Bradley Block

Facing Adverse Outcomes and Malpractice Litigation, Part 2

This is part two of the interview with Dr. Stacia Dearmin. She builds on the idea of the physician’s second victim status in bad outcome and potentially in litigation. The plaintiff’s attorney can weaponize our empathy against us after a bad outcome and she teaches us how to defend against that. She builds on ideas on how to recover that were discussed in the first episode.

She is a speaker, coach, consultant and blogger on the topic. She went to medical school at Case Western Reserve and has a masters in religion and ethics from Vanderbilt. She did her residency in pediatrics at Akron Children’s Hospital and worked as a general pediatrician for a few years. She has worked as a pediatric emergency medicine physician since 2004. After working at Case Western Rainbow Babies, she is back at Akron Children’s Hospital. She is the founder of thrivephysician.com, where she focuses exclusively on the well-being of physicians facing adverse outcomes and malpractice litigation. Her experience in practice raised her awareness of the deep pain and isolation that physicians experience after an adverse outcome or in the midst of a lawsuit. She alleviates that isolation and provides insight and support around some of the toughest experiences many physicians will face in their careers. She draws on her personal story to illuminate the experience for physicians and to educate about the needs of physician defendants.

She has created a course to help us at deposition. “Deposition Magic” is a new course designed to give physician-defendants exactly what they need to know to soar at their own deposition. In a series of brief, friendly videos, you’ll explore the nature and purpose of deposition, the goals and tactics of the opposing attorney, and most importantly, the high-integrity mindset and strategies that will serve you as a physician-defendant. Together, we’ll exchange confusion and anxiety for clarity and calm, and help you to level the playing field at deposition. Available to you online on-demand, “Deposition Magic” confers up to 3 hrs Category I CME.

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

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.

In the second part of Dr station demons interview, she builds on the idea of the physicians second victim status in a bad outcome, and potentially in litigation. We talked about how the plaintiff’s attorney can weaponize our feelings after a bad outcome against us, and how to defend against that. In the first interview, she had some suggestions for how to start to recover and she builds upon that in the second part. If you didn’t catch part one, be sure to listen to that first.
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 kreb 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. Station deerman. Thanks so much for being on the show again today.
Oh, My pleasure. We had fun last time. So it’s good to be back.
So last time we ended with the second victim, right? What would you classify that as, let’s say, you have a bad outcome, or rather one of your patients has a bad outcome that, again, makes you the second victim, because you’re going to be taking that personally and grappling with that, and we’re going to get to those thoughts in a second. But what’s the first thing someone should do even before they’ve been served or even thought of litigation? What steps can that physician take to maybe protect themselves?
So Well, I think the first thing you have to do, always, always, always, obviously, is do your best to continue to provide the patient with what they need. Right. So first, we’re going to lean into our highest ethical standards or highest values that work To ensure that the patient receives what they need, if the outcome is surprising enough or bad enough that the physician feels burdened by it, they may even want to involve colleagues and helping them to sort out how they’re going to continue to provide that care. They may need relief, they need a colleague step in. They’re really quite stunned by something happening. So there’s, there’s that piece you’re going to lean in to good pair. And you may need some guidance from a risk manager or people with legal knowledge or your division director someone have more years of experience, but you also want to be as truthful and transparent regarding what’s happened with the patient or their family as you can Important for ethical reasons. But also, it’s important to know that the sense that we are being forthright with patients and families, in and of itself, in many instances, Bill, prevent a potential lawsuit from taking root. families feel that we’re not being truthful with them, quite simply, that our anger and anger i think is at the basis of many lawsuits is faces from elastic. So it can be very difficult to feel like you have the words to tell people what you need to tell them or you’re feeling so spun yourself. You don’t know where to begin, if sometimes it can be helpful to involve colleagues and in sorting through that, but I think that’s the starting place there. If you think there’s any possibility at all. that a particular situation may result in litigation. Even if you think it’s a small possibility, then I think it’s prudent. And in many instances, your malpractice insurance policy requires that you make your malpractice carrier aware of what’s occurred. And it’s actually to your advantage to do so. Because they will start to collect information, collect records, and basically start to lay the foundation to support you in the best possible way if the claim arises. But you want to do that. Another tip I would throw out there that actually very useful to me, my own patient had a bad outcome is that you can even at that moment, within a day or two that something has occurred. Take the time to write down Everything you remember about the interaction and the situation, particularly with an eye towards capturing things that would never be captured in a medical record, like tone in the room or aspects of your conversation with the patient that weren’t captured in the record, write those down in the form of a letter addressed to my attorney may not even know who your attorney would be. You were sued, but address it to my attorney and then that letter becomes privileged, confidential attorney client communication, you can give it to your malpractice carrier. Give it to your hospitals Risk Manager, they’ll guard it for safekeeping for you. And at the time of the claim may arise that letter will go in To the hands of the attorney, sign to your face and provide them with details. You may not remember a year or two or more after the fact,
in all of the risk management reduction lectures that I’ve been to I’ve actually never heard that before. That is a that is a first that sounds like excellent advice and easy to do. And also therapeutic I’m sure in some ways.
Yeah, yeah, I think that’s true. I think that’s true. I think it is therapeutic. What you don’t want to do is create a shadow record that is not intended to be privileged communication with your attorney. In other words, you don’t keep a journal, a personal journal or personal diary or a personal set of notes that supplement the record if it’s not something that can legitimately be considered attorney client communication and it is Not privileged, and it will become discoverable. If a legal process begins meaning it will become a document that you will be forced to hand over to the legal process.
So how do we differentiate one from the other? Oh, by by making it addressed dear attorney, wherever you might descend, and then that’s what make it privileged. Interesting. Okay.
Exactly to my attorney.
Right. So let’s say you have this bad outcome.
And then it does go on to litigation. So you have a colleague who, you watch them get served, right? You watch all of the color leave their face, as it happens, and you happen to be right next to them. What do you see what is someone with your experience and your knowledge of this? What do you say to that physician? What do you say to that colleague?
What I would personally say as I I’m so sorry this is happening to you. I have been through it. And I am right here with you. And I am so sorry this is happening to you very much like I would say, I am so sorry to someone who’s lost a loved one because it’s so surprising to people and heartbreaking. The papers that your SIR when your serve suit, really, I think deliberately incorporate a harshest language while alleging wrongful death and willful neglect and just the very harshest language. So they’re very hard to read. And I think particularly if someone has never previously been sued, when we see those papers, really like the end of a chapter of their career in which they could hold out hope that they would never be sued. Does that make sense? You’re suddenly in a new chapter
and a very hard time and and we talked about that before the show, and I think it’s important for us to realize. So first, if you haven’t listened to the previous episode, please listen to the listen to the first episode where Dr. Dearman talks to us about the statistics of your likelihood of being sued. And as it turns out, most of us will not spend the lion’s share of us will not spend a career not getting sued at least once. And so, to hold out hope that you are going to be in this small minority of physicians where that never happens seems unrealistic. So I think it’s probably healthier to think it will eventually happen to me, so that when it does, you’re mentally prepared so that you don’t turn from the physician who’s never been sued to the physician who has been sued. You were a physician for both For you are still a physician, and it shouldn’t change your identity. And if you think that going into it, you will, you will come out the other side, the same person, you went in maybe a little bit wiser for it.
Right? I might even take a little bit larger view and look just at the adverse outcomes. And again, kind of going back to the second victim theme and say that the literature around who is at risk for becoming a second victim is says that there are two factors all second one having common the first factor being that they are doing, that they possess a deep commitment to humanity, and that there’s some type of professional doing work in the service of humanity will be commitment to humanity. And then the second piece being that they’re doing work of high complexity, often involving rapid fire decision making. And frequently in the face of significant unknowns. So that sounds very much like our work of medicine, right? deeply committed to serving humanity with compassion, and also significant unknowns and make complex decisions. Where those two factors intersect is the place where we are at risk of encountering that other person we’re trying to heal or protect, and countering their bad outcome and having an impact on us. So I would say that every day that you go into the situation of caring deeply for someone making difficult decisions, at some level, you’re in the line of fire. Now, is that a bad thing to be in the line of fire? No, it’s amazing work. We’re, I mean, we’re really of service. We’re a very deep service to our fellow human beings. But we have this baseline risk that we’re going to encounter these difficult situation. And similarly, in medicine in the United States, as we invest ourselves in caring for the members of our community, we’re always experiencing a certain baseline risk that a lawsuit will arise. Does that make it pleasant or acceptable to us? Really, it doesn’t. It is not a reflection on any one of us as an individual physician, out of reflection, our competence or compassion or our ability to establish rapport with patients, when one of these adverse outcomes or lawsuit arise, it’s a it’s actually a reflection of the fact out there, a root sets ending at the plate swinging the bat,
right? And I’ve heard you say that so if you take it a step further, reframing the situation, and that’s one of the things that helped you to heal. After your lawsuit, right? reframing what we do. So can you go into that for a second? Because I think it really is just a little niche further than what what you were just talking about.
So reframing it, in what sense to take me a little further with what you’re thinking so
so that we as physicians are willing to put ourselves in such situations that we’re constantly encountering in situations with incomplete information, and having to rapidly draw conclusions that could influence somebody’s health and well being every day, multiple times a day, it takes a certain type of person to put yourself in that situation. So the fact that you treat patients in acute situations, you have to be a certain kind of person in order to be able to handle that. And as such, you are putting yourself at risk for then being you know, being involved in a negative outcome and therefore named in a lawsuit?
Yeah, absolutely. I think really all second victims, all professions that run the risk of second victimhood. At some level, they’re doing heroic work. Right. And sort of the classical sense of the hero, the person who is really willing to get out there and take risks that may impinge even on their own well being in the interest of a higher good, right. We are out there taking those risks because we actually care about our fellow human beings. The fact that we actually care so deeply is why we get out there and do what we do. And it is also why it hurts so badly. Things don’t go
right. And the plaintiff’s attorney knows that and they use it to their advantage. Right? This is why the personal injury attorney is not invited back for brunch, because the second victim status, and they weaponize it against us. They take the fact that we feel for our patient, we feel badly for the fact that they they’re not doing as well as they could have. Whether or not we could have done anything differently. Even if we practice medicine, like a page out of the textbook and did everything we were supposed to if they had a negative outcome that people don’t sue for people sue for negative outcomes. If you didn’t have a negative outcome. You couldn’t you couldn’t bring a lawsuit. So, but the plaintiff’s attorney knows that we take it home with us knows that we feel guilty and responsible, even if we did everything right. And they’re gonna weaponize that against us. How do we steal ourselves? against that, how do we defend ourselves from falling into their traps?
Well, that’s a great question. I think there are probably two primary places that come to my mind that where our own emotions can be weaponized against us. One is that many, many physicians when a bad outcome arises that they didn’t foresee and potentially could not have even prevented, they will feel guilty. They’ll find themselves wondering if they could have prevented it and feel guilty in my particular patient’s case. Even after an autopsy, I don’t really understand why she died. It remains unclear why she arrested why she died. But the fact that I made the choice to discharge her home the day before she arrested left me feeling deep guilt over whether I had played some unexplained role in her death. So we have this feeling of guilt. I think we need to acknowledge to ourselves that it is normal to feel guilty under those circumstances that feeling guilty is not the same as actually being guilty or responsible for an outcome. But a good example a good analogy I would give as someone in the world of Pediatrics, I’m very aware that not uncommon Lee, after a woman has a miscarriage, right after a miscarriage in a desired pregnancy. Many mothers feel guilty and feel like they must have done something that causes miscarriage. Even people who are medical people who know better than an electrical Level feel guilty. So similar thing I think we feel guilty when these bad things happen. Now a plaintiff’s attorney can
use that feeling of guilt as a cool
tool to make the argument that we all are guilty and make it difficult for us to defend against that argument, because it aligns with how, how we feel, right. I think we have to really seek a lot of clarity around for one how the law defines what constitutes medical malpractice. And number two, with difference between our emotions and objective reality and work hard, oftentimes with the help of an outsider, to sort through those feelings. Particularly prior to any situation in which we would need to testify. Like. I think the other emotion that arises that can be, as you said weaponized against us, is the sensation of shame. It’s quite normal for second victims to feel very ashamed of the fact that they weren’t able to protect or prevent, to protect the person or prevent the injury that occurred, and that shame can be used against us. There’s a lot of literature. popular literature from people like me brown and scientific literature from people. Doing scientific research into the experience of the second victim, tells us that the way we heal shame is through connection to others who can hear our story and support a sense So I think that, in and of itself is an important piece of how we heal ourselves and then equip ourselves to deal with the legal process.
What was it that helped you heal most, after your lawsuit?
Wow, that’s a really good question. I think it was probably a lot of things along the way. I mean, I think the last time you and I spoke, we talked about the support that I received from a couple of colleagues, and from nurses and a social worker, other people who I worked with loved and respected me. But I think there was also a lot of inner work I had to do, examining my values around the value of human life. I mean, I think one of the core values of a, of an ethical physician is that every human life is as valuable as every other And there came a point in the course of my own suffering and healing, where I actually had to remind myself that my life is also valuable and as valuable as the life of the young lady who’s, whose death touched my life, and that it was imperative that I be able to heal and continue to do my work. So I think there’s that piece of it the internal work that we do, there certainly is a huge sense of loss that comes along with feeling like you weren’t able to do for your patient, what you would hope to do a sense of loss that many people experience along the lines that they’re not With physician they thought they were thought they would be if this has happened to them, and then of course that is amplified by litigation, but even just around the patients false many people feel that way. So, coming to terms with that sense of loss, acknowledging that it’s grief and allowing yourself to have that grief just like you would around, you know, the death of a loved one, I think with a piece of it, and then being very careful with what you choose to use to fill the vacuum that a sense of loss creates. So for example, there is a real risk for physicians after a bad patient outcome or in litigation, that they will feel this sort of vacuum of loss and attempt to fill it with things that don’t serve them. Well. classic examples would be alcohol or drugs, or other behaviors that put them at risk like gambling or other addictive things like pornography. But it’s also been shown that we who are very diligent will often fill that sense of vacuum by working more, and that predisposes to depression. So, being very careful to fill the sense of a vacuum with something that actually benefits you. And that might be for me, time in nature was absolutely healing. And I think for many people it is exercise if it’s not used in sort of an addictive way, but if it’s actually used as a means of promoting health and releasing all the healthy neurotransmitters that go along with exercise can be super healthy. digging a little deeper into relationships can be helpful. And many people need just need guidance of someone who’s been through it appear who’s been through it, or have psychologists or other kind of spiritual advisors.
That’s where the, the reframing also can be useful because you might be having thoughts like, my patient had this bad outcome. I don’t deserve to put myself in these situations doing these things that I enjoy. But I think the reframing comes in. I put my side for a living I put myself in a position where things like this can happen. Therefore, I deserve to have this time in nature this time exercising this time with my loved ones. I think that’s the that’s and I think I recall that that’s actually how you how you phrased it is is you know, is I I put myself in these situations, and therefore, I deserve to have these things.
That’s right. No, I think that’s exactly right, that we owe it to ourselves to attempt to put the one incident into the larger perspective of our lives, and also the larger perspective of the care that we provide, right. Another way that I sought healing was exactly that trying to see my patient in the context of my career. At one point, I sat down and did the math. I’ve been in practice for Let me think like about 14 years or so, when this happened with my patient. And when I sat down and did the math, I realized that I probably seen about 50,000 patients before I met Wow, wow, one in 50,000. It didn’t feel like 151 felt like she was the only one that mattered at that point. But I needed to remind myself that I had given something to 50,000 baby, children and teenagers. And if I could take care of myself and recover, I would yet attentionally if to another 50,000. Right. So I think that can be helpful as well. I view it really, and I like to encourage other physicians to view these experiences, not as a flaw as the result of a plot and meme, but rather as sort of an occupational injury, right? Like if someone’s working on scaffolding and some pieces of scaffolding this way and they fall several stories and somehow survive. Well, we certainly would want for them to get the best care possible in order for them to continue to live a full life. I think when these events are And frequently like we’ve fallen from the scaffolding, but the fact that we work on scaffolding is an important part of why we have potential.
It’s interesting that you draw that parallel because I’ve definitely heard other physicians refer to the workman’s comp system and how it would actually make sense for our medical malpractice system to work more like the workman’s comp system where you know, if a patient has has an adverse outcome, then they get compensated by the system, but at the same time, you know, that when something does happen, there, there is an opportunity for quality improvement, but still not this, you know, almost cannibalistic system where, where physicians are through what were put through.
Right, right. And you,
you said that it was your colleagues, your friends, your family that that really were part of the crux that helps you get through this, but For other physicians who are who are grappling with this, what are some other resources that you would recommend for them? Either books or blogs or websites? other podcasts?
Yeah. Well, I have a website, I blog regularly and I would invite everybody who’s interested to visit the blog at www. Fry physician calm. The focus of my blog is very much on issues surrounding litigation, and issues surrounding physician and other healers well being after adverse outcome. So that’s one resource that’s out there. And actually, I’m in the midst of developing my first online course on the subject of deposition and hope to develop an array of courses that people can pack them to, if and when they need them. So that is out there. Quite recently, another physician colleague practicing general Emergency Medicine named Dr. Geeta pensa started to create a podcast called The L Word l for litigation. And that you can find, I think, pretty much wherever podcasts are found she has maybe four or five episodes out now exploring litigation and how it impacts on us as physicians, what we experience is like, and trying to think what else there are a few books available, not as many as maybe we might like, but there’s one called when good doctors get sued. I can’t give the name of the author at the moment, but that is well worthwhile. And there’s lots of very interesting literature on the experience of the second victim written by a gentleman named Sidney Decker de Payton er, who is actually a pilot, who now specializes in safety science. And explores the experience of the second victim has written quite a lot about second victims in health care. So there’s some resources that come to the top of mind.
Well, I can definitely vouch for thrive physician as an excellent resource as well as Dr. penances podcasts. But both of those have been, you know, extra have been extremely helpful for me and very, very engaging as well. So I’m glad to hear that.
I’m glad to hear that any
any parting words for our audience?
I guess the last thing I would like to say in line with what you were alluding to, in regard to reframing experiences is that while this was one of the hardest experiences of my life, it has in common with all very other hard life experiences the potential to grow us and make us better people. And there again, the literature on second victims alludes to this theme After these hard experiences, some people drop out. Some just barely survive, and others thrive. And the one to thrive seems to be the one to find a way to take the very hard experience and extract something beautiful from people can read more about this on my website if it interests them. But I would simply like to say, anyone who’s going through this at all, it is very hard. But it need not be the end of your life may not be the end of your career, certainly not the end of your joy. It like many other hard life experiences, has the potential to become something you look back on as a place where you grew tremendously, and where you learned a lot about yourself as a person and about Life as a human being on this beautiful earth, so I want to encourage you to just hang in there and hold out hope in the very, very long run, you will be a better person or having been through what you’re going through.
Well, Dr. Station Gentlemen, I really appreciate you taking the time to talk to us on two episodes. And really, all of the work that you’re doing is going to help everyone that you touch to be a better physician and more prepared for these outcomes and your your gift from this is that it will make it much easier for us to get through these experiences. So thank you for your time and thank you for all the work that you’re doing.
Thank you so much. Thank you for giving me the chance to share it.
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

Facing Adverse Outcomes and Malpractice Litigation, Part 1

Dr. Stacia Dearmin can help us get through adverse patient outcomes and malpractice litigation. She has been through it herself. She is a speaker, coach, consultant and blogger on the topic. She went to medical school at Case Western Reserve and has a masters in religion and ethics from Vanderbilt. She did her residency in pediatrics at Akron Children’s Hospital and worked as a general pediatrician for a few years. She has worked as a pediatric emergency medicine physician since 2004. After working at Case Western Rainbow Babies, she is back at Akron Children’s Hospital. She is the founder of thrivephysician.com, where she focuses exclusively on the well-being of physicians facing adverse outcomes and malpractice litigation. Her experience in practice raised her awareness of the deep pain and isolation that physicians experience after an adverse outcome or in the midst of a lawsuit. She alleviates that isolation and provides insight and support around some of the toughest experiences many physicians will face in their careers. She draws on her personal story to illuminate the experience for physicians and to educate about the needs of physician defendants.

We start out discussing the statistics about how frequently physicians are sued and why we never talk to each other about it. Her own experience with an adverse outcome and lawsuit led to the creation of thrivephysician.com. We learn about the second victim and how being a second victim can take its toll on physicians especially amidst the isolation put upon us by the legal system. We learn how to start recovering.

She has created a course to help us at deposition. “Deposition Magic” is a new course designed to give physician-defendants exactly what they need to know to soar at their own deposition. In a series of brief, friendly videos, you’ll explore the nature and purpose of deposition, the goals and tactics of the opposing attorney, and most importantly, the high-integrity mindset and strategies that will serve you as a physician-defendant. Together, we’ll exchange confusion and anxiety for clarity and calm, and help you to level the playing field at deposition. Available to you online on-demand, “Deposition Magic” confers up to 3 hrs Category I CME.

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

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.

Dr. Stacy deerman Can you help us get through some unexpected patient outcomes and malpractice litigation. She’s been through it herself and is now a speaker, coach, consultant and blogger on the topic. Dr. Derman went to medical school at Case Western and has a master’s in religion and ethics from Vanderbilt and did her residency in pediatrics at Akron Children’s Hospital. She worked as a general pediatrician for a few years as worked as a pediatric emergency medicine physician since 2004. After working at Case Western rainbow babies, she’s now back at Akron Children’s Hospital. She’s the founder of Thrive a website where she focuses exclusively on the well being of physicians facing unexpected patient outcomes and malpractice litigation. Her experience in practice raised her awareness of the deep pain and isolation as physicians and other healers experience after an adverse outcome or in the midst of a lawsuit. She alleviates that isolation and provides insight and support around the toughest experiences many physicians will ever have. She draws on her personal story to illuminate the essence perience for professional healers, and to educate defense lawyers, risk managers and healthcare leaders regarding the needs of physician defendants. She blogs and can be reached at thrive physician calm. We were fortunate to have Dr. Dearman for a two segment special interview. In the first half. We started out talking about statistics and it is staggering how frequently physicians get sued. And if we’re getting sued that frequently why we never talked to each other about it. She gives us some details of her experience that led to her creating thrive physician, an online resource for physicians undergoing litigation. We’ll learn about the second victim and how being a second victim can take its toll on physicians especially admits the isolation put upon us by the legal system. And she helps us learn how to start recovering.
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 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. setia deerman. Thanks so much for being on the show today.
Thank you for having me. I’m very happy to be here.
So this is a deep topic and, and it can be challenging to talk about. So I think it’s incredible that you’re actually able to discuss this as openly as you are. But to break the ice a little bit. We’re going to start with some humor. And this is a true story. I didn’t ask my wife for permission to tell this story. But I’m telling it anyway. So recently, my wife invited someone from my son’s class, my son’s preschool class over for brunch. So the kid from the class and his parents, but she warned me beforehand that the father is a personal injury attorney, and was so pleased about that.
I wouldn’t be there.
If you’re in my situation, what would you have done? The options being? Would you have let this person in your house to break bread allowed them in, but pretended you had something else to do. So you didn’t actually have to spend time with them or allowed them in, but glared silently the entire time. It would be maybe a more reasonable thing to do. But my my choices were really one of those three.
What would I do?
I think if my spouse had invited them, I would be too polite to just not show up. But I I would say this is a one time thing
for them, let them come back.
You get one I get the one wasn’t Yes.
would be hard. It was hard for me to hold in the glare, but I think I did a pretty good job of masking it. Good. I couldn’t rescind the invitation that would have been embarrassing. Yeah. Yeah. Yeah.
Your relationship with your spouse is definitely much more important.
Yeah, whatever, whatever it is that I’m trying to do by making this person uncomfortable, really just make myself uncomfortable, I guess. Okay. So So let’s talk about statistics. Okay, so for the, for the physicians out there, for the residents, maybe choosing a fellowship or the medical students choosing a residency because once we’re in our field, it’s not like we’re going to stop once we once we learn about the statistics, but maybe it’ll influence someone’s decision out there. So talk to us about our likelihood of getting sued overall. And then any particularly any particular specialties that are more vulnerable, either getting sued more frequently or when they do for larger sums of money. So who’s vulnerable?
Well, I don’t know that I would advise anybody to base their choice of specialty on this particular factor. But I would say that it would benefit all of us to have a better sense of what’s going on in different specialties. And particularly for a young person making a choice, what the frequency is and the specialty they’re choosing. So probably the best data we have around how often people get sued and how often they get sued in different medical specialties, actually comes from a study from the New England Journal of Medicine that was issued all the way back I think in 2011. So the study already is a little bit old, but there are not a whole lot of studies like this one out there. And in this particular study, they gathered data from a large medical malpractice insurance carrier, so and the value of gathering data from that kind of a source is that it’s going to give you data about claims that were opened and closed with out any settlement which the national practitioner data bank is not going to record. And this particular insurance carrier was so large, that the data covered something like 40,000 physicians practicing in all 50 states in all manner of specialties. So that’s very helpful that it’s such a diversity of physicians, geographically, as well as in terms of specialty. And with that particular study found was that approximately seven and a half percent of physicians in the US are named in a lawsuit every year. Some people say lawsuits Average a duration of one and a half years. Other sources say three to four years. In any case, it’s clear that it’s more than one year. So I would guess that that means that at least about 10%, maybe 12%, or maybe more of American physicians are in the middle of litigation at any one time. It’s quite a lot of us at any one time, even though most people cannot look around a large group of colleagues at their hospital or in their group practice and tell you who is in the middle of litigation or who has been litigated against. The other thing that that study did was looked at specialties and sort of ranked them according to the frequency with which they’re sued. They found that among what they called high risk specialties, according to their data, high risk 99% physicians will be sued by the age of 65. In what they called low risk specialties. 75% will be sued by the time they’re 65. So to me, that means nobody really is actually low risk, right? Pretty much in all specialties, you’re more likely to be sued at some point than not. And in those higher risk specialties, you also see people sued with greater frequency. So the one that comes immediately to my mind is neurosurgery. Where I think their data said that almost 20% like 19.6%, or something like that are named in a lawsuit every year. So if you figure 20% are named per year, then that says to me that on average, a neurosurgeon will be named in a lawsuit roughly every five years, some more, some less, probably all depending upon the environment that they practice in the A degree of litigiousness of the state where they live in practice, the complexity of the patients they’re seeing and any other
number of factors, I’m sure
you know, I wonder if there are program directors talking about this. Because if it’s happening so frequently, and it’s inevitable, then preparing your trainees for not just complications of surgery, but what could potentially come next and will come next, and how to grapple with that and continue seeing patients and doing surgeries while it’s happening. It seems like it should be a critical part of training.
I absolutely agree with you. I will say though, you know, I’ve been engaged in
learning about this issue, talking with people about this issue and working around this issue for a few years now. And I have yet to meet anyone who has said that oh, we were very well trained around this issue in my program. I think I meet people who say, I’ve been made aware that my specialty in my specialty, I’m very likely to be sued. And I think lots of people get some tips on minimizing the risk of lawsuits. But I’m not sure, really, that much of any program is doing the really thorough job we ought to be doing for young physicians and teaching them what to expect. How many of their colleagues have been through it, who they can turn to where they can turn for support? All the pieces and parts they’ll need to get through it. Right? I don’t know. Did you get any of that kind of training and you’re in the course of your education? I really
didn’t. The first thing the first time I ever heard a topic like this discussed was hearing you on another podcast. Oh, wow.
Yeah, that’s not very long ago. That’s like 15 months or a year ago.
Yes. So, so, no, it was not part of any of my, my training. And it’s not it hasn’t been part of any of the the CME that I’ve received from attending talks by lawyers about how to minimize your risk. Yeah, it’s all about preventing, while the education is about preventing, or possibly they might even get to what happens during a deposition. But yeah, they never really get into mentally preparing yourself for what what it’s like and and what it does to you. So all the more reason for us to be talking to you today.
Absolutely. It’s an important conversation because I think if the message is continually around, how to minimize the risk, if that’s the only message we hear, then if we get sued, or more likely when we get sued, we feel that we failed, right? Everybody taught me how To avoid this happening, now it’s happened, then I feel like I’m a failure. And that really doesn’t help. Because already the whole situation makes you feel like you’ve failed. So, you know, there, there are much better ways for us to be preparing people for this. And the plaintiff’s attorney is going to use that to their advantage.
But we’re gonna get to that later. So yes, I’m sorry, I took you I took you off track a little bit. We were talking about statistics. So you mentioned that, that neurosurgeons what was it, you said 99% of them end up getting sued, and the frequency with which they’re sued is, I think, what 20% of them at any given point, or in a year ago?
Well, probably more in litigation at any given point,
because I would imagine their suits drag on for a lot longer because of what they the type of things that they treat so badly, at the very least 20% of them are being sued at any given time, but probably significantly more. Yeah,
yeah. Yeah. So you also asked about like which specialties are more likely to be sued. Which are less definitely surgical specialties, the most high risk specialties, for the most part, our surgical specialties, vascular surgeons, neurosurgeons, etc. ob gyn we all know the practice of Obstetrics is high risk. And I sit, you know, my heart goes out to the OB GYN because as I think about this particular issue, I’m especially aware of the fact that if you’re practicing ob, every patient encounter, actually, you get two patients for the price of one or maybe even more, maybe you’ve got twins or triplets, right? You’ve got multiple patients sort of rolled into each patient encounter. Emergency Medicine is a high risk area. Some people say emergency physicians currently are sued every five to eight years. So that’s a high risk area. And it’s understandable because there’s Very high acuity in the emergency environment. And also, every almost everything that comes into an emergency department and I’m speaking from the perspective of someone who works in a pediatric emergency department is undifferentiated when it comes in most things are undifferentiated when they commit. So if I had somebody with abdominal pain really could run the entire gamut of causes for abdominal pain from a tourist testicle, to appendicitis to your bread and butter, constipation. So it makes sense that there’s a lot of risk in the practice of emergency medicine.
Also, in emergency medicine, you don’t have the advantage of having a prior relationship with the patient. And I think in some ways that that can protect you, right? If you’ve got a long history with this patient, and they end up having a complication it and we’ll get to this later. It’s not an impenetrable shield, but it does, it can decrease your risk of them. Turning to literary
right? That is certainly one of the challenges of emergency medicine that there’s no prior rapport. And prior rapport not only provides a, hopefully a ground or a foundation of warmth in the relationship and mutual respect, but also, I think when someone’s in an ongoing relationship with a patient and then that patient comes in looking a little different than they normally do, or complaining of pain in a way they normally would not. If you have that prior experience with that patient, your clinical meter for what’s going on with them is a little bit more sensitive, right a little more fine tuned. So at the other end of the spectrum specialties that are less frequently sued, would be pediatrics and family medicine. psychiatry is less frequently specialty that sued pathology luxurious, less frequently sued. But interestingly, pediatrics is one of the specialties that has the highest payouts when a payout occurs, probably for obvious reasons that the patient is young. And so there’s a, you know, added years of life ahead of that person,
which results in adequate added medical needs and also perhaps an added component of compassion on the part of a jury that could influence a payout. So the special teams that are the most frequently sued are not necessarily the ones with the highest payouts. So you practice emergency medicine or pediatric emergency medicine. So that’s a field so given the acuity, what you said about the frequency, so a high frequency but given that It’s a, it’s within the field of Pediatrics that also leads to higher payouts. That seems like a subset of physicians that are going to have, I guess, greater challenges in this in this
arena. I think that might be true. I don’t think we have crystal clear enough data in this domain for me to say that with any certainty and even what data we do have from that 2011 study, I think this is a constantly shifting domain. And I don’t think we have enough data, basically.
But I do I think also probably ours. There are there are some pediatricians that are in some of the ers working in the emergency department. There are some emergency medicine physicians who are probably treating children as well. So there’s probably a lot of overlap that would muddy the waters for statistics.
Absolutely. I think that’s absolutely right. Yeah.
So one thing you mentioned earlier was so many of us are being sued. But when you look around the room of your colleagues, you’re not able to identify anyone who has been sued. So how did we get there? And how do we get out of that situation?
Oh, wow, that is a great question and a huge one. How did we get there? Well, I think probably part of how we got there. I think there are multiple factors here. I think one piece of it is that any physician in the midst of litigation will be strongly encouraged by their defense lawyer, or by representatives of the hospital to keep talking with others about their case to an absolute minimum. The most common advice is something like don’t talk to anyone. So that is one piece prompts us to keep it to ourselves. But I think what’s, what’s the reason for that?
How come we’re not allowed to talk about it? So personally, just so the audience knows I’ve been sent. And so what I was told was, if you talk to anyone about it, they may need to be deposed. So, if I, if one of my patients has a complication, or even a perceived complication, and we go to litigation, and I get served, I’m told, so first, you’re what you’re told is immediately call your lawyer. Right? That’s the first thing you need to do. And, and then the Lord is going to tell you don’t talk to anyone about it, because if you do they meet, you know, the the plaintiff is, plaintiff’s lawyer is going to ask you, well, have you spoken to anyone about it? And if you do, that individual may need to be deposed for what? I can’t understand because whatever happened already took place. So it seems a strict strategy that works greatly to their advantage, because then they’re able to isolate. Right,
right. So I think let’s, let’s break that apart a little bit. I do think that is the advice people commonly hear. Don’t talk about. to anyone about it, but I would like to break that down a little bit and make sure that people know there are certain kinds of relationships that are protected. So there are some people that you can safely talk with, and they will not be deposed. And among them are your spouse, someone who is engaged with you in a professional relationship providing care to you. So that would be your own physician, a psychologist, you might see any any other type of counselor or you’re engaged in a professional, confidential relationship, clergy person or spiritual advisor, that is also a protective relationship, and certainly your defense. That’s a protective relationship. And then additionally, probably the risk manager at your hospital and the claim manager, whatever entity is providing your medical malpractice insurance coverage. Those are all protected settings. And the second piece would be to think about, well, what is it that someone would want to depose this person about? And what they want to depose them about is the details of the case, the medical details of the case and the events that occurred. They are not going to depose someone to talk with them about the fact that you told your best friend, that a lawsuit is in progress, and it’s deeply stressful to you and it’s breaking your heart and patient of yours was, you know, unexpectedly injured when you were performing surgery. That emotional content is not the details of the case. So if I’m a defendant and I’m deposed, that lawyer will ask School, who I discussed the case with. And what they’re talking about is the details, the medical details of the case, you want to be careful to be just twice full about to discuss those medical bills. Now, most hospitals today offer opportunities that are legally protected for discussing that very thing, the medical details of the case. And those legally protected situations are things like morbidity and mortality conference, peer review, a formal peer review, a formal root cause analysis, anything that really is formally under the umbrella of quality improvement is protected from legal discovery by a plaintiff’s attorney. So I think it’s hard after your patients had a bad outcome to Bring that to morbidity and mortality or to participate in that peer review conversation. But I think we should take advantage of it. I think it’s our opportunity to explore medical details and seek out answers to questions we have about whether the care we provided could have been provided differently or should have been provided differently. And then seeking emotional support is is another has an another objective or other and is not the same as discussing the medical being helpful. That makes sense.
Yes, I still still seems to me a little nefarious on the part of the plaintiff’s attorney that these are the rules. It seems it does seem to me strategic in order to isolate us but I think taking that into account, we should try to be within the confines of those rules as non an isolated if that’s a word as possible. And I think and we’re going to be in we’re going to be getting to that, because that’s that’s the theme of today’s talk right is, is is how to get there. So I think an incredible example of how to get through it is you’re right, I have so much admiration that you’re able to talk so openly about one of the most difficult experiences of your life. So if you could share that with us today, I really appreciate it.
Sure. So my particular case and the life experience that I had that brings me to working on this issue today is that I was working in pediatric emergency department in a community hospital different from the hospital where I practice today and saw a young woman on a Friday afternoon. She was a young woman with some underlying medical issues but generally doing pretty well and a contributing member of her family and her community, saw her over the course of several hours, ordered a number of tests, thought she looked well. And at the end of that period of maybe five or six hours, talked with her and her parents, and as a group, we decided that it made sense for her to go home and follow up with her doctor on Monday. So I discharged her home at the end of the day, like five or 6pm. On a Friday, I came back to work on Saturday, going to work an evening shift. So I came in at 5pm. And very shortly after I came on duty, I was approached by ear, nose and throat specialist who came the left We know that one of the patients I’d seen the day before was now in the ICU. And when I inquired further, he told me that this young lady who I discharged home the day prior and arrested that afternoon at home. Yeah, CMS responded, good not secure in their way. They transferred her to freestanding emergency department near her home, where skilled or on duty who still could not secure an airway and flew her to the ICU at the hospital where I worked with the CMT airway. You can imagine that was some time after she arrested quite a lot of time elapsed. So as soon as he told me that, I mmediately knew that her prognosis was not clear at all. And I really haven’t Say it was an experience that sort of left me feeling disoriented in the moment, sort of an out of body experience. That reminds me of times when I’ve gotten a phone call to tell me that someone I love inside. I felt really stunned, ashamed, guilty. I really felt terrible. And that was the beginning of a very long journey. Those feelings didn’t pass quickly. Someone’s I had a lot of questions about what if any role I had in her death and whether I could have prevented it. About a year after she died. I learned that I had been named in a lawsuit. I wasn’t surprised on probably about two and a half years after that. So three and a half years after she died, I went to trial and spent about three weeks in a courtroom as Defendant in a wrongful death case around her death. It was really one of the more complicated life experiences I’ve had. It was a marathon was draining and impacted on me personally, as well as professionally, in so many ways, I mean, I, I’m really
like most pediatricians, somebody who is in pediatrics because I love my own patients. So I felt her death very hard. And I interestingly, in the midst of my trial, I stumbled upon a TED talk on the subject of physician suicide. I had not previously been aware of how prevalent physician suicide is. And so it’s only when I got halfway into it, I realized what it was about. Immediately, I thought myself I don’t know what all the causes of physician suicide are, but I am absolutely certain that what I’m going through has to be one of them. So really, right in the middle of the trial that I started to realize that I felt a need to begin to break open the conversation to alleviate some of the isolation that we as physicians feel middle experience and to start just generating conversation and resources for going through it.
And that’s what I’ve been doing since that time and to this day,
when when you were in the middle of all of that, how did you how did you get up, start your day and see patients I just, I can’t imagine you know, going through this and then having to muster the confidence that it takes to continue doing what you do. Right. It’s such a it’s such a blow. How did you get through that? How did you get through that and continue being able to help people?
Wow, that is? That’s a good question. I think, Well,
for one, I was still paying off my student loans.
I know that wasn’t on our on our list of pre discussed questions, but as I’m listening to your story and trying to put myself in your shoes and thinking what what you’re thinking because it just having been sued myself for something, you know, that pales in comparison to something like that, you know, I did get up and see the patients the next day after learning that it was a blow to my confidence. And and thankfully, the first patient that I saw, you know, was one of my regular patients who was doing great nothing but thanks And, you know, that really helped helped me to get started. But But, you know, I just, I just can’t imagine having to continue working in that situation doing what what you do putting
one foot in front of the other, I think I cannot overstate the importance of the support of people who reached out to me in my workplace. So I certainly, you know, immediately after her death within a day or two, I reached out to my medical director, I was the assistant medical director of that department at the time. And I reached out to him because I wanted him partly to hear what it happened for me first, but also I needed to talk with people I respected about what had happened, whether they would have done anything differently. I had done for her no questions. We all have like, what did I miss here? I reached out to him. And I also reached out to someone who is really only a year or two older than I am, but has been in practice longer than I have a more direct route into medicine. And as someone whose clinical skills I really respect, so meet up with them to talk the case over with them, and just to reflect on it a little bit. And both of them offered important word support in terms of just reminding me that they viewed me view me as a gifted physician. So that was really important. I think also, you know, I’d been working in the department that I was in at the time for at least 10 years, I think, at the time when this happened, and had close relationships with a number of nurses and some social workers. So a tiny handful of those people saw that I was struggling. They had been on duty with me when we saw this young lady. And they reached out to me with words of support. They, they just, I think saw my demeanor that I was really taking it hard. One nurse in particular, this came to me at one point, she’s sort of a religious person. And she came up to me and said, You remember that you don’t get to choose who lives and dies. Right? And quite honestly, I did not remember that at that point. And those were very, very valuable words. I mean, obviously, I remember them now more than seven words after the fact. Another social worker who had transitioned from our department into the intensive care unit, where the shown patient came a patient came to me to check on me and she realized that A person taking care of her in the ER. So I think those things, those reminders that other people saw my commitment to my work and recognized that being a compassionate soul, I wouldn’t be hurting those things. Absolutely. essential to my survival
in that time. I think there are two lessons here. I think one is you’re going to be relying very heavily during this time on your social system for support. But at the same time, if you are not the person who is who’s being sued, if you know of someone who is recognize that they need you, and reach out to them, don’t wait for them to come to you. Talk to them with words of support and let them know how valuable you are. They are to the system and to their patients,
I think that’s really important. And this all what I’m describing these people reaching out to me that all transpired long before I was sued. So I think that’s the other piece that we have to remember. At, even though we know, let’s say that every surgery carries a risk of an adverse outcome or in the course of seeing people, we’re going to see adverse outcomes. Still, sometimes those adverse outcomes really hurt us. And just reach out to one another and check in after we’re exposed to those hard things because we invest ourselves in trying to ensure a better outcome, right? And standing outside it is somewhat objective outsider, you can say, Oh, well of course a baby with meningitis may or may not make it with a person who’s invested in caring for that baby and wants to see the baby make it
there may be some heartache potato.
Right? So the topic of this discussion is litigation, but at the same time, it’s any negative outcome in any situation like that when there’s a negative outcome of a patient, it’s going to be important to to heal. And I think that segues into one thing that I’ve heard you talk about, and that’s the second victim. So, tell us what is the second victim. So,
you know,
this really was a an important piece in my healing process that probably maybe 10 or 11 months after my patient died. I don’t even remember by what series of fortuitous events, I stumbled across a brief but very eloquent little essay, written by an internist at Johns Hopkins named blue in which He pointed out that when patients are harmed, his essay was referring to medical mistakes. But subsequent literature’s said medical mistakes or any other situation where a patient is harmed. When patients are harmed, we also experience an injury many times if we wonder whether we could have prevented that injury or wonder whether we had a hand in it, then we are also harmed. And so he really coined the use of the term, second victim to refer to that physician who is injured when their patient within burden some way. So in encountering that essay, I was touched, I was moved by it he describes very beautifully, how distressed a second victim can be. And when I read his description, I immediately recognized My own experience that was enormously helpful to me. Because at that point, I was almost a year out from the event. And I was still struggling feelings of grief and stuff out and wondering about whether I would ever feel really great about practicing medicine again, and starting to really beat myself up over the fact that I was not able to shake this off, is that really what we’re taught to do in medical school and residency somehow shake these bad outcomes off, and I wasn’t checking it off very well. So when I read this description, and I realized that I was not the only person to go through this, it was a huge relief to me. I started thinking, Oh, it’s not that I’m weak. It’s that I’m compassionate and I’m reflective, and so on suffering,
and ongoing. What I was thinking actually, as you were describing it, I thought, this is actually one Have her strengths as if your inability to shake it off speaks to your compassion and your empathy for your patients, how you carry them with with you, you know, long after they’ve they’ve left the emergency room, you’re know, even the ones that don’t have outcomes like this, I’m sure there are many times when you’re still thinking about them, which might interfere with your ability to carry on your day to day existence, because you’re thinking about your patients. And that doesn’t make you weak, it makes you strong, it makes you a better diet.
Right? I think that’s exactly right. And I think that’s part of what I learned that there are these vulnerabilities embedded in our strengths, right? There’s an array of strengths and classically we know are essential to an excellent position and among them are compassion and self reflection and diligence, right conscientiousness, with in those strengths are embedded these vulnerabilities, the more compassionate I am, the harder I’ll feel it when things don’t go well for my patient, the more diligent I am, the harder I’ll feel it if things taken an expected turn, or I feel like I’ve missed something along the way. So right, you’re exactly right. So then I became quite fascinated by this concept of the second victim, because it spoke to me so deeply and it was so healing for me that as I came out of my lawsuit with this newfound drive to teach other physicians what I had learned, I didn’t have experience. It started to explore the literature a little bit. And I learned that after Dr. Wu wrote this essay, which he did in the year 2000, long before my lawsuit, there was this whole explosion of research which took place which continues to this day into the experience of the second victim. It’s really fascinating. Literally insofar as it makes it clear at first of all that be physicians are not the only health care and health care givers are not the only second victims who exist pilots and aircraft controllers and all men are first responders, police, firefighters, etc. Members of the military, all are vulnerable to come second victim. And this somewhat earth shattering life experience that I had the emotional experience that I had is classic second victims in every domain. So it’s really not a doctor experience. It’s a human experience that I had. Right? Very complex human.
Well, I think for today’s episode, we’re going to stop here because I think you’ve covered extremely well. You know what happens with regards to who is likely to be sued? And what happened in your situation. And then, you know, this this concept of the second victim, but I think for the next episode, we’ll be covering how we can get through it. So you’re going to help us get from we’ve been served to walking us through what it’s like, and then how we can heal from that. So I really appreciate you taking the time to, to talk to us today and to really reveal so much of what you’ve been through again, I know I said it but I’ll say it again. I can’t imagine how challenging it must be to talk about such such a subject but you really have handled it with such grace and and you’re allowing your experience to help so many physicians, so thank you.
Thank you. My pleasure.
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 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

How to Put the MD in Social Media

Professor Sarah Mojarad is a lecturer at the University of Southern California where she holds joint- faculty appointments in Viterbi School of Engineering and Keck School of Medicine. We discussed why we should act online like our first-grade teacher is reading all of our tweets and even our emails.  Her areas of expertise are in social media, science communication, and online medical professionalism. Prior to joining USC, Professor Mojarad was at Caltech where she co-created the course “Social Media for Scientists” and now she teaches us Social Media for Physicians.  It’s believed to be the first course of its kind to educate students on the issues and opportunities of social media-based science communication. You can find her at smojarad.com and @Sarah_Mojarad on Twitter.

She gave us some tips for communicating complicated medical information – keep it simple, but include links to your bibliography.  We talked about how pseudoscience and purveyors of misinformation gain traction by tugging at heartstrings and that we may be able to use those tools for good.  In the end, our real audience, the ones who are really listening, may not be who it seems, it is the unseen lurkers, so get out there and don’t let the trolls get you down.

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!!!

Snapchat talking point: https://www.dovepress.com/evaluation-of-the-snapchat-mobile-social-networking-application-for-br-peer-reviewed-article-BCTT

 

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.

Professor Sarah mo dread is a lecturer at the University of Southern California, where she joint faculty appointments in the Viterbi School of Engineering and Keck School of Medicine. We discussed why we should all act online like our first grade teachers reading all of our tweets, and even our emails, her area of expertise or in social media, science, communication, and online medical professionalism. Prior to joining USC, Sarah was at Cal Tech where she co created the course social media for scientists, and now she’s teaching us social media for physicians. It’s believed to be the first course of its kind to educate students on the issues and opportunities of social media based science communication. So in today’s show, she gave us some tips for communicating complicated medical information. Keep it simple, but include links to the bibliography in case someone wants to take a deeper dive. We talked about how pseudoscience and the purveyors of misinformation online gain traction by tugging at heartstrings and that we may be able to use those tools for good in the end, our real audience The ones who are really listening may not be the ones who it seems. It’s the unseen lurkers. So get out there, and don’t let the trolls get you down.
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 kreb 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.
Professor Sarah mogera. Thanks so much for being on the podcast.
Hey, thanks for having me.
So first, let’s discuss the different platforms. I was kind of saying this in jest, but then you sent me back a serious article about it. Should we all just be exclusively on Snapchat, right? Should we be on Snapchat? Or should we be delving into those other other platforms as well,
I know I had to laugh when I saw that because people never really know what to do with snapshot. And so I did some digging to see how that platform is actually being used in an educational context. And I found this really interesting study that was conducted in northern Saudi Arabia. And what they did was use the platform to raise awareness for breast cancer. And it turned out to be a very effective way of disseminating information. So yeah, I don’t know if you’re going to post that or not. But it’s I appreciated that question.
Yeah, no, I’m happy to link to that article. So how did they do it? How did they manage to utilize that platform that I only see as being used for the silly photo filters?
Yeah, so they used it to raise awareness about breast cancer and the way that they did that was by pushing different videos and different images and texts. And users, the people who participated in the study. Were then receiving that content throughout the day. And I believe it was. Don’t quote me on this, but I think it was a two week study. And it involves around 200 people.
So for the rest of us that aren’t aren’t using that we just, you know, perceive it. I’m 40. So, you know, I just see people in their teens and early 20s using it that way. I don’t not quite there yet. In terms of using it educationally. I’m basically on Twitter. Actually, a couple of weeks ago, we had someone on the show who has her own podcast, she’s an allergist, and she said, Brad, you have to get on Instagram. If you want to publicize your show and increase awareness that it’s out there. You have to get an Instagram. No, no, I’m on. I’m on Twitter, and that’s where I encountered you, right. That’s how we meet and that’s how I’m meeting a lot of other physicians and non physicians in this space. So each have their own reasons for using these different platforms. But But what’s what’s your take on the utility Each one for science education,
well, they, they’re all very different, and they attract a different audience. So I’m very biased. I’m like you, I really enjoy using Twitter. I like the discussions that are happening there. So it’s a great platform for engaging other people in academia and in medicine. And it’s very easy to find those conversations using specific hashtags. And the reason why I love it too, is I can be walking between two buildings, and I could quickly be putting out a tweet, the time saying for me is very low. But then you compare that to say something like blogging, where you would probably sit down for a few hours to put together a blog post that can be appealing for somebody who prefers communicating in that format. And the audience there is going to be very different as well. Now with Instagram. I’m actually kind of curious why you decided not to test out and Instagram because just
my limited time yeah right like if I’m one of my favorite sayings is every time you say yes to something you’re saying no to something else. So there’s nothing right now that I’m willing to say no to. Because I’m you know, I’m enjoying Twitter for the most part when I don’t fall down the rabbit hole and it’s very easy for me to post the episodes on on Facebook although I don’t really have a lot of engagement there. Right? I don’t have people commenting on on Facebook, because I don’t have a Facebook group. But I you know, I don’t want to make this all about me. It seems like everybody’s got their own Facebook group now. And that’s like that’s becoming a thing, or it’s already become a thing. I guess once it’s become a thing. It’s already passe. But yeah, I just because I it’s just more time.
Yeah, I can understand that. It is a very social media in general can be a time sink. But Instagram is interesting to me because it’s where I’m seeing to be honest with you the most problems that are occurring in social media. Medicine, Instagram tends to be very millennial and younger audience focused. So the the photos that are posted there tend to be very polished photoshopped, and it’s all about the image. That’s how you’re going to get your followers. So outside of outside of medicine, that’s, I think, can be very innocent. But when you combine discussions about medications, and there’s people in white coats who are promoting different products, then I think it becomes a bit of a bit of an issue. Yeah, that’s, that’s the biggest difference I see too, between Twitter and Instagram in the context of medicine.
I mean, I can post on Twitter some content about our conversation, and say, This is what this episode is about. I just don’t know what picture to post like, I’m just gonna post another picture of me. I’m you know, that’s not really my thing. So I guess I could post a picture of the guest but yeah, I just I just don’t see how to work in the whole the whole picture. But what you’re saying is when people do that can end up being deceptive in a way?
Yes. And there’s actually somebody who I will not highlight on this episode who has been doing that for years. And it’s been, it’s been an issue, hopefully an isolated one, as far as I can see that that’s in case. So. So one of
the things you do is you you lecture to medical students about this specific topic? And so what are some of the pitfalls that you see with a medical professional or even a medical student who’s got some pre professional communicating with the lay public? What are some of those pitfalls? So I
think the biggest issue is that when people are entering into medical school, they they have to be aware of the fact that they are now becoming professionals. And I know that sounds very obvious, but with medicine, there’s once you’re a physician, you’re a physician. There’s no clocking out that. So I think that’s the biggest concern with an online presence is just being aware that no matter what if you’re in the hospital, if it’s the weekend and you’re not working, that MD carries weight, and that translates to an online presence, so students that are going into medical school, they’ve never had to really consider this too deeply. So what I do with the first year medical students is I’ve done these three hour workshops, where it’s in small groups, and I provide them opportunities to look through these case studies and determine for themselves what they perceive to be professional and unprofessional. So finding cases on each of the different social media platforms and saying, hey, look what this person’s doing. This is a really interesting way that they’re presenting themselves. What do you think of it, and I let them come to their own conclusion about whether or not what they’re doing is appropriate or inappropriate, and it’s created these really fascinating conversations and I’ve just enjoyed facilitating them. So when I speak to a guest spoke at a critical care conference a few months ago, what I’ve been doing with those types of audiences is presenting to them and saying, This is my approach in medical school. And I think this really needs to be taught more broadly. Because I think residency programs and hospitals can really benefit from having this content out there. Especially because there There seems to be two different camps, people who are on social media, and people who are off social media. So at this conference that I was at, I think half the audience was over the age of 65, and avoided social media their whole lives. So they were completely unaware of what was happening. And yeah, I just think that having these conversations and being able to teach about what issues and opportunities are available has been really great. Powerful.
So when you’re when you’re teaching the medical students, is there anything that you find that they’re reluctant to accept? In terms of who, who they’ve decided they’re going to be? Right? Like they’re used to posting themselves, possibly drunk at a party while in college. And now a year later, they’re suddenly supposed to be a completely different person, at least online. So do you find that they’re resistant at all? Are they open to embracing it? What are the what are some of the road bumps that you see some of the resistance that you see from them?
So what’s been most interesting for me is when I’m teaching the first year students, they all really appreciate that there’s this almost collectiveness to it. We’re all in medicine and we all want to represent the field appropriately, somewhere in the education and I’m not sure how or why this is happening. But when I work with students that are in the third year That shifts they become very focused on. I am an individual and I have my freedom of speech and I should be able to exercise it no matter what.
Yeah, I can tell you why. Because as soon as you enter the hospital, you lose your name and you become a med student. There’s nowhere for you to stand. That’s not the wrong place to stand. You don’t know what you’re supposed to be doing. So they’re, they’re suddenly you know, it. They’re used to being at the top of the class and captain of the team. And, you know, maybe there’s some camaraderie in the first and second years, but then the third year, then you’re at the bottom of the totem pole, and it is a terrible feeling so I can see why they’re wanting to find an identity for themselves online.
Hmm, that’s interesting. Thank you for sharing that.
That would be my explanation. I don’t know you know, this is I’m a ways away from that. But that’s, that’s what I remember from third year medical school. And hopefully it’s evolved. But I don’t know how much something like medicine can evolve that quickly. Mm hmm.
Yeah. So it’s just it’s an interesting topic to explore too, because I think social media, it’s such an individual preference. So some people are going to feel more comfortable with putting more out there about themselves versus others who want to keep it strictly professional. My, my biggest thing is really making sure that there’s space to have those conversations and come to a conclusion that’s really thought out. So oftentimes, growing up as a digital native people, when they’re kids, they’re not really thinking about what they’re posting. They’re just posting, and you fast forward to being in medical school, that whole digital history is out there. So I really like to make sure people are aware of it and that they can become more mindful of what message they’re currently putting out there into the world.
Keep in mind, you may someday be running for office and someone will find all that stuff. Do you have any general rules like don’t post anything that you wouldn’t want your patient or your mom to see or something like that, that that we can all just keep in the back of our heads before we’re posting anything,
I really encourage people to think about what they’re posting from multiple perspectives. So yeah, like you just said, a parent or a patient. When I do these case studies with them, I actually sit them down and say, is this appropriate if you saw another student in the class posting something like this? Okay, what about if somebody else was doing this, like the head of medical education or a somebody on a residency committee? Would you still feel comfortable with that content? And I also really encourage people to not be that any sort
of digital overly curated, oh, yeah,
we can go that direction. The overly curated content is actually it’s very concerning. To me, it comes across as not being authentic. And everybody seems to be wanting to be a social media influencer right now. So a little concerned about that.
Oh, yeah, that’s the new professional athlete, I guess. Although, in some ways it looks like it takes less work for professional athlete, at least you can tell that they’re spending tons and tons of time honing their craft, on being a Instagram model looks like all you do is you wake up looking like that and eat your cereal looking like that. And, yeah, but but I’d actually like to change the focus of the interview. So because because everyone’s gonna have their own moral compass when they’re deciding what’s right and what’s wrong and, and I definitely appreciate that it’s now being taught at least in some medical schools, so that it gets the students at least thinking about it, whereas they may not have had context to think about it before. But let’s let’s change the topic a little to the effectiveness of communicating medical information over social media because it’s an uphill battle. For us, right? You’ve got this, these industries out there whose job it is to tell people what they want to hear, right? Put this on your skin, and you’ll look younger, do this and you’ll lose weight. Do that. And you’ll attract the opposite sex, right? And it’s or you’ll be healthier, however you define healthier, right? And it’s very seductive. Because mostly it’s baloney. Right? Whereas us as physicians, it’s our job to tell people what they don’t want to hear, but what they need to hear, right? Sometimes we have the benefit of being able to tell people things that are easy to hear, right? That thing that you have is not cancer, great news, but sometimes, right? What we’re telling them is going to take hard work or it’s just not what they want to hear. So how do we want to communicate medical information that is tough to hear? And then from that we can talk about communicating medical information that’s even complicated to understand. So So first, what about the how do we how do we get across these these tougher messages?
Yeah, it’s a really, it’s a difficult topic to explore. And I know that in the social sciences right now, there’s a lot of research into how to communicate effectively, and make sure that your message is really understood. And right now, I think that’s a complicated topic and medicine because as a physician, you would never want to come across as giving medical advice on the internet, because that just opens up all sorts of issues. But there’s also a tendency to be very technical with the communication, because going through all the training that physicians go through, it’s it’s very important to be impersonal and objective with your information. But the content that is are what makes misinformation and disinformation so persuasive, is that it’s subjective and emotional. And that’s just a whole different world. But more and more research is coming out that indicates you have to have some of this personal vasive communication with the technical in order for it to be effective with these general audiences? Oh,
thank you for saying that, because I put out a tweet a while ago, and it wasn’t met with resistance. But I said, should doctors be taught persuasion? And and a lot of the responses I got were, well, you know, I think you should just be open with your patients and give them all the information and let you know, let them decide and kind of help them along the way. And I don’t agree with that. I think yes, you’re, well, anytime we’re giving them information. We’re framing it in such a way that we’re trying to make a case for what they should be doing. But I think it would also be who has to have a little bit of ability in that department because, I mean, for instance, patients of mine come in thinking that they’re having sinus problems and it turns out, they’re having migraines that are giving them sinus pressure. Now that feels like there’s a problem with your sinuses. It really feels that it feels like your sinuses are going to explode, but it’s not as sinus infection. It’s a variant of migraine, and to get them to, to stop believing that they’re a sinus, they might believe that they’ve had sinus problems for the last 20 years, how, you know, it’s not an easy thing to do to get them to do something that will give them relief, right? Because that’s, that’s all I’m trying to do is get them to feel better. And I think some some persuasion would be helpful. Do you have any? And this is not necessarily even in the realm of social media, but in general, I think I heard you say once, you know, telling stories, stories are powerful, is that a good way to to try and convey our information in a more effective way?
Definitely. And with this example, you just used an area that I’m most excited about with communication right now, especially in medicine is the use of augmented reality and virtual reality. And this case would be perfect. So you’re trying to convince a patient that they have a migraine and it’s not an issue with their sinesses if you have the ability to put that person into a VR That, that shows what’s actually happening, then maybe they can leave that consultation feeling like they they have reasoning and rationale behind why you’re saying that. So definitely narrative plays into it. And I hope in the future technology can really be an asset to
so you also mentioned that we tend to get too technical and that the snake oil salesmen are seductive because they pull pull at the heartstrings. So how do we, how do we make it less technical, right, because some of these, like if you’re understanding how chemotherapy works, right, how do you explain that to a patient and convince them that that’s the right thing and not rubbing linseed oil on their skin? like someone’s trying to sell them?
Yeah.
That’s that’s tough because you don’t want to dumb it down. On you want to be authentic to your message, but at the same time, there’s a technicality of the topic. But that patient has the ability to go home and check with Dr. Google. So it’s, it’s tough. I don’t have any answers off the top of my head because I think being able to Google things and how open information is whether it’s credible or not really makes medicine a very complicated area.
And so let’s go back to social media since that’s, that’s really your area of expertise. So if we’re trying to disseminate medical information there, right, not give someone medical advice, but just say, right, there’s there’s an advanced in this area, or there’s an advanced in that area. How do we can we use like cases perhaps, to try to make our information more relatable?
I think so. cases are a good way to go, especially if they are somebody that is recognizable in the public eye. So that could be an option. But I if we’re thinking about Instagram, I think Pat Judging information in a way that’s easy to be viewing, like the like a meme, for instance. And then having those captions so that it really drills down into more of the details is a good way to go. And making sure that information is linked to appropriate sources. So if somebody does want to dig a little bit deeper, they can. I’m not sure if that addresses your question. I
think so. So So, like finding a way to make it a bite sized bit of information, palatable, understandable, but then with links to the more complicated maybe, you know, trials to or or the CDC website or something like that. So that if the patient does want to take a deeper dive, right, and this gets to like, this gets to Twitter and Instagram, where it’s all little bytes of information, so you can, you can just put so it was saying is, make sure that it’s understandable and palatable, but at the same time, make sure that it Has credibility by linking to some trusted source?
Yeah. And so an example I know people always love examples, a physician that I think is doing amazing work on Instagram is Dr. Alan cadabby. And he is a immunologist in the Los Angeles area, and I love his presence because he does follow this sort of Wednesday a meme format, but it kind of is when you’re scrolling through a feed because it’s just the photos and the text with it. And then it’s it’s not the selfies and things like that, that we were talking about it beginning of this episode, so
So what type of give us give me some examples of what types of pictures he puts out there. I’m not on Instagram. So it’s not like I’m on there looking at examples, but just it boggles my mind, what types of pictures people could be using. So what what types of pictures
are mostly interesting articles and the titles to these articles. So for instance, I just pulled one up boarding now parents of children with nut allergies. And then he goes through and basically summarizes what that article is about. Others using
text. It’s just text, not pictures.
Yeah.
He does have videos on here, one that I liked from last year was demonstrating how to use nav even. And I thought that was that was smart. It was incredibly helpful and informative, but it’s not providing medical advice. So
yeah, yeah, you can’t get an epi pen without a physician prescription. So
it’s tough because sometimes people come into the comments and they find that you’re a specialist and they want to ask you these questions that they should not be doing. So being able to manage that I think is important.
Yeah, I think you need a standard response for something like that. Like it you just need like a rubber stamp. Like I apologize. This is not the venue for that that happened to me once when I was giving a lecture on sinusitis at the end at the end. It was barrage with. So I’ve got this bupkis in the back of my throat, you know, like things like that. And I’m sorry you’ll have to make, but it’s sometimes seems self serving, right? Like, I’m sorry, you’re gonna have to make an appointment. And then it seems like well, I just want your copay. I don’t want to give you advice, right? It’s, it’s you have to spend it in such a way that it’s not perceived as self serving.
Yeah. And must be so frustrating when it happens because, you know, there’s liabilities associated with that you can’t just be giving out advice freely, even though somebody in the audience insisted on it.
Oh, yeah. And it burns me up that everyone’s Twitter account has to say something like, retweets are not medical advice is it’s just come on. The fact that we need to put that in there seems just preposterous, but there it is. Yeah. There are doctors out there with burner accounts. So I’d like to be I’d like to hear what your your thoughts are on that. Like, for instance, I was just at my hospital learning how to use epic because my hospital was bought out by NYU. According to epic, and it seems actually pretty user friendly to me. But there is an epic parody account out there that the that is doesn’t identify the physician, but it’s just basically it’s parodying all EMRs to begin with, and it’s very funny, but right, it’s anonymous. So what are your thoughts on on burner accounts for physicians on anonymous accounts? Is there a danger out there? Is it is it going to make us lose trust of the public? So
I think this epic parody EMR account is actually pretty hilarious. I didn’t go too deep into the feed to read through it. But I thought this was funny and I didn’t really jeopardize the trust of the public has and medicine, because it’s, it’s talking about something relatable and it’s not at the expense of anyone else. So you see a different side to epic, and I think most patients wouldn’t really be seeing it as problematic, but People are poking fun at the platform. But you know, there are other burner accounts where it’s just somebody who’s very frustrated with the system is having a really difficult time. And they’re using this as a way to get their voice out there that can be concerning in the sense that what’s happening in the system where somebody would have to go to that extent to be able to, to feel heard, and why are they afraid to be having those discussions? So it’s, yeah, it definitely can violate the public’s trust and medicine. But at the same time, I like to take a step back and say, let’s not necessarily say this person is wrong. Let’s look at the bigger picture.
Is there a danger for the individual right because this the I’m pretty sure it’s a male because I’ve heard him on another podcast during the epic parody. If he gets discovered, they might tell him to take it down, but I don’t think he’s in danger of losing his job. Right or losing or working. is getting investigated by the Office of professional medical conduct or something like that. But I think there are accounts out there where you really could if you were discovered the ramifications of that could really be career ending. So I mean, how anonymous can these accounts really be?
Nothing is ever anonymous. And if one aspect that I go through when I train people to is just because it feels like a private interaction online doesn’t mean it necessarily is. Things can be screenshotted shared, you don’t know who, who could potentially have access to your computer, your email, things like that. So don’t fall under the illusion that just because it’s private to you is private to everybody. I mean, what happened within the last 48 hours? I don’t know if you saw my tweets that just went out. Recently. His interaction between a New York Times op ed columnist and a professor at George Washington, did you see this?
No, I didn’t. I was stuck in the computer lab. Learning epic. Okay, well, yeah, can my Twitter feed? So I was in a good, good boy.
That’s fair. Yeah, it was just this really bizarre situation. But to keep it short, a couple of emails were screenshotted and shared online and they did go viral. So
come on, tell us tell me a little more. What do you want on this? Gotta be in it. Yeah, this sounds like an interesting
story. Okay, so basically what happened is this New York Times columnist, and he posted something about a bedbug issue and New York. And this professor at GW followed up with a tweet. It wasn’t even using the guy’s handle on he said that the New York Times columnist was a bedbug himself. And this got almost no attention on Twitter. Zero retweets, nine likes. And that’s it. Well, the New York Times columnist, he ended up getting a hold of the professor’s email, he sends him an email saying, you know, that comment was appropriate. I am inviting you to my house to meet my wife to meet my kids to have dinner with us. And then, you know, I dare you to call me a bedbug. So, that email, he has CC, the provost of GW on it. So it became this whole issue and the email was screenshotted and shared on Twitter. That right now has 35 point 6000 likes and over 4000 retweets. And the follow up was, the professor went on to write a couple of op eds. All of that happened within 24 hours. Then finally, GW they released on their Twitter account, the email that the Provost wrote Following up, and it’s just it’s hilarious because he says, You know, I invite you to come to our campus to speak about civil discourse in the digital age. And please reach out if that’s of interest. so fascinating that this all just happened. And but yeah, the moral of the story being anything can be screenshotted and share.
Yeah, I remember when I was in college, and it was the first year that the freshmen dorms had Ethernet. So there was an email that went viral. And I just remember the title is, and you can google this Chong is king. This is a guy, I think he was in finance. He was transferred to maybe a different country and was doing very well socially and apparently sexually, and was bragging to his friends about it. And that email ended up going viral. I guess that was probably one of the first things To go viral, and you know, it cost him quite a lot. So, you know more to your point. Everything can you know, be Be very careful, even with emails even with the most. Okay, so this is all the stuff that can make us lose the trust of the public. How do we use social media to regain the trust of the public? Because with all the vaccine hesitancy and you know, concerns that doctors are in the pocket of Big Pharma, and people, you know, we don’t we don’t have the trust that we once did. So I feel like social media is a really powerful tool that we can use to regain that trust. How can we use it in that way? For To that end?
Yeah, I think that it can be and I don’t have any concrete advice in terms of what to do. But I will say some of the things that people should not be doing to combat this misinformation is being rude and combative and I No with vaccines, for instance, this is a very hot topic online. And it’s it’s a concerning one because I know physicians in the medical community overall feel very frustrated with this. It’s a no brainer get your kids vaccinated. So when they see or hear people saying, No, no, I’m not going to do that, because vaccines are unsafe. Of course, you want to go after that logic and say, you know, you’re completely wrong, what’s what’s wrong with you, but actually trying to come in and say, Here are the facts. And that’s why this should combat misinformation. It’s a well known model called the deficit model, and that just does not work. What it ends up doing is it actually reinforces these myths, and that’s called the backfiring effect. So I think being able to put information out there and do so in a respectful way, is really, really important. And when people come with these questions, especially on a public forum, Making sure to be listening to it. And instead of just shutting the person down and saying, nope, you’re wrong, which tends to happen. So I don’t know, I feel like social media is the best place for people who are maybe skeptical. They haven’t really figured out which side of the argument they’re standing on. So in thinking about posting to that audience, you want to really be respectful and make sure that the language does have a component of persuasiveness in it.
And I think also, you’re speaking not to the individual who posted the reply, but rather to the lurkers. So if you get angry and post something inflammatory, what does that going to say to the lurker? But if you can be level headed and respectful, then the lurker is going to read that and you’re more likely to persuade that person I think,
exactly, yeah. So you’re never gonna encounter that audience or if you do, it might be They feel more comfortable sending a DM. So if if somebody were to just fly off the handle, well, that could be the thing that’s persuading them to be anti Vax. Because now now they’ve seen the way doctors are talking to anti vaxxers. And that’s something that they don’t want to encounter. So you just never know what people’s perspectives are, where they’re coming from.
So is there any other pieces of advice rather big or small that you would give to doctors that are either seasoned in social media or just starting to dip their toes into social media, on how to interact with the lay public?
I think for folks who are more seasoned, it’s important to almost show that you are somebody who is willing to coach and guide others who are less experienced, and this could be something that is offline as well as online. I think a lot of people are very scared to enter into the conversation because The perception of physicians just is very different from other professions. So showing a willingness to be open. And in a public forum, having discussions is really good. And seeing the shift happened more recently in social media is is something new and great, but it’s going to need other people who are established right now to be welcoming new voices. So I definitely encourage that. And also for people who are new to the platforms, don’t be afraid to reach out and ask for help. And don’t be afraid to experiment. People who are doing well and have massive amounts of followers is because they’ve experimented and figured out what’s working for them. Since we’re at a place where we don’t really know yet. What information resonates best on social media in terms of medical information and science community I really want to just to figure out our own personal formulas and see what works and what doesn’t.
And my advice would be for the physicians out there, you’re an expert. Just because you didn’t write the textbook doesn’t mean you’re not an expert. And I think there’s a lot of imposter syndrome. This term goes out a lot goes on a lot in medicine, where you feel like, you’re suddenly going to be discovered that you’re not really an expert that you shouldn’t have been here to begin with. But you’re an expert, whatever your field is, you’re the expert. And so if you’re not comfortable posting, then lurk for a while. But, you know, get get in the game, get in the game. It’s a it’s a big time sink, it’s a big time sink. So be prepared for falling down the rabbit hole quite a few times and losing sleep. But
try not to do that. But recognize that you’re an expert and the world needs your expertise. Absolutely. And communicating online also makes you a better communicator, face to face because you you’re practicing how to get a message across to different audiences. So on that aspects, I know the lurking can definitely be a time sink. If you’re actually out there and putting that information in front of people, then there’s some experience that comes with it.
One final question I heard you say on another podcast that you’ve been to Monsanto. So my question is, did you when you came out, did you come out genetically modified?
I did not. I was the same or maybe I did. I was the same person that who went there. And yeah, I spent two days at their headquarters. And it was just an absolutely fascinating visit. Being able to speak with their communications team and then also see the science behind it. Yeah, I fell in love with how their community or how they work communicating because they really honed into this Whole lurker aspects and that they’re not engaging people online who they know, are very anti GMO. They’re aiming for people who haven’t quite figured out where they stand on the topic.
And I would imagine with all of their countless funds that they have the ability to figure out what works and what doesn’t.
Yeah, yeah, they they have this cnn type, communication, and center where they were keeping a pulse on all the different conversations that were happening around the world involving their brand, and that we didn’t really get too far into the weeds on how, what their strategy is, but it is very much so multipronged on every platform they’re on and then they’ve also the information easily digestible, very colorful use of graphics designs. So yeah, it was fascinating and it kind of plays into the whole aspect of We need a lot of physicians online talking about their expertise, because it could be that something that someone identifies with how a physician is communicating on Instagram, but not so much on Twitter. So really making sure all those voices are on these different platforms and communicating at different levels as well. Oh, great. So now I’ve got
to get on Instagram to some.
No, you’re doing great. See, I work in social media full time. So I have a presence on every single one of them. But I think it’s important that if you want to be online and doing something well pick one and stick to that because other people okay,
I’m out. Not on. I’m off Instagram. Not on. Okay. Thank you. Well, Professor Sarah mudra. And thank you so much for taking the time to teach us all about how we can get onto social media and be effective on social media.
You’re welcome. Thanks so much.
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 webpage. 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.
Today’s guest is not an attorney, accountant or financial advisor and neither am I. This information should not be considered personalized financial advice, and we will not be held liable for the use of any information contained within this interview. It is your responsibility to verify anything you’ve heard using other trusted and reputable resources.
Transcribed by https://otter.ai

Does Everyone Have Pencillin Allergy? Does Anyone?

On today’s show we speak to allergist, Dr. Payel Gupta about penicillin allergy.  Dr. Gupta is triple board certified in Allergy & Immunology, Pediatrics and Internal Medicine and currently has a practice on the Upper West Side of Manhattan with ENT and Allergy Associates.  We discuss how common penicillin allergy is and how commonly the diagnosis is incorrect.  She goes through the four types of hypersensitivity reaction, and then focus in on type I, the IgE-mediated reaction.  We go through presentation, treatment, and some commonly confused conditions.  She teaches us how penicillin testing is done, why we can trust it and dispels some misconceptions about penicillin allergy.

Dr. Gupta earned her medical degree from Michigan State University; and then pursued a residency in both Internal Medicine and Pediatrics at Rush University Medical Center in Chicago. She then moved to New York City where she completed a fellowship in Allergy and Immunology at the State University of New York, Downstate Medical Center.

She is currently on the board of the New York Allergy and Asthma Society and serves as the treasurer/ secretary.  She is also a National Spokesperson for the American Lung Association.

Find her podcast at itchpodcast.com and follow her on Instagram @nycdoctor.

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

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