Subscribe to The Podcast by KevinMD. Catch up on old episodes!

Join Dawn Sears, a gastroenterologist, and Kim Downey, a physical therapist. We delve into the insights that reveal how taking care of your doctor can ultimately lead to better care for you. They share perspectives on improving patient-physician relationships, understanding health care dynamics, and fostering empathy in the medical field.

Dawn Sears is a gastroenterologist and can be reached on Twitter @GutGirlMD, YouTube, and at GutGirlMD Consulting. Kim Downey is a physical therapist.

They discuss the KevinMD article, “10 things to know about your doctor that will get you better care.”

Our presenting sponsor is Nuance, a Microsoft company.

Do you spend more time on administrative tasks like clinical documentation than you do with patients? You’re not alone. Clinicians report spending up to two hours on administrative tasks for each hour of care provided. Nuance, a Microsoft company, is committed to helping clinicians restore the balance with Dragon Ambient eXperience – or DAX for short. DAX is an AI-powered, voice-enabled solution that helps physicians cut documentation time in half. DAX Copilot combines proven conversational and ambient AI with the most advanced generative AI in a mobile application that integrates directly with your existing workflows. DAX Copilot can be easily enabled within the workflow of the Dragon Medical application to bring the power of ambient technology to more clinicians faster while leveraging the proven and powerful capabilities used by over 550,000 physicians.

Explore DAX Copilot today. Visit https://nuance.com/daxinaction to see a 12-minute DAX Copilot demo. Discover clinical documentation that writes itself and reclaim your work-life balance.

VISIT SPONSOR → https://nuance.com/daxinaction

SUBSCRIBE TO THE PODCAST → https://kevinmd.com/podcast

RECOMMENDED BY KEVINMD → https://kevinmd.com/recommended

GET CME FOR THIS EPISODE → https://earnc.me/xj5XlH

Powered by CMEfy.

Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast, get CME for this episode by clicking on the CME link in the show notes. Today we welcome Dawn Sears and Kim Downey. Dawn is a gastroenterologist, Kim is a physical therapist and a physician advocate, and together they co-wrote the KevinMD article “10 things to know about your doctor that will get you better care.” Kim and Dawn, welcome to the show.

Kim Downey: Thank you, Kevin.

Dawn Sears: Thanks, Kevin, thanks for having us.

Kevin Pho: So both Kim and Dawn have been on the show before. Go to KevinMD.com/podcast and search for their names to hear prior episodes. But today let’s jump right into their article, “10 things to know about your doctor that will get you better care.” So Kim, how did this article come together?

Kim Downey: Well, Dawn and I had a conversation back in October, and during our Zoom I mentioned to her that I wanted to work on a talk I was giving locally, and Dr. Michael Hersh had helped me come up with the title, how caring for your doctor gets you better care. And that morphed into quite a discussion between Dawn and I, and we talked about it from various angles, and phrases like how to be a better patient, things you could do so your doctor won’t quit, all that kind of stuff. And we talked about collaborating on an article after the holidays.

But shortly after that, two things happened within 12 hours that made me think, now is the time. And one was, I received, it was probably a blast email from you, it was an invitation to submit another article. And then hours later, my friend, she has Parkinson’s, and she invited me to give a talk to her group later this month. So I thought, having that information would be invaluable, and I took that as a sign to write this right away.

So I reached out to Dawn to see if she might be able to share her thoughts sooner rather than later, and she had just come off of like eight days of working or being on call or something, but within an hour she sent the rough draft for the article. And it was a little long, so I spent a few hours the next day editing it and writing an introduction, and I sent it back to Dawn and she said, looks good. And so within a day or so it was ready to go.

Kevin Pho: So let’s get right into some of those points. So Kim, I’m going to ask you again, why should patients care about their doctor’s well-being?

Kim Downey: Well, I don’t know whether I’ve shared the quote on here or not before. Dr. Kathy Stepien says, everyone wins when physicians are well. And if your physician is not well, and if they’re disengaged, you’re not going to get good care. So even if it sounds a little self-serving, right, if anything else, you should care, because if your doctor isn’t well, you’re not going to get the best care that you can.

Kevin Pho: All right. So Dawn, specifically, what are some specific points that patients may not know about their doctors that they should know about in order to get better care from the doctor? What are some underreported things that patients often don’t know about physicians?

Dawn Sears: Yeah, for some reason the patients believe that I’m in charge of billing, coding, insurance approval, parking, everything. And I just do the doctoring. I just remove the polyps, I just prescribe the medicine. And so every time they come in with a complaint list of all the things that have gone wrong with health care, they were probably touched by 30 different individuals who may have not done it perfectly or may have dropped the ball. But they’re taking the most valuable, highly trained interaction, that is actually going to result in the procedure, the surgery, the diagnosis, the cure, and they’re using this as a venting place, because there’s no place else to go. There’s no manager of the hospital that they can go to. We’re the only face-to-face that they see.

And right now there’s so much frustration in the world, and people feel the need to vent and feel the need to share their experience. So they take that opportunity of that 20-minute appointment to tell them everything that’s gone wrong over the last six months. And you’re sitting there as a physician going, oh my gosh, do they realize the time that they’re wasting? Because I’ve got 15 other patients to see, and I want to hear more about their indigestion or their diarrhea or whatever is bringing them in today, but they want to talk about billing and coding and parking. And so if they actually took the right attention to what our skill set is, which is diagnosis, treatment, and care, and empowering them to care for themselves, that would be a much better utilization of their time and energy coming into a visit.

Kevin Pho: So Dawn, what do you do in that situation? Like if a patient hypothetically comes to you and said, I got a bill for my colonoscopy because it was coded as a diagnostic, not a screening colonoscopy, what can physicians, you, what do you do in that situation?

Dawn Sears: Immediately we have to be empathetic. We have to say, I get it, I understand, it is so frustrating. I personally have been turned into collections five times at the hospital I work for, because I have paid a co-pay on one of my children for $200 that was credited to one of my other children, so I’m delinquent 200, but over 200 and they send me to collections. So I get it, I’m not immune. I’m a physician who works in the system and it’s so frustrating for me.

So first I crawl in the sandbox with them, because they feel alone and they feel like they’re the only ones on the planet that this is happening to, and you normalize it, that absolutely, this is such an imperfect, broken system, I get it, I feel it, it stinks, and here’s the phone number you can call to try to resolve it, it’s the one I called to get mine resolved after two months, and give it a go. But in the meantime, can we refocus on the reason that you’re here? And so we try to give them time, give them space, but acknowledge it, but then shut it down so we can actually talk about the problem that they’re here for.

Kevin Pho: So Kim, I know that you are a fierce physician advocate, and over the past year or two you’ve connected with so many physicians and brought so many physicians together. What would you say are some of the top things that you’ve learned from all the doctors that you’ve talked to that you wish you knew before going on your advocacy campaign?

Kim Downey: Well, I don’t know so much about the difference before going on my advocacy campaign, because since I am a physical therapist, and I have been a patient, I had some general understanding. But I can tell you some of the things that I have a much deeper understanding of, and one of them would be, as you know, I just started my own podcast and I’ve dropped like a dozen episodes, and at least half of them the doctors say, I’m human too. And that’s one of the things, it was point four in our article, and the action step is, acknowledge that physicians are human too, with human needs and human wants.

And on one hand you would say, well, that’s a no-brainer, of course you’re human. But the fact that doctors feel the need to say that. And I think even my very first episode, I interviewed Dr. Todd, and when I said, the very first thing is, what do you want the audience to know about you, I think the very first thing he said is, I’m human too, I have feelings and emotions like everybody else.

And I think sometimes patients might, in a good way, I just interviewed Dr. David Alfrey, and what he shares is that patients put you guys on pedestals, which in one way is kind of nice, but on the other hand it kind of takes away that humanness, and they aren’t thinking that doctors are people too, and just that they can absorb everything and take everything. And then the other part is, doctors themselves need to remember that they’re human too, right, because they feel that they need to be superhuman.

Kevin Pho: So Kim, what are some ways where doctors can come off that proverbial pedestal and really showcase their humanity and better connect with patients? How can doctors do that?

Kim Downey: Well, finding safe places to have discussions, make connections, and feel vulnerable. Be willing to feel a little bit vulnerable. And I find that, like on LinkedIn, that now more and more doctors are feeling safe and comfortable talking about either horrible experiences in residency training, right, or things that are happening now, or even the feelings, right? I talk to the doctors I like on LinkedIn about feelings, who knew, right, that they would talk about feelings?

And again, you don’t have to open up, you don’t have to spill your whole life, right, but just being able to show little parts of yourself. And then when you realize that other people say, I feel that too, or I’ve had that experience too, it just makes you feel more connected. And also if you share, when they share, like little things maybe that went wrong or didn’t go well or ways they acted in residency, right, and when people then accept it and say, look, we understand, it also takes away the shame.

So between being willing to be a little vulnerable, and also finding a connection, whether it’s a community of doctors on LinkedIn, or just through your church or somewhere, it’s just that finding connection is critical.

Kevin Pho: Dawn, you are a physician and a coach, and I want to talk more about that vulnerability because I think that’s so important. The doctors that you interact with, how difficult is it for them to be vulnerable?

Dawn Sears: Oh my goodness. Yeah, we are taught to, as soon as you sign, here’s your stethoscope, here’s your armor, put it on and wrap this around your neck tightly. And so we use our stethoscope and we put on that white coat of armor of perfectionism, I’m now a robot.

And I was just coaching a colleague this week, and he said, you know the phrase, rest is for the dead. We don’t rest as physicians, we shouldn’t sleep, how dare you sleep when there’s more patients that could be seen, there’s more papers that need to be written, there’s more articles that need to be reviewed. He said, and I hear myself now six years into this and I’m like, oh my gosh, what have I done to myself, and what have I accepted as norm, and I am terrified to ask for help because it’ll be seen as a weakness, because I’m supposed to do it all.

So him just saying that, he said, I don’t need to live this way anymore, do I? I said, no, I give you permission to live differently. It’s OK for you to need nutrition to bring up your blood glucose. It is OK for you to gain the unconsciousness of sleep so that you are a better physician and a better spouse and a better dad tomorrow.

And getting them to that point of breaking down what we have been taught was expected of us, and what is reality, that we are simply human, is a beautiful thing. But it takes a deep safe space, that we were discussing, of all these safe spaces, to be able to do that in a place where you know you’re not going to be judged, you’re not going to be criticized, and you’re not going to be thought lesser of as a human or as a physician when you do just acknowledge basic needs.

Kevin Pho: And Dawn, when it comes to burnout and showing vulnerability, you’ve been involved in this area for years now, and we talk a lot about this on my podcast and on KevinMD of course. Do you actually see the needle moving from a medical culture standpoint in terms of accepting physician vulnerability and burnout? Are we moving the needle?

Dawn Sears: We are, we are. There was even an article in the last couple weeks that highlighted the CDC as well as our surgeon general talking about, let’s stop talking about resilience and let’s start talking about system changes. Because if we do that, then we’re taking the onus off of the individual that’s suffering, and let’s acknowledge that it’s a bigger problem.

So we’re having the conversations again and again and again, and now we’re starting to see that when someone does raise their hand to ask for help, people are actually coming to the rescue and saying, yeah, I actually will see those patients for you, or why don’t you just go home? And I am seeing that regularly in my practice and in my coaching, and for coaching physicians around the United States and around the planet, that more and more people are saying, I was stunned, I told the team I was going to go on vacation and not take my laptop, and they were OK with it. And I’m like, yes, they were. What did you expect? You expected to be fired on the spot, or expected to then be put on call for the rest of the month?

And so people are seeing that when they actually ask for what they need, people are understanding that they do need it, and they’re no longer coming back with that harsh reality in the past. Because we’re seeing the implications, with 40 percent of medical students saying they never want to practice medicine. How terrifying is that? We’ve got to change the culture. And people are seeing that reality, they’re watching their colleagues leave, quit, and retire early, and they’re saying, OK, what can I do to stop that? And when someone comes to me, I’m going to come with them with compassion and ask how I can help.

Kevin Pho: So Kim, in the article you list, or both of you list, action steps from the patient standpoint in terms of what they can do to facilitate that communication with their physician and see their physicians as more human. Tell us some of the most impactful action steps that patients can take.

Kim Downey: Sure. One of them, it was point number eight, that we talk about, can and should are not the same thing, and just because you can doesn’t mean you should. And one thing that is very critical is to have realistic conversations with your physician and family members while you’re able to speak for yourself, to ensure that your wishes are honored. That I think is very important.

And another one is number nine, not all medical records are shared, and you have to take responsibility to partner with your physicians. And even for me personally, my surgical oncologist is in the state of New York, my radiation oncologist is in my local health care system, but my medical oncologist is with Yale, and I even have more systems in that. So when I go to see my surgical oncologist, I have to bring a list every single time of fax numbers and say, fax this report, my gynecologist wants to see it, and those other oncologists. Because otherwise you’ll show up at one of the other appointments and they don’t know, because the systems don’t connect with each other.

Kevin Pho: So Kim, what was the response to the article? Did you get responses from patients after publishing this?

Kim Downey: Well, actually I just saw a couple comments on your site, but for some reason I didn’t see how I could respond. In a couple, one of them said thank you, because in the third one, so number five, Dawn talks about, physicians are the most highly trained individuals you’re likely to encounter in a given week, and she actually goes through what it takes to become a doctor. And one of the responses on your page was, wow, thanks, I didn’t know that.

Kevin Pho: We’re talking to Dawn Sears and Kim Downey. Kim is a physical therapist, Dawn is a gastroenterologist, and together they wrote the KevinMD article “10 things to know about your doctor that will get you better care.” Now I’m going to end with each of you to share your take-home messages with the KevinMD audience. So Dawn, why don’t you go first?

Dawn Sears: I just love this collaboration, for Kim to reach out and be such a strong patient advocate. I was very nervous to write an article addressing physicians as humans, because I am met with lots of backlash, that people think that I have a privileged life, and I do, but they don’t understand what we’ve been through to get where we are and what we endure every day to stay in it.

And through KevinMD and his work and his efficiency, and Kim’s efficiency, to be able to write an article within 48 hours, have it published within four days, I’m an efficiency advocate and passionate about that. So I just love these collaborations. And if health care took these kinds of collaborations and put it into systems, we could change the world. And so I just love even the logistics of how this happened. It is very telling of what is possible when you get very intelligent, passionate people together. So thank you both for that.

Kevin Pho: And Kim, we’ll end off with you. Tell us your take-home messages.

Kim Downey: Sure. I love that, Dawn, thank you. And so I have a few. So for doctors, as a health care professional myself, and as a patient who saw 37 doctors recently over a two-year period, I truly understand your frustrations. Some of them were my frustrations as well, and we PTs have our own stories that we could tell. And I want the doctors to know that I see you, I hear you, I understand you, and I’m looking for ways to do what I can, both locally and more broadly through my work with Medicine Forward, to make positive changes.

And for patients, I fully understand your perspective as well. We could write another article to physicians called “10 things to know about your patient that will help you give them better care.” And all my experiences were not good ones, even though I always tried to show up with the best self that I could, and I always expected a positive experience.

So to bring it all home, for doctors, patients, and health care leaders, really everyone, I recently watched a webinar moderated by Michael West through the Global Compassion Coalition, and the takeaway for me is, we’re all humans, doctors and patients alike. We all want to feel valued and cared for, we all want to feel like we matter. Let’s all do our best to treat each other with kindness, truly listen to each other, and demonstrate empathy and compassion. I do that, and my current doctors do that, no matter the length of our visit or the obstacles that they face. And it might sound simplistic, but it’s what’s at the heart of healing.

Kevin Pho: Kim and Dawn, thank you so much for sharing your time and insight, and thanks again for coming back on the show.

Kim Downey: Thanks so much, Kevin, appreciate you.

Dawn Sears: Thanks for having us.