Meaningful Medicine

In this captivating episode, join hosts Nicole and Shieva as they engage in a thought-provoking conversation with Dr. Bob Wachter, the eminent Chief of Medicine at UCSF. Together, they explore the evolving landscape of Generative AI, discussing historical challenges in early healthcare initiatives, notably the rollout of the electronic medical record. Dr. Wachter describes how AI will become a valuable ally for clinicians, lightening their workload by seamlessly handling tasks such as crafting meticulous clinical notes, expediting insurance authorization requests, and skillfully summarizing complex patient records. Importantly, Dr. Wachter discusses the pitfalls of AI in medicine, specifically inherent biases, hallucinations and the propensity to lead to clinician automation and complacency. Dr. Wachter discusses the potential for how AI will change the healthcare workforce and hopefully lead to a safer and more affordable healthcare system. Don't miss this insightful episode about the future of artificial intelligence in medicine.

To learn more about Dr. Bob Wachter:

X: @bob_wachter 

Join hosts Nicole and Shieva in this impassioned episode as they delve into the often overlooked yet crucial aspect of medical training - feedback. Nicole opens up about her personal journey of grappling with a loss of confidence following negative feedback, shedding light on the emotional toll it can take on medical trainees. Shieva provides valuable insights into the art of giving effective feedback to learners. Together, they explore strategies for fostering a constructive feedback culture within the challenging environment of medical training. The hosts discuss the intricate power dynamics between trainees and attendings and the role of implicit bias in evaluations for both medical students and residents. Tune in to listen to an interesting conversation about the current culture of giving feedback in medical training and how Nicole and Shieva hope to shift the learning environment to support and empower learners.  

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In this captivating episode of Meaningful Medicine, Shieva and Nicole talk to Dr. Tomás Magaña, an adolescent medicine doctor and co-founder of a nationwide pipeline program called FACES for the Future Coalition. Dr. Magaña discussed how he and his co-founder were inspired to create FACES and he describes the program’s comprehensive approach. Dr. Magaña delves into crucial themes like code-switching and resilience and through compelling anecdotes and insights, he vividly demonstrates the profound impact pipeline programs wield, not just in shaping the career trajectories of young people but also in fortifying their overall health and safety. Dr. Magaña's narrative underscores the incredible power and importance of pipeline programs for URM students and highlights the continued need for resources and support for these programs.

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In this compelling episode of Meaningful Medicine, we dive deep into the often-overlooked issue of ableism in medicine. Join us as we sit down with Dr. Meaghan Roy-O'Reilly, a trailblazing physician who became the first person in her neurology residency program at Stanford University to disclose that she is living with a disability. She shares her own lived experience working as a resident with a disability and discusses some of the systemic barriers that exist in medical training. She also offers valuable insights into the steps needed to create a more inclusive and equitable healthcare training environment.

Dr. Roy-O'Reilly's inspiring story is a powerful testament to determination, resilience, and the unwavering belief that doctors with disabilities provide much needed diversity and have a unique toolkit to provide exceptional patient care. Join us for this meaningful and insightful episode.

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San Francisco is often thought of as the birthplace of advocacy and innovation in combating the HIV epidemic. In this episode, Shieva and Nicole are joined by the world-renowned physician and researcher, Dr. Paul Volberding. Dr. Volberding not only took care of one of the first patients with HIV in the country, but he also was the co-founder of Ward 86, the world’s first HIV/AIDs specialty clinic. Dr. Volberding shares his insights and experiences from the harrowing early days of the deadly HIV epidemic. He discusses the vital roles of nurses, volunteers, and the San Francisco community as advocates for resources and research to be directed into supporting this largely marginalized community. Join us for this meaningful dialogue about the pioneer days of HIV care in San Francisco. 

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In this episode Dr. Kathy Morsea, a highly dedicated Native physician providing care to the Navajo community in New Mexico, explores the many health and resource disparities experienced by the indigenous population. Dr. Morsea discusses the impacts of lack of basic needs like clean air and electricity, food deserts and COVID-19 as well as the overall poorer health status of the indigenous population compared to other Americans. Join us for an enlightening discussion, as Dr. Morsea shares the joys, challenges and the crucial needs for improving the health of Indigenous communities.

To learn more about Dr. Morsea:

Mothers are often thought of as superheroes. For women in medicine, becoming a mother can seem daunting and even impossible. Dr. Andrea Tooley, an Ophthalmologist at the Mayo Clinic, joins Nicole and Shieva to discuss how she balances succeeding at work and in the OR while also succeeding at home with two small kids. Dr. Tooley shares her tips and tricks for maintaining a successful career, home and family: honest partner communication, organization and outsourcing. Join us for an honest conversation about the challenges and triumphs of motherhood in medicine. 

To learn more about Dr. Tooley:

Instagram: @dr.andreatooley

Blog: Andreatooley.com

In this episode, we are re-joined by Dr. Carla Kuon, an integrative medicine physician at UCSF's Osher Center. Dr. Kuon shares her knowledge and experience treating Long COVID: a condition that can develop after someone has recovered from acute COVID-19 that can cause a wide range of symptoms that can last for weeks, months, or longer. Dr. Kuon discusses the symptoms and underlying biological processes of Long COVID, as well as diagnostic tests and treatments that aid in recovery. Dr. Kuon shares her knowledge and expertise in her new book called "The Long Covid Solution -- a holistic,  integrative approach to post-viral recovery." Join us as we learn about Long Covid and find out how we can help our patients, families and friends recover.

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Nicole and Shieva are joined by Dr. Will Flanary, also known as his humorous social media persona: Dr. Glaucomflecken. Dr. Flanary talks openly about his experience as a two-time cancer survivor and shares how his personal and professional life was altered after surviving a sudden cardiac arrest. Dr. Flanary shares how he uses social media to highlight important topics in health and medicine and highlights the important role humor plays in healing both our patients and ourselves. Join us to learn more about the power of laughter in medicine.

To learn more about Dr. Flanary:

Twitter: @DGlaucomflecken

Many people, including clinicians, often conflate palliative care with hospice and end-of-life care. In today's episode, Dr. Michael Rabow, a UCSF internist who specializes in palliative care, shares the broader mission of palliative care and how it can provide compassionate and supportive care that is centered on quality life rather than end-of-life care. Dr. Rabow discusses what drew him to palliative medicine, what life lessons he's learned from his patients and how he maintains a meaningful relationship with human suffering while also combating burnout. 

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Have you ever wondered about how healthcare is practiced in other countries? In this episode Nicole and Shieva are joined by Dr. Joyce Hightower, a family physician who has spent more than a decade working closely with health officials and hospital staff in over 30 countries in Africa. Dr. Hightower shares her experience providing primary care abroad, building a sustainably-run hospital, combating the Ebola outbreak and creating an orphanage in Africa. Dr. Hightower reflects on what it means to provide meaningful healthcare that focuses on quality, community and sustainability.

To learn more about Dr. Hightower:

According to the American Association of Medical Colleges, the number of medical students who matriculate into medical schools has increased by more than 30% in the last 20 years, yet the corresponding number of residency program spots has not kept up. A consequence of this mismatch is that between 7-20% of 4th year medical students do not match into a residency program on their first try. In this episode, we bring back the beloved Dr. Andrés Calvillo, to discuss his journey of working as a medicine intern while also balancing re-applying to radiology residency. Dr. Calvillo shares his experience navigating the challenges of being partially matched into residency and offers practical and helpful advice that has helped him along the way. Join us for a meaningful, honest and uplifting discussion with Dr. Andrés Calvillo.

To learn more about Dr. Calvillo:

Ever wonder how we can better connect with and care for our veterans? Dr. Mikel Matto is a veteran himself and works as a psychiatrist at the San Francisco Veterans Affairs Medical Center. He is board certified in Psychiatry, Forensic Psychiatry, and Addiction Medicine and in this episode, Dr. Matto shares his approach of compassion, respect and cultural humility when caring for veterans. Dr. Matto discusses the unique aspects of providing mental health care to this special population and his clinical work with veterans in forensic psychiatry, trauma, and violence risk assessment. Dr. Matto shares his thoughts on clinician self-care, moral injury, and some of the barriers to clinicians seeking mental health care.

Have you ever doubted your own abilities or had a nagging feeling that at any moment someone was going to expose you as a fraud in your profession or area of study? You are not alone! It turns out that imposter syndrome is quite common and can occur at all stages of medical training and beyond. In this episode, UCSF emergency medicine doctors and educators Dr. Rosny Daniel, Dr. Jill Mongelluzzo & Dr. Marianne Juarez join us in discussing their varied and personal experiences with imposter syndrome, and how each has learned to recognize and overcome it. In this meaningful panel discussion, we also explore how we can view the imposter experience not as a weakness, but rather as a strength in a positive growth mindset.

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Pain isn’t just a sensation we feel in our body, it is a complex experience fueled by our minds. In this episode, Nicole and Shieva sit down with Dr. Zoffness, a leading expert in pain psychology, to uncover the root cause of chronic pain. Dr. Zoffness reveals the biopsychosocial factors that increase pain, uncovers some of the common misconceptions regarding pain management and discusses how we can turn down the dials of chronic pain.

To learn more about Dr. Zoffness:

Ever wonder what contributed to the Great Resignation in healthcare? In today’s episode, Shieva and Nicole discuss the intersection of race and burnout in medicine with Dr. Starr Knight, the Associate Chair of Diversity & Inclusion for the UCSF Department of Emergency Medicine. Dr. Knight delves into what the process of recovery and healing from burnout looks like at the individual and systemic level in healthcare.

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As rates of burnout, emotional exhaustion and depersonalization rise amongst healthcare workers, the National Academy of Medicine recently published a national plan for health workforce well-being. On today’s episode Dr. Larrissa Thomas, a nationally recognized expert in the field of physician well-being and burnout, discusses the root causes of burnout and discusses using Deep Thinking Human-Centered Design to develop systemic solutions to promote wellbeing in medicine.

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We often don’t associate healthcare and climate change, yet healthcare accounts for ~10% of U.S. greenhouse gas emissions. On today’s episode, Dr. Heather Whelan, an internal medicine doctor, climate change activist and educator at UCSF, explores how physicians can promote a climate-conscious environment. Dr. Whelan shares her innovative climate change curriculum and discusses opportunities to get involved in climate research and advocacy.

To learn more about Dr. Whelan’s work:

*Trigger warning- this episode discusses suicide and pays tribute to National Physician Suicide Awareness Day*

In today’s episode, Nicole and Shieva have a candid conversation in which they discuss the stresses and challenges of starting their intern year of medical residency. Facing new challenges such as imposter syndrome, difficulties coping with painful emotional situations, lack of sleep and the new responsibilities of being a physician can all feel overwhelming. In this personal conversation, Nicole and Shieva discuss the delicate balance of professional distancing versus empathy and reflect upon their own experiences with and coping strategies for the trauma and stress that is often experienced while working in healthcare.

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What happens when healthcare workers’ duty to care for patients conflicts with the interests of the system in which they work? In this episode, we discuss this conflict known as Dual Loyalty with Dr. Nathaniel Morris, a psychiatrist at UCSF. Dr. Morris shares his experience caring for incarcerated patients in the San Francisco jail system and discusses his experience tackling dual loyalty in this setting. Dr. Morris also highlights the complex, ethical challenges of being a psychiatrist in the correctional setting and how mental healthcare should be addressed in an ideal world.

To read Dr. Morris’s NEJM perspective article:

Free clinics serve as invaluable resources that provide critical health care to marginalized and underserved communities. In this episode, Dr. Mark Diaz, a Family and Occupational Medicine doctor who co-founded and runs Clinica Tepati at UC Davis, discusses the inception of this student-run free clinic, the challenges presented in facilitating these services, and the need for accessible healthcare. Dr. Diaz demonstrates the importance of these efforts and the role that undergraduate and medical students play in advocating for their patients and addressing their patients’ legal, social, financial, mental health and physical health needs.

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Microaggressions in medicine are all too common and are often disproportionately experienced by those underrepresented in the medicine. In this episode Dr. Melanie Molina, an emergency medicine physician at UCSF, shares her personal experience facing microaggressions and discusses both the psychological and physiological impact of microaggressions. Dr. Molina also highlights strategies to both reduce and respond to microaggressions.

To read Dr. Molina’s perspective piece and her feature in the NY Times:

Have we been overlooking food as a tool to potentially combat disease and reduce inflammation? In this episode Dr. Carla Kuon, an integrative medicine doctor who co-manages UCSF’s hematology-oncology inpatient service, highlights the importance of nutrition and nutrition education, and describes evidence-based dietary changes that can improve health and wellness.

To read more about Dr. Kuon:

*Trigger warning - this episode discusses suicide*

Is it possible to maintain a lasting experience of Joy with patient care in medicine? Dr. Ricki Pollycove is an Integrative Women's Health physician who shares her wondrous ability to derive joy and love in her daily practice even after 35 years of practicing medicine.

To read more about Dr. Ricki Pollycove:

*Trigger warning – this episode discusses suicide*

It’s heartbreaking to discover that suicide is the second leading cause of death of medical residents. Dr. Justin Bullock shares his personal experience with bipolar disorder and suicidality in medical school and residency. Dr. Bullock highlights the importance of being unapologetic about self-care and describes systemic ways to promote mental health for medical trainees.

To read more about Dr. Bullock’s story:

Have you ever wondered how Drs. Reza Manesh and Rabih Geha met and created the Clinical Problem Solvers platform? Join us for our informative and at times hilarious discussion as they share advice about medical education and medical entrepreneurship, and delve into the pros and cons of podcasts as an educational platform.

To read more about Dr. Reza Manesh and Dr. Rabih Geha:

*Trigger warning - this episode discusses suicide*

The Residency Match is one of the final hurdles medical students need to overcome in order to become a physician in the United States. Match Day is met with much anticipation by both medical students and programs. But what happens if a medical student doesn’t match? Andrés Calvillo shares his emotional journey of not fully matching and normalizes the discussion of what to do if you don’t match, as well as how to find community and resources for support.

To access the resources discussed in this podcast:

Since the start of the pandemic, burnout has been on the rise and more people than ever have decided to leave healthcare. The conversation surrounding combating burnout often revolves around strategies such as mindfulness and yoga, yet the key to resilience seems yet to be uncovered. We welcome back Dr. Bruce Feldstein to discuss alternative methods to build resilience and find joy while working in healthcare.

To read more about Dr. Feldstein: 

As the average age of those matriculating medical school increases, more and more medical students and residents will be faced with the question: how do I fit in building a family during my medical training? Hamidah Mahmud, a 4th year medical student at UCSF, discusses how she balances marriage and having a child during medical school.

To read more about Hamidah Mahmud:

Ever wonder what would happen if you chose the wrong medical specialty? Dr. David Elkin discusses his decision to leave internal medicine residency and follow a new path into psychiatry.

To hear more about Dr. Elkin’s journey:

Will the doctor’s office be replaced by a computer screen? Dr. Priya Joshi, Chief Health Informatics Officer and Innovation Fellow at the SF VA Medical Center, reveals the power of data informatics on health equity and shares advice on how doctors can slash their screen time.

To read more about Dr. Priya Joshi:

When is humor appropriate and appreciated in medicine? Standup comedian and 4th year UCSF medical student Chris Sifflet shares how his humor has evolved from the New York stage to the doctor’s office and reveals the truth behind gallows humor.

To read more about Chris Sifflet:

Is healthcare undergoing a compassion crisis? Dr. Laura Vater, an oncology fellow at Indiana University, discusses the importance of healthcare workers not only taking care of their patients but also taking care of themselves.

To read more about Dr. Vater:

Where does spirituality fit in at the doctor’s office? Most Americans believe that patients should receive spiritual and/or religious support when undergoing illness, but patients and doctors can’t seem to agree on when and how those conversations should start. Stanford emergency medicine doctor turned chaplain Dr. Bruce Feldstein sheds light on how spiritual care can be incorporated into healthcare.