Observations at the N of 1 by Cancergeek

We are joined with Dr. Join Luh in this episode discussing the serendipity of a random suggestion to do a rotation in radiation oncology that led Dr. Luh to a patient-facing practice in a non-metropolitan location.

We are excited to introduce you to our guest on this episode, Georgia Giakoumis Spear, MD. We discuss her work as a radiologist, educator, legislative activist, mother, and more!

It takes two to tango, and we discuss the steps to the familiar dance with our imposter syndrome and more.

The only constant is change, and in this episode Andy and AJ discuss the new rules of medicine that brings us to the n of 1 for the patient and their health.

We are back at the mics again, this time looking for those small moments where we find ourselves saying, "Aha!" and re-discover the art of Medicine.

Goodbye to the worst year ever as we look to the future.

Main Topic: Point Turning Point, The Case for Universal Health Care Secondary Topic: Unhealthy Dietary Habits are Associated With the Risk of Proteinuria Onset Third Topic: Wound-healing Biomaterial Activates Immune System for Stronger Skin

Note: Make sure to listen until you get to the second topic where we get into the meat of exploring leadership, it is worth the wait. As we begin to move into the winter months we are going to most likely have to face another set of challenges with darkness, cold, and additional loneliness due to the pandemic and social distancing. The three of us explore not only the "tips and tricks" of combating loneliness. We all know that winter is coming, so we need to begin being active both in connection and in physical activity. Awais helps us to unpack the topic of representation in leadership. We highlight and discuss the power of the leaders that influence or mentor each of us in our own work. We share why they are important to us, what they mean to us, and how it has shaped and impacted our own styles as leaders within the world of medicine and business. Lastly, AJ shares his experience with us in trying to find coupons for pharmaceuticals.

Have you ever seen the Christopher Nolan movie Inception? If not, you will want to make sure you watch it this weekend. It is a movie in which a team of dream hackers has the ability to plant an idea into one's mind, while they are dreaming. The idea takes hold, grows, and becomes the person's own conscious dream and therefore their reality. This very idea is something that has been explored by MIT researchers. They have created technology that can assess when one falls asleep and enters a state of hypnagogia, plant an idea with an app on one's phone, and help to bolster creativity. (article:MIT controlling your dreams ) We then want to ensure we highlight some really good techniques to remember to protect one's online identity and safety in a virtual digital-led world.

In this episode, we begin by exploring the topic of mental health and how it has been impacting residents within the hospital. As we begin to unpack the article we begin to highlight how the pandemic is shining a light on the system of productivity that has been perfected over the last 10 decades within medicine. What the pandemic has done is placed a spotlight on the cracks, the kinks in the chain, and the areas that are most vulnerable within this production system, exposed them, and forced the entire systems at large to falter. Those that are the most responsible for the care, oversight, and management of people in our communities and the patients that may become, are the same professionals that are now at more risk than ever to suffer from isolation, stress, pressure, mental health, and the physical manifestations. We end the episode by highlighting what we can do, at the N of 1, leveraging the foundations of stoicism to help us become aware of the things we can change, the things we cannot, and the difference between the two situations. Remember, we make change, beginning with ourselves, at the N of 1. Articles explored: https://www.kevinmd.com/blog/2020/10/the-impact-of-covid-19-on-resident-burnout-and-how-we-can-combat-it.html ; https://www.forbes.com/sites/davidplans/2020/10/12/workplace-mental-health-where-to-from-here/#55fb7c335259 ; https://medium.com/@writing.ejp/why-stoicism-is-so-darn-popular-right-now-728b6868dd3f

In this episode, we get into several heavy topics: President Trump being diagnosed with COVID-19, racism in medicine, and the need for physicians to help us transition from healthcare back to medicine. We need to understand that the pandemic we live in today is a matter of choice. Our choice to acknowledge, to do our part, and to ensure the safety of ourselves, our family, the people in our community, and the patients that they may become in life. This is serious. It is a matter of life and death. We need to address that racism does exist in medicine. From patients being disrespectful to physicians, or from administrative staff and colleagues. It is real. It does exist. We need to discuss it openly. We need to ensure that our leaders are prepared to address it in real-time, to say it is unacceptable, and to have the tools and support system for our colleagues to continue to allow them to practice their art in a safe environment. Our last topic is that there is a difference between medicine and healthcare. It is real. It is something we all experience. We need to choose which we want, and make that choice at the N of 1.

In this episode, we explore the opportunity Walmart has as they begin to open more healthcare (medical) clinics that offer a comprehensive set of services including imaging such as X-Ray and other diagnostic services. With more than 250 million visits per week globally it offers Walmart a footprint, access, and an opportunity to meet more people locally, during their normal daily life activities, and to potentially "nudge" their customers towards slightly better choices. At the same time, many of us do not think of Walmart in terms of customer service. However, a N of 1 experience demonstrates that their customer service may be the thing that helps Walmart achieve success. In addition, we discuss the topic of work culture and opening up the ability for other functions to learn, collaborate, and cross-pollinate with their co-workers. The first two topics lend themselves to our final topic, which is the importance of empathy. Taking the time to listen, observe, and understand the experience of another is just the thing that allows us to be more successful, to be great leaders, and to offer wonderful customer service.

This week's episode we welcome a special guest, Shawn Prince. Shawn is an expert in healthcare policy, reimbursement, and payment and government management. Shawn shares with us his views on how the RO-APM will potentially impact radiation oncologists, hospitals/clinics, insurance carriers, especially Medicare, and patients. The final rule was announced publicly on Sept 18, 2020. If you want to read the full 950+ pages of the final rule and policy you can find the link here: CMS Final RO-APM Rule We discuss with Shawn on what to expect, what it means, and how to interpret some of the key aspects to this final rule. The question will become, will you be deemed an efficient or inefficient "provider" in radiation oncology?

Today's episode we begin by looking at 3 interesting concepts to help focus on work that is the most important. Everyone has heard of and perhaps used to-do lists. We explore 3 concepts: Alarms, Just-in-Time learning, and the 20% itch rule. Our second topic on Nompohbia, or the loss of not being able to access a mobile device and the ramifications it has on sleep patterns. Our last topic highlights using codfish skin to help regenerate new skin for burn victims. The common theme with all of the topics is a balancing act between technology and nature. Nature has found a way to survive over millions of years. The more we can understand nature, and apply those learnings to life, the further we can take humanity in a positive step forward. A step towards living, healing, and caring at the N of 1.

#004 Will The New Norm Shift Culture? We investigate the topic of the "new norm" and what it means to our culture. Perhaps the new norm isn't new at all but rather what we should have been doing all along, wearing a mask when we aren't feeling well. For those of us that work within the world of medicine, perhaps being an ethical leader continues on beyond any pandemic, and means wearing a mask when we have signs or symptoms of not feeling well. We review how we believe the Unites States is performing when it comes to social distancing, wearing a mask, and being aware of others around us.

#003 we begin with the story of Chernobyl. If you were given personal safety equipment and told that you needed to go outside and perform a cleanup, were being timed, and then had to come out immediately and be showered off, what would you think? What would you do? We explore how this relates to the similar situation of what it is like to go out in the world with the current pandemic. Amidst all of the chaos and misinformation, we debate the importance of our kids returning back to school. We highlight the social contract that is required for all of us in order to ensure the safety of our children as they go back to school.

Episode 002: In today's episode we explore the topics of personal brand and what makes physicians stand out the most is the very thing that makes physicians human, their personal life. We discuss the pros and cons of sharing personal experiences on social media when working in medicine. We transition and discuss the topic of proton therapy and the care of prostate cancer. Protons have a wonderful brand reputation (in some instances of cancer) but the reality is that there is a huge cost disadvantage to implementation, acquisition, and that cost is ultimately passed on the patients. We explore the use of mobile phones as a tool for mental health.  Feel free to follow me on Twitter and Instagram as Cancergeek. If you have any other questions, comments, or topics you would like me to address or share my thoughts on, please email me at attheendood@gmail.com or cancergeek@gmail.com. ~Cancergeek

Episode 1: Observations At The End Of The Day is a new podcast hosted by Cancergeek and 2 of his colleagues and friends. On this episode, Andy, aka Cancergeek, introduces this new podcast, his friends AJ Montpetit and Awais Mirza to listeners. Each week they will each highlight an important and relevant topic in the world of medicine. Each bring's their unique perspectives while encouraging some wonderful debates. On today's episode it is all about "Traumatic Informed Care" as well as a few other anecdotes along the way.  If you have questions, thoughts, questions or feedback please email attheendpod@gmail.com or cancergeek@gmail.com.  Remember, care is always delivered at the N of 1.  ~Cancergeek

Episode 003 I highlight an amazing conversation I had with my colleague on social media, Erin Gilmer. Erin and I had a discussion about the use of empathy versus compassion within the world of healthcare. I share with Erin my own observations on using the word empathy versus compassion. I also share my own personal story of being caught between two worlds, one of being a minority, the other of being part of the majority; one foot in the world of healthcare while another foot is in the world of the general population. I hope you enjoy. If you have any other questions, comments, or topics you would like me to address or share my thoughts on, please email me at cancergeek@gmail.com. ~Cancergeek

In this episode, I highlight an article published on March 16, 2018 in the New York Times entitled, "Picture A Leader, Is She A Woman?" (link: https://nyti.ms/2JSenCQ) While I find the article fascinating, what I find even more interesting is that it is completely different than my own experience inside of healthcare. If I was asked to draw a picture of a leader, I would draw an image of a female. Most importantly, I am sad that no one draws a self-portrait. Leadership, like healthcare, happens at the N of 1. Feel free to follow me on Twitter and Instagram as Cancergeek. If you have any other questions, comments, or topics you would like me to address or share my thoughts on, please email me at cancergeek@gmail.com. ~Cancergeek

Welcome to the launch of Observations via Cancergeek. On episode 001 Sam's Story & Twitter I highlight the power of patient's, their stories, and the importance of remembering to share their stories inside of healthcare. I highlight the importance of tools such as Twitter. The tools we have, allow us to recall the past today so that we may connect to tomorrow. This allows us to document, share, and amplify stories and information. I hope you enjoy this episode. If there are questions you have, topics you would like me to discuss, or just want to say hello, please find me at cancergeek@gmail.com or on Twitter and InstaGram as @Cancergeek Care happens at the N of 1. Cancergeek