What Caregiving Taught this Physician about Physician Blind Spots with Heather Gatcombe, MD | EP512

Being on the caregiver side of complex, rare disease care reveals critical gaps in our healthcare system, even for two physician parents with strong connections. In this powerful follow-up episode of Succeed In Medicine, host Dr. Bradley Block welcomes back Dr. Heather Gatcombe, as she recounts her family’s journey: her son’s initial metabolic stroke-like episodes at age 7, the five-year path to a definitive mitochondrial disease diagnosis (including a muscle biopsy and eventual identification of a pathogenic variant), sudden heart failure at age 11 during the COVID-19 pandemic, ECMO, LVAD placement, and successful heart transplant. She openly discusses the immense challenges of hospital discharge with an LVAD when no pediatric rehab would accept him, managing tube feeds and alarms at home without adequate home health support, and the frustration of subtle symptoms like throat clearing being overlooked as a sign of heart failure. Dr. Gatcombe also reflects on moments where she felt her family wasn’t fully heard, and the lasting impact of those experiences. Throughout the conversation, she shares how this journey has made her a more empathetic and effective clinician, particularly in communicating uncertainty, avoiding premature reassurance, listening to parental intuition, ensuring robust discharge planning with support services, and staying curious even when a diagnosis remains elusive. This episode offers practical lessons for all physicians on improving communication, supporting families through diagnostic uncertainty, preparing patients for safe transitions home, and the power of transparency and advocacy in rare disease care. Three Actionable Takeaways: Communicate uncertainty honestly and compassionately: When the diagnosis isn’t clear yet, be transparent about what you know and don’t know. Offer guidance on next steps, second opinions, and support resources rather than premature reassurance that may later need to be walked back. Prioritize discharge planning and support services: The transition from hospital to home is one of the most vulnerable periods. Ensure patients and families have home health, equipment (wheelchair, shower chair, etc.), dietician and nurse navigator follow-up, and clear instructions before discharge, especially for medically complex cases. Listen to patients and families as the experts on their own bodies: Parental intuition and lived experience matter. When a child or family member expresses concern, even if it seems outside the norm,  take it seriously, investigate, and avoid dismissing it. Follow up after adverse events when possible to maintain trust. About the Show: Succeed In Medicine covers patient interactions, burnout, career growth, personal finance, and more. If you're tired of dull medical lectures, tune in for real-world lessons we should have learned in med school! About the Guest: Dr. Heather Gatcombe is a board-certified radiation oncologist at Winship Cancer Institute of Emory University and an Assistant Professor at Emory University School of Medicine. She specializes in breast radiation oncology and serves as Vice Chair for Community and Belonging. As the mother of a child with mitochondrial disease who experienced metabolic strokes starting at age 7, progressing to heart failure and transplant, she is deeply committed to raising clinician awareness, reducing diagnostic delays, and advocating for patients and families. She serves on the Board of Trustees and the Scientific and Medical Advisory Board Clinical Training and Education Committee of the United Mitochondrial Disease Foundation (UMDF). Website: https://winshipcancer.emory.edu/profiles/gatcombe-heather.php LinkedIn: https://www.linkedin.com/in/heather-gatcombe-md-3891875 Instagram: https://www.instagram.com/heathergatcombe UMDF: https://umdf.org/about/board-trustees About the Host: Dr. Bradley Block – Dr. Bradley Block is a board-certified otolaryngologist at ENT and Allergy Associates in Garden City, NY. He specializes in adult and pediatric ENT, with interests in sinusitis and obstructive sleep apnea. Dr. Block also hosts Succeed In Medicine podcast, focusing on personal and professional development for physicians Want to be a guest? Email Brad at [email protected]  or visit www.physiciansguidetodoctoring.com to learn more! Socials: @physiciansguidetodoctoring on Facebook @physicianguidetodoctoring on YouTube @physiciansguide on Instagram and Twitter This medical podcast is your physician mentor to fill the gaps in your medical education. We cover physician soft skills, charting, interpersonal skills, doctor finance, doctor mental health, medical decisions, physician parenting, physician executive skills, navigating your doctor career, and medical professional development. This is critical CME for physicians, but without the credits (yet). A proud founding member of the Doctor Podcast Network!Visit www.physiciansguidetodoctoring.com to connect, dive deeper, and keep the conversation going. Let’s grow! Disclaimer:This podcast is for informational purposes only and is not a substitute for professional medical, financial, or legal advice. Always consult a qualified professional for personalized guidance. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

A subpoena from the Department of Justice isn’t just paperwork, it’s a powerful tool that can drain resources, intimidate providers, and threaten patient care.  In this eye-opening episode of Succeed In Medicine, host Dr. Bradley Block welcomes back Dr. Crystal Beal, along with Adrian Levitt from the ACLU of Washington. In June 2025, Dr. Beal’s small private practice received one of over 20 identical DOJ subpoenas targeting providers of gender-affirming care for adolescents. While large institutions like Boston Children’s, Seattle Children’s, and Children’s Hospital of Philadelphia also received subpoenas, the impact on a solo practitioner is uniquely daunting. Dr. Beal describes the anti-climactic moment the subpoena arrived via their accountant and the immediate decision to fight it with pro bono support from the ACLU, Arnold & Porter, and Perkins Coie. The conversation unpacks the broader context: the Supreme Court’s decision in United States v. Skrmetti, executive actions, funding cuts, and the federal government’s stated goal of ending gender-affirming care for minors. Adrian explains how the DOJ is using the Federal Food, Drug, and Cosmetic Act (FDCA) in a novel way, traditionally applied to drug manufacturers, to investigate individual physicians. The subpoena demanded extensive records, including patient names, addresses, dates of birth, Social Security numbers, training materials, and communications with pharmaceutical reps. Throughout the episode, they emphasize their ethical obligation as a physician to provide evidence-based, life-saving care and reflect on the deeper moral questions raised by this moment in history. Three Actionable Takeaways: Know your rights and secure legal support early: If you receive a government subpoena or face regulatory pressure, contact organizations like the ACLU or the Abortion Defense Network immediately. Do not assume you must comply right away. Document and practice ethically, but prepare for scrutiny: Continue providing medically necessary, evidence-based care while understanding that political targeting of certain specialties is increasing. Build relationships with legal counsel before crises hit. Speak up and combat misinformation: Physicians have a unique platform in their communities. Learn about gender-affirming care if it’s within your scope, talk openly with colleagues and patients, and stand against efforts to criminalize or restrict legitimate medical practice. About the Show: Succeed In Medicine covers patient interactions, burnout, career growth, personal finance, and more. If you're tired of dull medical lectures, tune in for real-world lessons we should have learned in med school! About the Guests: Dr. Crystal Beal is a board-certified family medicine physician and founder of Queer Doc, providing expert, individualized queer and gender-affirming medical care. A nonbinary femme with lived experience in the community, Dr. Beal has extensive training in sexual health, queer health, and gender-affirming care. They also offer continuing education on transgender medicine through QueerCME.com. Adrian Levitt is an attorney with the ACLU of Washington, specializing in protecting access to gender-affirming care and defending providers against government overreach. Website: QueerCME.com Queer Doc website: https://queerdoc.com About the Host: Dr. Bradley Block – Dr. Bradley Block is a board-certified otolaryngologist at ENT and Allergy Associates in Garden City, NY. He specializes in adult and pediatric ENT, with interests in sinusitis and obstructive sleep apnea. Dr. Block also hosts Succeed In Medicine podcast, focusing on personal and professional development for physicians Want to be a guest? Email Brad at [email protected]  or visit www.physiciansguidetodoctoring.com to learn more! Socials: @physiciansguidetodoctoring on Facebook @physicianguidetodoctoring on YouTube @physiciansguide on Instagram and Twitter This medical podcast is your physician mentor to fill the gaps in your medical education. We cover physician soft skills, charting, interpersonal skills, doctor finance, doctor mental health, medical decisions, physician parenting, physician executive skills, navigating your doctor career, and medical professional development. This is critical CME for physicians, but without the credits (yet). A proud founding member of the Doctor Podcast Network!Visit www.physiciansguidetodoctoring.com to connect, dive deeper, and keep the conversation going. Let’s grow! Disclaimer:This podcast is for informational purposes only and is not a substitute for professional medical, financial, or legal advice. Always consult a qualified professional for personalized guidance. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

What if a patient’s multisystem symptoms, unexplained strokes, or exercise intolerance point to mitochondrial disease, but it takes 5–10 years and multiple specialists to confirm? In this eye-opening episode, Dr. Bradley Block speaks with Dr. Heather Gatcombe. As both a physician and the mother of a son with mitochondrial disease, leading to metabolic strokes, heart failure, and transplant,  Dr. Gatcombe shares her family’s journey, from a terrifying stroke-like episode at age 7, through years of uncertainty, negative initial genetic testing, muscle biopsy confirmation, and eventual identification of a novel nuclear DNA mutation. They explore the heterogeneity of primary mitochondrial diseases, why presentation ranges from infancy lethality to adult-onset fatigue, and key red flags: multisystem involvement, symptom worsening with metabolic stressors, and misdiagnoses like chronic fatigue syndrome, fibromyalgia, or psychiatric conditions. The discussion covers workup, multidisciplinary care, perioperative risks, and treatment.  They stress the power of early diagnosis: better empathy, treatment changes, support groups, and hope with new therapies in the pipeline. Clinicians in every specialty need awareness, especially anesthesiologists, surgeons, and hospitalists, to prevent crises. Three Actionable Takeaways: Spot the Warning Signs Early: Look for patients with symptoms in 3 or more organ systems, unexplained strokes or seizures, diabetes and hearing loss, brain lesions in basal ganglia, or symptoms that worsen with stress like fever, fasting, or surgery. Send them quickly to a geneticist or mitochondrial specialist for testing. Free options exist at umdf.org Protect Patients During Surgery or Procedures: For anyone known to have mitochondrial disease, talk to their mitochondrial specialist first. Avoid long fasting, dehydration, or extreme temperatures. Some need IV glucose before procedures and special care with anesthesia or certain drugs to prevent a dangerous metabolic crisis. Learn More and Speed Up Diagnosis: Visit umdf.org for free doctor education (CME courses), patient support groups, and the latest on new treatments. Raising awareness helps cut the long wait for diagnosis, gives patients validation, better care, and access to emerging FDA-approved therapies.  About the Show: Succeed In Medicine covers patient interactions, burnout, career growth, personal finance, and more. If you're tired of dull medical lectures, tune in for real-world lessons we should have learned in med school! About the Guest: Dr. Heather Gatcombe is a board-certified radiation oncologist at Winship Cancer Institute of Emory University and an Assistant Professor at Emory University School of Medicine. She specializes in breast radiation oncology and serves as Vice Chair for Community and Belonging. As the mother of a child with mitochondrial disease who experienced metabolic strokes starting at age 7, progressing to heart failure and transplant, she is deeply committed to raising clinician awareness, reducing diagnostic delays, and advocating for patients and families. She serves on the Board of Trustees and the Scientific and Medical Advisory Board Clinical Training and Education Committee of the United Mitochondrial Disease Foundation (UMDF). Website: https://winshipcancer.emory.edu/profiles/gatcombe-heather.php LinkedIn: https://www.linkedin.com/in/heather-gatcombe-md-3891875 Instagram: https://www.instagram.com/heathergatcombe UMDF: https://umdf.org/about/board-trustees About the Host: Dr. Bradley Block – Dr. Bradley Block is a board-certified otolaryngologist at ENT and Allergy Associates in Garden City, NY. He specializes in adult and pediatric ENT, with interests in sinusitis and obstructive sleep apnea. Dr. Block also hosts Succeed In Medicine podcast, focusing on personal and professional development for physicians Want to be a guest? Email Brad at [email protected]  or visit www.physiciansguidetodoctoring.com to learn more! Socials: @physiciansguidetodoctoring on Facebook @physicianguidetodoctoring on YouTube @physiciansguide on Instagram and Twitter   This medical podcast is your physician mentor to fill the gaps in your medical education. We cover physician soft skills, charting, interpersonal skills, doctor finance, doctor mental health, medical decisions, physician parenting, physician executive skills, navigating your doctor career, and medical professional development. This is critical CME for physicians, but without the credits (yet). A proud founding member of the Doctor Podcast Network!Visit www.physiciansguidetodoctoring.com to connect, dive deeper, and keep the conversation going. Let’s grow! Disclaimer:This podcast is for informational purposes only and is not a substitute for professional medical, financial, or legal advice. Always consult a qualified professional for personalized guidance. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

What if the term “provider” has no Nazi roots whatsoever, and the claim that it does actually harms important conversations about healthcare? In this myth-busting episode, Dr. Bradley Block sits with Dr. Volke Roelcke and Dr. Mical Raz as they trace the real origins of “provider” to the rise of U.S. health insurance: early Blue Cross/Blue Shield plans in the 1930s, then Medicare and Medicaid in 1965, when neutral language was needed to describe anyone delivering a paid clinical service; hospitals, physicians, nurses, physical therapists, everyone. The myth began with a single unfortunate mistranslation of the Nazi-era German term “Krankenbehandler” (a stigmatizing label restricting Jewish physicians to treating only Jewish patients) and exploded after a 2019 blog post.  They show how repeating this falsehood trivializes the actual persecution of Jewish doctors under the Nazis, turns physicians (one of the most privileged and highly paid professions in the world) into a faux “marginalized group,” dilutes the power of calling out real harm to truly vulnerable populations, and distracts from genuine issues like scope creep and regulation.  The conversation also highlights the importance of respecting expertise: physicians in medicine, historians in history, and why peer-reviewed journals should not let sweeping historical claims pass without proper review. Three Actionable Takeaways When you hear the “provider = Nazi” claim, correct it in one sentence: “The term has zero Nazi origins, it comes from U.S. health-insurance history. Here’s the open-access JGIM article.” Respect expertise the same way we demand it in medicine: don’t make or publish big historical claims if you don’t speak the language or read the sources, doctors aren’t historians any more than historians are surgeons. Focus energy on real solutions for professionalism and autonomy; lobbying, education, trust-building, clear regulation, instead of weaponizing the Holocaust for terminology battles. About the Show: Succeed In Medicine covers patient interactions, burnout, career growth, personal finance, and more. If you're tired of dull medical lectures, tune in for real-world lessons we should have learned in med school! About the Guests: Dr. Volke Roelcke is a German historian of medicine and the biomedical sciences whose work focuses on 20th-century medicine, especially under the Nazi regime and the ethical history of human-subject research. He trained in medicine, completed specialist training in psychiatry, and served for over 20 years as Professor of the History of Medicine and Director of the Institute for the History, Theory and Ethics of Medicine at Justus Liebig University Giessen before retiring. He was a member and briefly co-chair of the Lancet Commission on Medicine, Nazism, and the Holocaust. Dr. Mical Raz is the Charles E. and Dale L. Phelps Professor in Public Policy and Health at the University of Rochester, where she also practices internal medicine at Strong Memorial Hospital. Her grandfather left Berlin for Israel in 1933; most of his family perished in the Holocaust. She teaches undergraduates about insurance systems and has published extensively on child welfare, poverty, and coercive interventions. Her books include The Lobotomy Letters, What’s Wrong with the Poor?, Abusive Policies, and Making Families. Article:  Physicians or Providers: Inventing Nazi Origins, undermines Debates on Medical Professionalism.  About the Host: Dr. Bradley Block – Dr. Bradley Block is a board-certified otolaryngologist at ENT and Allergy Associates in Garden City, NY. He specializes in adult and pediatric ENT, with interests in sinusitis and obstructive sleep apnea. Dr. Block also hosts Succeed In Medicine podcast, focusing on personal and professional development for physicians Want to be a guest? Email Brad at [email protected]  or visit www.physiciansguidetodoctoring.com to learn more! Socials: @physiciansguidetodoctoring on Facebook @physicianguidetodoctoring on YouTube @physiciansguide on Instagram and Twitter This medical podcast is your physician mentor to fill the gaps in your medical education. We cover physician soft skills, charting, interpersonal skills, doctor finance, doctor mental health, medical decisions, physician parenting, physician executive skills, navigating your doctor career, and medical professional development. This is critical CME for physicians, but without the credits (yet). A proud founding member of the Doctor Podcast Network!Visit www.physiciansguidetodoctoring.com to connect, dive deeper, and keep the conversation going. Let’s grow! Disclaimer:This podcast is for informational purposes only and is not a substitute for professional medical, financial, or legal advice. Always consult a qualified professional for personalized guidance. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

What if mastering communication in your marriage as a physician could be as transformative as learning a life-saving procedure in residency?  In this second part of a two-part conversation, Dr. Michael Myers shares insights from his extensive experience treating physician couples, emphasizing the value of professional help in facilitating communication during protected times like retreats or dates. He illustrates how a third party can help rephrase defensive or hierarchical language, common in medicine's decisive environment, into softer, more effective expressions, such as turning "you're stubborn" into "I feel you're digging in your heels," to foster understanding without offense.  Dr. Myers discusses dynamics when the physician is female, noting women's multifaceted identities beyond medicine and potential role reversals where husbands manage home life, but warns of conflicts arising from feelings of being taken for granted or loneliness. He highlights red flags like unexplained drinking or affairs, urging early articulation of issues to prevent escalation, and notes that most couples recover from affairs by entering a "new normal" with professional guidance.  For same-sex couples, he addresses communication stereotypes: avoidance in male pairs or overthinking in female ones, while stressing commonalities in all relationships. In dual-physician marriages, intellectualization may dominate, but reviewing arrangements like part-time work during child-rearing years and supporting paternity leave promotes respect and balance. Parting tips include finding uninterrupted time, transitioning from work mode, taking risks by being vulnerable about insecurities, and converting individual therapy into couples work to avoid exclusion.  Three Actionable Takeaways: Seek professional facilitation for tough conversations: Use a therapist to rephrase defensive language and ensure both partners feel heard, preventing escalation into arguments or name-calling. Regularly review relationship dynamics: Check in on sacrifices like relocations or part-time work, honoring promises and expressing appreciation to avoid resentment or feelings of being sidelined. Take communication risks during protected time: Be vulnerable about insecurities or feelings, such as loneliness, to deepen connection, and avoid defaulting to safe topics, use this safe space to address meaningful issues. About the Show: Succeed In Medicine covers patient interactions, burnout, career growth, personal finance, and more. If you're tired of dull medical lectures, tune in for real-world lessons we should have learned in med school! About the Guest: Dr. Michael F. Myers is a professor of clinical psychiatry and recent past vice president of education and director of training in the Department of Psychiatry and Behavioral Sciences at SUNY Downstate Health Sciences University in Brooklyn. He's a specialist in physician health and the author of many books, including "Physicians with Lived Experience: How Their Stories Offer Clinical Guidance" and "Doctors' Marriages: A Look at the Problems and Their Solutions." He lectures widely on stresses in medical training, burnout, moral injury, depression, substance use, PTSD, marital discord, and reducing stigma in medicine. Connect with Dr. Michael Myers: Website: https://www.michaelfmyers.com About the Host: Dr. Bradley Block – Dr. Bradley Block is a board-certified otolaryngologist at ENT and Allergy Associates in Garden City, NY. He specializes in adult and pediatric ENT, with interests in sinusitis and obstructive sleep apnea. Dr. Block also hosts Succeed In Medicine podcast, focusing on personal and professional development for physicians Want to be a guest? Email Brad at [email protected]  or visit www.physiciansguidetodoctoring.com to learn more! Socials: @physiciansguidetodoctoring on Facebook @physicianguidetodoctoring on YouTube @physiciansguide on Instagram and Twitter   This medical podcast is your physician mentor to fill the gaps in your medical education. We cover physician soft skills, charting, interpersonal skills, doctor finance, doctor mental health, medical decisions, physician parenting, physician executive skills, navigating your doctor career, and medical professional development. This is critical CME for physicians, but without the credits (yet). A proud founding member of the Doctor Podcast Network!Visit www.physiciansguidetodoctoring.com to connect, dive deeper, and keep the conversation going. Let’s grow! Disclaimer:This podcast is for informational purposes only and is not a substitute for professional medical, financial, or legal advice. Always consult a qualified professional for personalized guidance. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Struggling to balance a demanding medical career with a healthy marriage? It might be more common than you think. In this part one of two eye-opening episode of Succeed In Medicine podcast host Dr. Bradley Block interviews Dr. Michael F. Myers, as they delve into frequent issues in physician marriages, including communication gaps, workaholism, and using work as an escape from home tensions. Dr. Myers shares insights on recognizing when overwork crosses into avoidance, the impact of poor role models from past generations, and practical ways to transition from work mode to family presence. Key discussions include protecting couple time amid busy schedules, handling defensiveness in conversations, and fostering intentional dates or "grown-up time" away from kids. They also touch on generational shifts in medicine, where younger physicians prioritize life balance over endless dedication, and the importance of transparency about personal costs of overwork. Dr. Myers emphasizes treating marital communication as a skill to master, like medical training, and highlights resources like retreats for enrichment. Whether you're a physician navigating marital discord or supporting a partner in medicine, this episode offers compassionate guidance to prevent burnout at home, strengthen relationships, and model healthy dynamics for kids, setting the stage for part two next week. Three Actionable Takeaways: Protect Couple Time Intentionally: Schedule uninterrupted "grown-up time" daily e.g., 30 minutes post-work with no distractions like TV or phones, or bi-weekly dates even low-cost walks; train kids to respect boundaries to rebuild connection beyond co-parenting, reducing feelings of drifting apart. Create a Work-to-Home Transition Ritual: Build in buffer time after shifts, whether a commute unwind, quick run, or quiet moment to shift from decisiveness at work to presence at home; recognize when exhaustion is temporary and communicate needs to avoid guilt or resentment. Listen Without Defensiveness: When a spouse flags overwork or avoidance, pause and reflect instead of rationalizing; treat communication as a learnable skill like medicine, seeking resources like marital retreats or therapy to address root issues before they escalate to fights or disconnection. About the Show: Succeed In Medicine covers patient interactions, burnout, career growth, personal finance, and more. If you're tired of dull medical lectures, tune in for real-world lessons we should have learned in med school! About the Guest: Dr. Michael F. Myers is a professor of clinical psychiatry and recent past vice president of education and director of training in the Department of Psychiatry and Behavioral Sciences at SUNY Downstate Health Sciences University in Brooklyn. He's a specialist in physician health and the author of many books, including "Physicians with Lived Experience: How Their Stories Offer Clinical Guidance" and "Doctors' Marriages: A Look at the Problems and Their Solutions." He lectures widely on stresses in medical training, burnout, moral injury, depression, substance use, PTSD, marital discord, and reducing stigma in medicine. Connect with Dr. Michael Myers: Website: https://www.michaelfmyers.com About the Host: Dr. Bradley Block – Dr. Bradley Block is a board-certified otolaryngologist at ENT and Allergy Associates in Garden City, NY. He specializes in adult and pediatric ENT, with interests in sinusitis and obstructive sleep apnea. Dr. Block also hosts Succeed In Medicine podcast, focusing on personal and professional development for physicians Want to be a guest? Email Brad at [email protected]  or visit www.physiciansguidetodoctoring.com to learn more! Socials: @physiciansguidetodoctoring on Facebook @physicianguidetodoctoring on YouTube @physiciansguide on Instagram and Twitter This medical podcast is your physician mentor to fill the gaps in your medical education. We cover physician soft skills, charting, interpersonal skills, doctor finance, doctor mental health, medical decisions, physician parenting, physician executive skills, navigating your doctor career, and medical professional development. This is critical CME for physicians, but without the credits (yet). A proud founding member of the Doctor Podcast Network!Visit www.physiciansguidetodoctoring.com to connect, dive deeper, and keep the conversation going. Let’s grow! Disclaimer:This podcast is for informational purposes only and is not a substitute for professional medical, financial, or legal advice. Always consult a qualified professional for personalized guidance. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Perplexed by patients with normal exams but persistent symptoms like recurrent UTIs or palpitations? It could be menopause. In this insightful episode of Succeed In Medicine podcast, host Dr. Bradley Block interviews Dr. Lauren Streicher. They explore commonly overlooked menopause symptoms beyond hot flashes: recurrent urinary tract infections tied to genitourinary syndrome of menopause (GSM), palpitations as "hot flashes of the heart" (often sinus tachycardia without EKG changes), GI microbiome shifts causing nebulous digestive issues, xerostomia (dry mouth) linked to oral health risks, and skin/hair changes like alopecia. Dr. Streicher emphasizes reassuring patients early, validating symptoms as hormonal, and tailoring treatments, vaginal estrogen, safe even for breast cancer patients, systemic hormones, or new non-hormonal NK3 receptor antagonists like fezolinetant. They discuss the SWAN study's findings on long-term risks from untreated hot flashes (e.g., cardiovascular disease, bone loss), the need to differentiate perimenopausal (temporary) vs. lifelong postmenopausal effects, and avoiding arbitrary hormone therapy stops after 5 years. The conversation also touches on sexual health gaps in medicine, with tips for better history-taking and resources like Dr. Stryker's "Come Again" course. Listeners, clinicians and patients alike, will gain tools to address menopause holistically, improving quality of life and preventing complications. Three Actionable Takeaways: Recognize GSM in Recurrent UTIs: For postmenopausal women with new-onset recurrent UTIs, suspect genitourinary syndrome of menopause, prescribe local vaginal estrogen (cream, suppository, or ring) to restore microbiome and tissue health; it's safe for most, including breast cancer survivors on aromatase inhibitors. Reassure on Palpitations First: When midlife women present with palpitations, lead with "This is common in perimenopause (up to 50% affected) likely autonomic dysfunction like a 'heart hot flash'"; order a Holter monitor, but emphasize it's often benign and tied to vasomotor symptoms, treatable with hormones or NK3 antagonists. Integrate Sexual History Properly: Ditch "Are you sexually active?",  ask "Many women in menopause experience low libido, pain with sex, or orgasm difficulty; are any of these issues for you?"; refer to resources like Dr. Streicher's course for evaluation scripts, screeners, and solutions to address 50% of patients' unspoken concerns. About the Show: Succeed In Medicine covers patient interactions, burnout, career growth, personal finance, and more. If you're tired of dull medical lectures, tune in for real-world lessons we should have learned in med school! About the Guest: Dr. Lauren Streicher is a clinical professor of OB-GYN at Northwestern University and founding director of its Center for Sexual Medicine and Menopause. A certified menopause practitioner, she serves on the Menopause journal's editorial board, is a Kinsey Institute fellow, and authors bestsellers like "Sex Rx" and "Hot Flash Hell." She hosts "Inside Information" podcast and created "Come Again" audio series on postmenopausal sexuality. Connect with Dr. Lauren Streicher: Website: https://www.drstreicher.com Email: [email protected]  About the Host: Dr. Bradley Block – Dr. Bradley Block is a board-certified otolaryngologist at ENT and Allergy Associates in Garden City, NY. He specializes in adult and pediatric ENT, with interests in sinusitis and obstructive sleep apnea. Dr. Block also hosts Succeed In Medicine podcast, focusing on personal and professional development for physicians Want to be a guest? Email Brad at [email protected]  or visit www.physiciansguidetodoctoring.com to learn more! Socials: @physiciansguidetodoctoring on Facebook @physicianguidetodoctoring on YouTube @physiciansguide on Instagram and Twitter This medical podcast is your physician mentor to fill the gaps in your medical education. We cover physician soft skills, charting, interpersonal skills, doctor finance, doctor mental health, medical decisions, physician parenting, physician executive skills, navigating your doctor career, and medical professional development. This is critical CME for physicians, but without the credits (yet). A proud founding member of the Doctor Podcast Network!Visit www.physiciansguidetodoctoring.com to connect, dive deeper, and keep the conversation going. Let’s grow! Disclaimer:This podcast is for informational purposes only and is not a substitute for professional medical, financial, or legal advice. Always consult a qualified professional for personalized guidance. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

What if robots could handle tedious retraction, precise bone milling, or even autonomous suturing, freeing surgeons to focus on complex decision-making and more patients?In this episode of the Succeed In Medicine Podcast, Dr. Bradley Block speaks with Dr. Michael Yip, as he explains that today's robots primarily serve as extensions of human surgeons via teleoperation (e.g., da Vinci for precision in hard-to-reach areas), enhancing dexterity, visualization, and accuracy rather than replacing them. He highlights existing autonomous applications in "hard tissue" procedures like the Mako or Stryker robots for precise bone milling in joint replacements, and non-contact examples like CyberKnife for focused radiation therapy.For soft tissue surgery, the more challenging domain due to tissue deformation and variability, autonomy is emerging in simpler, repetitive tasks such as retraction, suctioning, or basic suturing, with demonstrations dating back 15 years but real-world deployment lagging due to engineering, data, and economic hurdles. Dr. Yip discusses why demos in controlled settings don't easily translate to ORs, the shift to data-driven AI (with risks of out-of-distribution failures), and regulatory challenges like FDA expertise gaps and defining probabilistic safety. He predicts stepwise adoption: starting with assistant-level tasks (replacing med student/intern roles in retraction/suction), then progressing to free surgeons for higher-value work, especially in underserved rural areas via telesurgery. Full "skin-to-skin" autonomy (e.g., simple lipoma excision or appendectomy) remains years away, limited by hardware combining strength, dexterity, and precision in one system, though teams of specialized robots could accelerate progress. Ultimately, robotics will alleviate surgeon burnout from growing demand, not eliminate jobs soon.Three Actionable TakeawaysEmbrace Robotics Early in Training: Surgeons and trainees should gain hands-on experience with diverse robotic technologies now, treating them as essential tools that augment precision and dexterity rather than threats to obsolescence.Focus on Repetitive Tasks for Autonomy Gains: Prioritize robotic assistance in tedious, physically demanding steps like retraction, suctioning, or basic closure to free up time, reduce fatigue, and improve efficiency in high-volume or resource-limited settings.Stay Informed on Regulatory and Economic Shifts: Monitor evolving FDA guidelines for AI/surgical autonomy, economic incentives (e.g., cost savings in joint replacements or anastomosis), and liability frameworks to prepare for integration that enhances patient access and outcomes.About the Show:Succeed In Medicine covers patient interactions, burnout, career growth, personal finance, and more. If you're tired of dull medical lectures, tune in for real-world lessons we should have learned in med school!About the Guest:Dr. Michael Yip is an Associate Professor of Electrical and Computer Engineering at UC San Diego and Director of the Advanced Robotics and Controls Laboratory (ARCLab). His research focuses on surgical robots, biomimetic design, robot learning, autonomous robotic surgery, and deformable tissue manipulation. He has received the NSF CAREER Award, NIH Trailblazer Award, IEEE RAS Distinguished Lecturer recognition, and was named Faculty Innovator of the Year at UCSD in 2024 and elected to the National Academy of Inventors. Previously a Disney researcher at Amazon Robotics, he holds a BSc in Mechatronics Engineering from the University of Waterloo, MS in Electrical Engineering from the University of British Columbia, and PhD in Bioengineering from Stanford University.Website: yip.eng.ucsd.edu and ucsdarclab.comAbout the Host:Dr. Bradley Block – Dr. Bradley Block is a board-certified otolaryngologist at ENT and Allergy Associates in Garden City, NY. He specializes in adult and pediatric ENT, with interests in sinusitis and obstructive sleep apnea. Dr. Block also hosts Succeed In Medicine podcast, focusing on personal and professional development for physiciansWant to be a guest?Email Brad at [email protected]  or visit www.physiciansguidetodoctoring.com to learn more!Socials:@physiciansguidetodoctoring on Facebook@physicianguidetodoctoring on YouTube@physiciansguide on Instagram and Twitter   This medical podcast is your physician mentor to fill the gaps in your medical education. We cover physician soft skills, charting, interpersonal skills, doctor finance, doctor mental health, medical decisions, physician parenting, physician executive skills, navigating your doctor career, and medical professional development. This is critical CME for physicians, but without the credits (yet). A proud founding member of the Doctor Podcast Network!Visit www.physiciansguidetodoctoring.com to connect, dive deeper, and keep the conversation going. Let’s grow! Disclaimer:This podcast is for informational purposes only and is not a substitute for professional medical, financial, or legal advice. Always consult a qualified professional for personalized guidance. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

What if a simple posture adjustment or a moment of focused listening could transform your patient encounters, making them more efficient and empathetic?In this episode of the Succeed In Medicine Podcast, Dr. Bradley Block speaks with Dr. Nick Morgan, drawing from his work coaching Fortune 50 CEOs and TED speakers, Dr. Morgan breaks down how physicians can project authority and empathy right from the first moment in the exam room. He explains the "outside-in" and "inside-out" approaches to charisma: aligning your posture for confidence and clearing mental distractions to give undivided attention. The discussion covers reading patient cues, like open vs. closed postures to gauge understanding or discomfort, mirroring body language to build rapport during tough conversations, and respecting personal space (1.5–4 feet) for meaningful exchanges. Dr. Morgan also introduces "charismatic listening," where stilling your entire body signals genuine presence, fostering trust in seconds. Whether delivering bad news or handling hostile patients, these tools help doctors communicate more effectively, reducing visit times while improving outcomes.Three Actionable TakeawaysMaster Posture for Authority: Before entering the room, align your body against a wall or take a deep breath to stand at full height. This conveys confidence without arrogance and sets a professional tone.Clear Your Mental To-Do List: Pause for 30 seconds to erase distractions, using a personal ritual (like a head twitch or imaginary gesture) to focus solely on the patient, ensuring undivided attention that builds trust instantly.Practice Charismatic Listening: During key moments, face the patient fully, still your body, and maintain open posture to listen with your "whole body". This signals empathy and receptivity, especially in emotional or critical exchanges.About the Show:Succeed In Medicine covers patient interactions, burnout, career growth, personal finance, and more. If you're tired of dull medical lectures, tune in for real-world lessons we should have learned in med school!About the Guest:Dr. Nick Morgan is one of America's top communication theorists and coaches. As the founder of Public Words, he has spent decades helping leaders, entrepreneurs, and TED speakers master charisma and public speaking. He is the author of acclaimed books including Power Cues: The Subtle Science of Leading Groups, Persuading Others, and Maximizing Your Personal Impact. A former fellow at Harvard's Kennedy School, he bridges biology and communication to coach Fortune 50 CEOs, government officials, and keynote speakers.Website: publicwords.comAbout the Host:Dr. Bradley Block – Dr. Bradley Block is a board-certified otolaryngologist at ENT and Allergy Associates in Garden City, NY. He specializes in adult and pediatric ENT, with interests in sinusitis and obstructive sleep apnea. Dr. Block also hosts Succeed In Medicine podcast, focusing on personal and professional development for physiciansWant to be a guest?Email Brad at [email protected]  or visit www.physiciansguidetodoctoring.com to learn more!Socials:@physiciansguidetodoctoring on Facebook@physicianguidetodoctoring on YouTube@physiciansguide on Instagram and Twitter   This medical podcast is your physician mentor to fill the gaps in your medical education. We cover physician soft skills, charting, interpersonal skills, doctor finance, doctor mental health, medical decisions, physician parenting, physician executive skills, navigating your doctor career, and medical professional development. This is critical CME for physicians, but without the credits (yet). A proud founding member of the Doctor Podcast Network!Visit www.physiciansguidetodoctoring.com to connect, dive deeper, and keep the conversation going. Let’s grow! Disclaimer:This podcast is for informational purposes only and is not a substitute for professional medical, financial, or legal advice. Always consult a qualified professional for personalized guidance. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

How can physicians and their teams deliver exceptional patient experiences, even when things go wrong?In this episode of Succeed In Medicine Podcast, Dr. Bradley Block interviews Shep Hyken, as he shares practical strategies for elevating patient care, emphasizing that "amazing" service doesn't require grand gestures, it's about being slightly better than average, consistently. Drawing parallels from hospitality giants like the Ritz-Carlton, he explains how using patients' names, setting clear expectations, and leveraging technology like patient portals can reduce friction and build loyalty.The conversation dives into handling "moments of misery," such as late appointments or scheduling mishaps, with a five-step process: acknowledge the issue, apologize, discuss resolutions, own the problem, and act with urgency. Shep also stresses the importance of creating a patient-focused culture through leadership, training, and hiring for personality fit. He introduces concepts like "destination employment" to foster employee fulfillment and uniqueness, ensuring staff feel empowered to deliver compassionate care. Ultimately, Shep reinforces that patients compare healthcare experiences to top-tier service in any industry, so practices must prioritize convenience, empathy, and proactive communication to stand out.Three Actionable TakeawaysDefine "Amazing" as Consistent Excellence: Aim to be just 10% better than average every time—through friendly interactions, using patients' names, and meeting expectations reliably—to create loyalty without over-the-top efforts.Turn Complaints into Opportunities: Use a five-step process for moments of misery: acknowledge the issue, apologize, discuss fixes with options, own the resolution personally, and act urgently to rebuild trust.Build a Patient-Focused Culture: Start with leadership by defining a one-sentence vision for the experience, communicate it repeatedly, train staff ongoingly, role-model behaviors, defend the standards, and celebrate successes to empower your team.About the Show:Succeed In Medicine covers patient interactions, burnout, career growth, personal finance, and more. If you're tired of dull medical lectures, tune in for real-world lessons we should have learned in med school!About the Guest:Shep Hyken is a customer service and experience expert, award-winning keynote speaker, researcher, and New York Times and Wall Street Journal bestselling author. He has been quoted in hundreds of publications and is the author of eight books, including his most recent, "I'll Be Back: How to Get Customers to Come Back Again and Again." Shep works with companies and organizations that want to build loyal relationships with their customers and employees.LinkedIn: linkedin.com/in/shephykenWebsite: hyken.comAbout the Host:Dr. Bradley Block – Dr. Bradley Block is a board-certified otolaryngologist at ENT and Allergy Associates in Garden City, NY. He specializes in adult and pediatric ENT, with interests in sinusitis and obstructive sleep apnea. Dr. Block also hosts Succeed In Medicine podcast, focusing on personal and professional development for physiciansWant to be a guest?Email Brad at [email protected]  or visit www.physiciansguidetodoctoring.com to learn more!Socials:@physiciansguidetodoctoring on Facebook@physicianguidetodoctoring on YouTube@physiciansguide on Instagram and Twitter   This medical podcast is your physician mentor to fill the gaps in your medical education. We cover physician soft skills, charting, interpersonal skills, doctor finance, doctor mental health, medical decisions, physician parenting, physician executive skills, navigating your doctor career, and medical professional development. This is critical CME for physicians, but without the credits (yet). A proud founding member of the Doctor Podcast Network!Visit www.physiciansguidetodoctoring.com to connect, dive deeper, and keep the conversation going. Let’s grow! Disclaimer:This podcast is for informational purposes only and is not a substitute for professional medical, financial, or legal advice. Always consult a qualified professional for personalized guidance. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.