Month: April 2020

Is Single Payor Really Bettor? with Dr. Kwadwo Kyeremanteng

Dr. Kwadwo Kyeremanteng is the founder of the Resource Optimization Network and a critical care and palliative care physician. He is also the host of the Solving Healthcare Podcast. He is also Canadian, so we discuss the Canadian Healthcare System, which, on its surface, looks like a comprehensive, all encompassing, federally administered single-payor system, like what some of the democrats are discussing in the US. We discuss why this is not the case, and get into some of the details about what isn’t covered, how it is more of a provincial system and what are the differences in provinces. We discuss how the money flows through the system and how private insurance can play a role in some ancillary services. And true to the name of his podcast, at the end, we solve healthcare.

Dr. Kyeremanteng was born and raised in Edmonton where he did his medical school at the University of Alberta. He and his wife then moved to Ottawa where he did his Internal Medicine residency training at the University of Ottawa followed by a two-year fellowship program in Palliative Care and Critical Care. He stayed after his training and is now an Assistant Professor in the Division of Palliative Care and Critical Care Medicine. He also has research positions with Ottawa Hospital Research Institute (OHRI) & Institut du-savoir Montfort as a Senior Clinician Investigator.

His academic interests include the integration of Palliative Care in the Intensive Care Unit as well as health services research and cost evaluations. More information regarding his current research interests and projects can be found here.

Find this and all episodes on your favorite podcast platform at PhysiciansGuidetoDoctoring.com

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Is Single Payor Really Bettor? with Dr. Kwadwo Kyeremanteng

Dr. Kwadwo Kyeremanteng is the founder of the Resource Optimization Network and a critical care and palliative care physician. He is also the host of the Solving Healthcare Podcast. He is also Canadian, so we discuss the Canadian Healthcare System, which, on its surface, looks like a comprehensive, all encompassing, federally administered single-payor system, like what some of the democrats are discussing in the US. We discuss why this is not the case, and get into some of the details about what isn’t covered, how it is more of a provincial system and what are the differences in provinces. We discuss how the money flows through the system and how private insurance can play a role in some ancillary services. And true to the name of his podcast, at the end, we solve healthcare.

Dr. Kyeremanteng was born and raised in Edmonton where he did his medical school at the University of Alberta. He and his wife then moved to Ottawa where he did his Internal Medicine residency training at the University of Ottawa followed by a two-year fellowship program in Palliative Care and Critical Care. He stayed after his training and is now an Assistant Professor in the Division of Palliative Care and Critical Care Medicine. He also has research positions with Ottawa Hospital Research Institute (OHRI) & Institut du-savoir Montfort as a Senior Clinician Investigator.

His academic interests include the integration of Palliative Care in the Intensive Care Unit as well as health services research and cost evaluations. More information regarding his current research interests and projects can be found here.

Find this and all episodes on your favorite podcast platform at PhysiciansGuidetoDoctoring.com

Please be sure to leave a five-star review, a nice comment and SHARE!!!

 

EPISODE TRANSCRIPT

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Dr. quanto caramon Tang is the founder of the resource optimization network and are critical care and palliative care physician. He’s also the host of the solving healthcare podcast. He’s also Canadian. So we discussed the Canadian healthcare system, which on its surface looks like a comprehensive all encompassing, Federally Administered single payer system. Sound familiar, kind of like what Medicare for All is supposed to be. Which is because why this isn’t the case in Canada and get into some of the details about what isn’t covered, how it’s more of a provincial system. And what are the differences in some of the provinces we discussed how the money flows through the system, and how private insurance can actually play a role in some ancillary services, and true to the name of his podcast. At the end, we solve healthcare. Dr. Sherman Tang was born and raised in Edmonton, where he did his medical school at the University of Alberta. He and his wife then moved to Ottawa, where he did his internal medicine residency training at the University of Ottawa followed by a two year fellowship program in palliative care and critical care. He stayed after his training and is now an assistant professor in the Division of palliative care and critical Care Medicine. He also has research positions with the Ottawa Hospital Research Institute. And I apologize for the pronunciation Institute disavow your forte as a senior clinician investigator. His academic interests include the integration of palliative care in the intensive care unit, as well as health services, research and cost evaluations.
Welcome to the physicians guide to doctoring A Practical Guide for practicing physicians. Dr. Bradley Block interviews experts in and out of medicine to find out everything we should have been learning while we were memorizing Krebs cycle. The ideas expressed on this podcast are those of the interviewer and interviewee and do not represent those of their respective employers.
And now, here’s Dr. Bradley Block.
Dr. Quadro Carmen Tang, thanks so much for being on the podcast.
Bradley. Thank you for having me.
So, Canadians seem to think that American ambulances are going to check your credit score before they’re willing to take you to the hospital. And on the other end, you’ve got Americans thinking that Canadians have having a heart attack need to wait in a Soviet Cold War, breadline get into the hospital, right? Clearly, neither of these things are true, but this is how we view each other systems. Yep. American we’ve got multi payer private insurance with a little bit of government assistance and Canadians you’ve got this concept of single player. That being said, it’s it’s a bit more complex or a lot more complicated than that. So we’re gonna get into it. To start, how long has Canada been on single player and how did that system end up starting?
Yeah. Great question. Bradley. It’s, so officially this all started in 1968 ish. And so it was Put about by Tommy Douglas, from sketching. So one of our Western prairie conference provinces and yeah, Canadians being Canadians wanted universal health care that was accessible, complete, publicly run. And so with those principles, they produced the universal health health care in the mid in the late 60s and basically would find the federal government would fund provinces to say, you know, this is what our principles are, and you guys decide where their money needs to go. And, but like it in the big picture has to adhere to some key principles. And so, the Canadian Health Act was produced in 1984, which kind of solidified the principles of what Canadian healthcare was all about. And so, the key elements of that was that it was publicly run. That was accessible that was comprehensive, comprehensive, was universal and portable. And so since then that’s been officially documented and so legal document and yeah, and since then we’ve been running a publicly a universal single payer system
since 1968. That that, yeah, that sounds like a really civilized place to live.
And I gotta tell you, Brad, it is a civilized place to live yet because I get a lot of it’s like you said like those worries that if you come in with a medical problem that you are going to wait forever for, for things to be addressed. And to be honest with you. There are some areas in medicine where you are waiting a long time like if you depending on what province you’re in. If you are waiting for a hip replacement, you might be waiting a long time if you were waiting for any other orthopedic, elective procedure, but if you come in with any Thing urgent. Okay, so whether that’s you’re having an EMI you’re having trouble breathing, you need urgent surgery. Like doesn’t matter where you’re from doesn’t matter what card you have in your wallet, you get treated the same and you get treated urgently you get treated with respect and, and that’s key principles for Canadians and and we abide by that
well and they’re also I would imagine ways to kind of game the system, right? If you’re an orthopedic surgeon and you’ve got a patient who you think might need a knee replacement, I’m sure there are ways to kind of put them in line so that it makes it seem like it’s a six month Wait, but in reality, it’s really not that long of a wait because they they know the patients that are likely to need it and the patients that are likely to not so you don’t ultimately waiting, you’re waiting that long.
Yeah, exactly. As you put it like that. You can adjust a priority like if you think somebody needs a procedure sooner than later you have that prerogative If and so it’s like, there aren’t, I don’t want to make it appear like there’s millions of people suffering waiting for some procedures to happen. But I think what is consistent is that if something needs to be addressed sooner than later
it’s addressed. If it’s elective, it’s elective and urgent. It’s urgent. Okay, exactly. So is it? Is it really a federal system? Or is it more of a provincial system that utilizes federal funds?
I think the latter like is a better way to put it. So literally, the federal government gives payments to each province based on population based on need, and the provinces decide how they’re going to distribute funds. So for example, in Alberta, when I was still living there, there would be about I think, eight or nine health authorities and the government would give the provincial government would give each money, each Health Authority a pocket of money, and they decide whether that’s should be more focused on outpatient impatience or whatever. Ever, like community resources, like whatever they felt was of higher need in Ontario now they’re just in the process of trying to establish a system similar to that, but every province is variable. But the principle though is that federal government gives money to the each province and the decide how its allocated.
So you mentioned it’s based on population and it’s based on need How is need assessed? Is it based on the idealization?
Yeah, so once again, it’s it depends on the province, but I could speak to Ontario because that’s where I’m at right now. Part of the funding model for each hospital is based on it used to be on based on need, like if you’re seeing more volume of hip replacements, then we’re going to fund that are going to give you a certain amount of money, certain amount of intensive care admissions will give you a certain amount of money. Now they’re using it on quality metrics, like so if you’re, if you’re meeting specific quality metrics within each sector in medicine, like within the orthopaedics within general surgery, then they will provide a certain amount. So basically, they’re rewarding hospitals that are of higher quality. But this is something that’s always changing in healthcare, like I think Ontario now is, is trying to go towards that Alberta model that I was describing earlier where there’s a health authority, we’re going to provide you with money in that health authority. And you as the Health Authority, decide where you want to put your money and how you want to put your money into your area,
but more regional control, if you know that exactly. That happens in American in Medicaid, you have these private companies, where the if the patient qualifies for Medicaid, they can get their insurance through a managed Medicaid provider. So the provider or the the insurance company will get a lump sum per patient that they take care of, and they will decide how they’re going to administer that. And that kind of takes the government out of the loop because, you know, I think government does something Well, but it’s not the most efficient, the private industry tends to be more efficient. So it’s a way to capitalize on both of those strengths. So that’s what it sounds like you give more regional control. And now the federal government doesn’t need to be involved in the minutiae of what happens in that province or even within the region of that province.
Exactly. And this is obviously just my opinion, I do feel like it’s probably a wiser approach, you know, like almost like a bottom up approach where you in your region, you know, where the needs are, like, you might be a region that has more and more elderly population, you might have a population that has, you know, more youth and having some more resources towards that specific patient population might make more sense. And so I, my bias, personally is like, this is the way to go because you get so much variability in in these approaches to how we fund healthcare and, and in my humble opinion, Brad like, the more government that gets involved, the more I find administrative positions or being involved in the more inefficient everything becomes so I love the idea of it coming from like a bottom up approach and be more regional and I think where you’re thrown down makes a lot of sense. I forgot what
it’s called. It’s it’s someone’s law based based on a some British ship captain where bureaucracy fills the space it’s given. Like you said, If you set a meeting for two hours long Parker’s meeting will let Parker’s nice I’m impressed. Yeah, by. Like, if you set a meeting for two hours long that meeting will last for two hours, even if you could get everything done in an hour. So yeah, Parkinson’s Law.
We talked a little bit of pre interview about some of our similarities. And I think one thing I must reinforce is efficiency. Like we’re both busy people. So yeah, the Parkinson’s Law is and I know you’ve been in these medical meetings too, like they are. Most people just like to hear
themselves talk. Exactly. I got stuff to do.
Yeah, go see patients got some family. Got some costs of health care. That’s right. Yeah.
Out of South Africa, or so we’re trying to do here. So so one one attempt at the American government to solve healthcare was Obamacare. Right, the Affordable Care Act and one aspect of the Affordable Care Act is that insurance needs to have these 10 essential benefits in patient care, outpatient care, medications, emergency department, maternity and newborn Mental Health and Substance disorder, physical and Rehabilitation Services, labs and imaging. I’m not sure if I’ve named them all i don’t think that was 10. But but you get the idea, right? All these different aspects of health care. If you’re going to have insurance, it needs to cover all of them. So But the Canadian healthcare system, right? It’s it’s single payer to some degree, yes. But it hasn’t covered all 10 of those things in their entirety, right? Because that would just be to expect to have all of that paid for in its entirety for every single person in your country. Just the the costs would end up skyrocketing. So that’s not how it works in Canada.
Exactly. What says
what is paid for,
it’s about 70 to 75% of healthcare related costs. So it’s essential services, actually, it’s probably easier to just say what’s not covered. So typical allied health like physiotherapy, occupational therapy, optometry is not covered drugs, unless you unless you’re elderly in most provinces aren’t aren’t covered. So there’s a good chunk of services that aren’t covered within the healthcare system and it’s as you said, like, we Pay this I would need to check a reference. But somewhere between 45 to 50%, I think of our GDP goes to goes to healthcare related expenditures. So we spend a lot. And that’s my whole area of research, to be honest with you is how we can be more efficient with our spending. But yeah, it is not complete. And so some argue do should we be covering more like one of the hot topics in Alberta, or in Canada, we just had a an election was pharmacare and having within the universal health care initiative to have drugs covered, and no party was really diving into details on how this would be approached. But it was certainly on the minds of Canadians of having more complete coverage of some of the medication. So yeah, but you nailed it, Brad, like we’re not it’s not, we’re not covering 100% of health care’s use, or their private insurance companies that come in to fill the gaps like You pay us this amount per year and you’ll get this percent of your rehabilitation services or medications or long term care or whatever it is that’s not being covered. Are there private insurance companies that are trying to fill those gaps? 100% So, the I’m in a government town capital of Canada, Ottawa here. And a lot of for example, government employees have a very complete insurance packages where, you know, a large portion of medications, a large portion of massage therapy, physiotherapy, optometry, all those have to be covered. And usually there’s limits but there’s, that is absolutely true that there’s private health care companies that supplement Yeah, so
a lot of single payer system that that makes it
illegal. I guess a single payer for essential services is the way I would look at it. Okay. But for the, you know, the non essential services like dental, for example, didn’t mention that as well. You we all have most of us have insurance, separate insurance for that.
Yeah, I’ve been in the situation I’m in. I’m an EMT. So I’ll have a patient that comes in with a neck abscess. Right? So I get called by the emergency department to assess this patient. They’ve got an abscess, where’s the next neck abscess coming from what’s coming from an infected tooth. So the tooth needs to be pulled? Well, this patient doesn’t have dental care, they have Medicaid, so their emergency department stay is going to be covered. But if we call a dentist to take out their tooth, not covered. So you know, they’re kind of stuck having to pay out of pocket even though they have you know, they’re, they’re a certain percent below or I think it’s like 135% above the poverty line qualifies for for Medicaid. Right. So they’re not coming in with much of pay for this dental care, but now they’ve got to pay for a dental extraction out of pocket. So it’s dental dentistry is I think sometimes is frequently forgotten about in these insurance plans. But it is, it’s sometimes critical. Yeah.
And I mean, we kind of touched on this earlier about some of the myths of, you know, within Canada, everyone, it’s very, you have a heart attack, you’re gonna have to wait. But, you know, one of the, like, a true common concern when we hear about some of the scenarios in the states is that if you for example, and correct me if I’m wrong, okay, because I don’t you know, this is just from what I’m hearing from my colleagues is, if you have you know, minimal insurance and you come in with a problem, say you have a cancer related a head neck, malignancy, and you need x medication to be able to, to cover or to go to chemo or to have an adjuvant therapy, you might not have, like, if you don’t have insurance, you might not be able to afford treatment. And so what we often hear about us people having to do, you know, their second mortgage on their house, just to Ford
most common cause of bankruptcy in America medical bills. Absolutely. So, so what, you know, the whole pre existing condition debate, right, that’s something that that came out in the Affordable Care Act is that if you had head neck cancer before the Affordable Care Act, you couldn’t afford insurance. So what would need to happen, you’d need to pay for it out of pocket until your funds are so depleted, that you would qualify for Medicaid, and then you’d go on Medicaid, and then the government would pay for the rest. But meanwhile, you’ve you’re, you’re just depleted. You’re just depleted your future, right? Yeah. So so but now with the Affordable Care Act, you can now apply for private insurance. However, it’s not on a rolling basis. You can’t just apply for it right now. You need to apply for it when it’s available, and I can’t remember if it’s quarterly or once a year, but you’re you know, in that interim, you’re either just gonna have to wait for your cancer to progress waiting for insurance, or you’re gonna have to pay out of pocket until until that happens and end up in that in that similar slip. scenario. So preexisting conditions doesn’t mean you can get insurance just when you need it. Oh, wait till you get pneumonia and then apply for insurance? No, you should. It just prevents you from when you make that decision to get health care. It can’t or health insurance, right? It’s not the same thing to get health insurance that they can’t stop you from getting it, which can also make premiums go up for everybody else because now you have to pay for the possibility of someone with an expensive condition that’s going to end up on your plan. And that’s what insurance does, it spreads out the risk. That risk needs to be spread up beforehand, but you’re totally right. It can. You can you can end up bankrupt from a condition but you did have the ability to pay for insurance. The problem is that some people end up with plans frequently that they don’t understand. Meaning like yeah, I have a high deductible. And so I have low premiums but I have a high deductible which means that my monthly payments if I don’t go to the doctor are low but If I do go to the doctor, then it’s I’m gonna have to pay out of pocket, probably 100% until I meet my deductible. So it seems like I don’t have health insurance, because people think that it’s going to cover everything. But really, it’s, it’s in a lot of ways just for those disasters that you’re referring to where, if you didn’t have it, you would end up bankrupt. Yeah, those are some plans or you end up with a high premium plan and the low deductible it just, you know, but you’re when you’re choosing it, you it’s hard to understand all the nuances of it.
Yeah, cuz it sounds like there’s a lot of nuance. You know, just to contrast that with us. It’s, you know, there’s some provinces that have you pay a small premium for your insurance from like your provincial health care insurance, usually somewhere between than what’s and forgive me if this is mildly wrong, but it’s usually between 50 to $400 a year kind of thing. But regardless whether you if you didn’t pay it, you still get treated. You might get a bill for the government versus you had to pay for your insurance premium, but you’re still getting treatment. And I, I think, when we hear stories like that, like, I could speak for almost all Canadians, when we hear, you know, someone’s has to bankrupt their house in a time of need, when, you know, they just need optimal care. It just breaks your heart, especially, you know, we’re talking to clinicians here we got in this game because we want to help people, not break people. You know what I’m saying? So it’s, it’s it’s tough to hear
scenario scenarios like that.
But it doesn’t mean that you Yeah, the American system is just, it’s preposterous. Yeah. I had an interview a little while ago with an evolutionary biologist. And one thing that we the whole theme was, the human body just doesn’t make sense. It’s kind of cobbled together over time. And things are built on other things like the fact that our hand has is like a bunch of rocks, like Put together and then our fingers extend out of these like eight different buttons. It doesn’t make sense. And that’s kind of what the American system is. It’s not like it was built from the ground up. It started kind of with in World War Two there because there was no workforce, there was caps on salaries. And so they they started offering other benefits like pensions and health insurance. And that was the start of the American system. So it’s based on it’s an employer based system, which just if you’re going to build it from the ground up doesn’t make sense. It doesn’t mean that single payer is the way and the only way. But I think you and I are on the same page and that we believe in universal coverage. So you know, so everyone has something so that stuff like this doesn’t happen. And I think most Americans are on the same page with that, that like health care is a right. You know, I’m of the belief that there is a role for the private sector and for individual payers, you know, for individual people, if you want to pay for more care, then and you want to pay for foster care and you want to pay for that, you know, great have a way to get private money. For those that can afford it, to just inject more money into the system, rather than just having it be single payer, everybody gets the same because it’s just, it’s just not going to be as as efficient. But that’s my personal. That’s actually what happens in I think, Germany. If you make less than 30% above the poverty line, you get health insurance, you just you just have it. You don’t don’t, I don’t think you have to apply for it. You just have it. And above that, yeah, you have to pay for private insurance. And there are a bunch of different systems out there and you choose which one that works for you and in fine. So that’s, that’s my, that’s my soapbox.
And Brad like, honestly, it’s a hot topic in Canada to like privatization, you know, cuz you bring up a lot of good points. Like it’s not, it’s not the most efficient system in the world. And like, like I said earlier, there are people that have long wait times for some elective procedures and there’s people out there that want to be more functional and not wait 18 months or are a year for their hip to be done.
And also you’re spending a ton you’re spending a ton there’s more efficient ways to spend the money. I mean, it’s great that, that you have the system but, you know, American is America is much more efficient with the spending, but but Canada, also you got the person that you said, I think it was 50% of GDP. Like, that’s
just a tremendous, it’s like,
it’s high. And like, and once again, this is my personal belief, too. I actually legit feel like there’s a role of privatization in healthcare, even in Canada. And the worry is that, you know, one of the common words that you hear mentioned in debates is having that read, like resource drain where, you know, the best surgeons, the best EMT surgeon is now just going to work in the private sector and, and you know, not not, so it’s going to be kind of like a two tier system. Well, yeah, the rich get a better service. But you know, there’s like everything else like you just got to be a little bit nuanced about it, like Say, if that EMT surgeon is only allowed to work 25% of their time or 50% of their time in the private sector, that will offset some of that, you know, concern that the, like the quality drain is is happening. And so I just think we got to be, we just got to think through it a little bit more. And use util because we have the capacity we have, like I can speak for the our orthopedic surgeons, like we have guys that are on their third, the third fellowship, they got some of them even got PhDs because there’s no work. Right. And if you think about what’s happening in North America, throughout the world, we have an aging population, baby boomers are getting into the height of resource utilization. There’s tons of people that need work like that need to have treatment, and it’s just we don’t have enough money to fund a wars for 24 hours or for you overtime and so on. But if there was a private element to that, where, you know, people that could afford it are willing to pay there were 20 to 25 K to get their hip done earlier. Yeah,
wait times go down, and that money is going to be used to offset the cost for those who don’t have that type of
exactly. Yes, exactly. So I think there’s, I think resolving
right now, right, we’ll get right.
But yeah, no, I do. My bias is there’s a there’s a role.
So we got a little off the rails and that both you and I, we know how to self healthcare if someone would just listen to us. Yeah. So but there are some things that are done well in some promises, and maybe a little more poorly in another. How do the promises differ in how they administer health care and which province is your favorite? It’s
gonna give me a trouble
So, in terms of different provinces will have a more regional approach. So bottom up where, you know, they fund the region and region decides where the resources go, some are not regionalised. And, you know, the provincial government decides how much money a hospital is going to get based on either a volume based on quality. I got to go back to Alberta, like I really, they went away for a while from the regionalize approach, and I think it in some ways, made care worse. The function functionality of the province worse, they’ve been not totally adverse to privatization so you could get your an MRI CT scan, you can get that done and pay for it privately in a bat doc did that quite early. The reimbursement for their physician services is is I would Say, more than appropriate. So if you if I had to say one, I would, I would, I would, I would lean on Alberta. And sorry for my Ontario folks that are listening. But like I said, they’re they’re moving towards a more regionalized approach as well. And I’m optimistic that things will start to be more efficient and, and, and care will improve. But we also one of the things that I don’t know if it’s fair to talk about, but I’ll do it anyway, one of the things that really irked me about how things were handled in Ontario was from physician pay perspective, they made some unilateral cuts. So some specialties For example, some cardiologist based on if there were heavy diagnostic practice, they they could have lost up to like 20% of their income from these unilateral cuts. And I I gotta tell you, I was not happy with this approach because, you know, we this is a clinic, a physician audience, but you We hustle, we do what we need to do for our patients. We take the brunt of, you know, Dr. Google, of administrators of unhappy patients, we do our best to try and serve. And then for the organization to just unilaterally, you know, take the wheels out and make these cuts. It was it was upsetting for, to say the least. And so that left the sour spot and a lot of clinicians for sure, and things have gotten better in terms of now there’s arbitration between our Ontario Medical Association and, and the government. So the process is better. But when you do that, you know, I guess just, it’s just a big slap in the face, like our specialty lost about about 5%. And, and I’m all about, you know, if there’s areas where it needs to be tweaked, because yeah, there was some specialties that Some opinions would say is overpaid and or the fee schedule is outdated. And, you know, I think that’s fair. But it’s got to be discussion. It’s got to be a by, like both parties to decide what, what’s the best approach. But so that left of real. Ah, that was upsetting.
Yeah. And that happens that happens in the states too, where an insurance company can just make this unilateral decision. And, you know, if you’re a big hospital system, then maybe you have some leverage, but then then you’re leaving a lot of patients out in the lurch if you just decide, you know, what, we’re not taking your insurance anymore. So you know, it gives the insurance company a lot of leverage, just make these heavy handed decisions. And, and there’s very little recourse other than just not taking that insurance and ultimately, in that situation, it’s the patients who suffer. So how does the money flow? Like, how is it that doctors get paid to that you said, you know, in a lot of provinces, it’s Regional, it’s a bottom up, you’re given a lump sum. So So is it? Is it your a salary? Is it fee for service? Is it come some combination
of the two? I’m glad you brought this up. So most provinces, it’s a combination, it’s a combination. So most provinces regardless of whether it’s mostly regional or not, it’s actually going to be the province that decides a fee schedule. And it’s agreed upon that every physician in the province is going to be paid that same within that specialty the same further based on the fee schedule. So most specialists, our our our bill, essentially the Ministry of Health or the government, the provincial government, and would be reimbursed based on the services they provide some province. Some specialties also have like an academic plan which is mostly salary based So basically incentive to be able to teach residents because there’s also a cost to that, right? Like, if you’re teaching residents, you’re not as efficient, you’re not as fast. So compared to the dogs that are in the community that would be able to see more patients in a shorter period of time. So there’s a lot of provinces and a lot of specialties have that option to go towards a more salaried approach. And some also have a hybrid where they get a salary but for example, if you all their night calls or weekend calls might be billable. And so there is some flexibility in terms of how it’s how it’s how physicians are paid, certainly in our in my situation in critical care, we are paid a fee for service. And then my I also do Pyatt of care which that is being paid a salary. And so I get both sides of the equation.
Interesting. What about the hospitals? How do they How do they give you? Or is it the money flows from the region to the hospital in the hospital is the one that pays the doctor. One thing
I guess that’s quite unique in Canada, like, I am not a hospital employee, you know, the hospital, hospital doesn’t pay me, jack, it’s I build the government and the government pays me based on services are provided based on this fee schedule. Okay. And then the hospital does the same thing. And so the hospital, so they will either get paid by like, the most updated one that I know is our hospital will be paid based on quality metrics on the ability to minimize, for example, part of the equation, not the whole equation be the volume of patients they see but also are you meeting your quality metrics, less, you know, surgical infections, less ventilators, associated pneumonias, and so that enhances their their budget as well. So, yeah, so basically physicians get paid by the government. directly, hospitals get paid by the government or region. And but certainly the docs are being paid by the hospital. Okay. Okay.
Is there anything right now that’s being debated in the government any any hot topics? Or is it something that they’re trying to stay away from? Because because it’s too much too
sensitive to touch all man, there’s a lot of like hot topics in general like, or no healthcare sorry,
healthcare related. Yeah, being
debated in the government. Ya know, there’s lots so there’s where to start. So we mentioned pharmacare. There’s the privatization that’s still being debated, like having some level of privatization. There’s medical assistance in dying, like, you know, having more clear legislation in terms of who’s eligible. What else is there, all the cannabis legalization like, Ah, you know, in terms of, you know, right now, you could legally purchase Cannabis, but how safe is it? Are we doing effective monitoring? Well, what what if you’re if you if you consume and you drive like what’s the level? That is okay and what’s not okay?
They recently maybe figuring that out before legalizing I gotta
tell you a bunch of it in the wind and seeing what happens.
I gotta tell you this. There’s been a bit of a shotgun approach with a couple of things, but one of them was the candidates who were eager to to get the my personal opinion they’re eager to get the revenue because it’s obviously heavily lucrative if adopted appropriately and then medical assistance and dying. I don’t know what drove that one. But we, I would say we weren’t 100% ready for that when it came out as well. But, um, but yeah, there is a bit of a, hey, we’ll figure this out as we go approach in some of these. Some of these tissues.
It was popular so the politicians decided to pass it and just figured they would kick the can down the road for figuring out all the nuance that really makes it or breaks it.
Yeah. That’s what it feels like. Interesting. Okay.
Just like America. Yeah. So tell us about your podcast solving healthcare. My main question for you is, have you solved healthcare yet? And if not, What’s taking so long?
I love it. I love that question. So, so Brett, what’s it stem from is like I mentioned earlier that we have a research group resource optimization network. And we’ve been pretty productive over the last few years. And our area of interest is how to make healthcare more sustainable. How do we save money? How do we improve care? And honestly, we were doing these what I would say pretty great studies and nothing was changing at all. And it was totally myself like what are we like, what are we doing? Like, what’s the purpose of this if nothing’s gonna change? So then, you know, podcasts and fuzziest. And so I was like, you know, maybe if we increase awareness, and maybe maybe this could start drumming up some noise. And so, we decided to develop solving healthcare. And, you know, we’re about at the time of recording about five months deep into it, and I gotta tell you, Bradley like I’ve, I’ve never outside of like moments in medicine, but a this is truly been a humbling experience because like, I do feel like we are solving healthcare and things are changing and things are improving. I’ll give some examples. Like we did an episode on overparenting and, and the lack of support for kids with anxiety, depression and other mental health disorders and Like, for example, in Canada, we’re talking about what’s covered what’s not, if you wanted to see a child psychologist for services, that’s about a $3,000 bill for a proper assessment, and a lot of people can’t afford that. And so we brought this issue up. And now one of the clinics in Ottawa is going to be providing free care for, for kids that can’t afford it, essentially. And so I
feel like that’s such a great investment. Right? Like you provide child childhood mental health services, and you’re gonna save yourself a ton, right decades down the road, but you’re gonna save yourself a ton down the road that and that seems like they could. It’s so it just intuitive. But you’re right, you got to find the money somewhere to do that. And someone’s got to have the political will to say, you know what, we’re going to take money away from this and put it towards that.
Exactly. And so by increasing the awareness, bringing it up and like I’m married to a psychologist, and I had no idea what some of some of these issues, you know, I didn’t Know About the $3,000 bill that these families got to sort out or, or maybe just not go to see a psychologist because of and that discussion with Adrian, it was Dr. Adrian Matheson. And talking about as you put, if you invest in this in these kids early, it could have such upstream positive impacts on their lives. And that you wouldn’t believe it, you know, avoid long term mental illness, avoid them being incarcerated, avoid them and having drug addictions. And and it just hits such a. I mean, you and I, we both have three boys. And like, it’s like if we can’t step up for a kids, but can we step off for you know what I’m saying? And so like, when, like, when I heard about this initiative of having free care for the kids, I was like, This is what it’s all about. This is why we’re doing this. This is a small step. This is a little thing, but this i’m a i’m one person. I have a team now helping out with the podcast, so shout out to the team. Love you guys. But this is me five months in and already having a footprint. And this is to me, this is how we’re solving. And this is just the beginning to Bradley like, we, because of this similar episode, we did one on marginalized patient populations, like people that are on the streets in the care that they need. You know, there’s one of our intensivists approached me saying, Can we not start funding some kind of program to get, you know, these kids that are vulnerable into some program to try and, you know, give them some hope. And so, like, nothing has materialized yet. But we’re having that discussion. We’re having that dialogue, and that’s how it starts, and it’s how it started.
I can’t happen without that dialogue.
And I believe in my loins, I believe, like, things are gonna get better.
Well, where can people find where can people find your podcasts? Yeah, so
solving healthcare. We’re on or everywhere. We’re, we’re on. We’re on Apple. We’re on Spotify, Stitcher, everywhere you find your podcasts cost box, wherever you are Google Play, you can follow us at Quantcast on Twitter, Facebook, Instagram, YouTube, and I really appreciate the listenership and those that are listening already.
And I think there’s also a link to it on your web page resource optimization network comm it’s a good place to find it too.
And can I say one more thing, Bretton Woods, I, I want to make sure that your listeners realize how beautiful of a thing what you’re doing is okay. We as clinicians, and and medical trainees, we don’t get some of these finer skills in medical school. It’s very mentorship dependent and if you don’t have that kind of access to good mentors and like, some of the stuff the content you’re creating, we people don’t get that exposure. So I think Just want to commend you for the value of the show. I’ve been a recent subscriber and the content that you’ve been throwing down. It’s been beautiful and i think it’s it’s a way that we can become stronger we could become more connected with our patients and their families. So like, Good on you, my friend.
I appreciate that. That really means a lot that really warms warms the cockles. Should buddy
should
so I really appreciate you taking the time to be on the show. You’re you got a lot of hats, the podcasts resource optimization network, palliative care, the ICU three boys. Yeah, you got a lot going on. So I really appreciate it and it’s been a lot of fun, a great conversation, and I appreciate the compliment there on the
absolutely means a lot. Thanks for reaching out boyfriend.
I take care.
That was Dr. Bradley Block at the physicians guide to doctoring. He can be found at physicians. Guide to doctoring comm or wherever you get your podcasts. If you have a question for a previous guest or have an idea for a future episode, send a comment on the web page. Also, please be sure to leave a five star review on your preferred podcast platform. We’ll see you next time on the physicians guide to doctoring.
Transcribed by https://otter.ai

Economic Impact of When To End Shelter-in-Place for COVID-19 with Adam Block, PhD

Adam E. Block, PhD, is a recurring guest, having spoken previously about common misconceptions of the Affordable Care Act, and Medicare for All. Today we will be discussing the how erring on the side of an earlier end to shelter in place could have a worse impact on the economy than waiting longer. We also discuss what a return to work could possibly look like and when can we expect our elective patients to start coming back to the offices. In our industry and many others, it is important to be able to pivot and adapt to the new needs created by this virus. From a public health perspective, we also talk about when the risk of poverty as a social determinant of health starts to outweigh the risk of the coronavirus itself and what populations are at highest economic risk.

Dr. Block is currently an Assistant Professor of Public Health at the School of Health Sciences and Practice at New York Medical College. He is a health economist with deep experience in the hospital, health plan and government sectors. His research is focuses on how individuals make decisions in health care markets including patient choice of hospitals, physicians and insurance plans. 

Prior to joining New York Medical College in 2017, has worked for a major hospital system, a large Medicaid managed care plan, spent several years developing the legislation on the Affordable Care Act as an economist at the Congressional Joint Committee on Taxation and later as Division Director of Health Plan Policy in the Center for Consumer Information and Insurance Oversight at CMS. 

In July, 2018 Dr. Block founded Charm Economics, LLC a translational economics consulting group.  His consulting work focuses on managed care contracting and pricing optimization of new technology and data analytics.  Dr. Block received his PhD in Health Policy from Harvard and undergraduate degree in neuroscience from Amherst College.

@AdamBHealthEcon on Twitter

CharmEconomics.com

Please be sure to leave a five-star review, a nice comment and SHARE!!!

This and all episodes can be found at PhysiciansGuidetoDoctoring.com

Economic Impact of When To End Shelter-in-Place for COVID-19 with Adam Block, PhD

Adam E. Block, PhD, is a recurring guest, having spoken previously about common misconceptions of the Affordable Care Act, and Medicare for All. Today we will be discussing the how erring on the side of an earlier end to shelter in place could have a worse impact on the economy than waiting longer. We also discuss what a return to work could possibly look like and when can we expect our elective patients to start coming back to the offices. In our industry and many others, it is important to be able to pivot and adapt to the new needs created by this virus. From a public health perspective, we also talk about when the risk of poverty as a social determinant of health starts to outweigh the risk of the coronavirus itself and what populations are at highest economic risk.

Dr. Block is currently an Assistant Professor of Public Health at the School of Health Sciences and Practice at New York Medical College. He is a health economist with deep experience in the hospital, health plan and government sectors. His research is focuses on how individuals make decisions in health care markets including patient choice of hospitals, physicians and insurance plans. 

Prior to joining New York Medical College in 2017, has worked for a major hospital system, a large Medicaid managed care plan, spent several years developing the legislation on the Affordable Care Act as an economist at the Congressional Joint Committee on Taxation and later as Division Director of Health Plan Policy in the Center for Consumer Information and Insurance Oversight at CMS. 

In July, 2018 Dr. Block founded Charm Economics, LLC a translational economics consulting group.  His consulting work focuses on managed care contracting and pricing optimization of new technology and data analytics.  Dr. Block received his PhD in Health Policy from Harvard and undergraduate degree in neuroscience from Amherst College.

@AdamBHealthEcon on Twitter

CharmEconomics.com

Please be sure to leave a five-star review, a nice comment and SHARE!!!

This and all episodes can be found at PhysiciansGuidetoDoctoring.com

Do No Harm, a film by Robyn Symon on Physician Suicide

Robyn Symon is a two-time Emmy Award-winner, and an accomplished writer,

producer/director, and editor. She is the producer and director of the documentary film, Do No Harm, about the healthcare system that drives us to take our lives.

We discuss how prevalent physician suicide is and how the real numbers and demographics are so difficult to track. We talk about the difference between paying lip service to change and what changes may actually help. We also talk about how the current coronavirus epidemic will make more apparent how overtaxed and overburdened many physicians really are. There will be an upcoming virtual screening on April 19 (see below).

 

Ms. Symon began as a television news reporter in Texas, then joined PBS in Miami where she hosted and produced documentaries, public affairs programs and the TV series Florida! (6 seasons; Travel Channel). She wrote and produced the docu-series “Voices of Vision,” which focused on the work of non-profit organizations worldwide. She has produced hundreds of hours of TV series for major cable networks including Discovery, CNBC, HGTV and currently produces a series on the Reelz Channel.

DoNoHarmFilm.com

Virtual Screening

WHEN: Sunday, April 19th at 8 PM EST/7 PM CT/5 PM PST

WHERE: FOR TICKETS: ZOOM WEBINAR LINK https://zoom.us/webinar/register/8715849795868/WN_x–X68dnR_i6_kTXvCyVFA

Do No Harm, a film by Robyn Symon on Physician Suicide

Robyn Symon is a two-time Emmy Award-winner, and an accomplished writer,

producer/director, and editor. She is the producer and director of the documentary film, Do No Harm, about the healthcare system that drives us to take our lives.

We discuss how prevalent physician suicide is and how the real numbers and demographics are so difficult to track. We talk about the difference between paying lip service to change and what changes may actually help. We also talk about how the current coronavirus epidemic will make more apparent how overtaxed and overburdened many physicians really are. There will be an upcoming virtual screening on April 19 (see below).

 

Ms. Symon began as a television news reporter in Texas, then joined PBS in Miami where she hosted and produced documentaries, public affairs programs and the TV series Florida! (6 seasons; Travel Channel). She wrote and produced the docu-series “Voices of Vision,” which focused on the work of non-profit organizations worldwide. She has produced hundreds of hours of TV series for major cable networks including Discovery, CNBC, HGTV and currently produces a series on the Reelz Channel.

DoNoHarmFilm.com

Virtual Screening

WHEN: Sunday, April 19th at 8 PM EST/7 PM CT/5 PM PST

WHERE: FOR TICKETS: ZOOM WEBINAR LINK https://zoom.us/webinar/register/8715849795868/WN_x–X68dnR_i6_kTXvCyVFA

EPISODE TRANSCRIPT

Disclaimer: This is the transcript to the episode. This transcript was created by a talk to text application and the function of having this here is to improve the page search engine optimization. This transcript has not been proofread, so please listen to the episode and don’t read this. The information contained herein will inevitably contain inaccuracies that affect that quality of the information conveyed and the creator of this content will not be held liable for consequences of the use of the information herein.

Robert diamond is a two time Emmy Award winner and an accomplished Writer, producer, director and editor. She’s the producer and director of the documentary film do no harm about the healthcare system that drives us physicians to take our lives. We discuss how prevalent physician suicide is, and how the real numbers and demographics are so difficult to track. We talk about the differences between paying lip service to change and what changes may actually help. We also talk about how the current Coronavirus epidemic will make more apparent how overtaxed and overburdened many physicians already were. There’ll be an upcoming virtual screening of her film on April 19, and see her website do no harm film calm for details. Miss Simon began as a television news reporter in Texas then joined PBS in Miami, or she hosted and produced documentaries public affairs programs in the TV series, Florida. She wrote and produced the docu series voices of vision, which focused on the work of nonprofit organizations worldwide. She has produced hundreds of hours of TV for major cable networks including discovery, CNBC, HDTV and currently produces series on the real channel.
Welcome to the physicians guide to doctoring A Practical Guide for practicing physicians. Dr. Bradley Block interviews experts in and out of medicine to find out everything we should have been learning while we were memorizing Krebs cycle. The ideas expressed on this podcast are those of the interviewer and interviewee and do not represent those of their respective employers.
And now, here’s Dr. Bradley Block.
Robin Simon, thanks so much for being on the podcast.
It’s my pleasure to be here. Thanks, Fred.
So let’s start with the hard numbers. how frequent is it that a physician dies by suicide?
The numbers that are used by suicide experts is about 300 to 400 a year but it’s really underestimates because many of these suicides are listed as accidental and planned as extra as accidental overdoses or car accidents. And so the families of the physicians and the hospitals, and you know, the medical community are not eager to say this was a suicide. So we don’t really know it could be three or four times that we just we don’t know. But that’s what the experts are saying three to 400. And, and they say that mid career physicians have the highest rate and women attempt more than men but male physicians are more successful if you use that word. Yeah, at suicide, but mid career. We see when there are a lot of factors that come into play. It could be, you know, a malpractice food that threatens your financial security, your inability to pay off alone, ruins your reputation, your job to be at risk, and you have a family. And it just, you know, leads physicians to make what they feel is a logical choice, a logical solution to the problem.
Yeah, that actually doesn’t surprise me that it doesn’t surprise me that it’s an underestimate because, as physicians, right, we also recognize that if you die by suicide, your family can’t collect your life insurance. And so if you are going to do it, you do it in such a way that it does not appear to be a suicide so that they are able to collect I can see that being a very calculating thing for you know, a physician just the way that’s that’s the way we think we’re very pragmatic. Yes. So where does that put us compared to other professions?
Well, you know, near the top is not the top when I was working on the Film Editing, which was about a year and a half ago, because we’ve been on the film tour for about a year and a half positions had the highest rate of suicide among all professionals, and almost twice the rate of the general population. So it fluctuates, you know, from year to year. And because we don’t really know the true numbers because of the stigma of suicide and mental health in general. We don’t really know but let’s just say it’s
towards the top if not at the top. That’s interesting. Yeah, I do. I do not when I was a medical student, when I was applying to medical school. I do not remember that being on the brochure I you know, they put those shredding. They put those short white coats on us and say welcome to the club, and something that they neglect to tell us is that That, you know, here’s this short white coat. Every patient you see from now on could be something a diagnosis that you could miss and get wrong that ruins your life and could be something that haunts you for the rest of your life and affect them for the rest of their life. And by the way, we have one of the highest if not the highest suicide rate of all professions. Here’s your white coat. Right? Yeah, I do not remember that being something now. Gustin medical school. That being said, it has been a while, since I since I graduated. So you know, I know this. The schools have evolved. And they’re including more,
they’re still around. They’re still not saying that. No, that’s still not part of the tech talk. Yeah. for new students. Yeah. Because another big issue is statistics. You know, we’ve been trying to find out statistics on the rates of depression and anxiety among medical students. You We know that when they go into medical school, they’re normal or above normal. And when it comes to mental health, and within a year, they have a 25% increase in severe depression and anxiety. So, medical schools don’t want to do these anonymous surveys, because if they have to show their statistics and other schools don’t, would it leave them at a competitive disadvantage? So in the film, there are parents who, you know, were blindsided by what happened to their perfect son. And when he died by suicide, they turned their grief into action, and worked to try to get legislation passed that would force medical schools in Missouri to reveal their Or surveys for depression and anxiety. And at first, all the medical schools killed the legislation. And then they tried again. And finally, you can see in the film after much effort with the help of a very brave state representative who also have position, they finally were able to get it passed. But no, it’s the transparency is not, not the top of the list for medical schools and hospitals. Quite frankly,
that’s interesting that you say you said that they start that we that physicians or rather medical students start out with with mental health that is either consistent with the national average, let’s call it or even better than the national average. But I would think that dying by suicide would be there’d be a higher incidence among high achievers So how do you I don’t know how to juxtapose those two ideas. Right?
Right, you would think so, but their emotional state and they are perfectionist, yes, there, there may be some emotional aspect of, you know, them being perfectionist, OCD, or whatever. But this isn’t a generality. This is a survey of them being above normal. So that’s what we know. But there are ways to mitigate those rates. And it’s St. Louis University in the film, they did a pilot program, and we’re able to reduce pression and anxiety by like 20%. So it was down to 4%. And it wasn’t that difficult to do. It didn’t cost that much. But the most important thing is these young med students, this is the foundation for their career positions. So the whole premise of the film is that, you know, if you don’t have a doctor who’s mentally invested Physically functioning? Well, you can’t provide good quality care. So this is something that affects, you know, all of us. What was
it that St. Louis University did? What were the changes?
Uh, it was a combination of small things. So, for example, they went to pass fail, which, you know, step one,
and I would say that’s a big deal. I don’t think that’s a small step.
That’s a big step. Now, they’re all doing it. But at that point, there were only like 20 schools that did it. They provided they got rid of classes that were too difficult. And they gave their students time off. They extended holidays like thanksgiving for the students to go home. And they and they provided them an opportunity to do charitable work in the community. So they felt fulfilled. Not just you know, with their heads in the book. And they also did, you know, a small resiliency program. But it was the combination of these things. And of course, you know, anonymous counseling, a combination of all these things that really work. So you have a lot of hospitals now that are doing what I call bandaid approaches to improving wellness among physicians going online and do this model. So in the AMA website,
you know, the the irony of having to do medical having to do additional model modules additional work. Yeah, it’s incredible.
More, it’s incredible. And so when there’s
a lot of it’s mindless clicking Yeah,
mine was and what does it do if you don’t complete it? It makes you feel worse. Well, Wow, I can’t even do these modules, you know, for resiliency and burnout. So that’s not the solution. The solution is looking at systemic changes. That should be made to allow physicians to perform at their best, whether that means providing more support people, whether it means, you know, dealing with the EMR system that, you know, nobody seems to, like, time off, you know, dealing with a sleep deprivation, whether it’s dealing with the stigma of mental health, providing anonymous counseling, there’s so many systemic things that should be done, but not these meditation and yoga classes. And certainly, when you have bad outcomes with a patient, you know, they should be providing regular support, like support groups, every two weeks for physicians, and you could you should drop in and if you’ve had a bad outcome, lost a patient, you drop in, and it should just be part of the program. Not like, Oh, well next Wednesday at 230 The Chapel if you want to talk, we’ll have a psychologist there for you. That’s basically what’s happening in many programs. It’s like lip service to wellness programs. And it’s just not good enough. And that’s why we don’t see the change that we should be seeing because it’s very meager attempt to support physicians. So when when you can be establishment when you confront the establishment about this, right,
who is the establishment who’s
who’s in charge here?
Like who do we? Who do we even go to?
Well, really, you know, it’s a hospital system, you know, if you work at a hospital, but there there are a lot of groups involved. So for example, the medical board the medical licensing board, the questions in many states, not in New York, they changed it, but in in many states, the questions that they asked on that licensing board exam to get relicense or license in the first place. about mental health needs to change. They asked you just filled out that form. It’s still there. There was a question that was asked, Do you remember?
i? Honestly, I don’t remember. I don’t remember exactly how it was phrased. But I definitely had to check some box about make you feel uncomfortable. No, but just given that I have this podcast, I am more aware of that question than I otherwise would have been. You know, like I, as someone, you know, I don’t have any diagnosed mental health issues. So in the past, I would have just checked that off. But, you know, this this, one of the benefits of hosting this podcast is it’s made me a little more attuned to issues like this. And so yeah, when I had to fill it out at it, I understood why people would not come from forward with their mental health issues because now they’re having to check this box and you know what checking that box means Yeah, right. There’s gonna be a whole lot more that comes down the road that’s gonna make it harder for your license renewed. If you if you check yes on that box so I just you know, I just I don’t remember specifically how it was phrased but I’m definitely more to that
needs to change because this positions you don’t have the right and should be encouraged to seek mental health counseling there there on the front lines and we see that now more than ever people are finally starting to see how important positions are you know, there’s so much anger and anger towards positions you know, between the patient and condition relationship has deteriorated so much, but,
and everyone right now who’s on the front lines dealing with the Coronavirus, right the the ICU doctors, the hospitalists, the palliative care physicians, the ER doctors, the anesthesiologist, the pulmonary physicians that all of these doctors that are like neck deep in Coronavirus right now are should, should all have easy access to counseling because of what they’re going to leave they’re getting there really
is these these now we’re getting the respect that they have deserved all along. But I really fear that when this who’s done or when this was passed that day, those on the front lines are not going to have access to mental health counseling. I mean, this is like a war. And they will be suffering from PTSD. Many of them already have PTSD from losing patients. But you know, But I fear that it’s just going to be business as usual. And no mind is going to be paid to what they’ve gone through emotionally. And it’s going to be a big problem. And I just fear, you know, look suicide is, you know, what the end result gets a lot of attention. But there are just a lot of people, a lot of physicians suffering deeply with depression and anxiety. And there’s a lot as you know, self medicating. And, you know, I come from a family of physicians, but as a patient, you know, I want my doctor to feel great, and be at the top of his or her game. So we need as a as a society to wake up and understand that physicians are human and that they deserve emotional support because they’re human, just like firefighters and police officers. They’re on the front lines. They they have they have a sense of camaraderie that physicians don’t have. It’s not encouraged for them to get together. They fight fires together. We treat patients fire sensing. Exactly. So yeah, I have a big fear about what’s going to happen after this is over. So, yeah, we’re going to talk about it. Never that never a discussion that we’re going to have after the virtual screening on April 19. I know that a
virtual screening right now. Well, it’ll be in the show notes. But let’s plug the virtual screen.
Well, here’s how this happened. Because we were planning a we’ve been on a film tour for almost two years since September 2018. And we’ve had about 170 screenings at hospitals, medical schools, medical countries. foods like ASAP, and APA and many, many others. So we had a host spring, you know, live events at hospitals and conferences. And of course, with COVID-19, everything was just cancelled. But I people really wanted to see this film. So I said, you know, let’s have a virtual screening with a panel discussion. And so the film is heavy, like it’s about suicide and burnout. And it’s like, why do we need, you know, to talk about this, we’re already you know, barely surviving here. But the panel discussion is really going to focus on how this pandemic has impacted not only the healthcare worker, not only the physician but their family to what they’re going through emotionally, and what needs to happen. So we’re advocating for let’s not forget when this is over We need pork for physicians. It shouldn’t be business as usual. So that’s what I hope the focus of the panel discussion will be. First of all, what trends we’re seeing with Dr. Pamela Wible, who you know, is the physician advocate. She runs a hotline for physicians and medical students, a doctor called Puri, who does like Chi trust at UCLA. And he’s also a writer on the Chicago Med series. And parents who are featured in the film who lost their son Kevin to suicide. So we’re going to talk about what kind of numbers and calls the Pamela’s getting on her hotline. And, Paul, for us, it’s like high interest. We’ll talk about the impact on physicians families, and how they can cope best I mean, there’s a lot going on with separation of families because the physicians don’t want to infect their family. So you’ve seen the stories they’re sweeping into And in basements or not even at home where they’re sending their families away. So they’re coming home to empty homes. It’s just, you know, it’s a very scary time. So we need to, you know, deal with the fallout afterwards.
Yeah. And I think it’s, it’s important for the physicians that are going through it to realize that I’m sure as they’re going through it, recognizing that, that they’re, they’re not the only ones that are feeling this way. Right. They’re not the only ones that are having these thoughts. You know, we are we’re a community and we’re a tribe, as physicians,
that’s, that’s really the message of the film, you know, you are not alone. You’re not weak, because you’re feeling depressed or anxious or afraid. Even you know, before this crisis. You’re not alone. You’re You’re not a weak link, as the professional would like you to think because you know, there’s cutthroat competition starting in medical school, so the the message of the film is you our community, and we have to support each other. And it’s not you. It’s the system. And we need to change that
when you show this movie to physician audiences, what tends to surprise us because I think we understand, right? That we’re under a lot of pressure, right? We have to see a ton of patients, we have to chart correctly. Every patient could be a landmine of a possible, you know, an error that you can make sure you do everything perfectly, and yet they still come back and sue you, and then you’re staying late to finish your charts, financial pressures to pay back your loans. You know, you get home and then your family needs you and you feel like you’ve given everything at the office. Right? I feel like physicians, we we understand this. I’m not saying that I mean don’t misconstrue what I’m saying like as as that like validating the act, but like just the the crushing pressure that we’re under, I think you’d be, you’d be it would be hard to find a physician that wouldn’t understand that, that feeling of being under this crushing pressure, at least at some point in the career, maybe just in residency, maybe afterwards. But what do you find surprises physician surprises, the physician audiences when you show this to them? What, what really surprises us?
Well, first of all, you know, physicians are born overachievers. And then of course, you’re told, you know, now you need to build resilience. So which is kind of crazy. But I’ll tell you when when physicians see the film, because majority of the audience is made up of the blue ocean, they’re shocked at how repressed they are. about the experiences they had in medical school and residency, because they’re just, you know, trying to keep keep on that treadmill, and you don’t want to look back because you’re going to fall. So when they see with film and they see the hazing, the pimping, the bullying the, you know, sleep deprivation, in residency that we follow, they afterwards they say, wow, I had repressed so much of what happened to me. And I think being able to recognize that, even though it’s difficult is healing it’s part of the healing process because repression is not good. So it’s, it’s really good for them and it’s good for them to share their weaknesses and their fears. with each other, they normally would never do that. And I’m really surprised at how many people share their suicidal ideations, their attempt stories, their, you know, even mistakes that they’ve made their frustrations with administrators. I mean, they’ve been very vocal. So the dialogue that we see is really incredible. After the event,
it’s almost like the movie is a key that unlocks something that then just pours forth from us. Right. It’s almost like permission to start talking about the things that we weren’t, didn’t feel like we were able to talk about before.
That’s exactly what it feels like. And my uncle was a colorectal surgeon in New Jersey for 30 years, and I say was because we lost them a couple years ago, but I showed him 20 minutes of the film when I was working on it, and he said, this is going to open up Pandora’s box, because physicians are just not used to talking to each other about their struggles. It’s just not done. You know, in fact, like people would describe to me, you know, they would avoid each other in the hallways, other than like a little nod because, you know, you don’t want to ask how someone’s doing because, you know, they don’t want to show their weakness. And then you don’t want to get involved because then you might wind up holding their pager if they need help. So down the line, so there’s such little discussion about what’s really going on. So you have these relationships, but they’re very superficial. And what the film has done is really got people talking on a much deeper level and some administrators are supportive of this because they understand that to improve morale to improve wellness, you need dialogue. And you need support. So you can’t just have the film and say, okay, you have a film and you know, you got to air your feelings. Now let’s get that to work. You really need to take this and move the ball forward. What can we really do? How can we be proactive to make changes that will see real results in morale? And after the event I talked about, you know, because I’ve traveled to a lot of events. I talk about solutions that I’ve learned along the way at different hospital systems and I share them with other physicians and maybe it could work at your hospital or your medical school. So it’s been interesting to see that sharing going on. Could we do that? can we implement this? And so it’s, it’s the way I used when I do documentary films. It’s for change. And I hope that change is happening. But I just hope that it’s embraced more by the powers that the administrators at hospitals, medical societies have been very supportive. But the AMA is not supportive of the film, The acgme. Well, they don’t come off looking at well in the film, not supportive. So, you know, it’s too bad. We can all work together, but we’ll push forward for what really counts, which is systemic change to improve the wellness of physicians, and also quality of care patients. Is this an issue in other countries? Is this or is this a product of American culture where you’re worth really hinges on your status whether status is defined as academic excellence or financial Success is that is this? Is this a purely American phenomenon? Or is this happening in other countries? That’s what’s fascinating in the film, we have a section on what’s happening internationally. And what we found out is that this is truly a pandemic, because what we realized is that it doesn’t matter. Whether you have a managed care system, the pay system doesn’t matter if it’s socialized medicine. What it really comes down to is sleep deprivation and the stigma of mental health, the inability of physicians to get mental health, the stigma that they face, in their communities, for needing counseling. So if you have those two elements, the stigma of being depressed and needing help or just wanting mental health treatment or just appearing weak Feeling the stigma and sleep deprivation? together? You have this problem. And we hear from people all over the world. huge problem in Asia. We hear from Australia, big problem. South Africa, now in India, but it’s hidden, except in India in the film. You see, they read the suicide notes on the evening news. So they talk about it, but it’s a huge problem. So
still a problem even though it’s out in the open.
Yeah, exactly. Because the stigma still exist. And the sleep deprivation still exists. So especially for residents, you know, in the film, Dr. Charles Sizemore from Harvard, he and Dr. Chris Landrigan both from Brigham and Women’s and Harvard who run the sleep Center at Harvard, and they you know, they sent to me and I put it in the film like speak about it. You’re a resident, I knew Resident you’re an intern, you just got out of medical school, you’ve just had all this training. And now you’re about to see patients on your own. You know, you have clinicals, your third and fourth year of medical school, but I’m talking about really caring for patients on your own as an intern, and that they’re really you’re set up to fail, because you’re forced to work 28 hour shifts, when it’s been proven that after 16 hours, you’re not really learning your brain because you are human, doesn’t have the capacity after 16 hours. And they’ve done many studies in the lab about sleep deprivation and medical errors. So you’re a resident and you’re now forced to work these slave shifts. You get into your car, get into a car accident, sent out by the hospital, go home for come back in a few hours and then you live with a fear of hurting someone or worse killing a patient in the beginning of your career, so you’re set up to sale right from the beginning, that might hurt or kill someone. I mean this what kind of profession is this?
So well, that really begs the question, what is a resident? Right? What is an intern? Are they a student? Are they an apprentice? Are they an indentured servant? Like what? What are the what is their role? Is their role just to learn? Are we trying to optimize their learning? Or are they there to work? Like, you know, like a physician extender. Why? And I think if we really to sit down and define, we’d have to define it first before we could decide what they are. Right? And then you could decide whether those work hours are because they’re, you know, clearly they’re unreasonable. But are we going to be Are we going to accept it? Are we going to accept it They’re an apprentice. They’re not a student anymore. They’re an apprentice. So I think we need to define that. I mean, personally, I think the whole the system needs to be built from the ground up. Because Yeah, we know so much more about effective learning and effective teaching than we did. And this this system, the system has evolved. And just like we covered in episodes on the podcast about evolution with Nathan lense, who’s an evolutionary biologist, you know, evolution creates just a cobbles things together one thing on top of another, so something that used to be an arm now becomes a wing, because that was the limb that happened to be there was it? You know, if you built it from the ground up? Would you have that arm turned into a wing? Probably not. You probably have a separate set of wings and arms, but that’s not how it works. And that’s how the medical system has evolved, right? It’s just cobbled together over time. It hasn’t been built from the ground up and if we could build it from the ground up, then I think we we’d win Have an effective system because of how much research is out there. So if we’re really scientists, then we really do need to take what is what data is out there about the most effective learning and then institute that.
You’re talking about a one, nobody’s really asking me, no one asked you. And you’re talking about a century old system that no one wants to bother changing. And what you say is, that’s in medical school, and even in hospitals. Dr. ciphered said to me, Imagine that you’re using medicine has changed so much just even in the last 10 to 20 years. But yet, we’re using the same model that we did years ago, decades ago. It doesn’t work. So you can’t use the same system you have to resolve. But the system has not evolved in medical training, and it hasn’t evolved for practicing physicians. It’s a big problem because evolution could cost money and it could take time. And it seems that the people in charge, the administrators don’t want to spend the time and the money to evolve with what’s happening in our society and the demands on health care. So, for example,
because you’re going to take a financial hit, right, you’re gonna see fewer pay, it’s gonna end up with either residents who are attendings, or both see your patients, and that’s going to be a financial hit. Ultimately, it may lead to fewer medical errors and fewer lawsuits, but that front end investment that you got to make and that’s a that’s a tough thing to do. We got away from something that I want to come back to because I’m just really curious about what the answer is. You know, you mentioned that women attempt suicide more often, men die by suicide, because those their attempts are more right for lack of a better word successful but aside from the male female split, what are the other demographics is this is this more common in minorities, this is more common in people from a higher or a lower socioeconomic status. Is this, like who is this affecting the most? I’m
curious. Statistics are so cooler. Because until recently, I think since 2014, when in New York, I don’t know if you remember these two young doctors within a week of each other, jumped from the roofs of their hospitals. And it really woke everybody up once again, because I guess we went to sleep for a while to to the problem of suicide and burnout. And you know, there was renewed interest, because remember these tough topics on mental health and about suicide and depression, nobody would go. So it wasn’t just, you know, the leaders of the conferences of these big organizations. Physicians themselves, didn’t want to talk about this because they were You know, brought up just to say, this is not a problem for me because I’m supposed to be perfect. This statistics are very shaky for me. There there isn’t. There aren’t statistically say, you know, minorities are more effective. It’s it’s not. It’s not a minority thing. It’s not a socio economic crisis. You don’t really know and I don’t really because we don’t know because so many suicides are really coded as accidents. We don’t really have a good grasp. We’ve been using this 300 to 400 number for so long. Because we don’t really know I do know that Dr. Pamela Waibel when I started working on the film and she showed me this book, she said she had a die of suicide diary, and she was compiling for herself because there were no real statistics. suicides male female Now hot method of suicide. And when I shot that scene with her that you see in the film, she had about 200 names. Now she’s got over 1600 names in this diary, because I shot that scene with her in 2015, let’s say. So that’s what she’s added to her diary in just that space of time. And those are just the ones that she knows about. Those aren’t the ones that are coded as accidents, she can verify those. So we don’t really know, Brad, it’s just so that’s part of the frustration. That is not a real interest to find the numbers. The real numbers. Yeah,
yeah. I mean, you know, that was gonna make the segue into the current pandemic, same issue, the numbers, how many cases are out there? We don’t you know, we’re not tracking it. We’re not we’re not our testing is Limited, that the numbers that they’re putting out there are, you know, pale in comparison to the, to the real numbers. And it’s hard to code, you know, who actually dies as a consequence of COVID-19 versus, you know, some secondary cause. And then, you know, those statistics are just are just challenging. So, in the face of this pandemic, let’s say you, you were in the process of creating your documentary. Hmm, right. You had done it a couple years later. So that this was occurring in the midst of you creating your documentary.
What would you have done differently? In the wake of the current pandemic, what would you have either included or tracked or covered? If you had included this, what we’re going through right now in your documentary, first of all, Brett, I think it would have been easier because when I started working on excel in 2014, no One wanted to talk about it. It was so challenging to get physicians and medical students, or part of the establishment to talk about this topic, it was still very much hidden. And, you know, people just have this vision that physicians had this cushy life. And you know, they were playing golf, it just, there wasn’t a lot of motivation to talk about it. So I think now if it had happened now, there would be a lot more interest to talk about the pressures, and a lot more acknowledgments, a lot more transparency, because we see it, we see them getting suited up and getting sick and losing their allies to help patients. So of course, this would be a fascinating example of how important positions are. But when I started working on the film, position, suicide and Look, you know, suicide is a problem in society in general, why should we care about physician suicide? And I, you know, was trying to draw the link Look, if if physicians are taking their lives, what kind of care do you think you’re going to get? as a patient? Think about it, think about it. So now it’s, it’s easier to see how important positions are now, you know, men don’t realize these are ER and ICU, you know, these are hospitals that are really on the front lines, physicians like you that have private practices that are hurting and other ways you know, financially. You know, no one’s having elective surgery and people are reluctant to go out of their house forget about, let alone go to an empty appointment to get their deviated septum
earwax clean. Yeah.
physicians in private practice are hurting in other ways, but it just would have man made it easier to get along. empathy for positions that what I experienced back in 2014 1516 of all it took me four years in between shooting for a year and a half, two years and then editing for another 18 months. So in in that space of time, you know, there was just starting to see, you know, more dialogue and more programs, but there was still a lot of resistance to talk about this. So it would have been actually easier.
Yeah, I can see that right now. They’re just so overburdened and overtaxed and if they were already even a bit burned out beforehand you know, they they have no guard left. So you ask them a question and they will be more than happy to go into great detail about what is what challenges they’re facing or and have been facing.
I’m holding posted a cold COVID-19 we can still use this film as a means To get the community together and have a dialogue about what has happened, you know, how can we use this spotlight this national spotlight, this global spotlight on physicians and all healthcare workers to demand change to improve wellness and safety. So
tell us one more time about the virtual screening for do no harm.
The screening is on April 19, which is a Sunday evening. It’s 8pm on the east coast. 7pm Central and 5pm on the east coast. The easiest way to register is if they go to the do no harm film website, and on the homepage, there’s a button right there to click to learn more about the panel and the event. And then you can register
and that’s do no harm film calm, correct. Okay. Robin Simon, thank you so much for creating this Extremely important documentary and for taking this time to do the podcast.
Thank you, Brad. It was a pleasure. Thanks for having me.
That was Dr. Bradley Block at the physicians guide to doctoring. He can be found at physicians guide to doctoring calm, or wherever you get your podcasts. If you have a question for previous guests, or have an idea for a future episode, send a comment on the web page. Also, please be sure to leave a five star review on your preferred podcast platform. We’ll see you next time on the physicians guide to doctoring.
Transcribed by https://otter.ai

Introduction to Meditation for Physicians with Jill Wener, MD

While this episode was recorded before the COVID-19 pandemic, it is all the more relevant. Meditation is an arrow we should all have in our quivers.

After over 10 years practicing Internal Medicine at Rush University Medical Center, Dr. Jill Wener knows firsthand what severe stress and burnout feel like. In the midst of her own burnout, she was introduced to Conscious Health Meditation, and it had a profound effect on her resilience and reactivity. After 2 years of coursework, Dr. Wener completed her 3-month teacher training in Rishikesh, India in April, 2016 and now teaches meditation, among other stress reduction techniques, full-time, primarily to physicians.

This is an introduction to meditation. She starts by defining meditation and then delve into the different types, and why she has chosen to teach Conscious Health Medication over the others. She is a skeptic turned believer and helps us to start heading in that direction. In addition to meditation, she also teaches tapping, similar to exposure therapy, and we briefly discuss this as well.

Dr. Wener’s 8+ years of practicing and teaching stress-reduction modalities such as meditation and tapping, combined with the teaching and mentoring skills developed during her academic medical career, her personal experience with burnout, and her intimate understanding of the healthcare system, make her uniquely suited to teach meditation and other stress-reduction techniques to healthcare professionals from all fields.

theresttechnique.com/

jillwener.com/

Please be sure to leave a five-star review, a nice comment and SHARE!!!

This and all episodes can be found at PhysiciansGuidetoDoctoring.com

Introduction to Meditation for Physicians with Jill Wener, MD

While this episode was recorded before the COVID-19 pandemic, it is all the more relevant. Meditation is an arrow we should all have in our quivers.

After over 10 years practicing Internal Medicine at Rush University Medical Center, Dr. Jill Wener knows firsthand what severe stress and burnout feel like. In the midst of her own burnout, she was introduced to Conscious Health Meditation, and it had a profound effect on her resilience and reactivity. After 2 years of coursework, Dr. Wener completed her 3-month teacher training in Rishikesh, India in April, 2016 and now teaches meditation, among other stress reduction techniques, full-time, primarily to physicians.

This is an introduction to meditation. She starts by defining meditation and then delve into the different types, and why she has chosen to teach Conscious Health Medication over the others. She is a skeptic turned believer and helps us to start heading in that direction. In addition to meditation, she also teaches tapping, similar to exposure therapy, and we briefly discuss this as well.

Dr. Wener’s 8+ years of practicing and teaching stress-reduction modalities such as meditation and tapping, combined with the teaching and mentoring skills developed during her academic medical career, her personal experience with burnout, and her intimate understanding of the healthcare system, make her uniquely suited to teach meditation and other stress-reduction techniques to healthcare professionals from all fields.

theresttechnique.com/

jillwener.com/

Please be sure to leave a five-star review, a nice comment and SHARE!!!

This and all episodes can be found at PhysiciansGuidetoDoctoring.com

 

EPISODE TRANSCRIPT

Disclaimer: This is the transcript to the episode. This transcript was created by a talk to text application and the function of having this here is to improve the page search engine optimization. This transcript has not been proofread, so please listen to the episode and don’t read this. The information contained herein will inevitably contain inaccuracies that affect that quality of the information conveyed and the creator of this content will not be held liable for consequences of the use of the information herein.

After over 10 years practicing Internal Medicine at Rush University Medical Center, Dr. Jill Wiener knows firsthand what severe stress and burnout feel like. In the midst of her own burnout. She was introduced to conscious health meditation, and it had a profound effect on her resilience and reactivity. After two years of coursework, Dr. Wiener completed her three month teacher training in Rishikesh, India in April 2016. And now teaches meditation among other stress reduction techniques, full time primarily to physicians, something we could all use a bit more of right now. This is an introduction to meditation. For the uninitiated. She starts by defining meditation and then delves into the different types and why she has chosen to teach conscious health meditation over all of the others. She’s a skeptic turn believer and helps us to start heading in that direction. In addition to meditation, she also teaches tapping, similar to exposure therapy, and we briefly discussed this as well. Dr. wieder is eight plus years of practicing and teaching Stress Reduction modalities such as meditation and tapping, combined with the teaching and mentoring skills developed during her academic medical career. Her personal experience with burnout and her intimate understanding of the healthcare system, make her uniquely suited to teach meditation and other stress reduction techniques to healthcare professionals like us from all fields.
Welcome to the physicians guide to doctoring A Practical Guide for practicing physicians. Dr. Bradley Block interviews experts in and out of medicine to find out everything we should have been learning while we were memorizing Krebs cycle. The ideas expressed on this podcast are those of the interviewer and interviewee and do not represent those of their respective employers.
And now, here’s Dr. Bradley Block.
Dr. Joel Wiener. Thanks so much for being on the podcast.
Thanks for having me.
So let’s start off with your origin story. How did someone start out being a hospital Put a list internist and then become the internist Yogi.
Oh, such a lovely story. For me it started with burnout. And in 2011, they changed the residency work hours. And I don’t know where when you started when you did training, but a lot of the work ended up falling on the attendings. And that was my five year mark into being an attending and so I think it was a perfect storm, a bunch of other stuff that happened leading up to that, so I got really burnout, like it hit me like a Mack truck. It was pretty intense. And I was crying every day, one little bad thing would happen. And I would just get up and leave our office where we’d all be writing our notes and doing our documentation and go home. I just had no I had the shortest fuse and I had no ability to adapt to anything that happened to me. I wasn’t yelling at people I was just more like defeated and sad and crying and
and So,
around that time I met someone who told me they meditated twice a day. And Previous to that point, I had been the most skeptical unspiritual type a doctor, I had done some yoga before, but nothing, nothing crazy. And but something in me said, Sure, I’ll go hear your teacher speak. And when I went to go hear the teacher speak, he’s his yoga teacher from LA who was in town yoga teacher turned into a meditation teacher. And I everything he said was just like speaking to my soul. I don’t know how to describe it any other way. And I showed up. Like, I didn’t Google him, I had no idea what I was getting myself into. But I just was wearing my skeptical doctor pants and I was like, whatever, I’m smarter than everyone I know all the things about all the things and I’m gonna go there and I’ll just walk out and not have to do anything because I know better. And he started talking about stress and the way it affects our physiology and the way it affects our behavior. And that feeling of constantly being almost out of gas, that feeling of constantly being running on fumes. And he just spoke about that in a way that helped me understand how I why and how I had been feeling for the last couple of months before that. His course started the next day I had evening plans four nights in a row or four days in a row, about two hour one and a half to two hours each session. But I was like start me yesterday, I’m signing up, it was a week salary. So I was also very, very panicked about having to spend a lot of money on something that I didn’t know anything about no one I knew meditator This was we’ve come a long way. And in nine years, there was no one I knew, at least in my community that was meditating. And I signed up for this class and took it so that for me, and what I noticed was, oh, my god, these meditations are easy to do. It’s not mindfulness. It’s almost the complete opposite of that in terms of the actual practice. So it’s easy to do. You’re sitting comfortably with your back supported you’re not trying to control your mind at all. not fighting with what your mind does naturally. And I was having meditation experiences on the second day of class. So I was getting this like carrot approach rather than a stick approach that made me realize I’m actually doing something real and holy smokes. I cannot believe this was something that’s been in the world this whole time that I was just too skeptical or closed to realize. And I was able to fit it into my day. We carry pagers on us 24 hours a day, in my hospitalist job, depending on what we what service we’re on, but I was able to fit it into my day and make it work and I actually look forward to meditating and then my burnout went away. I mean, I started having benefits really quickly. I lost my road rage in three weeks, and
after a couple months, I just I wasn’t crying anymore. I wasn’t sad. I was
living in Chicago at the time, right?
Yeah, I was working at rush in Chicago and right,
downtown Chicago. Road Rage is probably different from rural Alabama. Road Rage right?
Well yeah, it’s not it’s not this is no fun. I wasn’t like a psychopath. I wasn’t like plowing into people and stuff, but I just didn’t get that like, panic anymore. And then I started to be like, Oh, actually the reason why I’m panicking right now is because I’m late because I left the house late so this is kind of my fault so me getting all freaked out about it isn’t going to help the situation I should have left earlier. And then usually when you get there and you’re late, the other person is even later and it all works out. So I I just kind of stopped mostly unconsciously stop sweating the small stuff but also was able to keep my head in moments where I would have been losing it and sometimes also doing additional talking myself down. So I felt great. You know, I burnout was great. I wasn’t at all thinking about anything else other than meditating is 20 minutes twice a day. All I was like thinking was I’ll meditate 20 minutes twice a day for the rest of my life because I’m never going back to how I felt before and then went on a retreat in India with my teacher. had some pretty incredible experiences there. And, like, you know, kind of, oh my god, even more amazing beyond what I had already been experiencing. And at that moment I was the, the stress, you know, compared to the rest of the group on the retreat, I was the closed minded doctor still, I was still very much like in my doctor world. And he said, Have you ever thought about becoming a teacher? And I was like, No, I’m a doctor, what do you mean I’m gonna be a hospitalist forever. And, but then I thought about it and I thought, Okay, well, like practice medicine and teach meditation and the teacher training is three months in India. So it’s a very intense training process Plus, it’s a couple years of prep work advanced coursework beforehand. So this is a pretty major undertaking. And so that was going to be my plan. hospitalist, you know, maybe point six FTP and then and then teach meditation the rest of the time. Then I had a really cool opportunity, opportunity to move overseas to China, and I had started to go Get some sort of itch of like, Hmm, maybe I’m going to be 65 one day and have been happy enough, but was starting to think that there was something else for me. And I’d be happy enough practicing medicine forever. But something else is out there and I had the opportunity to to China and that’s actually why I left my hospital, his job, moved to China for a few months, then went to India for my teacher training. And then that once I had been out of medicine for about six months, and did my teacher training and realized I had had a skill. That’s something other than medicine that I could do, that I was so so passionate about that I had personally experienced how life changing it could be. That’s when I realized I don’t think I want to go back to practicing medicine. I don’t see myself living that life anymore. I see myself doing things to help healthcare professionals to prevent them from getting to the point where I got where I was crying every day and losing it and to make everybody happier and higher performing and less stressed in at work. And at home as well. And so that’s that’s the answer.
That is quite the origin story.
Yeah.
So how do you define meditation, what makes meditation, meditation and not just sitting with your back straight in your eyes closed.
So meditation, meditation and mindfulness and yoga all kind of like tie in together. Yoga is typically thought of as physical poses that people do in order either to get exercise but but but traditionally, it’s physical poses that you would do to prepare yourself to sit in meditation. There’s all sorts of different types of meditation meditation in the Buddhist tradition. So what I what I teach them when I practice isn’t part of a religion. It comes from the Vedas, which is a body of knowledge that predates religion. Yoga comes from the Vedas. Ir VEDA, which is a holistic health practice that comes from India comes from the Vedas. There’s also Vedic warfare in Vedic architecture
the neti pot comes from and we use that all the time to learn
ology. Exactly, exactly. So, there’s a ton of really, really practical knowledge that comes from the Vedas, Buddhism and Hinduism. Both also came from the VEDA. So Buddhism, those types of meditation practices tend to be more contemplative meaning like you’re sitting and you’re focusing on something, you’re concentrating either on a word like a mantra, or your breath, or a physical sensation in your body, or what someone is guiding you through those, you tend to be sitting more upright. And those tend to be more what had been adapted to mindfulness practices. Now, they are also mindfulness practices that what we think of now as mindfulness is more adapted from the Buddhist lineage. Mine is more of more related to Hindu but it’s again, not at all religious, and it’s not Hinduism. But we are the difference is we are shifting our physiologic state rather than maintaining alertness and maintaining focus. Which is mindfulness, we are shifting our physiologic state when we meditate with my technique. The tradition is called Vedic meditation. I call it conscious health meditation for many reasons. But if you’re listening to this and wanting to look up more about it, Vedic meditation is where you would go. It’s also very similar to Transcendental Meditation. But I am not at all part of the TM, corporation or company or organization in any way. So I’m an independent teacher.
Why did you just have to clarify that?
I didn’t clarify that because tm is like an A Corp. It’s a corporation. And they teach people to meditate the same way I teach people to meditate, but they are their bigger cultural phenomenon. Some Some people love it. Some people get a little bit turned off by it because it’s a little bit. Some people find it maybe a little bit aggressive or a little bit culty. I’ve actually never been to any of their specific meetings. So I can’t speak for that. I’m just speaking for what people what people have reported back to me, but I tried to take any question. to try things out as hard as I can to take any of the trappings out of this practice because for me getting back to your question of like, what is meditation? It’s its physiology. It’s really so beautiful. I think one of the things that attracted to me attracted me to it so much is it made sense scientifically and medically to me, I didn’t have to stretch my brain to understand why it was working. It just was like, oh, okay, cool. That makes sense. So when we’re meditating, rather than sitting with our backstraight, and focusing and trying to cultivate present moment, awareness, which is awesome, and I think present moment, awareness, present moment, awareness is very important. That’s mindfulness. That’s not what I’m doing. When I’m meditating. When I’m teaching people to meditate. We’re using a mantra is the one that we use as a Sanskrit sound, and it has, there are many of them. I choose which one to give to my students, but there’s many different mantras that when you use them with the technique that I teach, they allow your your brain and body to settle into a distinct physiologic state. That is separate from sleeping, waking and dreaming, that is two to five times more restful than sleep based on the SPO. Two. So you’re actually more efficient, your body becomes more efficient. the metabolism of oxygen from your from hemoglobin is more efficient than sleep when you get to this physiologic state. And it’s super easy to get to and everybody can do it. I’ve never had a student that can’t get to it. So and you’re
seeing them that’s for conscious health meditation or for all forms of meditation
for what I teach. So people often will say that meditation mindfulness are the same thing. They’re like, Oh, I’m doing I’m on a meditation app. I’m doing a guided meditation. You could consider that but I think of those as more mindfulness and meditation is the actual transcending waking state consciousness and going to a different physiologic state, which then allows your body to it’s like defragging a computer. I also sort of think about it like a cooling protocol in the ICU, if you have cardiac arrest, and then you go, you know, you get the cooling blankets and everything to do Increase inflammation and free radicals so that the body is able to kind of cool off and then recover more quickly and have less damage from the cardiac arrest.
So that’s interesting. So you’re saying mindfulness meditation. For those who practice mindfulness meditation, you’re saying Actually, that’s not meditation? That’s something different. We’re using the same word. But actually, these are two different things.
Yes, I believe so. And there would be people who would be like, absolutely not what I’m doing is meditation. And I’m not gonna argue with them, I don’t care at all. It’s just a different you know, it’s on some level, it’s semantics. But it’s important to recognize that not all meditation is the same not all meditation requires sitting comfortably and maintaining alertness and fighting with your brain to make a do something that it’s not built to do because the brain just like the heartbeats, and it’s gonna beat all day long. The mind has thoughts all day long. And so to try to control those or, or or force the mind to do something other than is very uncomfortable and challenging. And that’s why you hear people being like, yeah, I meditated for three minutes today. And after, you know, four weeks, I moved up to five minutes. And then I stopped doing it because it was so hard. And I, you know, like, it’s not, it’s much more difficult to stay with it when it feels so challenging. And so this is so restful, and it feels so good that you come out of it feeling like you took the most amazing catnap ever.
So before we go take the deeper dive into the type of meditation that you practice, we just break down the other forms first, just so we know what’s out there and what the differences are.
Sure, sure. Do you have specific ones or you want me to
join? Well, I mean, you can, why don’t you start and then if there are any others that you don’t mention, then I’ll ask.
So mindfulness already talked about and mindfulness is a is a big umbrella. That’s gonna cover a lot of other types of meditation. So and again, I’m calling it meditation now, so I don’t, it doesn’t really matter to me, I just everyone always says At what I do is mindfulness and I just like to help educate people that there is a type of meditation out there that’s very different. So mindfulness meditation requires involves, you know, generally sitting comfortably, but with your back unsupported often with your legs crossed, but often not. And there’s a, an attempt to focus and cultivate your attention on something specific mantra breath, your body. The idea is becoming more aware in the present moment of what’s going on so that when you get into your real life, you are able to feel emotions coming up inside of you, and you’re not just completely a victim of the emotions as they come up and you can be more aware and maybe change the way you’re behaving a little bit. I’ve taken the Mindfulness Based Stress Reduction course I took that a few years after I learned Vedic meditation, and I loved it and I thought it was great. And it required a lot of homework and it required a lot of time to practice it. And I was just felt like, Okay, if I have to pick between one of the two, I’m going to stick with VEDA because I’ve got And such amazing results from it. And I can’t meditate all day I do want to do one to actually live my life. guided meditation or guided visualization is also a type of mindfulness because you’re, for the most part, you’re listening to what someone is saying and trying to put your attention on that and follow their instructions as they’re talking you through the sound of a waterfall or how you feel when you’re, you know, at the ocean and you hear the waves or imagining light coming through your head or you know, out of your head, whatever that is. That’s also cultivating awareness and attention. There’s chakra meditations. So chakras are energy centers throughout the body that are very much a huge central integral part of yoga practice, which we don’t always know when we go to a practice and get really sweaty. The yoga practice is all about opening and balancing these energy centers. I don’t really get into chakras much, if any at all when I teach my meditation, but that is a type of meditation where you go through There’s one at the top of your head, the corner the like your forehead and between your eyebrows, your throat, your, your chest, your heart chakra. There’s a few other ones. You can do a chakra meditation where you’re focusing on those energy centers and trying to open them or balance them. So that’s another thing. And chakras are really cool. They’re just not I’m not, I don’t have a expertise in them. And a lot of people will say, Oh, that’s too. That’s too woowoo. For me, I don’t want to get into that. But it’s actually pretty, pretty interesting. And there’s a lot of science behind it as well. So for anyone interested in taking it further, I do highly recommend that. Although studying with me isn’t, is not going to get you that what else there’s mantra meditation. So mantras. There’s tons of different types of mantras, there’s English ones, and Sanskrit ones, and German, let you know whatever language you speak, you can speak it in your own language or you can have it be some other ancient language, the ones that we use and you can say them out loud. You can say them silently. You can try to focus on them and concentrate on them in In the type of meditation I teach, you’re not focusing and concentrating on the mantra, it’s actually designed to be forgotten. Which maybe sounds a little confusing, but it’s not. You’re not trying to focus on that mantra for 20 minutes, as you’re meditating. So mantra meditation is a huge umbrella that can include mindfulness type practices that conclude what I do, which is more of a transcendental type of meditation. And that’s a umbrella term that can be there’s not just one type of that. Are there other ones that I’m
not? So that sort of sorry, the mantra meditation, you use a mantra in transcendental meditation, so as mantra meditation, the same as Transcendental Meditation.
So there’s Transcendental Meditation with like a capital T. That’s like the transcendental meditation brand. And then there is lowercase t transcendental which is just like a meditation that you do that’s going to shift your level of calm consciousness to a transcendental stage, kind of like, oh god, I’m trying to think of an example of that, you know, like Catholic, there was a lowercase E. And then there was a capital C, but I don’t remember I was a religion major in college.
I feel what they’re saying about Transcendental Meditation reminds me of like, when Bruce Lee came to America, and was teaching martial arts to Americans, and it was something that was supposed to be just within the Chinese community. And it was a problem that he was teaching it to, to non Chinese people. And I feel like that’s what you’re saying about Transcendental Meditation. It’s like, it’s this pre determined community. And if you you have to, you have to follow their rules and go within their rules and their scope and use their brand and sell their t shirts and coffee mugs.
Yes, to some extent, and bear in mind, some people who take the courses have no awareness of that and they just like learn to meditate and love it and it’s fine and some people do get much more involved. And in either way, they’re teaching people to meditate really well, and people love to practice. So. But yeah, it is a little bit more it’s like a more of a cultural community type, lifestyle kind of thing. Maybe there are types of meditation that allow you to shift to this other level of consciousness is transcendental consciousness. They’re not all capital transcendental tea, you know, capital T transcendental capital M meditation. mantras can be used for a meditation that might help you transcend waking state. mantras can also be used for mindfulness. If you think of you know people only as a mantra people sometimes meditate chanting a bunch so and and it also if you said, you know, I’m a, I’m a strong doctor, and I’m gonna kick ass at my job today. And you know, if you repeat that to yourself six times in the morning before that can also be considered a mantra and that’s English and that’s out loud. So, so there that that spectrum is very, very wide and and not very specific.
And so how did you arrive at conscious health Meditation of all of them. And I think you’ve, you’ve really covered it. But you know if you could take a deeper dive into, into, I mean, had you tried others it sounds like you tried others after you had already been a conscious health meditator and even a conscious health meditation. How did that? How did you arrive at that?
Sure when I learned that I was Vedic, so the community is Vedic meditation. So I was like zero to 60. I had no, I had done some, like, you know, very little mindfulness stuff at spas or at yoga. But I had never really been I wasn’t like looking for meditation. I was just desperate. And I was broken down enough that my consciousness cracked open just enough that I was receptive to something like this because I would not have been otherwise. Absolutely not would have, you know, if anyone listening to this is like, what is this crap? She’s just woowoo whatever. I was there, that was me. You know, I never would have been in anything like this. So. So I was I’ve met the person who told me they meditate and I went to go get the teacher. Speak. I honestly didn’t research. Not only did I not research, other types of meditation, I didn’t even research, Vedic meditation. I just signed up for the course. And it was awesome. So that that’s how I like to say it found me because it was sort of that moment in my life or something needed to change majorly. I call it conscious health meditation for a variety of reasons. I had a physical space, like a meditation, I usually teach from my home, but I when I first moved back to Atlanta, I grew up here. And so this is where I moved after my teacher training. I didn’t end up going back to China. So since 2016, I’ve been here in Atlanta, and I had the opportunity to open up like a commercial space of a meditation studio. And it wasn’t anything I expected to do. But I did and I decided the name of that was conscious health, meditation and wellness. It was not, but I was still teaching Vedic meditation. That’s what I was still calling it and then it sort of evolved over time because I teach positions. There’s also you people listening here have probably heard all sorts of horror stories about You know, the crumb crumb and Yogi Bhajan, and lots of other different guru types who have founded big movements who have done some not so good things to the people in their community. And there are some issues about that in my community as well. And I didn’t know that that happened directly to me. So I didn’t have this like big story to share. But I wanted to remove myself from any of that influence or connection. So that’s another reason why I call it conscious health meditation. So I like to be pretty forth. You know, honest about that. When asked about it, but so, for me, it’s a natural progression, but also an intentional thing as well to keep it my own community and my own brand,
so to speak to the skeptics out there, hmm. For those of us because because I’ve actually tried meditating before with my wife, we did the we did an app. We did it right before bed, because that’s really the only time that we were settled enough to do it. Yeah, man, I can’t even remember the name of the app. At this point, it’s one of the it’s one of the Uber popular ones. Yes, yes, it was headspace. And now we’re back to just scrolling our phones back right before bed. It’s you know, it didn’t, it didn’t stick. So, you know, convinced me that I should be doing it, but from a more, you know, physician skeptic kind of tilt.
Yeah, absolutely. And I love that you asked about this, because I have people telling me I’m like, it sounds too good to be true. And I agree it does. But it’s awesome. I think the only it doesn’t one thing I will say it does not fix everything. And I I was sort of sold that bill of goods a little bit when I learned so I was like, oh, if I just meditate enough, like everything in my life is gonna be perfect. And that’s not the way it works. But what I tell people and anyone that’s going to tell you that what they’re doing specifically is going to fix every problem in your life. You need to run away from them very quickly, because that’s there’s nothing that does that. There’s always going to be a side of Fact or a downside or, or an incompleteness to something you’re doing, I usually tell people 70 to 80% of things in your life, we’re going to get 70 80% better. This is if you practice consistently, this is not just taking the course, but actually doing it, taking the course and then actually doing the practice, some things in your life are going to get 50% better, some things in your life are going to get 100% better, and some things are going to be like the positive and negative symptoms of schizophrenia, but in a good way. It’s not just that the bad things are going to get better. But there’s going to be also these wonderful enrichments to your life that you didn’t necessarily know you could have or that would that you were missing, but just kind of got worse. What’s going to get worse.
You don’t have to take that question seriously.
No, I the only thing that would get worse, I think is when you start down the path of like, it can feel a little rough. Sometimes if you start down the path, this technique, as you’re going to this two to five times more restful state than sleep. It’s unwinding stresses from your entire lifetime. stresses that stress scars that we carry around with us. If you think about a song you hear on a radio that might remind you of a breakup or a particularly painful time in your life and yours, your friend is rocking out to the song and you’re like, oh, turn softball, and your heart’s pounding, and you’re sweating and you’re crying a little bit. You can’t bear to hear but someone else is having a completely different experience. It’s something in you that has this stress scar that is that you’re carrying with you. Or maybe you smell something that reminds you of your grandmother’s kitchen from when you were eight years old. And you’re like, Oh, this smells just like I could I’m right there with her God, you know, we carry these stress scars around with us, and they build up this wall around us, kind of like layers of an onion, I guess. And so you get kind of tough, and you feel like maybe you’re a little numb to the world, but it’s a survival mechanism. So it’s sometimes easier to go through life not feeling things, but also you don’t usually feel the good stuff, either when you’re that shutdown. And I think for physicians, in particular, with all the stuff that we see that just gets like layered upon layers upon layers upon us that we’re expected to just interact Realize that can happen. So as you start to peel back those layers, that’s another difference between mindfulness and this. What I’m calling metta. I’m just differentiating mindfulness and meditation. Mindfulness is great and burning off the stress, right then mindfulness will help get you out of your stressed out brain, right in that moment, and and calm the stress down. But what this technique is doing it’s it’s shifting your your nervous system from sympathetic, overdrive survival mode to parasympathetic activity. And that’s a healing mode, it’s rest and digest and, and healing. And so we’re actually able to reverse damage that’s that we’ve been stressed damage that we’ve been carrying around with us for days, weeks, months, years, decades. So this stuff as it comes out. Usually in meditation, sometimes you’ll be meditating and you’ll be like, Ooh, I’m anxious. Or I’m feeling annoyed or why is my you know, spouse making that weird noise when I’m trying to meditate or whatever it is. That’s just stress coming. Have you. And also as you start to become as that stress starts to peel to come out of you, you start it’s like peeling back the layers of the onion again, it can sometimes feel more raw and more vulnerable in there. But it’s a beautiful, it’s a beautiful space. But it’s it’s something that’s happening gradually. But I always tell my students, it’s not like you’re going to stop having emotions. I’m not, you’re not going to forget that these bad things happen. You might feel more, you might feel you might cry more commercials, if you’re watching if you’re ever watched commercials anymore, more emotionally affected by beautiful things around you as well. Because you no longer have that wall of stress around you. So for the most part is beautiful. But for some people, at times it can feel a little sensitive. But that’s why you have me when you take my my live course with me, you have me as your teacher for life. So you can email me and text me with questions at any time. And hey, I’m feeling this and I’ll explain why. So it’s not like the apps don’t do that. You know, you can’t write into the app and say hey, I had this experience while I was meditating Any thoughts? Because it isn’t a human being with expertise. So I would say that would be the only or the only downside as a long winded answer to that question, but I think it’s an important one. Absolutely. What’s some
of the science behind conscious self meditation?
Did I answer your skeptic question, by the way?
Well, I think that’s going to be more in the science aspect. Okay.
The other thing I will say is that it’s experiential. No one, no one quite understands where they’re about to get their songs get themselves into unless they know somebody who did it. And even so you still don’t know how awesome it’s going to be. Because no one believes that they’re actually gonna be able to meditate and that they’re actually going to do it and that they’ll everyone says, Oh, my mind is the only one I am the only one with monkey mind. I’m the only one who has thoughts all day long. That get louder and crazier. When I sit down to meditate. I’m the only broken one you know, I’m too my brains too active. Everybody says that. So so I don’t have to, you know, learn the techniques. Do the class and you will experience what it’s like rather than me having to convince you. So it’s kind of nice people, you know, definitely by the fourth part of the course, but generally well before that, or meditating very easily and successfully. So the question you had said the science behind it. I mean, there’s they’ve done studies on mindfulness, a lot of that that’s one of the great things about mindfulness is when it’s been adapted and secularized from the more Buddhist religious type practices to a more secular version. There’s been a lot of studies on benefits, pain control, and depression and anxiety. The Transcendental Meditation organization has a lot of money and they have done a lot of scientific studies as well on this practice. So what I teach again, is pretty much identical because my my teacher trained in that organization for 30 years and then and then he left so that organization has a bunch of studies they have but like anything you know, if you remember there’s one study about Rifaximin. Preventing hip hop encephalopathy and it was this like, oh my god is amazing results. But it was sponsored by the drug company. So you always want to be a little careful when the study is sponsored by the organization that is profiting from from the intervention. But so there’s great data there. And so there’s data on on improve school performance for kids improved depression, anxiety, pain, and and I’m talking specifically for the type that I teach, but there’s, there’s not a lot in the meditation can’t help. It makes you it’s they’ve done studies where it prevents secondary events for coronary artery disease and people who have already had events it can lower blood pressure, Gazprom so yeah, yeah, I mean, it’s, it’s you have the more benefits, the more consistent you are with the practice, but so there’s some pretty cool data and I think overall, the the body of the data suggests that it has a lot of really great impacts, but I think that studying meditations really hard because I I know that like when my students are coming to me, when they’re coming in, they’re choosing to learn to meditate because they really want to learn to meditate. They don’t like, that’s the choice that they’ve made for themselves. They’re going to be much more open and excited about it and committed to it, then if it’s something that like work is paying for, for example, that they’re like, Sure, why not some bias there? Yeah, yeah, exactly. So So and I, you know, I think that met it, it’s like a little slippery. It’s I think it’s a little bit hard to pin down and it can be frustrating. But when you do the practice, you feel the benefits. It almost stops mattering about the data, because it’s like, well, I’m doing it. I have this practice. I’m doing it I feel amazing. Data is great data helps make things more particularly something like meditation, it makes it more accepted by the mainstream scientific community, but it’s ancient knowledge that’s been around for thousands of years, if not longer. It’s it’s science. It’s science but in a difference presented differently. You know,
I wonder if there’s a minimally effective Right, like, at some point, if you don’t do it for long enough, you’re really not going to see benefits. And if you do it for longer it starts to be diminishing returns. I wonder if there’s an inflection point?
Sure, sure. Well, in my, in my technique from what I’ve been taught, at least, so that the man who started the transcendental meditation movement, who brought this technique over from people who were mostly like, monks and people who meditated all day long, he, he adapted this technique to people like you and me who have jobs and families and eat pizza and live in the world and drive cars and stuff. And so he, from what I’ve been told, tested it out. So right now it’s 20 minutes twice a day, but like, will it work with an hour once a day or two hours you know, and 20 minutes twice a day. In this in this type of meditation and and other types of meditation seems to be what people come out with as the sweet spot. I teach my course live. And in my live course, I do a ceremony on the first day and sounds good. Beautiful, but it’s you know, definitely for me it was outside the box for what I was used to, but I was I didn’t care. I thought it was lovely. I give a mantra to each person. And I’m teaching a practice, it’s 20 minutes twice a day, and my students are getting there are not 6 billion mantras. So not every student gets a different one. But it’s individualized to each student. I also teach an online course and both of my courses are CME accredited get CME for taking my courses. My, and I’m getting somewhere with this, I promise my online course. I use a this everyone gets the same mantra. And it’s 15 minutes twice a day, instead of 20 minutes twice a day, the type of mantra I use in the online courses just slightly less powerful because the students who take that don’t have that full access to me for a lifetime. And it’s important to have that ongoing contact with the teacher. But even with a different mantra, different, slightly different type of mantra that’s used in the same way. And the 15 minutes twice a day. My students are having incredible results who are taking it online, so you don’t necessarily need to go above 20 minutes twice a day. It’s like your receptors, your bliss, receptors are already full and there’s no need to stay in. Once you’re wet, you’re wet. And if you think about like dunking yourself in a swimming pool, you don’t need to dunk longer to get more wet, you’re already wet. But the 15 minutes also has been quite effective. So I think you can go a little bit less to that less than that. The 20 minutes, but generally I say less than 13 minutes is not going to be as effective.
Interesting. So where can people find those courses? My website,
I have a website meditation in medicine calm, and that’s going to have all the information about my online courses, my retreats that I do so I have a retreat for women and healthcare that I do in October at mirrorball spa. It’s the most amazing spot ever, and that’s all types of women in healthcare. But we’re not we’re it’s basically meditation and enjoying the spa and I do a little PowerPoint free little group lecture on Vedic knowledge and how it relates to life as a woman in health. Healthcare. So that’s really focused on the meditation and the stress reduction, I do another event called transformed with with my colleague, Marjorie Stiegler, who that’s more of a professional development, life transformational event. And we do that in January in Mexico. So registration for both of those are open for October this year in January of next year, and then the online courses as well. And I do another technique called tapping, which we haven’t really gotten into here. But that’s something else I do. That’s another really cool technique that helps people more with like specifics. If you want to global global life overhaul, you want to get more efficient at your job, you want to be happier, you want to be less reactive, meditations, what you want to do, but if you have a specific thing you’re trying to get over, you’re having specifically anxiety or a difficult decision to make or a phobia or trauma, difficult relationships, that’s, you can use this thing called tapping. So I have tapping question As well on that website,
what exactly is tapping.
So tapping is also called the Emotional Freedom Technique or EFT. And it is a technique that I first learned about when I was teaching my meditation course at a medical conference, the psychiatrists and psychologists came and they talked about using tapping and a few others similar modalities, with their veteran patients at the VA who had PTSD and the incredible results that they were getting. So I heard about it from a very, maybe a sanction inside the box source. And then I’ve heard about it more outside of that and people it’s it’s similar to maybe energy work, but you use the same meridians as an acupuncture or traditional Chinese medicine. But instead of using needles, you tap on them. And most of the meridians we use are on the face in the chest and you are basically tapped in and it works really really the the most effectively if you work one on one with a coach but you can also find free tapping videos on YouTube if you want to, you say negative things, whatever it is. bother you, let’s say you have a phobia of flying. As you tap through the meridians, you’re going to be saying out loud, I have this fear of flying, I’m afraid that we’re going to crash, I’m afraid that I’m gonna, you know, lose my life. I’m afraid that whatever it is you’re afraid of you say it over and over again, as you’re tapping, it actually sends Calming Signals to the hippocampus, as you’re saying it so it decouples that trigger from stress. And so the hippocampus is then not sending that stress message to the amygdala. And the amygdala is not going off into fight or flight. So you basically are changing the way your brain is reacting in the face of things that used to be very stressful, and it works very quickly. It’s very powerful. It’s incredible. I love it so much. And the results, if done right. are, they’re permanent, like you don’t have to keep tapping to get rid of the phobia. Once the phobia is gone, the phobia is gone. So I do that as well. I have an online course about using tapping for physician burnout. And I do a lot of tapping workshops at my retreats as well because people love it and you can do it very, you don’t have to get a full training in it to be able to tap on your own. That’s pretty much everything I do and teach people is to be a self sufficient practitioner at that. So I’m not guiding people through meditation, I’m teaching people specific techniques that they can do on their own without any apps, or they put their phone away. They meditate on their own same thing. Tapping, yes, you can work with me in person. But once you’ve done enough, a few sessions, then you are familiar with what to do. And you can just kind of keep it simple and treat yourself with it. It’s interesting.
It sounds familiar. It sounds similar to exposure therapy, for phobias, where you just started thinking about it and you look at pictures of it, and then you get a little closer to it and then eventually you just become habituated to it.
Yes. And the only difference is that as you were doing those sequential exposures, you will tap as you’re saying out loud, what emotion you’re having about it, what the fear is or what you’re afraid is going to happen and so what happens like, even faster and even more, it’s very streamlined. Right? So you don’t have to you can just think about it and tap on it you don’t actually have to like do it when you’re on an airplane in order to benefit from it. So you can do it sequentially like you were just suggesting as well. All right,
well, I really appreciate you taking the time to talk to us today and your website that’s where you can find all the courses Gil Wiener calm, correct. Spelling I have
comm w e n er that’s my like website for everything but I meditation in medicine calm is my website that’s more geared towards doctors to the programs that I do for doctors. So if you want to see more doctor specific programs and meditation in medicine, calm and then I’m on social media as well. Instagram and Twitter are at Gil Wiener MD. Remember it’s w e n er, and then Facebook. I have way too many professional Facebook pages and it’s Instagram and Twitter are much better if you’re like actually wanting to follow me And see what I put out into the world more streamlined, more streamlined. Yeah. And I tend to post there more often
will include all that in the show notes. Again, thank you very much for your time.
You’re welcome. Thanks for having me. This was fun.
That was Dr. Bradley Block at the physicians guide to doctoring. He can be found at physicians guide to doctoring comm or wherever you get your podcasts. If you have a question for a previous guest, or have an idea for a future episode, send a comment on the web page. Also, please be sure to leave a five star review on your preferred podcast platform. We’ll see you next time on the physicians guide to doctoring.
Transcribed by https://otter.ai