and the other who survived against the odds.  Using these stories as a backdrop, he dives into the often frustrating issue of Health and Healthcare Disparities in the United States. This topic has been a common theme and concern of many of our podcast guests, and we thought that it deserved attention in its own right. Dr. Fethke addresses the many facets of these disparities including their manifestations, causes, consequences and ultimately some possible solutions. Dr. Fethke stresses that “In a nation with such an abundance of material and human resources we should be able to address Healthcare Disparities much more effectively than we have done so far. It all comes down to whether our Values as a people allow us to Care Enough to do so.”

We hope this discussion provides a moment to reflect on this aspect of American healthcare, made so more urgent by the Covid-19 pandemic. Moving forward on the podcast we will continue to address this and many more important topics with our guests and audience.  Together we can narrow the chasm of Healthcare Disparities and create a much healthier nation.

We look forward to your input on this and any other of our podcast episodes and invite your suggestions for future topics of concern. We can be reached on facebook and Instagram at drfethkemd and on our website at drfethkemd.com.

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 investigation into the topic of Physician Burnout with Dr. Laura Vater.  Dr. Vater has gained a much deserved recognition for her approach to this issue by focusing on Humanism in Medicine. She received her Bachelor of Science and minor in Poverty Studies at the University of Notre Dame, Indiana. She then went on to complement her skill set with a master of Public Health degree at the University of Pittsburgh where she focused on Behavioral and Community Health.  She returned to Indiana to complete her residency in Internal medicine and this Spring will complete a rigorous fellowship in Hematology and Oncology at the Indiana University School of Medicine.

She is the recipient of many accolades including being selected as 1 of every 1000 residents to be a member of the Gold Humanism Honor Society. Though early in her career, she has already penned several research and narrative essay publications, is a regularly invited public speaker, and has a growing online platform addressing Humanism in Healthcare. She is also the creator of a very useful tool - the SMILE scale -  providers can use to help prioritize their own health.

During our discussion, Dr Vater shares the origin of her decision to become a physician and oncologist. This very personal story revolved around her mother as a role model who entered medical school later in adulthood when Dr Vater was already a teenager. Her interest in medicine was further heightened by the experience of a close family friend who lived through the challenges of cancer. Ultimately, confronting her mother’s sudden life threatening illness during Dr. Vater’s first year of medical school led her in the direction of Humanism in Medicine.

Dr. Vater reveals the current challenges in healthcare that take the Humanity out of Medicine and how she has been working diligently to reconnect with her true self and her patients and maintain the joy in her work through Humanism. She explains that Humanism stresses the importance of physicians establishing a connection with patients and caring for physicians as humans too.

Dr. Vater opens the door for our listeners into the concept of Compassion Fatigue and the associated  risk of clinicians losing empathy in training and practice. She believes that it is important for everyone involved in healthcare to continue talking about Compassion Fatigue in order to get it out in the open - thus restoring our vital human interconnections and preventing physician burnout.

Dr. Vater and Dr. Fethke share their love of teaching medicine to enthusiastic students as a way to find rejuvenation and remind us all why we entered medicine in the first place.  In so doing, they also warn about the risks of mentors modeling bad behaviors that lead the students towards being hardened and less empathetic.

Our guest and host find that they also both share a passion for writing about their experiences as physicians and the stories of those that have taught them the most about being a doctor - their patients.  They hope that this comes through not only in their  narrative publications, but in the medical records of their patients. These are human beings and we are honored and humbled to be invited into their lives and tell their stories.

The discussion with Dr. Vater finished with her introduction and explanation of the SMILE scale she established. Listen closely as she takes us through this simple yet powerful tool to help maintain Humanism in Healthcare.

Dr. Eric Fethke and the team at The Pursuit of Health Podcast look forward to your comments on this and any of our prior episodes.  We can be reached on Facebook and Instagram at drfethkemd and our website at drfethkemd.com.

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

The Pursuit of Health Podcast takes a bold look at the mounting stresses that have negatively impacted the careers and lives of too many medical professionals. We have invited a remarkable guest, Dr. Simon Maltais, to help us understand the root causes, profound impact and solutions to this growing problem.

Dr. Maltais is a high-powered cardiothoracic surgeon whose successful career has hit all the right marks along the way. A French Canadian who has trained and worked in some of the most reputable medical institutions in Canada and the United States, he has pioneered innovations in mechanical assist devices for the heart and made tremendous contributions to advance the field of heart failure and heart transplantation. He is recognized internationally for his over 160 peer reviewed articles, medical book chapters, editorials and contributions to several esteemed medical journals. As an academic teacher, researcher and lead physician through such prestigious institutions as Vanderbilt University, The Montreal Heart Institute and the Mayo Clinic, he has undoubtedly climbed the ladder to success.

Despite his numerous achievements, Dr. Maltais boldly and openly shares with us that he came to a point in his professional and personal life where things just started to fall apart. Though no one particular problem stood out, he describes a time when he recognized that he was experiencing what he refers to as “multifaceted failures”. In a bravely honest discussion, he takes us through this turning point in his life when he concluded that he was in a crisis and that things desperately needed to change.

Dr. Maltais goes on to describe how he took this very personal experience and began to analyze it closely so that he could make sense of his situation. As with all great and compassionate clinician pioneers, he began to look outward to see if other colleagues were experiencing the same issues. He explains how he implemented his strong research and diagnostic skills to tackle this problem and then proceed to reach out to others. This new work resulted in his groundbreaking recognition of a condition that he defines as “Healthcare Disease”. This ongoing journey has recently taken the form of a wonderful new book by Dr. Maltais and colleagues -  Healthcare Anonymous: Put Yourself First to Avoid Anxiety, Addiction & Burnout - to be publicly released in early April 2022.

In this powerfully refreshing and healing discussion, Dr. Maltais reflects on how his venture into Healthcare Disease has revitalized his physician career. He now works with a supportive and innovative medical team at the Hospital Corporation of America Healthcare based in California. Here he and his colleagues are making positive contributions to the way that healthcare is delivered in one of our nation’s largest providers of medical services. Dr. Maltais suggests that “Outside-the-box thinking is the best way for us to address problems such as healthcare disease and improve our healthcare system.” He is also the Co-founder and CEO of Breakthrough Points: a program dedicated to improving the balance, performance, and effectiveness of physicians and other professionals working in high-intensity environments.

As always, Dr. Eric Fethke and the team at The Pursuit Health Podcast look forward to the comments and contributions of our audience. We can be reached on Facebook and Instagram at drfethkemd  and on our website at drfethkemd.com.

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 dive further into the realm of public health by pausing to learn about the invaluable role of the Physician Assistant.  We are fortunate to have a frontline clinician, educator and pioneer, Joseph M. Daleo, as our guest to take us through this topic.

Major Daleo is an active member of the US Army Reserve and holds a Doctorate Degree of Physician Assistant Studies from Touro University. He wears many honorable hats including an Assistant Professorship and the Directorship of Clinical Operations at NY Touro College’s Physician Assistant Program.  He is a Clinical Instructor for SUNY Stony Brook’s Family Medicine and Nurse Practitioner Program as well as the Supervising Physician Assistant for the American Family Care’s Covid-19 Mitigation and Vaccination Program. 

Major Daleo begins our discussion by taking us through his often bumpy personal journey to pursue a health career as a practicing Physician Assistant and educator. In so doing, he emphasizes that Physician Assistants are a vital and unique profession within the US healthcare system. He explains the honorable history of the Physician Assistant profession in the US and marvels at the exponential growth of this field both domestically and globally over the past few decades.

Our guest sheds some very important light on the misconceptions about the Physician Assistant model, stressing that this model supports a complementary, not adversarial, interaction of healthcare professionals on behalf of the patient. He provides us with a sobering reminder of the serious gaps and failures of our current system and provides much needed recommendations to make healthcare partnerships stronger to address the disparities of acute and chronic disease.  He sees physician assistants as one of the critical  “force multipliers” of a potentially robust approach to healthcare reform. 

We finish our fascinating discussion with Major Daleo wisely advising us all to continue to adopt the pioneer spirit that made our health system exceptional in the first place.  He urges us to remain open-minded so that we may learn and apply new preventative and treatment modalities to the benefit of our patients, clinicians and society. 

Dr. Fethke and the team at The Pursuit of Health Podcast  look forward to our audience’s feedback. We can be reached @drfethkemd on Facebook and Instagram, and our upcoming website - drfethkemd.com. 

References:

1. https://www.researchgate.net/publication/236248847_Origins_of_the_physician_assistant_movement_in_the_United_States
2. https://pahx.org/timeline/
3. https://www.healthleadersmedia.com/clinical-care/why-physician-assistants-and-nurse-practitioners-need-supervision-say-physician-groups
4. https://www.kevinmd.com/blog/2020/01/stop-the-war-on-pas-and-nps.html
5. https://journalofethics.ama-assn.org/article/physician-assistants-and-their-role-primary-care/2012-05
6. https://www.bls.gov/ooh/healthcare/physician-assistants.htm
7. https://bemoacademicconsulting.com/blog/pa-vs-md

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

Public Health has become a term used repeatedly during the Covid-19 pandemic. On this episode, the Pursuit of Health Podcast is fortunate to have one of New York’s leading public health experts and educators to help us understand and appreciate the importance of a strong public health system. Megan Deichler is the Executive Director of the Catskill Hudson Area Health Education Center (CHAHEC). Ms. Deichler brings extensive global and domestic experience in population health research and strategic charity programs to her current position. 

Ms. Deichler explains that her focus on community health education is built upon a 50 year legacy of the federally-created Area Health Education Centers (AHECs). She shares her personal career decision to return to New York and serve our nation’s greatest number of people living in any state who are federally-designated as Medically Underserved.   

Ms. Deichler and Dr. Fethke help explain the meaning  and proud history of the US Public Health system. Our guest expands the scope of public health to include housing, food and the environment. She explains that her team at CHAHEC introduces and supports the role of public health to future and current health professionals at all levels of education and operation.   

She emphasizes the importance of an inter-professional Team Approach to achieve optimal healthcare for everyone. She remains optimistic about the future as long as healthcare workers and professionals continue to advocate for a strong and equitable American Public Health system, beginning with early education. Our discussion finishes with plans for possible future educational collaborations with our wonderful guest. Keep in touch and we’ll keep you posted. 

The Pursuit of Health Podcast welcomes your feedback and suggestions. We can be reached @drfethkemd on Facebook and Instagram, as well as our website at drfethkemd.com.

References:

• https://www.uwdor.org/megan-deichler 
• https://chahec.org/ 
• https://www.sciencedirect.com/science/article/abs/pii/0277953683900953 
• https://jamanetwork.com/journals/jama/fullarticle/183103 
• https://iranjournals.nlai.ir/handle/123456789/784141 

Visit CHAHEC.org to learn more!

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