How the Culture of Medicine Kills Doctors and Patients

Are you getting the medical care you hoped for? Perhaps you really like your doctor and feel listened to and well treated. Or maybe you’re frustrated with the lack of coordinated medical care, unconscious bias, and medical systems that don’t keep patients well-being at the center of their decisions. Most people agree that the US health care system is broken, but there is also a less talked about problem to address— “physician culture.” My guest, Dr. Robert Pearl, says, “Doctors are not heroes or villains. They produce remarkable successes and abysmal failures.” We’ll discuss what doctors do well, and how some miss the mark on compassionate, science based, high quality, and effective medicine for all.

**Listen now to About Health on KPFA.org—94.1FM, (7/12/21)**

https://kpfa.org/player/?audio=360279

 

ROBERT PEARL, M.D. is the former CEO of The Permanente Medical Group (1999-2017), the nation’s largest medical group, and former president of The Mid-Atlantic Permanente Medical Group (2009-2017). In these roles he led 10,000 physicians, 38,000 staff and was responsible for the nationally recognized medical care of 5 million Kaiser Permanente members. Named one of Modern Healthcare’s 50 most influential physician leaders, he is an advocate for the power of integrated, prepaid, technologically advanced and physician-led healthcare delivery. He serves as a clinical professor of plastic surgery at Stanford University School of Medicine and is on the faculty of the Stanford Graduate School of Business, where he teaches courses on strategy and leadership, and lectures on information technology and health care policy. Board certified in plastic and reconstructive surgery, Dr. Pearl received his medical degree from the Yale University School of Medicine, followed by a residency in plastic and reconstructive surgery at Stanford University.

He is the author of Mistreated: Why We think We’re Getting Good Healthcare—And Why We’re Usually Wrong,and his most recent book is, Uncaring: How the Culture of Medicine Kills Doctors and Patients. All proceeds from the book go to Doctors Without Borders.

Dr. Pearl hosts the podcasts Fixing Healthcare and Coronavirus: The Truth and he publishes a newsletter, Monthly Musings on American Healthcare. He has published more than 100 articles in medical journals and contributed to numerous books. From 2012 to 2017, Dr. Pearl served as chairman of the Council of Accountable Physician Practices (CAPP), which includes the nation’s largest and best multispecialty medical groups, and participated in the Bipartisan Congressional Task Force on Delivery System Reform and Health IT in Washington, D.C. Connect with Dr. Robert Pearl on Twitter @RobertPearlMDLinkedIn, and at his website robertpearlmd.com

A Personal Battle Against Alzheimer’s Disease

Listen now on About Health on KPFA radio— 94.1FM  (6/28/21)

https://kpfa.org/player/?audio=359452

Alzheimer’s, which is a neurological disorder, affects 6.2 million Americans. “Worldwide, around 50 million people have dementia, and there are nearly 10 million new cases every year. Alzheimer’s disease is the most common form of dementia and may contribute to 60–70% of cases.” —World Health Organization.

There is no cure for Alzheimer’s, but there is extensive clinical research being done. The pathological changes in a person’s brain start ten to twenty years before there is cognitive impairment…and so it’s vital that life style changes begin before typical symptoms show up. My guest, Dr. Daniel Gibbs, has been devoting his time to raising awareness about early-stage Alzheimer’s, and what people can do about it, in order to live a meaningful life for a longer time.

Guest

Dr. Daniel Gibbs is a retired neurologist in Portland Oregon, with early-stage Alzheimer’s disease. Having spent twenty-five years caring for patients, many with dementia themselves, he is now an active advocate for the early recognition and management of Alzheimer’s. He is the author, along with Teresa H. Barker, of the recently released book “A Tattoo on my Brain. A Neurologist’s Personal Battle against Alzheimer’s Disease”

Breakthrough Treatment: Psilocybin-Assisted Psychotherapy

**Listen now to About Health, (6/14/21) KPFA radio—94.1FM**

 https://kpfa.org/episode/about-health-june-14-2021/

We discussed the research and best practices in psilocybin-assisted psychotherapy. This is being explored as a promising treatment for people with depression, OCD, anxiety, addiction and other mental health challenges. “Magic Mushrooms” have been used by many cultures since ancient times for medicinal and spiritual purposes. It is believed by some that taking psilocybin in a therapeutic setting can result in neuroplastic changes that can lead to improvement in mental health.

Guest:

James Keim, LCSW, is the founder of Mimosa Therapeutics, Inc., which uses bioreactors to grow research grade, natural psilocybin and other entheogens.  He is a trauma and psychedelic therapist and is co-author of the book, The Violence of Men, and a contributor of chapters to over 10 edited books on psychotherapy. He has served as a Fulbright Specialist in Southeast Asia where he provided training to clinicians that treat victims of human trafficking. James heads the Institute for the Advancement of Psychotherapy’s Oppositional and Conduct Disorder Clinic.

Epigenetics: Creating Optimal Health

Listen now to the 5/3/21 show on KPFA.org—94.1FM

**https://kpfa.org/player/?audio=356073**

Epigenetics is the study of how our lifestyle, behaviors, and the environment we live in can cause changes that affect the way our genes work. It used to be thought that our DNA rigidly determines our health, but scientists have confirmed that the vast majority of our genes are actually fluid and dynamic. Our gene expression is a powerful part of our overall health, and the more you understand this complex topic the more empowered you will be to influence your health and longevity.

Guest

Dr. Kenneth R. Pelletier, PhD, MD is a clinical professor of medicine at the UCSF School of Medicine and former clinical professor of medicine at the Stanford School of Medicine. He is also Chairman of the American Health Association and is a vice president with American Specialty Health. At the UCSF School of Medicine, he is the Director of the Corporate Health Improvement Program (CHIP), a research program between CHIP and fifteen Fortune 500 corporations. Dr. Pelletier has authored numerous books (over 13) including international bestseller, Mind as Healer, Mind as Slayer, and his 2018 book, Change Your Genes Change Your Life. He is a peer reviewer for several medical journals including the Journal of Occupational and Environmental Medicine and serves on a number of corporate boards. He has published over 300 professional articles and has appeared on ABC, CBS, CNN, NBC, and the BBC to discuss his research.

To learn more and get a free copy of his book, Change Your Genes Change Your Life, go to https://drpelletier.com.

 

 

Complexities of Parenting

When it comes to parenting approaches, one size does not fit all. There are many factors that influence how you raise your child based on things like temperament, parenting style, culture, and family and social influences. There are many different styles and methods of parenting, and if you get confused about what your child or grandchild needs, you’re not alone.

Listen now to KPFA.org 94.1FM (4/19/21)

** https://kpfa.org/player/?audio=355287 **

My guest on About Health, Dr. David Rettew, will join me to discuss topics such as screen time, eating habits, discipline, and the benefits and challenges of different parenting styles such as “helicopter” versus “old school” parenting. There are a lot of questions facing parents of young children, but  understanding more about your child’s temperament and yours will guide you through the different stages of childhood.

Guest: David Rettew, MD is an Associate Professor of Psychiatry and Pediatrics at the University of Vermont Larner College of Medicine. Dr. Rettew has over 100 published journal articles, chapters, and scientific abstracts on a variety of child mental health topics, including a 2013 book entitled Child Temperament:  New Thinking About the Boundary Between Traits and Illness.  He also writes a blog for Psychology Today called, “The ABCs of Child Psychiatry.”   His newest book is called Parenting Made Complicated: What Science Really Knows about the Greatest Debates of Early Parenting. You can follow him on Twitter and Facebook @PediPsych.

Staying Healthy During The Pandemic

It’s over a year now since we began to adjust to the many challenges of the Covid-19 pandemic. How are you doing?  And what questions do you have about staying healthy as things are opening up and more and more people are getting vaccinated? Let’s talk about how to keep your health and well being front and center as we start to enjoy some of the things we’ve missed so dearly.

Listen now to KPFA.org, 94.1FM, 4/5/21

https://kpfa.org/player/?audio=354359

GUEST

Harry McIlroy, MD, is an integrative physician certified with the Institute for Functional Medicine. Before medical school and completion of residency at Contra Costa Regional Medical Center, he had a background in nutrition and obtained a Master’s degree in acupuncture and Chinese medicine. Dr. Harry strives to provide patients with health tools that empower them to improve their well being. Some of his specialities include Medical Cannabis, Chronic Pain, Digestive HealthRegenerative Medicine, and Insomnia. He serves as a volunteer clinical faculty member for the UCSF Medical School, and mentors and teaches medical residents at the Contra Costa Regional Medical Center, which provides medical care to underserved populations. He has recently joined BioReset Medical where he continues his focus on treating chronic disease with Functional and Regenerative medicine.

If you want to hear the previous show I did (April 2020) with Dr. Harry McIlroy, you can listen here for many good tips on health:  https://www.nurserona.com/staying-healthy-during-covid-19/

 

Staying Healthy During The Pandemic

It’s over a year now since we began to adjust to the many challenges of the Covid-19 pandemic. How are you doing?  And what questions do you have about staying healthy as things are opening up and more and more people are getting vaccinated? Let’s talk about how to keep your health and well being front and center as we start to enjoy some of the things we’ve missed so dearly.

Tune in to KPFA.org, 94.1FM, 4/5/21 from 2-3PM (PST)

Call us at 1-800-958-9008 with your questions and concerns regarding Covid-19, your general health, and ways to keep your immune system strong.

GUEST

Harry McIlroy, MD, is an integrative physician certified with the Institute for Functional Medicine. Before medical school and completion of residency at Contra Costa Regional Medical Center, he had a background in nutrition and obtained a Master’s degree in acupuncture and Chinese medicine. Dr. Harry strives to provide patients with health tools that empower them to improve their well being. Some of his specialities include Medical Cannabis, Chronic Pain, Digestive HealthRegenerative Medicine, and Insomnia. He serves as a volunteer clinical faculty member for the UCSF Medical School, and mentors and teaches medical residents at the Contra Costa Regional Medical Center, which provides medical care to underserved populations.

If you want to hear the previous show I did 4/2020 with Dr. Harry McIlroy, you can listen here for many good tips on health:  https://www.nurserona.com/staying-healthy-during-covid-19/

 

Uprooting Racism in Medicine: Where Do We Go From Here?

In the US, Black and other ethnic minority groups are hit the hardest by Covid-19, creating a renewed focus on racism in healthcare. There are so many false beliefs that many doctors and other healthcare providers still work from about Black people, such as their skin being thicker, their blood coagulating differently, and that they feel less pain.  When doctors are blind to their racist beliefs and attitudes it can lead to less effective treatments, more pain, humiliation, and even death. It’s time that doctors, medical students, and other health care professionals take anti-racist study seriously and get support to see bias in themselves and in others.

On 1/18/21 we had a conversation on About Health (94.1FM KPFA.org) to discuss racism in medical care. We heard about personal experiences of racism and some of the history that has added to the mistrust of doctors based on racist practices. You can hear that show here: https://www.nurserona.com/racism-in-medical-care/  It seemed important to me to do a follow up show to continue the conversation.

What are ways to uproot racism in medicine?

Listen now to About Health on  KPFA.org—94.1FM (3/22/21)

**https://kpfa.org/player/?audio=353495**

Dr. Jeff Ritterman is a retired cardiologist from Kaiser Richmond where he worked for 29 years.  He was also a Professor and Clinical Coordinator for the Physician Assistant Program at Touro University and  worked for three years doing Adult Primary Care at Lifelong Medical in San Pablo. He is on the Board of Directors of San Francisco Physicians for Social Responsibility and served on the Richmond City Council when they introduced the first municipal Soda Tax. In the 1980s he helped start the Salvador Medical Relief Fund and the Committee for Health Rights in Central America.  He personally delivered medical supplies to Salvador Refugees in Honduras and Costa Rica.  In the 1990s he started the Southern Africa Medical Aid Fund and delivered medical supplies to the African National Congress’s Clinic in Lusaka, Zambia. He has helped start two Racial Equity Book Clubs, one with Kaiser Oakland and the other with San Francisco Physicians for Social Responsibility.  He is the author of two recent papers on combating Medical Racism.You can read one of them here: http://www.thepermanentejournal.org/issues/2021/spring/7609-the-ally-book-club-a-tool-for-challenging-racism.html

Dr. Nadia Gaber is a postdoctoral fellow in the Program on Reproductive Health and the Environment, studying the influence of the chemical industry on the science and regulation of toxic chemicals. She received her PhD in medical anthropology and is obtaining her MD at UCSF with support from the NIH Medical Scientist Training Program. Her research in Detroit and Flint looked at the politics of urban health and safety in the U.S. through the lens of water. She is continuing to develop that research in a book project called Life After Water that blends ethnography, grassroots epidemiology and critical race theory. She is a member of the new UCSF REPAIR Project, a three-year initiative to combat anti-Black racism in the health sciences and has organized off-campus with groups like Critical Resistance and the Arab Resource and Organizing Center.

 

Some References From Dr. Ritterman

1. Washington HA. Medical apartheid. New York, NY: Anchor Books; 2008.

2. Owens DC. Medical bondage. Athens, GA: University of Georgia Press; 2017.

3. Diangelo R. White fragility. Boston, MA: Beacon Press; 2018.

4. Kendi IX. How to be an antiracist. New York, NY: Random House; 2019.

5. Metzl JM. Dying of whiteness. New York, NY: Basic Books; 2019.

6. Hoffman KM, Trawalter S, Axt JR, Oliver MN. Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites. Proc Natl Acad Sci USA 2016 April;113:4296-301. DOI: https://doi.org/10.1073/pnas 15160471131073 Accessed August 20, 2020.

Estrangement in Families

Many people who are dealing with estrangement in their family don’t talk about it because of shame and fear of judgement. Dealing with estrangement takes an emotional and often physical toll on the people involved. You are not alone! There are things that can sometimes help family members reunite.

Listen now to the show on 3/8/21 on KPFA.org—94.1FM Radio, for an interview with Dr. Joshua Coleman, author of the newly released book, Rules of Estrangement: Why Adult Children Cut Ties and How to Heal the Conflict.

** https://kpfa.org/player/?audio=352549 **

Dr. Joshua Coleman is a psychologist in private practice in the San Francisco Bay Area and a Senior Fellow with the Council on Contemporary Families. He is the co-editor, along with historian Stephanie Coontz of seven online volumes of Unconventional Wisdom: News You Can Use, a compendium of note worthy research on the contemporary family, gender, sexuality, poverty, and work-family issues. His new book, Rules of Estrangement: Why Adult Children Cut Ties and How to Heal the Conflict, was just released by Penguin Random House. He is frequently contacted by the media for opinions and commentary about changes in the American family. He has been a frequent guest on the Today Show, NPR, The BBC, NYU Psychiatry Radio, and has also been featured on Sesame Street, 20/20, Good Morning America, America Online Coaches, PBS, and numerous news programs for television. He has written for the the Atlantic, The New York Times, CNN, NBC, Aeon, Psychology Today, the SF Chronicle and other publications. He is the father of three adult children, has a teenage grandson, and lives with his wife in the San Francisco Bay Area.

2/15/21 Dementia: Culture, Race, and Care

Listen now to the 2/15/21 show on KPFA.org (94.1FM)

https://kpfa.org/player/?audio=351134

50 million people are living with Alzheimer’s and other dementias worldwide, and there are nearly 10 million new cases every year. Here in the U.S. African Americans are twice as likely to develop Alzheimer’s and other dementias, but only half as likely to get a proper diagnosis, treatment or access to support resources.Join us to talk about the diagnosis and care of people with dementia and how culture, race, and health disparities are important parts of the discussion.

Guest:

Karla Fields is a Community Outreach Specialist at the Alzheimer’s Association.  Her primary focus is outreach to the African American community.  She is a former educator and has over 30 years experience in education, public relations, fundraising and civic engagement.  In her free time Karla enjoys spending time with her husband and three children. https://www.alz.org/norcal

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I'm thrilled to offer my book to parents, teachers, therapists, and anyone who cares for and about children. If you would like to set up a presentation or training for your child's school, or your work place, contact me at rona@nurserona.com.

Is That Me Yelling? is available in most bookstores and at Amazon

"Engaging and practical, humorous and evidence-based, prescriptive but not preachy, authoritative yet never stuffy, Is That Me Yelling? quickly rises to the top of the many parenting books I've ever read. Rona Renner provides thoughtful and achievable solutions. If you're a parent who has ever yelled at your kid and wished you hadn't, this book is for you."
Stephen P. Hinshaw, PhD, professor in the department of psychology at the University of California, Berkeley; and vice-chair of psychology at the University of California, S.F.

"Is That Me Yelling? is a complete and compassionate companion for every parent​ and ​educator​. ​With excellent examples from her extensive professional and personal experience, nurse Rona illustrates fundamental psychological principles and functional parenting practices with empathy and enthusiasm."
Marisol Muñoz-Kiehne, PhD, clinical psychologist, parent educator, radio host, and author.

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The Importance of Play download PDF (English)