Best Saul J. Weiner and Stefan Kertesz Podcasts (2024)

1
A Conversation with Pediatric Surgeon John Lawrence MD, Past Board President of Doctors Without Borders, USA 56:05

3h ago56:05

56:05

At a moment of increasing isolationism and xenophobia and -- for physicians – burnout, in a highly bureaucratic and profit driven health system, service in low resource high needs settings can be an antidote for what ails America and American medicine, at least for the individual clinician. John Lawrence has spent decades serving all over the globe…

1
Addressing Social Drivers of Health: What is the role of the clinician? 52:56

28d ago52:56

52:56

In can be confusing and even demoralizing for a medical student or resident to understand what’s expected of them when caring for patients with social needs. They already feel overwhelmed. Are they supposed to now also screen for housing insecurity? Is it their job to intervene to address social needs? And if someone else is doing the screening, wh…

1
“Simonisms”: Revisiting the uncommon wisdom of a physician and educator who shaped us deeply 34:01

2M ago34:01

34:01

To commemorate the start of our fifth season, we revisit a conversation we had almost two years ago about the wisdom of Simon Auster, MD. Simon was a family physician and psychiatrist who inspired the conversations we’ve been having with each other and with guests on every episode. “Simonisms” embody Simon’s insights: pithy observations about the p…

1
Do the doctors who sold Matthew Perry ketamine indicate something rotten in mainstream medicine? 57:24

3M ago57:24

57:24

The two doctors charged for their roles in the events leading up to actor Matthew Perry’s death were both involved in a “side hustle”: selling ketamine at a big mark-up to make extra money, above what they earned through legitimate practice. One was an internist-pediatrician and the other an emergency medicine physician. Their cynicism was starkly …

1
Some Pitfalls of Narrative Medicine and How to Avoid Them 55:52

4M ago55:52

55:52

The term “Narrative Medicine” (NM) refers to a range of activities, including close reading and reflective writing about literature, designed to improve the clinician-patient relationship. What could go wrong? Our returning guest, English professor Laura Greene, lays out the case for narrative medicine, while co-host Saul Weiner highlights his conc…

1
The chasm between how doctors are taught to communicate and what they actually sound like 46:09

5M ago46:09

46:09

There is an idealized version of physician-patient communication that is taught in medical schools, reinforced with acronyms like PEARLS, SPIKES, and LEARN, but what resemblance does it bear to how doctors actually sound in the exam room? Co-host Saul Weiner leads a research team that has audio recorded and analyzed thousands of medical encounters.…

1
What do we lose and what do we gain by calling addiction a disease? 50:10

6M ago50:10

50:10

The National Institute on Drug Abuse defines addiction as a “chronic disease” occurring in the brain – Many believe this definition can help to reduce stigma. But, is it helpful in the care of individual patients? In this episode we discuss what we gain and what we lose when we speak of people with addiction as having “diseased brains.” The view of…

1
Can we learn and practice medicine well in a system that is so ill? 51:26

7M ago51:26

51:26

In his book, The Present Illness, American Health Care and Its Afflictions, physician and historian Martin Shapiro, MD, PhD, MPH presents a scathing critique of a profession suffused with status, money, and power. At the same time, he also describes many deeply caring and rewarding patient care experiences, his own and those of colleagues. But thes…

1
“Tough Love” is Not the Answer: A critique of NEJM reporting on student/trainee grievances and educator discontent 59:53

8M ago59:53

59:53

A recent NEJM article and accompanying podcast episode (“Tough Love”) authored and hosted by the Journal’s national correspondent sound the alarm that a culture of grievance among medical students and trainees about the discomforts of medical training is threatening to undermine both their medical education and patient care. She also describes wide…

1
What a James Baldwin story can teach doctors and patients about care amidst suffering 1:02:37

9M ago1:02:37

1:02:37

“Sonny’s Blues” is a 1956 story by the author, James Baldwin, about a “sensible” and pragmatic algebra teacher and his younger musically gifted younger brother (“Sonny”), who struggles with heroin addiction. Both of them, raised in Harlem, are deeply affected by anti-Black racism. Although the older brother, who narrates the story, feels responsibl…

1
How confronting racist ideas I didn’t realize I had is shaping me as a physician and a person 55:30

10M ago55:30

55:30

In a 2021 episode that we reran last month, “About me being racist: a conversation that follows an apology,” Saul talked with a former Black colleague after apologizing to her for something racist he had done twenty years earlier that hurt her for a long time. Since then, Saul has been thinking about how he got exposed to racist ideas and notions o…

1
About me being racist: A conversation that follows an apology 42:49

11M ago42:49

42:49

We are re-running this episode from 2021 because we’re releasing a sequel next month in which Saul reflects on his journey confronting racist ideas he’d absorbed and that became impossible to ignore after he’d acknowledged his role in the incident described here. We are also re-running the episode because it exemplifies our commitment to facing thi…

1
How effects of racism were mistaken for “race” in clinical algorithms: What clinicians should know 1:03:58

12M ago1:03:58

1:03:58

For years, when physicians order tests to assess lung function, or blood work to determine kidney function, or look up guidelines for managing high blood pressure the results have been adjusted for race. This practice has been based on studies that seemed to indicate that the same result means different things if the patient is Black vs white. So, …

1
Drug testing at time of birth: How physicians are co-opted into harming families while thinking they are doing the right thing 1:02:43

1y ago1:02:43

1:02:43

The practice of urine drug testing during pregnancy and then often reporting positive results to Child Protective Services triggers a cascade that can result in separation of mother and newborn, with devastating consequence for both. These practices are more common when patients come from marginalized communities even when baseline substance use ra…

1
Directly and Covertly Observing Care: How it Can Transform Medical Education and Improve Clinical Practice 50:47

1y ago50:47

50:47

Direct, covert observation of health care is a novel and underutilized tool to assess health care trainees and clinicians. In this episode we talk with experts about two such approaches: the unannounced standardized patient and patient-collected audio. In the former, actors are sent incognito into practice settings, and in the latter real patients …

1
"Dire Consequences": When students do not receive appropriate accommodations on the USMLE examinations 43:32

1y ago43:32

43:32

In the prior episode we learned that there is no evidence that time-limited testing improves test validity and that, in fact, there is ample research showing that it makes tests less valid and less equitable. In this episode we discuss how, despite the data, the NBME denies accommodations on the USMLE exams to over half of medical students who have…

1
Why it's time to remove time limits on tests, like the USMLE exams 39:27

1+ y ago39:27

39:27

There is a widely held perception that being able to complete a test quickly is an indication of mastery when compared with those who need more time. As a result, it is often difficult to obtain accommodations on high stakes examinations, including the USMLE exams. Many students who request extra time because of a disability are denied accommodatio…

1
Running the Gauntlet: My Journey into Medicine with a Learning Disability 20:57

1+ y ago20:57

20:57

Stefan interviews co-host Saul about his experiences becoming a doctor with a learning disability. This episode, first run in 2020, sets the stage for two that will follow – in August and September, with experts on the science of student learning assessment and its implications for the USMLE examinations. These will address questions such as: Does …

1
Why are doctors turning to ChatGPT for help relating to patients? 33:29

1+ y ago33:29

33:29

A recent New York Times article, titled "When Doctors Use a Chatbot to Improve Their Bedside Manner," should raise questions about why physicians are turning to artificial intelligence for help talking with other humans. While GPTChat can generate things to say, what comes out of AI is impersonal, as it knows nothing about the individuality of the …

1
Prescription Opioid Reductions and Suicide: What Should Caring Physicians Do in the Face of Uncertainty? 36:58

1+ y ago36:58

36:58

The narrative that getting patients with chronic pain off opioids makes them safer was reinforced by a recent paper that got substantial media attention showing an association with reduced suicide rates at the population level -- But other data, at the patient level, shows an increased rate of suicide. Which is closer to the truth? And, if there's …

1
My patient’s in shackles: Can we take these off? 39:44

1+ y ago39:44

39:44

By Saul J. Weiner, Stefan Kertesz, Lawrence A. Haber

1
From medical student mistreatment to burnout: How can we change the culture? 40:31

1+ y ago40:31

40:31

In this second of a two-episode series on medical student mistreatment, we discuss its impact on burnout with a colleague who is working to change the culture of medical education and practice through research and leadership.By Saul J. Weiner, Stefan Kertesz, Lotte Dyrbye

1
Medical Student Mistreatment: A Wicked Problem 43:08

2y ago43:08

43:08

How is it that a healing profession -- medicine -- has such a deeply ingrained culture of harming its own? And what can we do about it? In this first of two back-to-back episodes on medical student mistreatment we consider the scope of the problem and attempts to confront it. We hear from one medical school that, with external funding, developed a …

1
Uncommon wisdom from a family physician and medical educator 33:00

2y ago33:00

33:00

Simon Auster, MD, was a family physician, psychiatrist, and medical educator who had extraordinary insight about practicing medicine but absolutely zero interest in drawing attention to himself. His students and patients had the good fortune of having him as their teacher or doctor but far too few have benefited from his wisdom. Today we discuss so…

1
Challenging Questions to Help Physicians Reflect, Grow, and Find More Joy Practicing Medicine 43:27

2y ago43:27

43:27

Medical training and practice habituates physicians to a culture that narrows the possibilities we see for finding joy and meaning in our work. We often become efficient task completers, stuck in routines, and prone to burnout. Saul and Stefan discuss a set of questions that challenge physicians to look at their work and themselves in fresh ways, c…

1
Organic Chemistry and the Questionable Ways We Select and Train Physicians 30:03

2y ago30:03

30:03

In October, the New York Times published the first of several articles about an eminent professor at NYU who was dismissed after his students complained that his organic chemistry class, essential to medical school admission, was too hard. Thousands of comments were unsympathetic saying, essentially, that students who couldn't hack it shouldn't be …

1
Contextualizing Care in a Nutshell (and a New Study) 27:29

2y ago27:29

27:29

Today, Stefan talks with Saul about his favorite topic (and life's work), contextualizing care. We're re-releasing this conversation (from January of last year) because Saul's research team has just published a new study -- an RCT, titled "Effect of Electronic Health Record Clinical Decision Support on Contextualization of Care: A Randomized Clinic…

1
Medical Gaslighting: Why Are We A--holes? 35:29

2y ago35:29

35:29

Recent articles in mainstream media about "medical gaslighting" have struck a nerve with thousands of comments on social media platforms. People are complaining about how their doctors are treating them, with women and underrepresented minorities disproportionately telling some of the worst stories. Meanwhile physicians are responding, mostly on th…

1
Urine Drug Screening: How it can traumatize patients and undermine the physician-patient relationship without helping anyone 38:02

2+ y ago38:02

38:02

Urine drug screening (UDS) is used in the care of patients with opioid use disorder, and for patients receiving opioids for chronic pain. There's no strong evidence that testing helps patients, however, and no consensus on what to do with the results anyway. These tests, often mandated, may cause serious harm when physicians don't realize how often…

1
Pursuing a Medical Career While Black: What it Takes and Why it Matters 55:43

2+ y ago55:43

55:43

Making it into and through medical school is tough even for those who have all the advantages: excellent schools starting at a young age, well-educated parents who may be doctors themselves, lots of role models and…white skin. In this episode we hear from two pre-meds and one newly minted physician, all Black, about their journeys with few of these…

1
Rescuing medical professionalism: Could “cup-of-coffee conversations” do more good than committees and letters-to-the-file? 42:06

2+ y ago42:06

42:06

Medical students may be subject to professionalism review by committees, most commonly for “unreliability” such as not responding to emails, falling behind on compliance requirements, showing up late for assignments and so on. Then they hit the wards, and frequently experience mistreatment by residents and attendings (many of whom also don’t answer…

1
Why Residents Unionize 36:35

2+ y ago36:35

36:35

Many residents are not doing well, psychologically, and sometimes physically -- and with good reason. High levels of mistreatment and harassment, patient care that some experience as moral injury, and a lack of voice in the workplace, contribute to burnout and can adversely affect the kind of physicians people become. A growing path to empowerment …

1
Opioids and the physician-patient relationship: What are we getting wrong? 41:32

3y ago41:32

41:32

The opioid crisis was precipitated by physicians overprescribing opioid pain medication, egged on by the pharmaceutical industry, contributing to suffering and death from addiction and overdose. Now, many physicians are forcibly cutting patients off of opioids and refusing to prescribe in the setting of a backlash, contributing to suffering from pa…

1
False Positives Traumatize Patients...If Clinicians Aren't Careful 30:16

3y ago30:16

30:16

On January 1st, the New York Times ran a story about prenatal genetic tests that are "usually wrong" -- but they got it wrong. These are actually just tests to tell if someone is high risk. The real story is that clinicians are not communicating with patients about what these tests mean, causing confusion and trauma. This happens across medicine an…

1
Healing Interactions: What are they made of? 27:57

3y ago27:57

27:57

There are two qualities we may experience in others who comfort and ground us when we feel vulnerable and lost. First that they engage with us, meaning that they are fully present with a sense of shared humanity. Second, that they respect our personal boundaries and know their own. Such boundary clarity makes them a safe sounding board. In this epi…

1
Kind People on Airplanes 19:35

3y ago19:35

19:35

Lately we've been hearing about bad behavior on airplanes. Here we discuss an incident in which a passenger unselfconsiously stepped up at an inconvenient time to assist a group of passengers in a tough spot. Saul and Stefan reflect on the qualities of people who go through life making the world a better place in small ways. As millions travel duri…

1
When an attending yells at a resident 25:51

3y ago25:51

25:51

Our guest, a physician a few years out of residency, describes an experience from her training when an attending yelled at her and hung up the phone when they were discussing a patient. We talk about resident abuse, its impact on patient care, and what can be done about it.By Saul Weiner, Stefan Kertesz, Anna Gramelspacher

1
When your patient has a Swastika tattoo 38:57

3+ y ago38:57

38:57

Our guest, a resident physician, describes her reaction and what followed, when she discovered a symbol of hate tattooed on her hospitalized patient's leg. Most of us appreciate that as physicians we don't get to choose who are patients are, and that all deserve good care. But is there more to it than that? Can one grow as a physician and person, a…

1
The Dartmouth Debacle: Why the culture of medical education needs to change 43:13

3+ y ago43:13

43:13

In a widely reported incident, Dartmouth Geisel School of Medicine accused, suspended and expelled medical students for cheating based on faulty data -- and then retracted the decision amidst a large public backlash. During the episode students were allegedly given only 2 minutes to defend themselves and were encouraged to plead guilty. When they c…

1
Vaccine Hesitancy and the Doctor-Patient Relationship 23:30

3+ y ago23:30

23:30

A primary care doctor in solo practice in a small mid-west city who is deeply trusted by his patients talks about talking about vaccine hesitancy.

1
Engagement and Boundary Clarity: 27:57

3+ y ago27:57

27:57

We feel safe and can open up in conversations when there is full and open engagement combined with a clear, respectful sense of personal boundaries. Why are such exchanges so rare and yet so important to medical practice and to the good life?

1
Judgementalism 25:38

3+ y ago25:38

25:38

Physicians are neither judges nor God, and yet we seem prone to judge our patients...and ourselves. Saul and Stefan discuss.By Saul Weiner and Stefan Kertesz

1
Contextualizing Care: What it means and why it matters 27:14

4y ago27:14

27:14

Saul and his research team have listened to and analyzed thousands of audio recordings of medical encounters for clinician attention to the life context of each patient when planning their care. Here is what they've learned.By Saul J. Weiner and Stefan Kertesz

1
Part 2: International Medicine 25:16

4y ago25:16

25:16

In Part 2 of our interview with Dr. Bhalla, hear what makes for a good fit for a long term career practicing medicine and leading projects in international settingsBy Saul Weiner and Stefan Kertesz

1
Part 1. International Medicine 40:16

4y ago40:16

40:16

A physician describes what attracted her to international medicine where she’s worked for Doctors Without Borders in many challenging places. Guest: Naina Bhalla MD, MPH Intro and Outro are Prelude by J.S Bach, arranged by Sophocles Papas, with permission from Carl Fischer. Also, Largo from Four Seasons by Vivaldi, arranged Per-Olov Kindgren. Guita…

1
My Learning Disability 21:47

4y ago21:47

21:47

Stefan interviews Saul about his experiences becoming a doctor with a learning disability, leading to questions such as: Does struggling with multiple choice tests mean you won't be a good doctor? How do grades shape our self image and the culture of medicine?

1
Asking patients "Why?" 16:11

4y ago16:11

16:11

What should a doctor do when a patient behaves in a way that doesn't seem to make sense? Saul and Stefan discuss a case.By Saul Weiner and Stefan Kertesz

1
Part 2: “This is what I trained for.” 28:12

4y ago28:12

28:12

In Part 2 of our interview with Dr. John Scala, hear how an experienced primary care physician in solo practice responds to the pandemic, particularly as he thinks about the physician-patient relationship, the well being of his staff, and personal risk.By Saul Weiner with John Scala

1
Part 1: Meaning and Joy in Solo Practice 55:59

4y ago55:59

55:59

A primary care physician describes why he's loved being a solo doctor, mostly avoiding corporate medicine. His patients love him too. Learn how and why this kind of practice is still possible.By Saul Weiner with John Scala

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Saul J. Weiner And Stefan Kertesz Podcasts

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