Reflection Rounds

In the latest episode of Doctor Friends, Christian and Rosny speak with the UCSF emergency physician, researcher, and clinical informaticist Melanie Molina during a live Zoom conference. They explore whether AI will replace emergency physicians and the risks of de-skilling for trainees. They define clinical informatics, review Christian’s Annals paper mapping emergency medicine tasks to AI exposure, and describe Mel’s work using AI for social risk–informed decision support and an ED clinical reasoning benchmark. They also discuss documentation and EHR synthesis as promising AI uses, liability and regulation, environmental/resource costs, and potential for AI-enabled linkage to social services amid limited infrastructure.This episode was recorded in October 2026. Presented by Christian and Rosny. Music by Nylonia. Production support by Ilia Rogatchevski.Follow Doctor Friends on Instagram @doctorfriendspodcast Or write to us on [email protected] Hosted on Acast. See acast.com/privacy for more information.

Christian, Tomás and Rosny discuss the pros and cons of concierge medicine. They outline the practice as a broad set of models where patients pay a membership fee or a retainer for perks like direct messaging, same-day visits, and longer appointments. They recognise that concierge medicine reflects unmet needs in American healthcare but may further tier an already segregated system by drawing clinicians away from the broader public, worsening access for marginalized patients and increasing reliance on emergency departments. The episode also explores why physicians might want to switch to concierge models and features a discussion about possible regulation and a rethink of care delivery.This episode was recorded remotely in July 2026. Presented by Christian, Tomás and Rosny. Music by Nylonia. Production support by Ilia Rogatchevski.Follow Doctor Friends on Instagram @doctorfriendspodcastOr write to us on [email protected] Hosted on Acast. See acast.com/privacy for more information.

Christian and Rosny talk with Julian, a critical care specialist and associate director of a fellowship in California. They discuss why he moved from the Emergency Department to full-time Intensive Care Unit work. Julian describes a typical work day, the intensivist role as “plumber, chemist, and priest,” and explains how Covid intensified his exposure to prolonged suffering and death, prompting a reframing of healthcare outcomes, which led him to develop “reflection rounds” for trainees. These longitudinal, systems-based sessions emphasize group processing, normalizing distress, cognitive restructuring, celebrating wins, and sports-psychology tools like centering breaths, visualization, positive self-talk, and “highlight reels.” This episode was recorded remotely in June 2026. Presented by Christian and Rosny. Music by Nylonia. Production support by Ilia Rogatchevski.Follow Doctor Friends on Instagram @doctorfriendspodcastOr write to us on [email protected] Hosted on Acast. See acast.com/privacy for more information.

Christian and Tomás interview Joshua, a medical student focused on informatics, immunology, and improving trust and communication in healthcare. Josh describes how early exposure his oncologist father's work and an interest in science led him to medicine. He shares a clinical encounter in which a patient’s narrative conflicted with her chart history, prompting discussion about why patients might omit details, ways in which power and identity dynamics shape disclosure and how clinicians should respond. The doctors weigh up “chart lore” and push for the need of multiple perspectives to build understanding. Josh also introduces Alethia, a student group he co-founded that is aimed at countering health misinformation through interdisciplinary education.Dhruv Khullar - The Role of Doctors Is Changing Forever (The New Yorker, Dec 2025)This episode was recorded remotely in February 2026. Presented by Christian and Tomás. Music by Nylonia. Produced by Ilia Rogatchevski.Follow Doctor Friends on Instagram @doctorfriendspodcastOr write to us on [email protected] Hosted on Acast. See acast.com/privacy for more information.

Tomás, Christian and Rosny interview Michael, an emergency physician and healthcare administrator who founded a major public sector physician union in California. Emphasizing the contrast between public and private legal frameworks, Michael outlines what a union is, the history of unionisation in the US and argues for the advantages of joining one as a physician.The conversation highlights how physician unions agitate for better working conditions with patient care in mind. The doctors discuss the tensions between professionalism and unionism as well as public perception of unions, citing the Committee of Interns and Residents’ 1970s patient care fund and the 2026 nurses’ strike in New York. They also cover the ethics of strike action and predict growing physician unionization efforts amid the twin economical landscapes of corporate medicine and private equity.“The meaning of professionalism evolved over the past two centuries, from sacred vocation to secular occupational identity. During the 19th century and most of the 20th centuries, taking up a profession was a socially approved route to middle class status. Samuel Haber puts it this way – a profession in the 18th century was an occupation that a gentleman could take up ‘without demeaning himself and, more wondrously, an occupation that might make someone a gentleman simply by his taking it out’”. – Grace Budrys - When Doctors Join Unions (Cornell University Press, 1997)This episode was recorded remotely in March 2026. Presented by Christian, Tomás and Rosny. Music by Nylonia. Produced by Ilia Rogatchevski.Follow Doctor Friends on Instagram @doctorfriendspodcastOr write to us on [email protected] Hosted on Acast. See acast.com/privacy for more information.

Why do people turn to chatbots when seeking medical advice? Is it due to cost, out-of-hours access or simply wanting to feel heard? Christian, Tomás and Grace discuss why patients and clinicians are increasingly using Large Language Models (LLMs) in medical contexts and what that means for the American healthcare system. The doctors examine how certain attributes of LLMs such as sycophancy and engagement incentives can amplify anxiety, delusions or unrealistic expectations. The lack of accountability by big tech can also undermine trust for patients and healthcare practitioners alike. They raise concerns about training data quality (medical journals mixed with sources like Reddit) and the need for citations, transparency and regulation comparable to healthcare quality oversight. They also ask ChatGPT what it thinks about guardrails and risk controls! This conversation is spurred on by two New York Times articles (What OpenAI Did When ChatGPT Users Lost Touch With Reality; Empathetic, Available, Cheap: When A.I. Offers What Doctors Don’t). If you or someone you know needs help, in the US, you can call or text the National Suicide Prevention Lifeline on 988, chat on 988lifeline.org, or text HOME to 741741 to connect with a crisis counselor. If you’re listening in another part of the world, international helplines can be found at befrienders.org.The episode was recorded remotely in November 2025. Presented by Christian, Tomás and Grace. Music by Nylonia. Produced by Ilia Rogatchevski.Follow Doctor Friends on Instagram @doctorfriendspodcastOr write to us on [email protected] Hosted on Acast. See acast.com/privacy for more information.

In this episode of Doctor Friends, emergency physicians Rosny, Christian, Tomás and Grace are joined by Dr. Taylor Nichols, MD – an addiction medicine specialist. The discussion covers substance use disorders and the concept of harm reduction. Taylor shares insights into the impact of drug use on medical practice, his experiences in emergency medicine and the importance of approaching substance use with empathy and evidence-based practices. The doctors also unpack some of the stigma around harm reduction and propose policy-level solutions like overdose prevention sites and medically-assisted treatment. This episode was recorded remotely in January 2026. Presented by Rosny, Christian, Tomás, and Grace. Music by Nylonia. Produced by Ilia Rogatchevski.Follow Doctor Friends on Instagram @doctorfriendspodcastOr write to us on [email protected] Follow Taylor on TikTok @tnicholsmd and make sure to check out his podcast Recovery Reform, which is available on your favourite podcast app and YouTube. Substance abuse and mental health services administration SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.Safespot Hotline: 1-800-662-HELP (4357) Hosted on Acast. See acast.com/privacy for more information.

In this festive season finale, emergency physicians Grace, Christian, Tomás, and Rosny review the highs and lows of 2025 and share their “hot cakes” for the coming year.The doctors reflect on personal milestones alongside how the wider challenges of American healthcare impact their work. The episode also features their producer Ilia for a new segment, Asking for a Friend, answering listener questions about their close friendships and unique experiences of working in the emergency department during the holidays. Lastly, they predict trends for 2026, including the positive use of AI in medicine and the critical role that immigrants play in providing healthcare.This episode was recorded remotely in December 2025. Presented by Grace, Christian, Tomás and Rosny. Music by Nylonia. Produced by Ilia Rogatchevski.Liked the episode? Tell your friends! Follow us on Instagram or write to us at [email protected]. Hosted on Acast. See acast.com/privacy for more information.

Why is the proliferation of quick fixes such as detoxes, fad diets and weight loss injections so prevalent online? Is it really a shortcut to getting fitter and healthier? Why is the focus shifting onto these products and services when what people actually need are structural changes like access to affordable housing, child care, clean air and healthy food?In this episode of the Doctor Friends podcast emergency physicians Christian and Rosny are joined by Italo, who works in social emergency medicine, to discuss the social determinants of health in America. Italo explains his role in community health initiatives and the importance of addressing structural drivers of health. The conversation explores how structural changes are crucial for lasting improvements and strategies are suggested for clinicians to better serve their communities, including attending city council meetings, creating resource lists and effectively communicating with policymakers. The episode underscores the need for systemic change and active involvement from healthcare providers to bridge gaps in healthcare access and equity.This episode was recorded remotely in October 2025. Presented by Christian, Rosny and Italo. Music by Nylonia. Produced by Ilia Rogatchevski.Liked the episode? Tell your friends! Follow us on Instagram or write to us at [email protected]. Hosted on Acast. See acast.com/privacy for more information.

“There is nothing more profitable in our society today than a sick child, because all of these entities are making money on him: the insurance companies, the hospitals, the medical cartel, the pharmaceutical companies have lifetime annuities. They don’t want to kill them, they want them sick for the rest of their lives.” – Robert F. Kennedy, Jr.In this episode Christian, Grace and Tomás take on the Make America Healthy Again (MAHA) movement and the misinformation peddled by wellness influencers. The jumping off point for the conversation is Alexander Stockton and Derek Beres’s New York Times Opinion video ‘You Might Have Already Fallen for MAHA’s Conspiracy Theories’ (published September 2025) about ordinary people who got pulled into the MAHA orbit.The group reflects on social media’s contributions to public distrust in the American healthcare system and how this scepticism is compounded by the heightened emotional context of seeking care in an emergency room. They also touch on the split between public health and medical practice, spearheaded by the Flexner Report, and the perceived importance of individual control in personal health decisions. The discussion also addresses public health initiatives like MMR vaccinations. Their success has led to widespread immunity but also a lack of awareness about their importance, leading some to question their necessity. The doctors share personal anecdotes and insights on bridging the trust gap with patients and emphasize the importance of empathy.This episode was recorded remotely in September 2025. Presented by Christian, Tomás and Grace. Music by Nylonia. Produced by Ilia Rogatchevski.Liked the episode? Tell your friends! Follow us on Instagram or write to us at [email protected]. Hosted on Acast. See acast.com/privacy for more information.