Podcast appearances and mentions of harbin clinic

Karl Gyden, Director of Payer Contracts at Harbin Clinic, joined the podcast to talk about how payer negotiations are changing, compliance with the No Surprises Act and more.

In this Oncology, Etc. episode, Drs. Patrick Loehrer and David Johnson Speak with Drs. Lecia Sequist (Massachusetts General Hospital) and Melissa Dillmon (Harbin Clinic) on how ASCO's Leadership Development Program (LDP) has taken them down varying paths, as well as the ways it has influenced their lives, careers, and the lives of those around them. Subscribe: Apple Podcasts, Google Podcasts | Additional resources: education.asco.org | Contact Us Air Date: 2/1/22   TRANSCRIPT [MUSIC PLAYING]   PAT LOEHRER: Hi, I'm Pat Loehrer. I'm director of the Center of Global Oncology here at Indiana University. DAVID JOHNSON: And hello. My name is David Johnson. I'm at UT Southwestern in Dallas, Texas. So Pat, we've got a couple of really great guests today. PAT LOEHRER: Yeah. I'm really excited. I've been looking forward to this. DAVID JOHNSON: So have I. Listen. Before we get started, I have a book I want to recommend to you. This one I got over the holidays and just finished it recently. It's called The Doctors Blackwell by Janice Nimura. So as many of our listeners know, Elizabeth Blackwell was the first female physician in America. Her sister Emily also followed her into the medical profession. Nimura really writes, I think, a fascinating biography about both ladies, particularly Elizabeth. And one point she made, and I think it's interesting, it's not really clear why Elizabeth went into medicine. Certainly at the point that she did in the mid-1800s wasn't a profession of great reputation at that time. And, in fact, Nimura describes Elizabeth as, quote, "lacking a caring instinct," which I thought was an interesting characterization of the first female physician. And she indicated that she was hardly a feminist. She was actually opposed to Women's Suffrage, for example. According to Nimura, she became a doctor largely just to show that she could. And then, really, the rest of her career I won't give away. The subplot is really quite interesting. I think you would find it most interesting to recommend to you and our listeners who have a particular interest in medical history. PAT LOEHRER: Actually, I've ordered the book. I can't wait to read it. DAVID JOHNSON: Excellent. PAT LOEHRER: I got a book for Christmas, Lyrics by Paul McCartney. And I read through that. That's fascinating, actually. So 158 of his songs were detailed and the backgrounds for it. So that was kind of fun. We're excited today because we're going to talk to a couple of graduates of our Leadership Development Program. That was a program of ASCO that was conceived a little over a decade ago. It's been, to my mind, one of the best programs that ASCO has done. It has taken younger faculty and oncologists from around the country, and Dave and I were among the first leaders of the program as mentors. I think that was one of the bigger mistakes ASCO has ever done. But despite that, we have a lot of fun. There were 12 graduates each year. They all had projects they presented to the board of directors. There were, if you will, classes and lectures throughout the year on leadership. And they all had projects. And for me, it was the best three years of my life, I think, through ASCO. It was just a lot of fun. And part of it was getting to know a lot of people, including Melissa and Lecia, who are with us today. Lecia is a Professor of Medicine at Harvard and Mass General Hospital. She did her medical school at Harvard, residency at Brigham and Women's Hospital, fellowship at Dana-Farber. She is currently the co-leader of the Cancer Risk Prevention and Early Detection Program at Dana-Farber and director-- I think I want to hear more about this-- she's the director of the Center for Innovation in Early Cancer Detection at MGH. Melissa, she went to Converse College in Spartanburg, South Carolina, went to medical school at Wake Forest. Then did her internship and residency at UAB. She did her fellowship at UAB. And she now serves as the Chairman of the Department of Oncology and the Board of Directors at the Harbin Clinic. And we're so excited to have both of you here. DAVID JOHNSON: Yeah. Very much so. And why don't we get started by just getting a little background information. Melissa, let's start with you. Can you tell us a little bit about how you got into medicine and, more specifically, why did you choose oncology? MELISSA DILLMON: That's a great question. I was a political science major at a women's college in South Carolina and was destined for the State Department. And we used to have January terms. And I mistakenly got put with-- and I don't think it's a mistake-- former graduate of Emigre Medical School, who is a medical oncologist in Greenville, South Carolina, for a six-week term and fell in love with medicine, fell in love with the ministry that he provided to his patients, and followed him to Bowman Gray and went back years later and told him thank you for changing my life. So that's how I got interested in medicine. I come from a long line of accountants and engineers. There is no person in my family in medicine. PAT LOEHRER: I was an engineer. Some of the best people in life are engineers. DAVID JOHNSON: I didn't know you drove a train. [CHUCKLES] PAT LOEHRER: Eat your heart out. DAVID JOHNSON: So Melissa, before you leave, I actually grew up very close to where you practice. How did you end up in Rome, Georgia? MELISSA DILLMON: Well, my dad and his twin are proud graduates of Georgia Tech. So he found me a job. And I said, well, I'm grown up. I was going to stay on faculty at UAB but came to Rome, Georgia and really was excited about the multispecialty group that I ended up joining. There's about 250 of us now. And kind of had the feeling of a university but in a small town. Kind of best of both worlds. Neither of my two daughters have gone to Georgia Tech. One of them is at Georgia. Just won that national championship. But my third one, we're hoping maybe she'll be the one that goes to Georgia Tech. PAT LOEHRER: So you stayed up and watched the game. I have to ask this, right? MELISSA DILLMON: I did. I stayed up to the very end. PAT LOEHRER: And so who are cheering for? Alabama or Georgia? MELISSA DILLMON: Definitely Georgia. PAT LOEHRER: Interesting. Good. Good. DAVID JOHNSON: And Lecia, why don't you tell us about your background and how you got interested in oncology. And let us know if MGH has a football team. [CHUCKLES] LECIA SEQUIST: Oh, sure. Thanks for having me here. This is going to be a fun conversation. So I grew up in the Midwest, in Michigan. But I've been on the East Coast now for the majority of my life. And when I was a resident, I was actually in a primary care track residency program, because I thought I wanted to be a primary care physician. And I really liked the idea of sticking with people, getting to know them over long periods of time, and kind of standing by them through the highs and the lows of their lives. Well, I was finding out in residency that primary care wasn't really like that. That was for television shows. People change primary care doctors and move around so much, it's rare that you actually do get to take care of people for a long time, at least in a big city. And I also found that, for me, primary care was a lot of asking people to do things they didn't want to do-- exercise, lose weight, stop smoking, do this, do that. And I always felt that I was at odds with my patients or nagging them. And then, when I would be in the hospital on oncology rotations, trying that out, I really felt like I was allied with my patients and not nagging them or pushing them, but really here we were together against this fight against cancer. And cancer was what we were fighting together. And I just fell in love with that. So much to the disappointment of the residency program that was really trying to get people to go into primary care, I said, I've got to be a specialist. And here I am. PAT LOEHRER: It's interesting, though, that you do risk reduction and prevention. So you're back to telling patients to lose weight and exercise again, you know? [CHUCKLES] LECIA SEQUIST: Yeah. I guess, in some ways that's true, although I'm not really taking care of primary care patients. But after spending a lot of years doing a more traditional medical oncology track of drug development and targeted therapies, the last five years I have switched my research over, kind of a midlife crisis situation, where I said I've got to do something different. I'm in a rut. And I started looking at new technologies for early detection. And I really enjoyed it because it's something different. For one thing, I just felt like I was in a rut. But it's really a way to be a lot more proactive with the community and to work on issues of social justice, thinking about cancer screening, and who has access and who doesn't, and what can we do better. So I'm really enjoying that in this phase of my career. PAT LOEHRER: Terrific. The four of us are linked because of this Leadership Development Program that the American Society of Clinical Oncology put together. And I think Dave and I are really curious whether, here it is many years later now. It's been almost 9 or 10 years later now. As you reflect on the LDP, what are some of the highlights? What did you learn about yourselves and was the program worthwhile for you? MELISSA DILLMON: Well, I'll start. I was part of the class, 2010-2011, best class ever. And it was the second class in the Leadership Development Program. I applied for the first year's class and didn't get it. And one of my friends and partners, a radiation oncologist, who was very involved in ASCO, encouraged me strongly. Said, don't give up. Try again. And I did. And it was instrumental in developing both my career within ASCO as well as pushing me to leadership positions in my own clinic and in my own state. And helped develop a lot of skills that have made me successful in pushing state legislative efforts. My political science background did not go away, just like her primary care roots. And so I think that the program also made friends with Pat and with Dave and with my co-classmates. And as the years have gone by, and I've gone to ASCO, when you see that LDP ribbon on somebody's tag, you immediately have a connection with them and know that you've been through a similar experience. So I think it's been really instrumental in developing my career. And I'm currently serving as a mentor for the leadership program. So I'm living your life 10 years ago, Pat and Dave, and it's great. DAVID JOHNSON: Oh, I'm sorry. PAT LOEHRER: Terrific. DAVID JOHNSON: [INAUDIBLE] LECIA SEQUIST: I would echo what Missy was saying about how much it's influenced my career. I was in the 2011 class. So I think the year after she was. And I also applied multiple times, and I always tell people who are thinking of applying that it often does take multiple attempts to get in and not to lose faith. The selection committee does like to see that persistence. So definitely apply more than once. I learned so much about what leadership is. I thought it was about being the best in a group of people. So then, being selected to have a certain title. And I just really learned so much during that year, that it doesn't really have anything to do with a title, although that can be a part of it for some people. But it's just more about a style, an approach to your profession, and that you can be a leader if you are the designated head or chief of something, but you can also be a leader if you don't have that designation. And there are many different styles and ways to lead and to help people to ultimately get a group to do the very best that they all can together. And the friends that I made that year from my co-classmates as well as you guys and Jamie, who are our leaders, are just lifelong friends and mentors. And you know, I think it really got me thinking seriously about my choices in my career too and not to just kind of cruise through a career and see what happened and where life took you, but to really plan and to chart your own course and to make sure to reevaluate. And if it's not going the way you want it to, to rechart and replan. DAVID JOHNSON: We had a bunch of different lectures on different topics. Was there one of the lectures or areas that was particularly beneficial to you? PAT LOEHRER: I can think of one. I'll start out by doing this. We threw this in the second year, just for the heck of it. We did this personality testing. And I thought it was fascinating because, in my group, there was a little bit of conflict going on with one of the people in my group. And I realized that we were both acting out our personalities. I like to look at the big picture, and he liked to just zoom in the middle one. And the other thing that I do remember is that we showed the profiles, and it turned out Dave and I were exactly opposite. And then we both said at the same time, we should be married. [CHUCKLES] MELISSA DILLMON: One lesson that stands out in my mind was the press preparation lesson that we received from Press Relations group at ASCO. And I think that was essential for developing skills with regards to preparing for difficult conversations and being able to redirect questions that were difficult. I use that as leader of the Government Relations Committee oftentimes. I will also say that the other lesson that stands out in my mind is conflict resolution because, at the time, I was not chair of my department and was having significant conflicts with the current chair of my department. And that lesson helped me to go back week after week and more constructively work towards a solution and then eventually became chair of that department. So I think those two lessons gave me lifelong skills that I've used in all my leadership roles. LECIA SEQUIST: Yes, it's amazing how 10 years later, we can still remember the specific lectures and specific comments that people made. I remember those that you were talking about Melissa, but yeah, before you had said yours, Pat, I was going to say the same thing, that personality test was extremely helpful. And I certainly don't remember all of the different initials of the personality types. But just to understand that concept that people have different emotional skills and blind spots that very much influence how they deal with others in the workplace. And to be able to think about that when you're having conflict with someone and think about how to take that into a strategy where you can kind of play to their strengths and understand where they're coming from, that was extremely helpful. And then, I also think that talking in small groups with our teams about specific problems we were having or obstacles that we were facing and getting advice from others on how to overcome them, that really started me on a recurrent mission to find friends who I could share that with outside of my institution, over the course of my career. I think that was a real exercise in how valuable that could be. It's so critical to have peer mentors that you can talk to and strategize with and get advice about how to handle something that you're struggling with at work and have people that aren't in the same room full of people or aren't living in it. So they're a little bit more objective. DAVID JOHNSON: Let me ask a question of the two of you. Do you think your home institutions in your case, Lecia, MGH and in your case, Missy, Harbin Clinic, valued that training that you received? Did they recognize it as something that was worth the time that you spent or do you think it just something that happened and they didn't really take notice? MELISSA DILLMON: I learned in LDP that institutions don't love you back. PAT LOEHRER: They don't love you to begin with. Joe Simone. Joe Simone. DAVID JOHNSON: So I take that as a no. Your institution really said, eh, OK, great. We're glad you did it, but so what? LECIA SEQUIST: I wouldn't say that. I don't know that they said, so what? I just, I'm not sure that they-- there was no rolling out the red carpet, thank goodness you did this. But I do think it's had an institutional impact in that I have since encouraged other people to apply from my institution. And I think that only strengthens the institution, to have multiple people going through that program. MELISSA DILLMON: So my clinic, being private practice, when I take time out, it is just a cut from my salary. There's no support given from the institution. But in order to be in positions of leadership, department chair or on the board of directors, which I later was elected to of the clinic, you have to have completed a leadership development program. And the clinic will pay for you to go do those things. But my participation in Leadership Development Program met all those criteria. So my clinic highly values professional development classes or meetings or programs and encourages that. Even if there's no financial support necessarily, it is encouraged, if you want to assume positions of leadership within our clinic. And so I think that it's important for institutions, whether they're private practice or university, to recognize the benefits that come from participation in a program like this. And it was interesting as a mentor this year, we did a personality test, but this time they did an interesting look at what our priorities, our top five priorities or values are. I think it was values. And it was a list of 300 things basically you go through. And you listed your top five values. And then you listed the values of your institution or employer. And then you wanted to look at, did they match? And did your university value what you value? And that was a really interesting exercise to go through because a lot of these young leaders who are taking their time out to do this program did not feel that support necessarily for them seeking out this program. PAT LOEHRER: It's no coincidence that Dave and I asked both of you to join because you both come from different places, if you will. And I think, Melissa, you've just been a rock star in terms of the community practices and so many things that you have done in the leadership roles. And Melissa's, you can't get any more prestigious in being in one of the Boston medical schools and particularly at Mass General. But the other reason we wanted to have you come in is to talk a little bit about your perspective as women and women in leadership roles. And if you could maybe share a little bit about your thoughts and perspectives of gender leadership and what you have noticed in men in leadership roles and women and what lessons you might give to other people, particularly other women in this capacity. MELISSA DILLMON: Well, I think we both were trained in a day. And I might be speaking for you, but when there were, at least here at the institutions where I trained, not that many women in internal medicine. Medical school was probably 45% female by the time I was in medical school. But when you look at the faculty of those medical schools that I went to and trained at, there were very few women in positions of leadership. And so there weren't very many role models. My dean of students at Wake Forest was a female nephrologist. And so she was a huge role model for me. And then I went to UAB, and I remember being asked in my interview, are you OK with being in a male-dominated program? Because you will be in a male-dominated program. I think there were 45 of us in my intern class, and eight of us were female. And I said, that's fine. But I had gone to a women's college, where obviously there were only women leading. So it was a big change for me to go back into a situation where I had to assert my unique female leadership qualities, which are different, and still use those in an effective way to lead. Right now, I'm serving as a mentor also for a small liberal arts college, primarily those interested in going into medicine or nursing, and usually most of those have been female. And so it's been a really great opportunity, because I've had very few mentors who were female, who were positive role models for me. So I think Leadership Development Program, one of the things they taught me was to go back and say thank you to your leaders and to be a leader for others. And specifically, as a female leader, I think that has been an important call for me. After leaving Leadership Development Program, I went back and ran for the board of my clinic as the first female to be on my board. My clinic was started in the 1860s, I think right after the Civil War, and I'm still the only female on that board. And I feel that it's important for me to stay there or to promote up more females within my clinic to be on that board because I think that having a diverse board helps in bringing different skill sets to the table. So I think Leadership Development Program gave me that courage to step up. LECIA SEQUIST: That's inspiring. Congratulations on being the first woman and may there be more soon. Yeah. I don't know that I've felt that I was in as much of a male-dominated field up in Boston. But certainly, leadership in my hospital and in my cancer center has been more male-dominated. And I think as I'm getting older now, I definitely appreciate-- of course, every individual has different leadership style. So you can't just paint a broad brush and say men are this type of leader and women are that type of leader. Everyone's a little bit different. But in general, I think women do tend to have a different leadership style and one that is maybe, present company not included, one that's less talking and more listening. And I think, when I was younger and trying to become a leader, I really felt out of peer pressure that I needed to talk more and sort of demonstrate more what a good leader I could be or what great thoughts I had. And I've really come to embrace a more listening type of leadership, which I have been happy to say that younger women that I work with have come up to me privately and thanked me for. And so I do think it's important to have all different types of role models for our junior faculty and all different types of styles, sort of on display and doing their best so that people can find something that matches with their own unique style to emulate. PAT LOEHRER: One of the lessons I learned a long time ago from someone, and I loved it, a great leader is one that changes the conversation. And to your point of listening, but it's really changing the conversation, deflecting it around it so that other people are talking. But you have a little role in moving that around. And I always liked that. MELISSA DILLMON: Today, I was listening to the National Press Conference, and I heard a definition of leadership that disturbed me. And I thought, I don't think that's my definition of leadership. So I think that defining what your type of leadership style is, is something that leadership development helped me with. And then, once I knew what my leadership style was, then using those skills to pull together a team and achieve a goal, a common goal, not the description of leadership today, which was pushing something up a mountain and rolling over boulders and doing whatever you had to do to get your way. I thought, well, that's not leadership, not my leadership. So I think that that was something that Leadership Development Program help me do is identify what my leadership style is and what kind of leader I want to be. DAVID JOHNSON: So I want to follow up on a point that both of you are making in a slightly different way. And that is, who are your role models? I mean, apart from Pat and me, but who are your role models? [CHUCKLES] LECIA SEQUIST: I've had lots of role models over the years, and I think at the beginning, my role models were really people that I wanted to emulate and be just like them. And that probably started with Tom Lynch, who was my initial research mentor when I started in lung cancer. And a lot of it was just the way he was with patients. I wanted to have that ability to make a patient feel just right at home from the first minute they walked in the door, which Tom is a master at. But over time, I think my mentors or my heroes have more become people that are different than me. And I'm not trying to be like them. But I appreciate the ways in which they lead or in which they conduct something, like balancing their home life and their professional life in a way that's just different but I appreciate. And that, in lung cancer, I would say another real big influence on my career has been Heather Wakely. She really has been my main female role model in my career. And she's given so much of her time to me and to so many to kind of sit and have personal talks and pep talks and strategies about what we're doing in our home institutions. DAVID JOHNSON: Missy, what about you? MELISSA DILLMON: So I would say from a professional standpoint, someone I respect and see as a mentor is actually now the female CEO of my clinic, who has been with my clinic for 20 years and worked her way up. And I think that's because she has retained her femininity, but she is recognized as a tiger that no hospital or other clinic wants to make mad. So she has a way of leading and listening that is unique. And I have learned a lot from her over the years and watched her rise in her leadership skills as I have alongside of her. And then, I will say from a personal perspective, one of the books I have enjoyed reading recently really talks a lot about servant leadership. And so I've really tried to identify servant leaders in my community and why it is that they're able to weather the storms of the last couple of years, for instance, and why their teams rally behind them and support them. And they're successful. And my husband is a restaurant owner times three, opening two of those, one right before COVID and one during COVID and yet has been able to mobilize a team. And that's because he's a servant leader that will get back in the kitchen and make pastry cream if that's what needs to be done or make reservations. And so I think during the last two years, what I have learned from that is to be a servant leader in the tough times has really helped rally my team and my clinic to be better and to continue to work, despite the challenges for our patients, for the bigger goal. PAT LOEHRER: Love it. We recently had a guy give a talk here at IU, and the lecture was on being a visionary leader. And to be honest, it was fine. It was good, but being a servant leader and being part of a group is more important than being the one right up in front. And it's good to be a follower too as a leader. So I really appreciate those comments. Just in a couple of sentences, I don't know if you guys could do this and reflect a little bit about your younger self. Say you're 21, and you could give yourself some advice now, what would those pieces of advice be? LECIA SEQUIST: I think one thing, and that's the common thread I've heard among a lot of more senior people in medicine, or in any profession probably, is that the things that you think are disappointments at the time often turn out to be some of the greatest opportunities that you're faced with. You plan and you think things are going to go a certain way, and then something doesn't work out, and you're very disappointed. But it's usually that process of how you deal with that disappointment that actually brings so much opportunity back to you. You can't see it at the moment. All you see is the disappointment. But I think that's a big lesson. PAT LOEHRER: Terrific. MELISSA DILLMON: So kind of similar to that, Lecia, doing our personality test this time, I wish I had done that same exact test 10 years ago, because I'd like to see what my leadership personality was 10 years ago versus now. I would not have scored as high in certain areas that I think I do now. And I think that one of the biggest things I have learned is, I'm very much a person of tradition. And I like things to continue the way I expect them, and I like things to be planned and done in medical school in four years, done with fellowship. So I like a regimen and a routine. And I have learned over the years to be comfortable with change. And I wish I had learned that earlier and to be open to change and listening to new ideas. I think that probably for the first few years of my practice and training, I was very much, this is the way it's done. And I think that that expressive part of my leadership had not developed yet. And I think that being open to change and looking at things in new ways, I wish I had learned that earlier. DAVID JOHNSON: So we only have a few minutes left. And what we have done in previous episodes, we like to ask our guests to tell us the book they've read recently or maybe a documentary or something they've watched recently that they would recommend to our listeners. LECIA SEQUIST: I really enjoyed the book The Four Winds by Kristin Hannah. That is a historical fiction about the Great Depression and the Dust Bowl and the migration of farmers from the Central Plains out to the West. And it was a really captivating book with a female protagonist. I enjoyed it quite a bit. MELISSA DILLMON: It's funny. I read that one just a few months ago. I love historical fiction, but I would say recently, and I know it's not a new book, Andre Agassi's Open, his autobiography, I found fascinating. I love sports, but it was very interesting to me to see how someone who's thrown into the limelight at a very early age and the pressure put on him by his parents and how that affected the course of his life. I found it a fascinating book and very insightful. And I like to play tennis, but I'm not a tennis player. But I found it interesting as a parent, who's got several sports-minded children, it gave me some lessons about parenting and how to just raise your children and where the focus should be. DAVID JOHNSON: Both my wife and daughter had been tennis players. I'm sure they would both love reading that book. Thanks for that recommendation. LECIA SEQUIST: It's a great book. DAVID JOHNSON: Well, that's really all the time we have for today. And Pat and I want to thank both of you, Missy and Lecia, for joining us. It's been a terrific conversation. Thank you so much for what you do. You're both, in our minds, fantastic leaders. You were when you arrived, and you certainly have been ever since. So thanks so much for that. I want to thank all of our listeners for tuning in. This is Oncology, Et Cetera an ASCO Educational Podcast. And we really have talked about anything and everything. And we'd like to continue to do so. So if you have an idea for a topic or a guest, please email us at education@asco.org. Thanks again for tuning in. And Pat, I just wanted you know I've ordered a chicken and an egg from Amazon. [CHUCKLES] PAT LOEHRER: It's because you couldn't quite make up your mind which was going to come first. I love it. I love it. You're the best. Thanks for doing this. And Dave, it's good to see you, as always. Take care. DAVID JOHNSON: Thank you so much. We really, really appreciate it. LECIA SEQUIST: Thank you. MELISSA DILLMON: Great to speak with you. Bye. [MUSIC PLAYING]   SPEAKER 1: Thank you for listening to this week's episode. To make us part of your weekly routine, click Subscribe. Let us know what you think by leaving a review. For more information, visit the comprehensive e-learning center at elearning.asco.org. [MUSIC PLAYING]   The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. [MUSIC PLAYING]

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On this episode, Karolyn talks with radiation oncologist Dr. Matt Mumber to get an update on the latest advances with radiation treatment. Dr. Mumber will also describe the potential side effects of radiation treatment and how to help heal from those side effects. Dr. Mumber is an integrative oncologist with the Harbin Clinic in Rome, GA, where he specializes in integrative oncology.Five to Thrive Live Radio Show is broadcast live at 7pm ET on W4CS – The Cancer Support Network (www.w4cs.com) part of Talk 4 Radio (www.talk4radio.com) on the Talk 4 Media Network (www.talk4media.com). This podcast is also available on Talk 4 Podcasting (www.talk4podcasting.com).

Conversations With Success Podcast Episode 48 features, Josh McClure, Corporate Communications and Patient Experience Manager, Harbin Clinic, conversing on "Perseverance"!  In this episode Eric and Josh discuss how to keep moving despite obstacles and a personal growth tool that will help you start, stop, or continue during your journey of success. Josh also shares 4 (Four) steps sure to assist turning any setback into a great bounce back!

Matthew Mumber, M.D., practices medicine as a board-certified radiation oncologist with the Harbin Clinic in Rome. After entering private practice, Matt attended and graduated from Dr. Andrew Weil's fellowship in integrative medicine at the University of Arizona, where he met Rachel Remen and attended trainings on facilitation of physician-patient retreat groups through Commonweal. Subsequently, Matt attended and graduated from a 2-year program on spirituality at the Living School for Action and Contemplation through the Rohr Institute, where he studied with Jim Finley. An author of academic and lay press texts on the subject of healing, Matt has edited an academic textbook entitled Integrative Oncology: Principles and Practice and also co-wrote a lay-press health and wellness book, Sustainable Wellness with Heather Reed. He has served as the president of the Georgia Society of Clinical Oncology. His first book of poetry, In the Awakening Season, was published in fall 2020. Matt's poetry, which draws on his personal, professional, cultural and natural-world experiences, stems from his Lectio Divina meditation and spiritual practice. Matt has facilitated groups and retreats focused on transformation and healing for over twenty years. He lives in Georgia with his wife and three sons.

Matthew Mumber, M.D., practices medicine as a board-certified radiation oncologist with the Harbin Clinic in Rome. After entering private practice, Matt attended and graduated from Dr. Andrew Weil’s fellowship in integrative medicine at the University of Arizona, where he met Rachel Remen and attended trainings on facilitation of physician-patient retreat groups through Commonweal. Subsequently, Matt attended and graduated from a 2-year program on spirituality at the Living School for Action and Contemplation through the Rohr Institute, where he studied with Jim Finley. An author of academic and lay press texts on the subject of healing, Matt has edited an academic textbook entitled Integrative Oncology: Principles and Practice and also co-wrote a lay-press health and wellness book, Sustainable Wellness with Heather Reed. He has served as the president of the Georgia Society of Clinical Oncology. His first book of poetry, In the Awakening Season, was published in fall 2020. Matt’s poetry, which draws on his personal, professional, cultural and natural-world experiences, stems from his Lectio Divina meditation and spiritual practice. Matt has facilitated groups and retreats focused on transformation and healing for over twenty years. He lives in Georgia with his wife and three sons.

“Some say no one really lives his own life, true face covered by a mask, stuck tight and fashioned by a series of random voices, interactions, childhood dreams of flying, long lost, adult desires for comfort superficially gained, mismatched pieces welded sequentially over time, firmly, to the fragile, baby skin of who we really are. Some say all paths lead to these false lives discarded, rain-soaked clothes hanging against a damp, shadowed stone wall. Standing here, midlife, children grown and mostly gone, I let the cold, winter air in.   ~This Precious Life poem by Matt Mumber   Valeria interviews Dr. Mumber, the author of In The Awakening Season Dr. Matthew Mumber practices medicine as a board-certified radiation oncologist with the Harbin Clinic in Rome. After entering private practice, Matt attended and graduated from Dr. Andrew Weil's fellowship in integrative medicine at the University of Arizona, where he met Rachel Remen and attended trainings on facilitation of physician-patient retreat groups through Commonweal. Subsequently, Matt attended and graduated from a 2-year program on spirituality at the Living School for Action and Contemplation through the Rohr Institute, where he studied with Jim Finley. An author of academic and lay press texts on the subject of healing, Matt has edited an academic textbook entitled Integrative Oncology: Principles and Practice  and also co-wrote a lay-press health and wellness book, Sustainable Wellness with Heather Reed. He has served as the president of the Georgia Society of Clinical Oncology. Matt's poetry, which draws on his personal, professional, cultural and natural-world experiences, stems from his lectio divina meditation and spiritual practice. Matt has facilitated groups and retreats focused on transformation and healing for over twenty years.   To learn more about Dr. Matt Mumber, please visit her website: https://drmattmumber.com/ For Intro-free episodes: https://www.patreon.com/aquestforwellbeingpodcast Podcast Page: https://fitforjoy.org/podcast   — This podcast is a quest for well-being, a quest for a meaningful life to the exploration of fundamental truths, enlightening ideas, insights on physical, mental, and spiritual health. The inspiration is Love. The aspiration is to awaken new ways of thinking that can lead us to a new way of being, being well.

For five blistering days, most of what we heard about was face coverings -- also known as masks. Yes votes, no votes, "education," "marketing plans," litigation, masks having some imaginary connection to the state's economy and for reasons that should be criminal -- politics as well. All over as simple a thing as trying to save lives -- our own, our friends, our family, our community. By Friday, most of us were numb and confused. The adults needed to take control. They did so in such a way that any executive order signed by a one-term governor trying to bully local governments would have the impact of a dying fly. The private sector stood up and won't be seated any time soon. Starting with Starbacks and later including Walmart, Sam's Club, Kroger, Publix, Target, Kohl's, Lowe's and Home Depot, some of the biggest names in retail make it easy for all to understand: Wear a mask or stay out of our stores. By midday Friday, Harbin Clinic did the same, requiring all patients and visitors to all offices to wear masks during the entirety of their stay. We expect others to follow. And soon. Does the private sector have the clout? You bet. Now's the time for the locals, the moms-and-pops to step up as well. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/john-druckenmiller/support

A 2019 report on physician burnout found that nearly 60% of physicians identified as either burned out, colloquially depressed, or clinically depressed. And some estimates indicate that 76% of physicians worldwide are experiencing burnout. In this interview, integrative medical expert and radiation oncologist, Matt Mumber, MD, reminds practitioners to try a mind-body integrative approach to reversing and reducing risk of burnout. Mumber is presently a board-certified radiation oncologist with the Harbin Clinic in Rome, Georgia. Approximate listening time: 17 minutes About the Expert Matt Mumber, MD, is a board-certified radiation oncologist with the Harbin Clinic in Rome, Georgia. He received his medical doctorate from the University of Virginia and he also did a fellowship in integrative medicine with the University of Arizona. He is the coauthor of the book Sustainable Wellness and the editor of the textbook Integrative Oncology: Principles and Practice. Mumber is the director of medical affairs of the iTHRIVE Plan.

Coronavirus updates: The day after: Most Rome/Floyd restaurants move to a to-go scenario while some notables close temporarily as enforcement begins. It is an emotional time for the service industry. We have more on that in today’s Rant of the Day. Local: At least 78 awaiting test results in Floyd, Bartow; 55 hospitalized. We also remember Beth Wells of Rome, the Church at Liberty Square choir member and volunteer, who was the area's first coronavirus victim. Statewide: 10 deaths; 287 positive tests. Coronavirus/health: Hospitals canceling nonessential surgeries, procedures. New screenings at Harbin Clinic sites. Updates from Public Health. Resource guide. Business: #ForBartow page combines business, community updates. Banks, credit union urge mobile, drive-through. Bowling alleys, Dollar Days close. Changing times: With public services suspended, some churches are turning to Facebook, webcasts to spread The Word. Today's other news: Remembering Glynn Stone, former pastor of West Rome Baptist Church, who died Thursday following a crash in Texas. Ware Mechanical Weather Center: A bit cooler today and through the weekend; half inch of rain likely today. Rant of the Day: As restaurants move to to-go only, what will happen to our owners and the people they employ? We have something like 300 restaurants in Rome and Floyd County. There are 20 or so restaurants up and down Broad Street as well as in connected areas and now across the Oostanaula on West Third. These owners and operators have leases to pay in most cases. While some are cushioned thanks to spouses in the medical community or financial backers, others are doing this strictly from the customers coming through the door. Rent, mortgages, utilities, inventory, overall sanitary needs. It adds up quickly. Add to that the salaries of employees. Sure, some get tips to sustain the hourly rate but what about those in the kitchen or doing clean up? --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/john-druckenmiller/support

Dr. McBride from the Harbin Clinic answers our questions about the coronavirus. 

Today's headlines: Corona virus updates: Floyd leasing space at soon-to-close Kindred Hospital 'just in case' as threat continues. Local/state: 3 patients with 'positive' tests remain at Redmond, Floyd. Georgia has 7 cases, 16 others with presumptive tests. Calhoun/Gordon task force meets. Alabama to post weekly test results – negative and positive. 28 deaths so far in the United States including 23 in Washington State, two in Florida, two in California and one in New Jersey. 1,037 confirmed U.S. cases. Druck Report: What to know about coronavirus with Dr. Charles McBride, Harbin Clinic chief medical officer. Business: Robinson changes plans for The District off West Third; new concept includes several buildings with housing aimed at millenials. Politics: Local House members OK state spending plan that cuts teacher raises to $1,000, half of what governor sought. Politics: Advance voting continues; Floyd can vote this Saturday and Sunday; Saturday voting in Bartow, Gordon, Polk counties. MIDWEEK OBSERVATIONS: A different level of coronavirus concerns Item one: One of the early predictions we heard as the coronavirus threat grew has come true. Early speculation was that Floyd, Redmond or even Public Health would grab some of the vacating space at Kindred Hospital as it prepares to close April 6. Floyd is leasing some rooms on a “just in case” basis. Kindred does have the needed “negative pressure” rooms used in isolation cases. The other area that came up as an overflow site was the Northwest Georgia Regional Hospital buildings. We’d rather not say in what capacity. Item two: the numbers. We’re already seeing some number issues with corona virus confirmations and presumptive tests in the state. Example: The latest Redmond case was not included in the state roundup Tuesday night. Plus, some of those tracking maps showed Georgia with 17 cases. Georgia has seven confirmed cases, 16 presumptive cases. At least we think that’s correct. Let’s get this worked out today, please. Item three, the numbers again. Maybe we heard it all wrong the other day with it was announced those cruise ship patients would be coming to Dobbins Air Force Base in Marietta for testing and quarantine. First we heard 34 people. Then that there were 34 people from metro Atlanta in the group from the cruise ship. Now WSB reports two planes carrying a total of 271 passengers were en route. In fact, the first wave of patients has arrived. Again, nail this down. Item four: Again, a well done to the Calhoun-Gordon County Corona virus task force. As promised, this collection of government, first responders and healthcare leaders are meeting on a weekly basis and reporting back to the community. Calhoun/Gordon continues to lead the way in this area. Item five: As of this recording, Alabama has not had a positive corona virus test, one of the few states that hasn’t. Testing has been under way and will continue. What’s interesting: The state plans to make public the number of tests it conducts overall. Good luck trying to get a Georgia-based source to say as much despite all the transparency hype. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/john-druckenmiller/support

First up, our coronavirus updates: Local: The Polk County patient remains 'stable' at Floyd Medical Center. Also, the 20 caregivers at Floyd remain under self-quarantined. No updates yet on 3 tested from Redmond Regional Medical Center but we do expect those results today. Cartersville Medical has not had any patients or tests as of Sunday. Rome’s City Commission is scheduled to hear from the emergency management director during an extra-long caucus beginning at 4 p.m. in the Sam King Room at City Hall. The meeting is open to all. Phoenix Air of Cartersville is being hailed for getting 1,100 Americans out of China as the crisis began. We’re also following confirmation that two Jacksonville State students are self-quarantined after their recent exposure to a coronavirus patient in Georgia. JSU notified the student body on Friday. We’ll have updates today. For all your virus answers, please listen to our podcast with Dr. Charles McBride, chief medical officer at Harbin Clinic. State/nation: 4 more presumptive tests in Georgia, bringing total to six in all. Five confirmed cases in the state as well, including the Polk patient. 34 cruise ship passengers heading to quarantine at Dobbins in Marietta. 19 dead so far in the U.S. as even more states report first-time cases. Other headlines today: Local artist Cabell Sweeney expanding her Cabell's Designs Studio, bringing her creative touch to Bale Street in the growing River Arts District. Politics: Daily advance voting today through March 20 -- weekend included -- for presidential primary. Updated election calendar. Ware Mechanical Weather Center: Look for highs near 70 later in the week; a bit more rain as well. --- Support this podcast: https://anchor.fm/john-druckenmiller/support

With new interest on the coronavirus in our community, dozens of questions are on the table. We have those answers today as Dr. Charles E. McBride, Chief Medical Officer at Harbin Clinic, joined John Druckenmiller to discuss: Feeling bad: The potential symptoms and how the virus is spread. Most of those feeling ill in our area likely are battling a cold or the flu. Treatment: Don't go to the ER or immediate care first. Talk to your doctor or healthcare professionals and follow their recommended steps. One way to do us: Use your "patient portal." At this time, no testing is being done in Floyd County. Staying safe: If feeling ill, stay home. Give yourself a little "social space." Wash your hands often, with soapy water or alcohol-based gel hand sanitizer. He adds that coronavirus is new and different, and that the healthcare community is learning along the way. Best bet, he says, don't fear but respect the virus. About this podcast: We thank Brand Red Studios for the production support of our long-form podcasts and Todd La Berge for another superior job producing this conversation. The Druck Report is part of the Hometown Podcast Network. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/john-druckenmiller/support

A 2019 report on physician burnout found that nearly 60% of physicians identified as either burned out, colloquially depressed, or clinically depressed. In this interview, integrative medical expert and radiation oncologist, Matt Mumber, MD, reminds practitioners to try a mind-body integrative approach to reversing and reducing risk of burnout. Dr. Mumber is presently a board certified radiation oncologist with the Harbin Clinic in Rome, GA.

The latest from a very busy news week: Latest updates on the manhunt for the suspect in a double murder in Chattooga County. The suspect has been spotted near Birmingham; the victims have been identified. Harbin Clinic breaks ground on new pediatrics center rising at John Maddox and Woodrow Wilson Way. Full Circle Wellness of Rome opens Oct. 1 at 318 Broad St. Druck Report: As 'vaping' spreads among our middle and high schoolers as well as adults, Erin Hernandez of the Northwest Georgia Regional Cancer Coalition details escalating health risks. Ware Mechanical Weather Center: Watch for morning fog. Morning lows to drop into the mid 60s or lower through Saturday. Plus: Storm Dorian links. Rant of the Day: As $150 million in growth continues near Redmond Corridor, a look at what could follow. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/john-druckenmiller/support

Lots of health and football news today including: Harbin Clinic's second campus on Gentilly Boulevard in Cartersville begins welcoming patients Aug. 19. Harbin Clinic named presenting sponsor of the Corky Kell Classic at Barron Stadium on Aug. 22. Weekend! presented by The Forum River Center: Rome Braves at home in season's final weeks. Chieftains' low country boil. Rodeo at the fairgrounds. Night at the Museum Health: Floyd Urgent Care offices add 'Save My Spot.' Sports: Darlington opens high school scrimmages tonight. Falcons at Dolphins in preseason NFL at 7:30 p.m. Peaks & Valleys: Cool way to start school. Families, not empty suits, should have greeted Pence, Air Force 2. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/john-druckenmiller/support

In this interview, Natural Medicine Journal Publisher Karolyn Gazella discusses the challenges and solutions associated with enhanced integrative care for cancer survivors with integrative oncologist Dr. Matt Mumber. More than 15.5 million cancer survivors are currently living in the United States, with more than two-thirds alive five years after their diagnosis. And yet, most survivors report side effects long after treatment and many experience significant distress and fear of recurrence. Mumber describes how an integrative approach can help all practitioners serve the special needs of cancer survivors in their practice. About the Expert Matt Mumber, MD, is a board certified radiation oncologist with the Harbin Clinic in Rome, Georgia. He received his medical doctorate from the University of Virginia and he also did a fellowship in integrative medicine with the University of Arizona. He is the coauthor of the book Sustainable Wellnessand the editor of the textbook Integrative Oncology: Principles and Practice. Mumber is the director of medical affairs of the iTHRIVE Plan. About the Sponsor iTHRIVE is an online web application that creates personalized wellness plans for cancer survivors that focuses on five key areas: diet, movement, environment, rejuvenation, and spirit. Cancer centers, hospitals, and clinics can license the iTHRIVE Plan to help meet the special needs of their cancer survivors. iTHRIVE also helps cancer centers meet the Commission on Cancer Mandate. For more information, visit iTHRIVEplan.com. Transcript Karolyn Gazella: Hello, I'm Karolyn Gazella, the publisher of the Natural Medicine Journal. Today our topic is cancer survivorship. My guest is radiation oncologist, Dr. Matt Mumber, who's also the editor of the textbook, Integrative Oncology. Before we begin, I'd like to thank the sponsor of this podcast, who is iTHRIVE Plan. That's ithriveplan.com. Dr. Mumber, thank you so much joining me. Matt Mumber: Oh, thanks for having me. It's always good talking with you. Gazella: Yeah, well, you know I've been reading research clearly showing that cancer survivors say they have unmet needs and they have special needs. Take us through what some of those needs are, specific to cancer survivors. Mumber: The diagnosis of cancer is really a whole-person diagnosis. People wonder about, first thing they wonder, "Gosh, am I to somehow blame for this diagnosis?" I think people think about that. Of course, various levels of lifestyle and choices they've made throughout their life. Whether they're smokers, how they've generally eaten, what environment they live in. What their family history is, so they think about all of that, obviously. Then stress weighs in on it. When people get the diagnosis, they have a lot of stress. Then people maybe even think about compounding the fact their lives are stressful, well maybe my stress caused the cancer. That type of thing. That all impacts them and then the physical aspect of it. Of course, we're all, as whole people, we have a physical body that we inhabit. We have our minds and our spirits, our heart, our emotions, and pretty much all of those are impacted by cancer diagnosis. The physical aspects, people can feel different, they can have symptoms related to the cancer or actual problems. Bleeding, pain and other issues that are outside of normal function. Then, for example, just the fatigue that comes along with having a cancer diagnosis, because fatigue is multifactorial, too, and tends to weigh on people emotionally. Then that has a physical ramification. The stress and so forth can cause problems with how we eat, drink, move. How we sleep at night. How we relate to others. Different things like sexuality and other aspects that we take for granted as just people walking around being healthy. One of my teachers says that he really enjoys, every now and then, takes time to enjoy the fact that he doesn't have a toothache, because when he has a toothache, it's kind of all-encompassing, so we can be happy our non-toothacheness. I think people with cancer often feel that way. "Gosh, if I could just get a break from having cancer," because once you have cancer you're kind of a cancer patient and you're a cancer survivor, so it really does define who you are. It's a very much of whole person oriented type of thing. Of course there's all the practical matters, financial, social, and so forth. It really does affect people in a multifactorial way. Perhaps because of the general stigma that's associated with a diagnosis of cancer, for then has been for decades, perhaps more than most of other types of chronic illnesses. Gazella: I think you may be right, and then there's this issue of fear of reoccurrence. I read in one study saying that upwards of 90% of cancer patients, even if it's not valid, they're afraid. They're so afraid of a reoccurrence of getting cancer again. Mumber: That's right. No doubt. Gazella: You've just mentioned a lot of factors. Is this the reason why the American College of Surgeon created the Commission on Cancer Mandate, and you can talk to us a little bout about that Commission on Cancer Mandate? Mumber: The Commission on Cancer is a wonderful organization, their real mission is to make all of the hospitals that participate in their system as good as they can be. First things they start with were very conventional, let's make sure we have accurate data. Let's make sure people are being treated in facilities that have up-to-date conventional types of processes and that they're recorded and they're followed over time so we can then get feedback and learn and grow with regards to how we're doing in the conventional care of cancer patients. Then about the time that the Institute of Medicine started to branch out and look at things like cancer survivorship and psycho-social screening, and integrative approaches ... what I would call integrative approaches. They started saying, "Gosh, this is just as important as the conventional. We've got that under control. We've got that to the point where we have standards, we really need to create some standards that affect more of this whole person, outside of the what we do to people," type of scenario. That's really when they started to build these criteria, starting with patient navigation, trying to identify access to caring disparities that people face. Then moving on to actual distress screening, so that we can find a way to identify the stress, almost like another vital sign. Recognize distress and then intervene early before it becomes a problem. Then moving past when we've gone through active treatment and people that have been treated definitely and curatively and they've done active treatment. Like I said, they're always cancer patients. Cancer survivors now. How do we address that survivorship such that we can make sure they're getting appropriate screenings, that they understand what's been done to them and ultimately what they need to do in order to stay connected, to try to decrease recurrence rates and to function in a way that gives them the best chance of surviving long term. Gazella: Speaking of these special needs, it certainly seems that because of the sheer number of cancer survivors, pretty soon there's going to be 20 million cancer survivors alive in the United States alone. It certainly seems like their care is spilling out into other medical disciplines, well beyond oncology. I'm wondering what role can general practitioners or integrative practitioners play when it comes to meeting the special needs. Physical, mental, emotional, special needs of cancer survivors. Mumber: Medicine, I think is evolving. Medicine has evolved from being purely focused on the downhill, what we do to somebody, and has really become more of a partnership where we are able to focus on the commonalities that make us all human and to do so in a way that is therapeutic. For the physician, the physician can bring the power of themselves as they are, what they do to help stay healthy. They can bring in a compassionate way to the doctor patient interaction. Primary care has led the way in this, with the primary care patient center medical home concept. That's now actually something that's billable and is paid for through Medicare, where you can get a group of people together and you can give them ideas and ways to help prevent certain illnesses, for example diabetes, heart disease. Haven't done it so much with cancer yet, because that hasn't filtered into the primary care mechanism, but it's happening and it's a good way for that to happen, because there's only so many oncologists available and there's a much larger pool of primary care doctors. Prevention has really been in the purview of primary care physicians. There's really 3 types of prevention. Primary prevention in order to try to prevent diseases before they come up. Secondary prevention to prevent disease when people are high risk group, for example prevent heart disease or lung disease from people that are already smokers. Then finally tertiary prevention, which means when people already have an illness or have a diagnosis, for example, cancer, we try to decrease the chance of that recurring or having it again. The primary care center medical home is mainly focused on the primary prevention, somewhat in the secondary prevention and then it also filters over into the tertiary prevention. In each of those groups, one of the foundational principles that I found to be true in my life is that there's tremendous power in getting groups of people together with similar experience. It's kind of like if I went, no matter how compassionate I am, if I went and tried to sit down with a group of pregnant women and talk with them about what it's like to be pregnant and to be able to have a baby and so forth, I would just be ... There's no way I would add anything that would mean anything to anybody, but if you get a group of pregnant women together, they're going to be able to speak a language that women who have gone through that experience will have. I think that's a very powerful thing and that's filtering into medicine more and more, it's getting reimbursed by Medicare through the primary care patient center medical home. It's filtering into oncology care. Certainly there are specialty oncology medical homes, as well. However they tend to focus more on what to do during therapy, how to support patients during therapy and it really hasn't filtered over into the tertiary prevention model. I think as a field, medicine in general is evolving a very positive way, mainly it costs so much to have illness, right? If we can prevent it, the ounce of prevention, right? I think that's a good thing. I do think that's the wave of the future. How it's going to filter into oncology versus primary care, with regards to that tertiary prevention piece, I think that's still to be worked out. Gazella: Yeah, I would agree. We're making progress though. It is all about serving these special needs of cancer survivors. Now you are the lead investigator on a study that combined patient navigators with an online tool. Can you tell us a little bit about that research and what the outcomes were? Mumber: Yeah, yeah, so my research is mainly focused on the application and implementation of integrative approaches, especially those that focus on people being able to make and embrace long-term change, kind of what I think of as the difference between translation, which is just giving people information and hoping that they'll understand it. Maybe apply it, versus transformation, which is being able to actually apply information in one's life and make a major change in life. Initially, we started looking at, can we approach this with physicians, for example with integrative medicine approach. We did a study about a dozen or so years ago that was a computer-based educational program, did it in conjunction with the University of Arizona and the Georgia Center of Oncology Research and Education and GSSACO, Georgia's State Society of the American Society for Clinical Oncology. Basically, we did a prostate cancer where they did integrative medicine, educational module, to educate physicians and provides, nurses, other providers associated with prostate cancer about different complementary alternative methods associated with prostate cancer. We found that that web based educational intervention was very successful. Kind of fast forward to this most recent study, the next logical step would be is there anything we can do to improve upon the ability of this translational information delivery to move more towards a transformational approach. Or what people think of is generally a transformational approach. The study that we did was, basically, a randomized trial, a small pilot trial. We had 24 people, 24 patient navigators in the state of Georgia that were randomized in this trial to give 1 of either 2 arms. One was an educational, web-based modality that looked at educating about integrative oncology for a patient navigators. We had a bunch of didactic presentation. We had a weekly video presentation that people could watch with regards to how they eat, drink, move, manage their stress, based upon our sustainable wellness book that we had ... Heather Reed and I had written. Then there were a variety of materials that were present. There was the ability to chat online. That was one arm of the study. The other arm of the study was to do all that, but to also to have the opportunity to do a residential retreat, which I've been facilitating those types of educational types of retreats for years. Focusing more on a variety of contemplative practices and a personal experience and providing those contemplative practices with people that have similar experience. In this case, patient navigators. The word contemplative is often kind of confusing. It sounds kind of mysterious and mystical. Contemplative is a good way of thinking about, contemplative practice when we can be in a position in which our body and our mind and our heart are in the same place at the same time. That's likely a contemplative practice. One of the features of it are that the result of that is that it brings about a certain level of awareness. It brings about a sense of communion and it brings about a sense of connection. We would sit with people. We had a three day residential retreat that Heather and I facilitated and basically just experienced a variety of things, like yoga, meditation, massages. Everybody loves massage. We did some creative art therapy, like picture drawing and interpretation of those things. We randomized the trial and the outcome measure was do people learn better when they have this in person interaction, then they do when they have more of an online interaction. It was a very small study. The numbers hint that there's a slight increase in educational benefit with the in person interaction, in addition to the online interaction. However both interactions resulted in, just like our previous study, significant learning and ability to actually apply these integrative modalities. It was the next step in research with a more focused group. I do think that's it a pretty exciting trial, because it does show the value of somehow having that link to that group of similars. Now whether or not that needs to be based in person or whether it could be based online, with like an online chat that's real active, that's kind of another question, research question, but it was an interesting study. Gazella: Yeah, sounds very interesting. You know the point with some of the emerging research is to reduce the burden of care. It reminds me of research that was presented at this year's ASCO [American Society of Clinical Oncology] with Dr. Hess from Switzerland, who used the web-based modification tool for cancer survivors and she demonstrated that distress was significantly reduced and quality of life significantly enhanced without a face to face visit. I'm just curious, is this in part the way of the future? Mumber: I think it could be. I think, of course, that intervention what they did was really more of a psychologist or psychiatrist doing counseling with the individual. They did a good bit of that. They tried to, instead of having to take the patient's time because there's some access to care and disparity issues, in that study, 70% of the patients had an online presence. They were open to using that modality. The counselors would basically do counseling with the patient, instead of them being in a room, basically do it online. I think as time goes on and as people have more penetrance and more of an online life, I do think that that's going to become more applicable. The current ... It depends on where you are, I guess. It depends on the age of your population and penetrance of internet use and so forth, but I do think that's a positive study. I do think it addresses some of the barriers that can occur, relative to actual time for both the therapist and for the patient, to actually sit down and do it, it's a heck of a lot easier than if you have to travel. Let's say you had to travel 45 minutes. There's also a stigma, I think, to especially the psychological counseling piece where people say, "Gosh, I've got to go to a counselor." It's almost like they're admitting some kind of a weakness. That gets over that barrier as well. I do think it's going to have applicability in multiple methods. Just in the research that we did, relative to the many uses of the internet and how they pertain to educating people and bringing along. There's absolutely no doubt that the internet has revolutionized the ability to educate people, there's no doubt about it. It makes perfect sense that it would have the ability to be applied in this specific situation, to reduce the stress, to do things with cancer patients that require, in the past, that required face to face interactions, but to do so in a way that's much more practical and less costly, ultimately, than actually having to take the time to do that. Yeah, I think it has significant potential benefit. Gazella: Yeah, I would agree. I'd like to talk briefly about the iTHRIVE Plan, which is an online tool. Now you in your clinic, the Harbin Clinic in Georgia, you're using the iTHRIVE plan in conjunction with a nonprofit called Cancer Navigators. I'm wondering what your experience has been with the patients who are using the iTHRIVE plan, in particular. Mumber: Yeah, I think the folks that are using it really enjoy it. Basically, it's a plan that when we set them up, we just basically say, "Look, this is a plan that's written by cancer survivors for cancer survivors." What it does is it evaluates you in 5 different domains of your health, how you eat, how you drink, how you move your body, your spirituality and then how your environment affects you and what things in your environment may be lurking that you're not even aware of that could potentially influence you. Basically, it's written in a way that there's a nice melding of really good, hard science that each one of the little action steps that are given, are discrete action steps. It's really hard for a patient, when they sit in a room for 15 minutes at a follow up visit where we're talking about, "Well, gosh, you got to do your screening here. You've got to come back for this appointment. Got any questions? Okay, hey, by the way, make sure to eat better, drink pretty of fluids. Exercise. Manage your …" It's such a big elephant, it's hard to bite off. What you do is you start off with one discrete action step. Each of those steps, to the extent people happen to have like a little scientific citation with them. It's very, very valuable. The people that have been involved in it, they may not like every one of the steps, because everybody's different. Everybody has their own way of doing things. People have different expertise and so forth, but what I tell them is, "Gosh, if you have a set of action steps and one or two really hit home, that's a big deal," because just think about the difference between saying, "Oh, go ahead, eat better, drink better, move better, etc. Handle your stress," and then giving people an option of let's say 30 different steps that pertain to one of those topics. They can go around, in their own time, on their phone and look at each one of those steps and say, "I'm going to try that." It might really hit home and it might stick with them for the rest of their life. It's a really beneficial thing. The feedback we've gotten has been very good. It has helped us, as well, in identifying people that are in distress that we wouldn't have known otherwise. As a part of that, they'll take a 15-minute survey that evaluates them in those 5 domains. Then one of the domains ... Then it has different symptom complexes like fatigue and pain and so forth. If they reach a certain threshold, then our nurse is identified. Our nurse calls them up and what that's done is it's allowed us to get them to specific services they would not have gotten to otherwise. It's a very beneficial thing on multiple levels. On the patient navigation level, to go back to the COC, well, what a great tool for being able to intervene and educate and identify access to care and disparities issue. Some of those could be a person can't travel to do various things, so this is a great way of addressing that. The second piece, distress screening, we can identify distress, and appropriately manage it. The third thing, of course, this is a survivorship piece. Really the weakest part of survivorship, in the COC platform, has been that tertiary prevention piece. How you take care of yourself in order to decrease the chances of them coming back. Gazella: Right, and I'd like to talk a little bit about that, because you and I and Dr. Lise Alschuler wrote a paper that was published in the Natural Medicine Journal that shined a light on emerging research that's showing that survivorship care plans that only focus on the treatment summary and the follow up care are actually causing more distress, because they're not focusing on proactive prevention strategies that can empower the patient. What do you think is the solution to that, because that's kind of troubling, that even after the mandate, these SCPs are causing more distress? Mumber: I think what's happened is that they've followed the general history of the medical model, ultimately. That is that we figure out what needs to be done and in our infinite wisdom, we then deliver it. We deliver it in the best way that we can, unfortunately the initial way we deliver almost everything in medicine is from the top down. From somebody who knows something better to somebody that doesn't know anything. Somebody who needs help to somebody's who's going to be stronger and has the ability to get the help. Somebody who's broken to somebody who's going to get fixed. It's not unusual, it's a normal part of the evolutionary process of the way medicine is delivered over time. In the initial part of this, it's very important for us to get the conventional part right. It is very important that people get to their screenings, to make sure that people understand how important it is to eat well, to drink well, to manage your stress, to understand what radiation and chemo they got. How that might place them at greater risk, etc. those are all very important pieces of the puzzle. However, if all we do is try to deliver information downhill and to a person that literally, all they know is what we're telling them, for the most part, it's going to create distress. It's going to create more distress than if we didn't tell them anything. It's almost like ignorance is bliss to a certain extent. When we overload people with information, without any real applicability of how it means something in their life, it tends to cause more distress. I think it's very important and over time, I think what we'll see is a progression for engaging the patient, engaging the patient in their own care. Engaging the whole person in their own care. That's where I think that it's going to evolve over time, naturally. Gazella: I would agree with that. What would you like to see happen in the future, when it comes to getting these special needs met? Physical, mental, emotional needs met for cancer survivors in the future? Mumber: Well, I think from a standpoint of Medicine. Medicine with a big 'M'. Not just medicine that we use to fix people, but medicine that serves the needs of all the participants that are involved. Not just the patient, doctor, community member, all aspects of the community in general. All people involved in it at all levels of their being. Physically, mentally, emotionally, spiritually, and all levels at which they experience life. As an individual person, as a family member, as a community member, etc. That's an integrative approach, a whole approach that addresses everyone at all levels of their being and experience. That, again, that's a huge elephant. What we're starting with is the ground foundational stuff of what's the science of all these things. What do we need to make sure people have done in order to have just a basement, foundational understanding of what's required for basic science survivorship. Basic science 101. That's the level we're at right now. Going from not doing that at all to doing that is a big step. That's a big step. We don't want to minimize that. It's going to take time. However, ultimately, what's going to happen is that it's going to evolve over time and it's going to progress to the point where we look at the person not just as a patient and as a body, but we look at the patient as somebody who's a responsible participant in their care. We take therapeutic advantage of their physical presence. Their emotional presence. Their mental and spiritual presence. We optimize their environmental existence such that it impacts everybody in the system. That is where medicine, that's what I'd like to see. I guess to say I'd like to see that is maybe a little self-centered. I think everybody would like to see that, right? It's just a matter of patiently, one step at a time, applying tools that we have that are capable of making incremental change at each of those areas. For me, I have a lot of people, a lot of colleagues say, "Gosh, I'd look to do some kind of integrative approach." I think starting small and then growing organically with it makes sense and using tools that apply to yourself as an individual, as well as the patient, is a good place to start. Using systems that are in place that can increase communication, break down some of those access to care disparity barriers and move things forward in a way of increasing patient responsibility and participation in their health. Gazella: I think that's great advice to practitioners who are looking to have a more integrative approach. Well, once again, I would like to thank the sponsor of this interview, which is iTHRIVE Plan. That's ithriveplan.com. Dr. Mumber, I'd like to thank you for joining me today. Mumber: Happy to be here. Thanks a lot. Gazella: Have a great day. Mumber: Alright, you too.

Dr. Todd Kelley, the chief pediatrician at Harbin Clinic, spoke on Talking to Kids about Sex.

Matt Mumber, MD, joins Dr. Lise Alschuler and Karolyn A. Gazella to explain what radiation is, its role in cancer treatment, and how one can support his or her body before, during, and after radiation. Dr. Mumber is a board certified radiation oncologist at the Harbin Clinic in Rome, GA, and the founder of Cancer Navigators, a non profit nurse navigation and educational resource for those touched by cancer.This show is broadcast live on Tuesday's at 7PM ET on W4CS – The Cancer Support Network (www.w4cs.com) part of Talk 4 Radio (http://www.talk4radio.com/) on the Talk 4 Media Network (http://www.talk4media.com/).