Raise the Line

On today’s Raise the Line, we continue our Next Gen Journeys series featuring conversations with learners in medical professions around the globe. Our special guest is Omer Rott, a longtime participant in our Osmosis Medical Education Fellowship and Osmosis Health Leadership Initiative programs. Omer will soon be earning his medical degree from Masaryk University in the Czech Republic. In addition to pursuing a career as a pediatrician, he’s an aspiring diversity and inclusion medical educator who has founded DiverseMedEd, an organization dedicated to improving how healthcare professionals interact with and treat patients from different backgrounds. “There is a big gap in medical education about diverse patient populations. I think healthcare providers and many other people are afraid about how to approach someone or how to ask about their situation, which might lead them to not say anything or not even act the way they think they might need to.” Through a website (link) and social media posts, Omer has already built a following, many of whom are patients happy to be seeing these issues addressed.  Join host Hillary Acer for a refreshing look at how the healthcare provider community can be more inclusive, and what lessons Omer has drawn from his extensive work mentoring fellow students over the past five years.

Mentioned in this episode:
DiverseMedEd

Equity Graphic

Elsevier Blog - Is Wearing Pins Appropriate?

The importance of understanding the connections between animal and human health reached new heights due to the COVID-19 pandemic, but this has long been a rich area of study and it’s also the foundation of the long and impressive career of today’s Raise the Line guest, Dr. Sue VandeWoude, dean of the College of Veterinary Medicine and Biomedical Sciences at Colorado State University.  Before assuming that role, Dr. VandeWoude was Director of CSU’s One Health Institute, an interdisciplinary center dedicated to advancing translational science. In this revealing conversation with host Hillary Acer, you’ll learn about developments in research and teaching in this area, what’s behind a curricular overhaul at the school, and about plans to enhance collaboration between basic science faculty and clinical instructors at CSU. 

Mentioned in this episode: https://vetmedbiosci.colostate.edu/

Raise the Line has been honored to be part of Osmosis from Elsevier’s Year of the Zebra campaign and we’re happy to share that this successful effort will continue throughout 2024. To mark that commitment and to celebrate Rare Disease Day, we have a very special episode of the podcast for our listeners in which, for the first time, we interview a child faced with the challenge of living with a rare condition.  She is Maddie McNeer, a seven-year-old from Kansas who developed a rare eye disorder called Coats disease which is characterized by abnormal development of blood vessels in the retina. According to the National Organization for Rare Disorders, affected individuals may experience loss of vision due to changes in the retina and, in severe cases, retinal detachment. Maddie and her mom, Loren McNeer, join host Lindsey Smith to share their family’s journey with Coats disease including the multiple treatments she’s had, the challenges in finding information and support, the positive experiences with healthcare providers and Maddie’s remarkable ability to rise above it all and, as she says, not let Coats disease hold her down. This is a super informative and inspiring episode that you won’t want to miss. 

Mentioned in this episode:

https://www.coatsdiseasefoundation.org/

https://www.osmosis.org/zebra

“I feel like I'm living a dream in many ways. It's really gratifying to be working in this area,” says 

Dr. Peter Hendricks, a clinical psychologist at University of Alabama Birmingham who is pursuing a long-held interest in the therapeutic potential of psychedelics. In addition to being chair of Psychiatry there, he is also a professor in the Center for Addiction and Pain Prevention and Intervention which explains why he is researching the use of psilocybin in patients with fibromyalgia, a condition which commonly involves chronic pain. “Pain involves a physiological sensation but also a psychological reaction to that pain. If we can alter psychological processes, we might be able to help people better cope with the experience of pain,” he tells host Michael Carrese. Although Hendricks has been excited about the prospect of being able to add this “new” tool to help treat addictions, PTSD, depression and other mental health conditions that are not well served by current therapies, he realizes the dangers of hype and the need for a balanced perspective. “I think it’s important to note that those of us who were enthusiastic were never under the impression that this would cure everything for everybody. It could really change your life or it may not -- and that's OK -- but it would be nice for that to be an option for those who could benefit from it.” Tune in for a super thoughtful Raise the Line episode on both the promise and challenges of psychedelics and the daunting amount of work left to be done to develop sustainable therapeutic protocols and business models. 

Mentioned in this episode: https://www.uab.edu/cappi/

After many months of emotionally wrenching, exhausting work on the frontlines of COVID, and the unexpected death of his mother, Dr. Michael Foti found himself in an emergency room dealing with what he suspected was a heart attack, but it was actually a panic attack caused by untreated anxiety and depression. “As healthcare providers, we're afraid to speak up about our mental health because it's seen as a weakness,” he explains. He’s trying to change that culture in his role as a clinical assistant professor of Internal Medicine at Touro College of Osteopathic Medicine. One key message he tries to get across to students is that healthcare providers have to be healthy themselves before they can do the most effective job possible helping patients. As he tells host Michael Carrese, he’s also urging providers experiencing mental health issues to speak up to help normalize the experience. “The more that we can share these stories amongst colleagues, then they will feel more empowered to get the help that they need.” On this insightful episode of Raise the Line, you’ll also have the opportunity to hear Dr. Foti describe Touro’s standardized patient program and its efforts to increase self-directed learning and interdisciplinary education. 

Mentioned in this episode: https://tourocom.touro.edu/

Our guests today have set a big goal to tackle a big problem. Jack Needham and James Naylor co-founded Sanctuary Health to build the largest video library for patient education motivated by the fact that patients forget approximately half of what doctors tell them in appointments. The young British entrepreneurs are aiming to move the healthcare system beyond the practice of handing every patient with a new diagnosis the same generic pamphlet as they leave an appointment. Based on research, they’ve chosen short-form video as the most effective vehicle. “Studies have consistently shown that if you break a video down into small topics with one learning outcome, then information recall and confidence levels around that information are consistently higher,” Naylor tells host Michael Carrese. And thanks to recent advancements in AI technology, videos can be easily translated into multiple languages, creating efficiency for providers and relevance for patients. Having built a presence with providers of virtual healthcare, Sanctuary is now working to license its ready-to-use content to payers, hospitals, and other stakeholders. Tune-in for a lively discussion the various ways Sanctuary Health is helping healthcare providers tackle this critically important problem.  

Mentioned in this episode: https://www.sanctuaryhealth.io/

Due to rising awareness of the importance of nutrition to good health and patient demand for alternatives to so-called Western medicine, the number of medical schools offering naturopathic programs has grown in the past two decades in the United States. Today on Raise the Line, we're going to learn more about this approach to medicine, the education and training involved, and where the field is heading with Dr. Kristina Conner, Dean of the School of Naturopathic Medicine at Bastyr University. As she explains to host Michael Carrese, Dr. Conner believes the rising interest is partially rooted in people wanting to have an array of options to improve their health. “They understand ‘maybe I do need to be on this medication for the rest of my life, but what else can I do to optimize my day to day life’ and that's where we can fill in the gaps as naturopathic doctors because we do have a different tool set and a different approach.” Tune in to learn about the similarities and differences in training compared to more traditional medical professions, the different modalities naturopaths use, and the challenges and opportunities involved in expanding the profession. “I think there's better understanding about naturopathic physicians and our level of training and the role that we can play within the healthcare system.”

Mentioned in this episode: https://bastyr.edu/academics/naturopathic-medicine

Today we continue our series Next-Gen Journeys, featuring conversations with students, residents, and early career medical professionals around the globe to get their fresh perspectives on education, medicine, and the future of healthcare. We’re delighted to do that today with Dr. Josh Bliss, a third-year internal medicine resident at NewYork-Presbyterian/Weill Cornell Medicine, who will continue his training there next year as a hematology-oncology fellow.  Josh was actually one of the first Osmosis Medical Education Fellows, later transitioning to a role creating and editing pharmacology content with our education team. In this heartfelt conversation with host Hillary Acer, Josh shares how his mother’s death from cancer when he was young spurred his interest in medicine and how his passion for the field has expanded over time to include the relatively new science of exercise oncology. “We are starting to look at exercise both in the lab and in clinical trials with patients where you could potentially dose exercise like you would a drug. You can measure it and standardize it and look at clinical effects.” For those hoping to build a multi-dimensional career in medicine, there is plenty of inspiration to draw from in this episode. 

Mentioned in this episode: https://www.nyp.org/

About one-third of Californians live in areas where there's a shortage of primary care providers, and this gap is especially apparent in what's known as the Inland Empire -- a rural region in the southern part of the state. As we’ll learn on today’s episode, the barriers to access this creates might only get worse because population is expected to grow sharply in that area. Our guest, Dr. Timothy Collins, has the challenge and opportunity of developing solutions to these thorny problems as CEO of UCR Health, a clinical enterprise affiliated with the University of California Riverside School of Medicine. “I think tremendous opportunities exist to create a more integrated network that's focused on quality and access to be able to address all of these challenges,” he tells host Michael Carrese.  Strategies including connecting with K-12 students to get them to see themselves as future physicians and helping to clear the pathways to med school. “You can change the game if you can move backwards to create opportunities for individuals that may not see a pathway towards success.” Tune in to learn about other tactics being used -- including debt forgiveness and optimizing healthcare teams -- and find out how UCR Riverside is working to increase the level of engagement by patients in their own care.

Mentioned in this episode: https://www.ucrhealth.org/

How do we solve for nursing shortages in a thoughtful way in which we're reinventing the way we deliver care? That question is asked and answered on today’s episode of Raise the Line by Mandy Richards, Chief Nursing Executive for Intermountain Health which operates thirty-three hospitals in seven states. The veteran nurse leader believes the go-to strategies of doing a better job at recruitment and retention, while important, will not be enough, so it will be necessary to reskill the current workforce and redesign nursing education. Or as she puts it to host Michael Carrese, “Are we ensuring that our students in nursing school are getting taught and equipped with what they're going to need when they come out?” Richards is also keenly interested in improving the transition from education to practice -- in fact she’s pursuing her PhD at Yale on that topic -- especially at the very start of the clinical work experience to avoid what is known as “transition shock.” As part of her academic work, she’s created a research project featuring a dedicated educational unit that trains new graduate nurses in cohorts in the first month on the job. In addition to reinforcing critical thinking skills, the experience helps establishes peer relationships the new nurses can rely on going forward. Tune-in for a wealth of other ideas and insights on this key challenge in modern healthcare including establishing travel pools within health systems and the potential for ambient listening technology to improve nursing efficiency.  

Mentioned in this episode: https://intermountainhealthcare.org/

Physician Assistant remains one of the fastest growing professions in the US, and the expansion of their role in healthcare delivery seems to be growing just as quickly. One of the biggest changes in that regard, according to Jonathan Bowser of the University of Colorado Denver School of Medicine, is that states are opening up opportunities for PAs to practice with more autonomy to fill needs in the healthcare system. “That requires PA education programs to think about who are we putting out there, what environments they are going into, and how do we best prepare them for those environments,” says Bowser, who runs the school’s Child Health Associate/Physician Assistant Program (CHAPA), one of the oldest PA training programs in the country. The need to adapt their program to these new realities and the desire to take advantage of advances in learning science led CHAPA to overhaul its curriculum in recent years. The result is a ‘spiral curriculum’ - an iterative approach to learning that reinforces key concepts and knowledge as students progress through their years of training.  Join host Hillary Acer as she learns about the underpinnings of CHAPA’s curricular approach, what the program is doing to prepare PAs to be leaders and the growing importance of residencies and fellowships to prepare PAs to work in clinical specialties. 

Mentioned in this episode: 

CHA/PA Program Overview

Managing Transitions by William Bridges

Make It Stick by Peter Brown

We're marking a couple of firsts on today's episode of Raise the Line. In the hundreds of podcasts we’ve done, we've never interviewed a goddess before, nor had a guest who has won an astounding seventy-five teaching awards, but that is the happy situation we face today in welcoming Dr. Linda Costanzo to the show.  She’s been on the faculty of Virginia Commonwealth University School of Medicine for forty-three years, earning the nickname “Physiology Goddess” for her trio of books -- including Costanzo Physiology 7th Edition, published by Elsevier -- that have been translated into thirteen languages. One key factor in Costanzo’s longevity as an effective teacher is finding new challenges in long-taught material. “I sort of concocted a scheme to dig into areas of comfort to get that edge back, that fear of falling short, I would call it,” she explains to host Michael Carrese. This lively conversation is packed with valuable insights on teaching and learning including tips for how students can maintain enthusiasm for their studies, standards teachers should set for themselves and the “stepwise” approach to teaching that she has also employed in her textbooks. 

Mentioned in this episode:

https://medschool.vcu.edu/

Costanzo Physiology, 7th Edition

It’s not often that you have the chance to benefit from the sweeping perspective of someone who has been in the same profession for 50 years, but that is the fortunate circumstance we find ourselves in on this episode of Raise the Line. Our guest, Dr. Jim Gordon, describes the remarkable evolution of physical therapists from being limited to hospital-based, post-op rehabilitation to becoming community-based providers of choice in a wide and growing list of specialties from orthopedics to oncology. “We have established ourselves as essential actors in the healthcare system. We have the education and research behind us, but most important, I think we have credibility among other healthcare professionals and with patients.” As the leader of one of the top ranked physical therapy programs in the US at the University of Southern California, Gordon is in a position to shape the future of the field as well. As he tells host Hillary Acer, he sees a greater role for physical therapists in prevention and primary care, and also expects changes in the application of new technologies in neurorehabilitation, his area of specialty. “What we’re trying to do is not look at technologies as a solution in and of themselves and instead develop a patient-centered approach which focuses on how people are able to use these technologies to make their lives better.” Don’t miss this great opportunity for a unique look at the current and future state of a vital part of the healthcare system from a leading figure in the field.

Mentioned in this episode: https://pt.usc.edu/

"Our faculty are really dedicated to trying to bridge that gap between academics and clinical practice," says Dr. Lisa Beals, the Nursing Department Chair at Missouri Southern State University and today’s Raise the Line guest.  A key factor in that effort is recording students while they perform clinical simulations and providing the students themselves, their peers and faculty an opportunity to watch the playback and weigh in on what happened, an area of expertise for Beals based on her research in the field. “It's just like a constant motion or cycle of feedback, which the literature speaks to of being so important to develop student learning.” As Beals tells host Hillary Acer, one of the department’s other main missions is to foster a culture of caring. “We're here to help them and support them in whatever way we can knowing that they face so many challenges, particularly now, to further their education.” Learn more about the successful recipe for training tomorrow’s nursing workforce from a pioneer in nursing education.

Mentioned in this episode: MSSU Nursing Program

February marks a major transition for Dr. Steven Halm as he moves on from leading one of the nation’s oldest schools of osteopathic medicine, at Des Moines University, to launching of one of its newest, at Xavier University, which is set to welcome its first class in 2027. Launch is actually a fitting word to use due to his background in aviation as a licensed pilot and former Senior Aviation Medical Examiner for the FAA. In fact, Halm believes medicine has a lot to learn from commercial aviation in the use of simulation to achieve the highest standards of safety. “One of my goals for the first week of the new medical school at Xavier is to have students in a simulation lab, working with task trainers and interacting with standardized patients in real scenarios of taking care of patients.” Other plans include an emphasis on newer teaching approaches such as small group and active learning paired with what he considers to be the fundamentals. “Student success depends on a combination of great faculty and great resources.” Join host Hillary Acer for a birds-eye view of osteopathic medical education and stay tuned to learn about Halm’s leadership education program for medical students and residents.

Mentioned in this episode:

Xavier University College of Osteopathic Medicine

Why Hospitals Should Fly by John Nance

“I think philanthropy’s role oftentimes is to come in and be the innovator,” says Dr. Bennett Nemser who is in a good position to do that as chief program officer at the Steven & Alexandra Cohen Foundation managing its health portfolios. Perhaps the best example of this is its involvement in psychedelic research where the Foundation is one of the largest private funders in the country including being a major backer of the Center for Psychedelic and Consciousness Research at Johns Hopkins Medicine. While he is excited about the progress being made in that space, Nemser says the Foundation is intent on ensuring equitable access to any new therapies that emerge, one of the organization’s chief overall aims. “We need to get the price point down so that we can make sure we have access to a lot more people that can benefit from this.” As Nemser tells Raise the Line host Shiv Gaglani, the Foundation is seeking to have similar impact in other critical areas. “We’ve provided over a billion dollars in charitable support to underserved communities, children's health and education, the arts, Lyme and tick-borne disease, psychedelics, veterans services and sustainability.” Don’t miss this expansive look at philanthropy’s change-making potential.

Mentioned in this episode: https://www.steveandalex.org/

All health organizations aim to be ‘patient-centered’ but not many actually give patients decision making power. That’s not the case with the 1,400 Community Health Centers (CHC) across the US which require 51% of board members to be patients. “That does so many things that I think changes the dynamics of healthcare and how it's delivered,” says Dr. Kyu Rhee, president and CEO of the National Association of Community Health Centers. Impacts include co-locating oral and mental healthcare with primary care and ensuring culturally appropriate delivery of care. Although CHCs already comprise the largest primary care system in the country -- serving 31.5 million Americans (1 in 11 people) regardless of ability to pay -- Rhee envisions eventually serving 30% of Americans. As he explains to host Michael Carrese, getting there will require a deepening of existing partnerships with local communities and more funding from state and federal governments. “An investment in Community Health Centers actually saves lives and saves money.” This is a great chance to learn about an innovative model of healthcare that looks beyond the exam room to address all factors in a patient’s life that may be barriers to better health, focuses on addressing health disparities and supports the resiliency of impoverished and underserved communities.  

Mentioned in this episode: https://www.nachc.org/

“Patient engagement is shockingly bad across the system. Doctors just don't have the time or mechanisms to educate their patients,” says former Amazon product manager David Neyhart. It’s something he learned firsthand during a scary health odyssey that included many rushed appointments where there was no chance to ask questions, and at best he’d be handed subpar educational materials. He’s filling this information gap through a company he co-founded called Encap Health which provides physicians with a seamless and customized way to give their patients the information they need to manage and improve their health. “We integrate with their EHR, so based on what the doctor's already entering - billing codes, prescriptions or visit notes -- we extract that and send related content to that patient automatically.” It comes in the form of an email from the doctor’s office with a list of health information and links where they can learn more. A patient with osteoporosis, for example, would get information on options for exercise and nutritional guidance specific to that condition. Importantly, neither party has to learn how to navigate a new app or web portal. Tune in as Neyhart fills in host Michael Carrese on how this process builds trust between patients and providers, and how he is eyeing a future in which Encap provides more personalized, proactive content journeys to guide patients on a path to improved health.

Mentioned in this episode: https://encaphealth.com/

For the two million Americans diagnosed with cancer each year, the emotional toll of absorbing the news is often exacerbated by uncertainty about the variety of treatments, and confusion trying to navigate a fragmented healthcare system. Accompanying patients on that journey and smoothing the way for them is where Thyme Care enters the picture, a company that supports and supplements the care provided by oncology practices at no cost to patients. “We do the types of things that everybody in the oncology space knows should be done, but it’s often hard to operationalize them at scale,” says Dr. Brad Diephuis, the company’s chief business officer and a cancer survivor himself. Those things include tracking patient reported outcomes and providing proactive symptom monitoring throughout cancer treatment in order to catch problems early and prevent unnecessary interventions and hospitalizations. Data presented at the American Society of Clinical Oncology conference in 2022 indicates Thyme Care is delivering on its value proposition for insurance plans and other payers: reducing costs and increasing patient satisfaction. Join host Michael Carrese in learning why Diephuis thinks its shared savings model is succeeding, how its “care pod” model works, and what the company’s plans are for growth.

Mentioned in this episode: https://www.thymecare.com/

“I did not see myself as a leader, to be honest. I had my mind made up on doing something else, but it has been an amazing journey,” says Dr. Tiffany Morris, director of Nursing at North Carolina Agricultural and Technical State University.  That journey includes being the inaugural department chair in the nursing program at Elon University School of Health Sciences and serving as an interim dean in North Carolina A&T’s School of Nursing. She returned to North Carolina A&T earlier this year partly because of the larger impact she can have due to the school being the largest Historically Black College and University in the nation. “The opportunity to serve students who are normally underrepresented and be able to produce healthcare providers that look like the people that they're serving is an amazing opportunity,” she tells host Michael Carrese. Highlights of the curriculum include an accelerated nursing program which allows those with bachelor’s degrees to earn an RN in twelve months, advanced simulation training -- including access to new 3D technology that allows for virtual dissection -- and an emphasis on providing culturally appropriate care, which Morris stresses goes well beyond race to include culturally-based food preferences and spiritual practices and beliefs.  Morris has a research interest in the latter where she focuses on why African-Americans have a lower rate of hospice enrollment. Find out about one key factor in turning that around, why the university is pursuing R1 research status and new degree offerings coming soon.

Mentioned in this episode: North Carolina A&T School of Nursing