KevinMD on the Co-Learning Clinician podcast

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In this special episode, I’m on the other side of the microphone. I’m interviewed by CMEfy’s Brian Cohen on the Co-Learning Clinician podcast, and we discuss the concept of physician co-learning, opinion pieces vs. gold standards in medicine, what I learned from interviewing physicians, physicians being more than their degrees, and how CMEfy has impacted my learning.

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Transcript

Brian Cohen: Kevin Pho of KevinMD, and he has joined us, and I’m super excited to have you here. Welcome, Kevin.

Kevin Pho: Brian, it’s great to be on.

Brian Cohen: So again, the Co-Learning Clinician. Why is it so fitting that you are here with us? In my opinion, you are the OG, the original gangster, of clinician co-learning. You founded KevinMD back in ’04, 2004-ish, but you’re up to 3 million-plus views per month on your site. What you did and what you created, probably at a time when you may not have even known what was happening at that time, you gave us as physicians and other clinicians this idea that we can have a voice, and we can actually put it through your microphone. And 20 years ago, you let us know that we can listen to and learn from each other, and that’s something that we’ve seen become more and more prominent today. Can you share with us a little bit about just how you started KevinMD? How did it come to you, and what was the process of getting that going?

Kevin Pho: Sure. So back in 2004, I’m sure you can imagine, there were very few physicians on social media. At that time, there was no Facebook, YouTube was really nothing much, and there was no Twitter and LinkedIn. There were just blogs, and very few physicians had blogs. And I think one day I started one up. I think one of my family members said, “You have a lot to talk about in medicine. You should start a blog and let people read what you think.” So really without any future planning, no business plan certainly, I started up a blog and started just writing my thoughts and giving my opinions on news that was published that day, studies that were published.

And I guess there was one study, actually one drug recall, that was published, and everyone was up in arms. This was a very common drug that people were on, and it got recalled because of some heart effect that it had. I wrote something about it, and the next day I was in the exam room, and I remember the patient said, “Dr. Pho, I read your blog post this morning, and I was really comforted by what you had to say.” And that was my light bulb moment, where I realized that I could have an influence not only in the exam room, one-to-one with patients, but outside of the exam room as well, one-to-many, where a lot of patients can read what I say.

And I continued writing and sharing my thoughts, and as the platform grew, I realized that it could be a space where physicians don’t necessarily have to start their own platforms, but they can use mine. I’ve built it up over so many years, and they can share their own thoughts and stories and really get their voice heard. And there are so many reasons why that’s important to mention. We should talk about advocating for our profession, clearing up misinformation, and managing online reputations. There are so many reasons why it’s important for physicians to get their voice heard and have an online platform, a website. And now it’s complemented by various forms of social media, like Facebook, Twitter, LinkedIn, YouTube, and Instagram. It’s tremendously important now, and there are so many avenues, so many directions that physicians can go when their voices are being heard.

Brian Cohen: Yeah, isn’t it amazing? 2004 doesn’t seem like that long ago. When I say 1999, it seems like yesterday. To think about it, the iPhone came about in 2007, 2008. That’s when, I personally think, that’s the information-at-our-fingertips time. That’s when I remember being in the operating room and Googling how to do something in the moment as an anesthesiologist on that first iPhone. So it’s interesting, the tools that exist now that didn’t exist then, and how you’ve actually evolved with them. And not to get controversial with music, but there are certain bands that started in the ’60s and ’70s and are still creating music now, and it stays relevant. There’s a talent to that. And so it’s amazing how you’ve been able to evolve with it and use those tools as they’ve come about, from a digital side and a media side.

When I say the word co-learning, what does that mean to you? Is that something that strikes a chord, empowering clinicians learning together via your platform and your content?

Kevin Pho: So what co-learning needs to be, and I think you alluded to it earlier, is when clinicians learn from each other, and it’s also what I learn from other clinicians as well. And that’s what social media is, right? Whereas before, you had that one-way communication. You would read a newspaper, you would watch television, and one person would be learning from another. Now with the advent of social media, you build communities. It could be the discussion in the comments of a blog post. You go to any Instagram or YouTube video, and underneath, in the comments, there’s a community. You go to these closed Facebook groups, physician-only Facebook groups, where someone can post an article and everyone can have a discussion. That’s all co-learning to me.

As it applies directly to KevinMD, someone would share a story, and then I would post them on various social media sites. And it could be a story about, say, physician burnout, right, 60 percent of physicians are burned out, and they would share and write their story on KevinMD. And then other physicians would chime in in the comments and say, “I felt that way too. This is my story.” And then they’ll share their story in the comments, and that normalizes burnout, right? Before, burnout would be a taboo topic, but then you have everyone talking about it, and then everyone realizing, “Hey, I’m not the only one going through this.” And then they each share their stories, and not only does it normalize it, it offers a level of support that physicians can offer to each other.

And then someone like me, as founder of the site, someone who runs the site, I learn a tremendous amount too from the feedback that I get from some of the articles that are published. If I post a video on YouTube or LinkedIn, I get feedback. Some people say, “I agree with you.” Some people say, “I don’t agree with you.” Some people say, “You shouldn’t post this.” That’s all feedback to me, and I’m continuously learning as well from the feedback that I get from the clinician audience, and that helps me going forward in terms of, “What should I post going forward?” So that to me is all co-learning, when physicians learn from each other, and, as someone who runs a platform, I can learn from my audience as well.

Brian Cohen: Yeah, it’s interesting, because I think you described one of the things that may separate some individuals from being talented at sparking that co-learning versus just participating in it. To host that side and to spark that side, you have to check your ego a little bit, in my opinion. You have to be super brave. It takes courage to put your voice out there, because especially, again, when we look at 2004 compared to now and how social media has changed, the chances of everybody coming back and saying, “Kevin, totally agree,” are probably zero. So you have to be open to getting that negative feedback and not taking it personally, but knowing what to do with it. And I think, again, that shows how some of the leaders emerge within the co-learning space. And we need that. We need leaders sparking conversation and sparking thoughts, and we need learners learning with them, and then that network of what happens and how we feed off of each other. It’s really cool to see.

I don’t know that it existed as much previously, especially in the physician population. I felt like we were always pretty closed off to each other, in either sharing our emotions, “Oh, I feel that way too,” or sharing our protocols, “This is how I do something, and it works well. Let me tell you about it.” What’s your opinion, Kevin? Have you seen us open up as a community a little bit more to each other?

Kevin Pho: Of course, I’m a little bit biased, because I’ve been involved with social media for so long. So I definitely do see a subset of the physician population where they’re eager to share their stories. You go to some Facebook or LinkedIn groups that are physicians-only, and some physicians post anonymously really vulnerable stories. And what that does is not only spark conversation, but like I said before, it really sparks others to share their vulnerable stories as well. And that’s how you learn from each other. And then you have the physician community not only being supportive but offering advice to these physicians during their vulnerable times.

I do think that social media is a tool that can connect physicians, because you’re right, physicians are in silos, especially now. We’re also specialized. There’s the demise of the proverbial physicians’ lounge, right? There’s no more physicians’ lounge anymore at the hospital. You have hospitalists and then the outpatient physicians, and we never see each other. The fact is, I’m an outpatient primary care physician. I don’t know the last time I rounded in a hospital. It must have been 15 years ago, right? And that’s a stark contrast to what I grew up with in residency, where in internal medicine, there’d be a lot more camaraderie, right? You’d see your colleagues every day. You could commiserate in person. But now that you’re out in practice, everyone is so siloed.

And I think that what I do on KevinMD, a little bit, is it brings physicians together, so they’re able to share these stories. We’re able to build a community and come together, because there are a lot of outside forces that work against our profession. And I think the only way for us to maintain our empowerment of the physician profession is to come together, because if we continue to stay fractured and siloed, those forces are only going to split us apart and weaken the profession as a whole.

Brian Cohen: We agree. It’s interesting. In medicine, we tend to measure things in a unique way. We live by this gold standard or standard of care, especially when it comes to, we’re talking about, written topics, written papers, protocols, policies, things of that nature. But many of your pieces focus more on experiences and opinions. And you said that from the very beginning, you wrote an opinion piece on a blog. So I’m interested to hear your opinion: Is there a balance in your mind on what we as clinicians should sort of regard as these different levels of knowledge? Or how should we as clinicians approach these pieces as far as taking them as learnings, internalizing them, and implementing them actually into our own practices?

Kevin Pho: So it’s probably no surprise that I think that both are important, right? So you’re going to have the evidence from studies, the rigorous evidence, and that’s of course well needed, because all of our evidence-based practice is essentially going to be based on the studies that come out. But I do think that the perspective part, the opinion part, is equally important, because that’s how you interpret the data. And sometimes with these studies, you do need to read that perspective. How does this study apply to my practice? What do these numbers mean for me when I treat patients? And in order to have that interpretation, you’re going to need some opinion. You’re going to need physicians talking about that article, because sometimes a conclusion from a study can mean different things to different physicians.

And the other part of that is that science is evolving, and we see that with COVID, right? What used to be scientific truths in the past is misinformation now. Science is constantly evolving, and you have so many studies that come out, and sometimes these studies contradict each other. And as physicians, we have to ask ourselves, how do we make sense of all this data that is coming to us? How do we sort through what’s true and what used to be true? And then that’s where perspective pieces and opinion pieces come in. We need these experts also to be online to help us make sense of all these numbers that are coming at us.

Brian Cohen: Yeah, I agree 100 percent. And the rapidity with which medicine and health care is changing is such that if we solely relied on waiting for the next textbook, or waiting for the next monthly journal of peer-reviewed articles to come out, we’re already like four months behind, right? So it’s filling in those gaps in between. But it is a challenge. It’s no different than social media in general. You have to be able to sift through the accuracy of the data, how it applies to you, and where it’s coming from. And that’s probably one of our biggest challenges as clinicians right now, but also one of our biggest responsibilities when we’re taking in this information and deciding whether or not, or how, to apply it to ourselves and our practices.

So I mentioned you are the OG of co-learning, which means, if I’m going to equate that to this podcast right now, it’s essentially saying that you are the Johnny Carson of this world, or the Jay Leno maybe, or David Letterman. And not only have you created and supported KevinMD as a typed platform, but you also do a podcast every day, and you speak to hundreds of clinicians or people within the health care space. What I love about that, and what you said, is not only are we learning from them, but you’re picking up things from every single person you talk to as well. So this is the point where I would love to hear, out of everyone you’ve interviewed or met with or learned from on your podcast, does any specific moment stand out to you? Is there that favorite guest who really sparked or struck something important in you?

Kevin Pho: So rather than citing a specific guest or moment, I’m going to say a specific theme that’s come out. So I’ve been doing The Podcast by KevinMD for about two and a half years now. We’re almost at 900 episodes, and I’ve interviewed so many physicians from across the country, in every specialty, who are doing so many different things. So the theme I want to really emphasize is that physicians are more than our degrees. Gone are the days where physicians are just in the exam room or at the hospital doing a procedure, and that’s what their identities are. I think that what a physician is has certainly grown and evolved. I’ve talked to doctors who are real estate investors. I’ve talked to doctors who are as active, if not more, on social media than I am. I’ve had doctors who go into venture capital. I’ve had doctors who do so many other things other than seeing patients in the exam room, or other than practicing clinical medicine.

And they do this for a variety of reasons. Number one, we talk about physician burnout, which I mentioned earlier. We need to find a way for physicians to sometimes find a passion outside of clinical medicine. Now, don’t get me wrong, there are a lot of doctors whose passion is 100 percent clinical medicine, but that doesn’t apply to all the doctors that are out there, and those doctors are burning out. And what good are doctors if they’re burning out and leaving the profession? So sometimes doctors cut down clinical hours, and then they do other things that fill their cup, fill the proverbial cup, and they stay in medicine, ironically, even longer than they would have otherwise. So that’s a theme that I think has resonated with me the most, that physicians are more than our degrees, and a lot of doctors don’t identify as being a traditional physician and seeing patients, because we can be so many other things other than that with our degrees today.

Brian Cohen: Yeah, and you mentioned that previously, we as physicians may not have been comfortable even recognizing that need, or recognizing that if we chose to do anything outside of the exam room or the hospital floors, it was a sign of weakness, or it was a sign of not being committed, or of wasting the time you spent earning this degree. It was a very negative perspective on that. Again, it took those first few people talking about it, spreading it out, and talking more for all of us to realize that this is actually quite the opposite, right? This allows us to do what we do better, with more heart and with more dedication. And I think it’s, again, another great example of how co-learning as a community can help drive impact and lift everybody up in a positive way.

So you have been a user of CMEfy with your podcast, and you’ve seen some data and reflections that have come back to you. You’ve received some amazing insights, or again, in the CMEfy world, what we call anonymous reflections, from your listeners. They’ve reflected on your podcast episode. They’ve earned CME credit. What are your thoughts on the impact that you’re actually having through things like your podcast, KevinMD, and via CMEfy, just having the opportunity to listen to the feedback, listening to people say you’re making a difference?

Kevin Pho: It’s important to have a platform where my voice is heard. So one of the reflections that’s in front of me is saying they listened to my podcast, and they talked about how that episode in particular resonated with them in their practice. We have some people who are physicians in training. They could be medical students and interns, and they listen to a show, and they realize, “Hey, I’m not the only one going through this.” So having that feedback from the people who use CMEfy to me is very valuable. It serves as fuel to keep me going, because it does take a lot of time, effort, sweat, and tears, proverbially. And knowing that what I’m doing makes a difference to these individual physicians who write their reflections on CMEfy to me is very rewarding. It’s very gratifying, and it’s something that fuels me to continue to do what I’m doing, because I do think that I’m making a difference. And it’s so important for physicians to not only find their voice but also realize how important their voice is.

Brian Cohen: Absolutely. You definitely don’t need me to tell you that you, yes, absolutely, make a difference, and you have a lot of impact on the clinician community. From a CMEfy view of your impact, one of the coolest things that I’ve seen that we can use as a measurement is, if an individual is reflecting on what they just learned from you, and they’re reflecting in order to earn credit, the average number of words they’re putting into reflections. So the average number of words individuals are putting into reflections when they reflect on your podcast is 40 words. You have some leaving over 100 words. What that means is you are sparking enough thought within these individuals, and these oftentimes, Kevin, are 10-minute podcasts, right? And you’re sparking enough thought in them to sit and reflect, and the job is to connect what they just learned from listening to you in your episode to themselves in their practice. An average of 40 words per reflection is pretty incredible, and it’s across almost every specialty in medicine and almost every stakeholder and persona in medicine: nurse practitioners, nurses, physicians, PAs, and, like you said, students. The reach of your impact and the degree of your impact is inspiring to us, and we very much appreciate it. Again, kudos to what you’ve been doing for many years, and I appreciate the time and your blood, sweat, and tears that you mentioned, and we look forward to many more impactful moments together.

Kevin Pho: Thanks, Brian. It’s great to be on.

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