Podcasts

Cognitive Biases in Vaccine Decision Making with Jonathan Howard, MD

Jonathan Howard, MD, is double boarded in Neurology and Psychiatry and as he puts it in his Twitter profile, the author of several non-bestselling neurology textbooks. That’s not why he’s being interviewed. He also co-authored a book chapter entitled “The Anti-Vaccine Movement: A Litany of Fallacy and Errors,” in the book Pseudoscience: A Conspiracy Against Science and wrote his own book on fallacy and errors in medicine entitled, Cognitive Errors and Diagnostic Mistakes: A Case-Based Guide to Critical Thinking in Medicine.

We discuss some of the cognitive biases that people use when they decline vaccines, like the nirvana fallacy, anecdotal fallacy, and conspiracy theories. In some ways, the decision to vaccinate or not can be inordinately complicated, almost as if every step of the scientific processes needs to be vetted by each individual getting the vaccine. Our goal as physicians should be to ease the cognitive load of the decision-making, so we talk about how we can accomplish this.

Dr. Howard did his residency and fellowship at NYU, where he is now an associate Professor of Neurology and Psychiatry, specializing in Multiple Sclerosis. He is the neurology clerkship director and director of neurology at Bellevue. He can be found on Twitter at @JHowardBrainMD.

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Moving the Needle on SARS-CoV-2 Vaccine Fence-Sitters with Jordan Harbinger

Jordan Harbinger is a recovering Wall Street lawyer, turned podcaster. He’s actually been podcasting for longer than we’ve had smart phones. So why would I be asking him about vaccines? I’m not. We’ll get to that. His previous podcast and company focused on dating, but he realized that the skills that they were teaching regarding that specific social interaction actually applied to other aspects of life and so he pivoted his podcast and now his podcast really applies to anyone interested in personal development.

His expertise focuses more on entrepreneurship, networking and social engineer and that last one is the reason he’s on the show today. The decision to vaccinate may seem straightforward to some, but if you are considering all of the knowns, unknowns and unknowables, as many vaccine-hesitant patients tend to do, it can be inordinately complicated. As physicians, it should be our job to lighten the cognitive load of that decision and he is going to help us make sure we optimize any interaction with our families, friends, patients and communities.

His main point is that for many who are hesitant about the vaccine, they may just want to avoid making the decision. It is easier to sit on the fence, so we need to clarify that by not getting the vaccine, they aren’t deferring the decision, but deciding to not get the vaccine. We also need to press upon them that given that scarcity of the vaccine, but deferring now, it is unclear when they’ll have access again.

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Deep Listening – Impact Beyond the Exam Room, with Oscar Trimboli

Oscar Trimboli is passionate about using the gift of listening to bring positive change in homes, workplaces and the world. Through his work with chairs, boards of directors and executive teams in local, regional and global organizations, Oscar has experienced firsthand the transformational impact leaders and organizations can have when they listen beyond the words and he helps us bring this skill into the exam room. He talks about giving attention instead of paying attention, how to frame questions so they won’t be perceived as judgmental, how to utilize silence, and when it is actually ok to interrupt our patients!

Oscar is a marketing and technology industry veteran with over 30 years’ experience across general management, sales, marketing and operations for Microsoft, PeopleSoft, Polycom, Professional Advantage and Vodafone. During his time as a marketing director at Microsoft, he was accountable for the five-year journey to move Microsoft Office from DVDs to the Data Centre. He consults to organizations including 20th Century Fox, AstraZeneca, Google, HSBC, PayPal, Qantas, Reebok, TripAdvisor and Universal Music. He can be found at oscartrimboli.com and there you can find his podcast, Deep Listening: Impact Beyond Words.

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VRx: How Virtual Therapeutics Will Revolutionize Medicine, Dr. Brennan Spiegel

Brennan Spiegel, MD, is director of health-services research at Cedars-Sinai Medical Center, where he directs the Center for Outcomes Research and Education, which maintains one of the largest and most widely cited therapeutic virtual reality programs in the world. Spiegel is also professor of medicine and public health at UCLA. He wrote ACING the GI Board Exam, but he’s on the show today to discuss his book, VRx: How Virtual Therapeutics with Revolutionize Medicine.

Dr. Spiegel shows how a simple VR headset lets hospitalized patients escape the four walls of their isolation room to visit Icelandic fjords, empowers patients with schizophrenia to confront the demons in their head, offers dementia patients a new way regain function in a life-sized virtual town, and enables burn victims to manage their pain by traversing snowy virtual landscapes. Scientists are starting to uncover these surprising benefits, and not so far in the future, we may have doctors specializing in virtual medicine with its own ACING the VR Board Exam Review Book. In an unexpected way, VR is also strengthening the humanity in healthcare: vivid simulations of patients’ experiences can make us more empathic.

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Benefits of the Presence and Consequences of the Absence of DEI with the DEI Shifters

The DEI Shift, Diversity, Equity and Inclusion, is a podcast whose mission is to focus on those issues in medicine, spark discussion and provide practice-changing data, stories and useful information to help healthcare practitioners to improve their practices and environments, gain empathy, cultural competency, and humility, and to learn more about emerging D.E.I. concepts. They discuss issues related to gender, race, sexuality, religion, ability, socioeconomics, and so much more. There are many professionals responsible for producing their informative and engaging content and on today’s show, we were honored to have Dr. Maggie Kozman, a Med-Peds hospitalist and Senior Producer and Cohost, Dr. Brittäne Parker, an academic hospitalist, Producer and Cohost; Deepti Yechuri, a recent graduate of UCSD undergrad and currently applying to medical school and Assistant Producer and Sarahy Martinez, a UCSD undergrad and Production Assistant.

We discuss why it is necessary to create their show and some interest and disturbing statistics behind the lack of diversity in medicine. We also discuss some of the consequences to our patients of that lack of diversity.

Each member of the DEI shift then goes through a personal experience with the healthcare system that demonstrates an untoward effect of lack of diversity and the highlights a positive experience because of the presence of it. 

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Should the Doctor Write a Book? with DocSwiner

Dr. Nicole Swiner is a family physician, 6-time best-selling author, blogger, speaker, wife and mother in Durham, North Carolina. How does she do it all? That’s how we start the interview! With her company, Swiner Publishing Company, she helps authors become best-sellers, from start to finish. We talk about why doctors should write books, why they shouldn’t, why they should self-publish and why publishing with her is really self-publishing and organizing events in the age of COVID and after.  

Dr. Swiner attended Duke University and went to medical school at the Medical University of South Carolina. She’s has lived in the Triangle of Durham, NC since finishing residency at UNC-Chapel Hill and continues teaching as an Adjunct Associate Professor with the Family Medicine department with interests in Minority Health, Women’s Health, Self-Care and Female Entrepreneurship. When she’s not treating patients at Durham Family Medicine, she’s spending time with her family, speaking nationally, freelancing for WebMD and teaching others to self-publish. Find her at DocSwiner.com.

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Get the Keys to the C-Suite with Sandy Scott

Sandy Scott is a physician and executive coach who has coached over 500 physicians and healthcare executives. Sandy’s vision is to transform the lives of all physician leaders into meaningful and high-performing journeys by teaching us the strategies and tactics we need to lead and live with purpose.

We discuss how to get to the C-suite and this requires a lot of self-reflection. The key is being able to identify your strengths and playing to those strengths in order to get to a goal that you may have never previously considered. This is all about big picture and big thinking in order to have a transformative experience. She gives us some steps that can build the foundation to start moving in that direction.

She is a Fellow of the American College of Healthcare Executives, a Board and Professional Certified Coach, and a Certified Physician Development Coach, with an Executive Master’s in Public Administration, from the University of Colorado.

You can find her at SandyScottLLC.com and on her podcast High Impact Physicians, where I was featured here: Stay Flexible by Playing with Your Kids (Dr. Brad Block) (buzzsprout.com)

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Value-Based Payment Models with Vanessa Guzman

Vanessa Guzman is the CEO of Smartrise Health, which specializes in all Value-based Payment and Accountable Care organization matters. She helps us make sense of the alphabet soup of acronyms like ACO, MIPS and why the Center for Medicare and Medicaid Services is CMS and not CMMS.

She defines value by CMS’ three aims: better care for individuals, better health for populations and lower cost. She attempts to shorten the chasm between what we see as useless clicking and how it actually helps our patients.

We discuss how this can help our bottom line and help our patients to thrive and how we can use the data we collect for CMS and commercial payers to help our own organizations. We also discuss the impact of COVID and where she sees these payment models going in the future.

With almost 15 years of experience, Vanessa has helped organizations gain over millions of dollars in value-based payment related revenue – through her unique integrated strategy that creates a collaborate space among health systems, payors, technology solutions and community-based organizations.

Vanessa graduated from Columbia University’s Fu Foundation School of Engineering and Applied Science with a BS and MS in Biomedical Engineering, specializing in Diagnostic Imaging. She is also certified in Quality Engineering and Quality Management and Organizational Excellence by the American Society for Quality.

For her outstanding contributions, Vanessa has been awarded the 2018 Becker’s Hospital Review “Rising Stars Under 40” and 2017 Modern Healthcare’s “Up and Comers” Awards.

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A Career in Clinical Research with Fabian Sandoval, MD

Dr. Fabian Sandoval is the CEO & Research Director of the Emerson Clinical Research Institute and has over 25 years of bench to bedside research experience. His diversified research career has been in academia, healthcare systems and the public sector. He received his Bachelors of Science in molecular and cellular biology from Marymount University, and his Doctorate of Medicine from the Autonomous University of Guadalajara, School of Medicine with clerkships through NY Medical College. 

We discuss the importance of clinical research, his unique path to a career of clinical research and the logistics of how his research institutes runs. We also discuss the ethics of enrolling people who are economically disadvantaged. We finish by discussing how and why private practice physicians can start participating in clinical research.

Before opening the doors to Emerson Clinical Research Institute (ECRI) Dr. Sandoval’s research activities have included bench research at the National Institutes of Neurological Disorders and Stroke, the NIHs’ Clinical Center, and Supervisory Research Integrity & Compliance Officer in the Army Human Research Protections Office.

Dr. Sandoval is also an Emmy Winner for the weekly medical TV show “Tu Salud Tu Familia” on Telemundo. He has since started the Emerson Community Clinic, in order to support un-insured patients across the DC metro area, as well as starting the Emerson Diversity Health Foundation, whose mission is to educate patients and providers in the importance of participating in clinical research and accesses to care.

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Democratizing Clinical Trials with Dana Dornsife of Lazarex Cancer Foundation

Dana Dornsife is a patient-advocate and the founder and CEO of Lazarex Cancer Foundation, a nationwide non-profit organization that seeks to improve the outcome of cancer care – giving hope, dignity, and life to advanced stage cancer patients and the medically underserved by matching patients to clinical trials and providing travel reimbursements to patients for the costs associated with FDA clinical trial participation.

 

Dana founded Lazarex in 2006 after her brother-in-law was diagnosed with pancreatic cancer and she learned first hand of the many barriers patients encounter when trying to access potentially life saving treatment through clinical trials. A passionate patient advocate, she works to disrupt the system to advance much needed change. Under her leadership, the organization was involved in getting the U.S. Food and Drug Administration to publish new guidance language that makes it clear patients can be reimbursed for travel expenses to clinical trial sites. Through Lazarex, Dana also advocates extensively at the state level for laws that reinforce the FDA guidance. She has succeeded in getting new laws passed in 5 states and legislation is pending or being considered in several other states.

In 2016, Dana expanded the mission of Lazarex with IMPACT (IMproving Patient Access to Cancer Clinical Trials), a 3-year nationwide program that works to increase cancer clinical trial enrollment, retention, minority participation and equitable access in the hopes of getting cancer drugs to market faster and finishing oncology clinical trials on time and on budget. Most recently, Lazarex is also working to create collaboration around a public health initiative in Philadelphia, PA – Community IMPACT. This bold effort is aimed at creating a replicable model to improve cancer health outcomes and associated co-morbidities, and address cancer health disparities for the residents of medically underserved and socioeconomically challenged minority neighborhoods throughout major metropolitan cities and beyond.

Dana is a graduate of Drexel University in Philadelphia. She is a board member of the USC Brain and Creativity Institute at University of Southern California, serves as Chair of the UCSF Cancer Leadership Council and is a member of the MGH Presidents Council. She is Vice Chair of the governing board of the Yosemite Conservancy in addition to being a council member. Dana and her husband, David Dornsife, a USC Trustee, are also long-time supporters of environmentalism and sustainability and are the world’s top investors in clean water projects in Africa through World Vision, an international humanitarian agency supporting water, sanitation and hygiene in 24 African countries.

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