Episode 277 - When “Yes” Becomes Too Much: Confronting Physician Burnout

Chadi sits down with Dr. Daniel Olson to discuss the growing excitement surrounding tumor-infiltrating lymphocyte (TIL) therapy in melanoma, including how these personalized cellular therapies are created (and sometimes engineered in the lab), the logistical challenges of collection and reinfusion, and the clinical data that led to FDA approval based on a single-arm study. Dr. Olson also explores treatment sequencing with immunotherapy and targeted therapy, the severity and duration of associated toxicities, response rates seen in practice, and the expanding potential for TIL therapy in other malignancies such as lung and cervical cancers, offering a practical and forward-looking look at one of the most promising advances in solid tumor oncology.Check out Chadi’s website for all Healthcare Unfiltered episodes and other content. https://www.chadinabhan.com/Watch all Healthcare Unfiltered episodes on YouTube. https://www.youtube.com/channel/UCjiJPTpIJdIiukcq0UaMFsA

Chadi is joined by Dr. Sewanti Limaye to discuss what precision oncology looks like in India, exploring the realities of access, affordability, infrastructure, and innovation in cancer care. Drawing on her experience training and practicing in the United States before returning to Mumbai to lead oncology and translational research programs, Dr. Limaye explains which genomic tests, liquid biopsies, and targeted therapies are currently available in India, the challenges surrounding out-of-pocket costs and insurance coverage, and why helping even a small percentage of patients access precision medicine can have a major impact. The conversation also covers clinical trial capabilities, lab turnaround times, international players in the liquid biopsy space, and the complexities of FDA-approved drugs that remain unavailable for prescription in India. Check out Chadi’s website for all Healthcare Unfiltered episodes and other content. https://www.chadinabhan.com/Watch all Healthcare Unfiltered episodes on YouTube. https://www.youtube.com/channel/UCjiJPTpIJdIiukcq0UaMFsA

Chadi sits down with sit down with Sue S. Yom, MD, PhD, FASTRO—radiation oncologist at UCSF, Editor-in-Chief of the International Journal of Radiation Oncology Biology Physics, and leader within NRG Oncology—to explore the critical role of cooperative groups in advancing cancer research. She unpacks their history, the benefits and challenges of large-scale collaboration, and how federal funding and partnerships with industry shape the design and execution of clinical trials. Dr. Yom also shares insights from her editorial perspective and highlights what’s ahead in radiation oncology, including the growing role of biomarkers, personalized treatment strategies, and smarter sequencing of therapies.Check out Chadi’s website for all Healthcare Unfiltered episodes and other content. https://www.chadinabhan.com/Watch all Healthcare Unfiltered episodes on YouTube. https://www.youtube.com/channel/UCjiJPTpIJdIiukcq0UaMFsA

Gary L. Simmons, DO, MSHA—physician and entrepreneur in a Virginia community practice—dives into the rapidly evolving world of cell and gene therapy (CGT), including bone marrow transplant, CAR-T, and TILs, and what it takes to bring these cutting-edge treatments safely into the community setting. He unpacks the operational, financial, and workforce challenges of building and scaling a CGT program outside of academia, from payer hesitancy and 340B pressures to the infrastructure and staffing required for success. The conversation also explores the future of CGT, how innovation may reshape access, and why community practices could play a critical role as demand outpaces traditional academic centers.Check out Chadi’s website for all Healthcare Unfiltered episodes and other content. https://www.chadinabhan.com/Watch all Healthcare Unfiltered episodes on YouTube. https://www.youtube.com/channel/UCjiJPTpIJdIiukcq0UaMFsA

Returning guest Dr. Tom Beer, Chief Medical Officer for Multicancer Early Detection (MCED) at Exact Sciences, joins the show to break down the promise and complexity of MCED testing—what it is, the clinical gap it aims to fill, and how it could reshape cancer diagnostics. He explores which patient populations may benefit most, the current limitations across different cancer types, and whether MCED tests are poised to complement or replace traditional single-cancer screening approaches. The conversation also tackles key nuances like balancing sensitivity and specificity, interpreting negative results, and how clinicians and patients should think about repeat testing in an evolving screening landscape.Check out Chadi’s website for all Healthcare Unfiltered episodes and other content. https://www.chadinabhan.com/Watch all Healthcare Unfiltered episodes on YouTube. https://www.youtube.com/channel/UCjiJPTpIJdIiukcq0UaMFsA

Chadi sits down with Dan Golden, MD, MHPE, Associate Professor of Radiation Oncology at Rush University, to discuss his deeply personal and recently published account of physician burnout. He shares the mental and physical toll of burnout, clarifies how it differs from depression and anxiety, and reflects on the pressures of academic medicine’s “say yes to everything” culture that leaves little room for setting boundaries. From masking symptoms and navigating a job change that added stress, to ultimately taking leaves of absence and undergoing intensive therapy, Dr. Golden offers an unfiltered look at how dire things became—and why speaking out may help others facing the same struggle.Read his article on burnout.https://www.redjournal.org/article/S0360-3016(25)06438-7/fulltextCheck out Chadi’s website for all Healthcare Unfiltered episodes and other content. https://www.chadinabhan.com/Watch all Healthcare Unfiltered episodes on YouTube. https://www.youtube.com/channel/UCjiJPTpIJdIiukcq0UaMFsA

Chadi sits down with Nina Sanford, MD, Chief of Gastrointestinal Radiation Oncology Service at UT Southwestern, to explore the evolving landscape of radiation therapy in upper and lower GI malignancies. They discuss how advances in systemic treatments are reshaping radiation strategies, current standards of care in colorectal, gastroesophageal, pancreatic cancers, and liver cancers, and the growing role of organ preservation and adaptive radiation in improving patient outcomes. Dr. Sanford also shares insights into emerging clinical trials, personalized treatment approaches, and what she is most excited about in the future of GI radiation oncology.Check out Chadi’s website for all Healthcare Unfiltered episodes and other content. https://www.chadinabhan.com/Watch all Healthcare Unfiltered episodes on YouTube. https://www.youtube.com/channel/UCjiJPTpIJdIiukcq0UaMFsA

Chadi sits down with Amy Comander, MD, a breast cancer medical oncologist at Mass General Brigham Cancer Institute and author of “Paving Your Path Through Breast Cancer and Beyond,” to discuss how patients can take control of their health and quality of life after a breast cancer diagnosis. She shares the inspiration behind her book and offers a practical, lifestyle medicine–focused roadmap—covering nutrition, physical activity, sleep, stress management, and social connection—along with her “PAVING” framework for sustainable change. The conversation also explores her perspectives on popular diets, the psychological aspects of survivorship, and the key takeaways she hopes patients and caregivers carry with them beyond treatment.View more about her book.https://healthylearning.com/paving-your-path-through-breast-cancer-and-beyond/Check out Chadi’s website for all Healthcare Unfiltered episodes and other content. https://www.chadinabhan.com/Watch all Healthcare Unfiltered episodes on YouTube. https://www.youtube.com/channel/UCjiJPTpIJdIiukcq0UaMFsA

Chadi sits down again with Dr. Urvi Shah for an in-depth, evidence-driven exploration of the often confusing relationship between food and cancer. They dive into how nutritional research is actually conducted—and why it’s so challenging—while separating widely regarded myths from what high-quality data truly support, including nuanced discussions on processed foods, red meat, plant-based diets, ketogenic diets, intermittent fasting, and alcohol use. Dr. Shah also offers practical, science-backed recommendations for cancer prevention in the general population, as well as thoughtful guidance on how patients might approach diet and lifestyle changes after a cancer diagnosis.Check out Chadi’s website for all Healthcare Unfiltered episodes and other content. https://www.chadinabhan.com/Watch all Healthcare Unfiltered episodes on YouTube. https://www.youtube.com/channel/UCjiJPTpIJdIiukcq0UaMFsA

Chadi sits down with Dr. William “Bill” Small, Jr., a nationally recognized radiation oncologist and cancer center director at Loyola University Chicago, to explore the evolution of radiation oncology from its historical foundations to its rapidly advancing future. They discuss cutting-edge developments including proton therapy, radiopharmaceuticals, and the growing integration of molecular tumor profiling with precision radiation techniques, as well as the field’s increasing collaboration with medical oncology. Dr. Small also shares insights on mentoring the next generation of researchers, expanding clinical trials in radiation oncology, and addressing critical challenges such as overtreatment while shaping the future of the discipline.Check out Chadi’s website for all Healthcare Unfiltered episodes and other content. https://www.chadinabhan.com/Watch all Healthcare Unfiltered episodes on YouTube. https://www.youtube.com/channel/UCjiJPTpIJdIiukcq0UaMFsA