Podcasts about tufts medical school

You've seen Dr. Motta on Restoring Darkness (https://restoringdarkness.com/episode/120-blue-light-leds-are-an-immune-suppressor-proven-to-cause-cancer-dr-mario-motta) now he's on Get a Grip on Lighting to tell you about the hazards of blue-rich LED's. No matter how some might push back, the evidence is irrefutable: blue light LED's suppress melatonin which can lead to cancer. When Dr. Motta's and the American Medical Association's report was released in 2016, the Lighting Deep State was “not polite” in their rebuttal. But it seems they have come around in recent years. Dr. Motta had been in practice at North Shore Medical Center in Salem, Massachusetts, since 1983, recently retiring in 2022. He is a graduate of Boston College, with a BS in physics and biology, and of Tufts Medical School. He is board certified in Internal medicine and Cardiology, and is a fellow of the American College of Cardiology, and of the American Society of Nuclear Cardiology. He is an associate professor of medicine at Tufts University School of Medicine. Dr. Motta has long been active in organized medicine, both in the American Medical Association (AMA) and in the Massachusetts Medical Society (MMS), holding a number of posts through the years. He is a past President of the MMS. He was elected and served 8 years on the AMA council of Science and Public Health, and then was elected to the Board of Trustees of the AMA in 2018, recently completing his term. In May of 2023 at its annual meeting, the MMS awarded Dr Motta its highest honor, the “Award for Distinguished Service.” Dr Motta also has a lifelong interest in astronomy, and has hand built a number of telescopes and observatories through the years to do astronomical research, including his entirely homemade 32 inch F6 relay telescope located in Gloucester, MA. He has been awarded several national awards in astronomy, including the Las Cumbras award from the Astronomical Society of the Pacific in 2003, and also the Walter Scott Houston award from the northeast section of the Astronomical League, and in 2017 the Henry Olcott Award from the American Association of Variable star Observers (AAVSO). He has served as a president of the ATM's of Boston, and has served as a council member of the AAVSO, and is a past president as well. He has also served on the Board of the IDA. He has worked on light pollution issues, and published several white papers on LP as a member of the AMA council of science and public health. He served on a UN committee (COPUOS) representing the AMA on light pollution for a worldwide effort to control LP and satellite proliferation. Finally, several years ago the International Astronomical Union awarded Dr Motta an asteroid in part for his work on light pollution as well as amateur research, asteroid 133537MarioMotta. Connect with Dr. Motta: www.mariomottamd.com Connect with The Soft Lights Foundation: www.softlights.org

Michael J. Hession, MD, is a distinguished graduate of Boston College High School, Boston College, and Dartmouth Medical School, where he was elected to Alpha Omega Alpha. His journey to becoming a physician is marked by resilience and deep empathy, shaped not only by academic achievements but also by profound personal experiences. Enduring two near-death encounters and health challenges, he emerged with a profound understanding of human frailty, enriching his medical practice with unique empathy. Recognized for his expertise and commitment to excellence, Michael is a Fellow of both the American College of Medicine and the American College of Cardiology. He completed his Internal Medicine Residency at University Hospital (Boston Medical Center) and further specialized in cardiovascular medicine during his fellowship at Brigham and Women's Hospital under the mentorship of Bernard Lown, MD. As Chief Medical Officer at Brigham Health Harbor Medical, Michael's impact extends beyond administrative roles. He serves as an attending physician at South Shore Hospital and as a consulting physician at Brigham and Women's Hospital in Boston, MA. Additionally, his contributions to medical education are notable. He has held academic appointments as a Clinical Instructor in Medicine at Harvard Medical School and as an Assistant Clinical Professor of Medicine at Tufts Medical School. Michael's dedication and expertise have earned him widespread recognition, being honored eight times in Boston Magazine's Top Doctors annual edition. Beyond his professional endeavors, Michael finds joy in sharing life's adventures with his wife of 40 years, Colleen, on Cape Cod, MA. Together, they cherish moments boating on Nantucket Sound, indulging in their love for reading—especially history—and eagerly exploring the world through travel, seeking out the most exotic destinations.https://www.acknowledgeacceptadapt.com/Become a supporter of this podcast: https://www.spreaker.com/podcast/i-am-refocused-radio--2671113/support.

Heart disease, cancer, and stroke are the leading causes of death—and premature death at that—in the US. These diseases all have several risk factors in common, like smoking, physical inactivity, and poor diet, which policy often views simply as personal choices. We need to begin looking at disease prevention beyond individual decision-making. In this podcast, I talk with Dr. Anand Parekh, Senator Bill Frist, and Dr. Dariush Mozaffarian on the need for government policymakers to address disease prevention. Dr. Anand Parekh is the Bipartisan Policy Center's chief medical advisor, providing clinical and public health expertise across the organization, particularly in the areas of aging, prevention, and global health. As a US Department of Health and Human Services deputy assistant secretary for health from 2008 to 2015, he developed and implemented national initiatives focused on prevention, wellness, and care management. He is the author of Prevention First: Policymaking for a Healthier America. Senator Bill Frist is a heart and lung transplant surgeon and former US Senate majority leader. He led passage of the 2003 Medicare Modernization Act and the historic PEPFAR HIV/AIDS legislation that has saved millions of lives worldwide. As the founder and director of the Vanderbilt Multi-Organ Transplant Center, he has performed over 150 heart and lung transplants, authored over 100 peer-reviewed medical articles, and published seven books. Dr. Dariush Mozaffarian is a cardiologist, Dean and Jean Mayer Professor at the Tufts Friedman School of Nutrition Science and Policy, and professor of medicine at Tufts Medical School. He has authored more than 400 scientific publications on dietary priorities for obesity, diabetes, and cardiovascular diseases and on evidence-based policy approaches to reduce these burdens in the US and globally. He has served in numerous advisory roles, including for the US and Canadian governments.⁣⁣ ⁣ View Show Notes From This Episode Get Free Weekly Health Tips from Dr. Hyman Sign Up for Dr. Hyman's Weekly Longevity Journal This episode is brought to you by BIOptimizers. Head to Bioptimizers.com/Hyman and use code HYMAN10 to save 10%.

GET MY FREE INSTANT POT COOKBOOK: https://www.chefaj.com/instant-pot-download MY BEST SELLING WEIGHT LOSS BOOK: https://www.amazon.com/dp/1570674086?tag=onamzchefajsh-20&linkCode=ssc&creativeASIN=1570674086&asc_item-id=amzn1.ideas.1GNPDCAG4A86S Disclaimer: This podcast does not provide medical advice. The content of this podcast is provided for informational or educational purposes only. It is not intended to be a substitute for informed medical advice or care. You should not use this information to diagnose or treat any health issue without consulting your doctor. Always seek medical advice before making any lifestyle changes. You can get Dr. Nadeau's book here: https://colorcurewarrior.com/ To book an appointment with Dr. Nadeau: https://hoagmedicalgroup.com/physician/daniel-nadeau-md/ Dr. Nadeau's new book: The Color Cure: Nutrition to Optimize Health and Reverse Disease extends the story of the The Color Code, A Revolutionary Eating Plan for Optimal Health. https://www.amazon.com/shop/chefaj/list/1GNPDCAG4A86S?ref_=aip_sf_list_spv_ofs_mixed_d He has an Instagram account on Dr. Daniel Nadeau (@dnadeaumd) • Instagram photos and videos where he posts recipes and images from vegan restaurants and impressive acai bowls. https://www.instagram.com/dnadeaumd/. He discussed his book on CNN (54) CNN Dan Nadeau MD Diet Diabetes - YouTube https://www.youtube.com/@dnadeaumdand has a Linkedin account at linkedin.com/in/dan-nadeau-md-16091014 He works with in Aliso Viejo, California Daniel A. Nadeau, MD | Hoag Medical Group Dr. Nadeau has been Medical Director of four Diabetes Centers from Maine to California and is former Assistant Professor of Medicine at Tufts Medical School in Boston, Massachusetts. Dr. Nadeau has engaged in extensive diabetes and obesity research, and lectures widely to both professionals, paraprofessionals, and universities on topics in nutrition, diabetes, and obesity. Dr. Nadeau received his Doctor of Medicine from Tufts University School of Medicine. He also earned a Master of Science in Nutrition from Tufts University School of Nutrition. He completed his internal medicine residency, and a fellowship in endocrinology and further nutrition training and research at the University of Vermont. Dr. Nadeau is the recipient of the National Research Service Award. He opened Nadeau's Natural Food in high school and has traveled the world with a backpack seeking out vegan food and experiences. Dr. Nadeau is driven by a passion to improve the health of individuals, but also to have a broader impact on public health in general. For both aspects he sees plant-based nutrition as the key; and more specifically the power of brightly colored vegetables and fruits as being nutritional powerhouses that can restore health. Plants live in a sea of ultraviolet radiation that would kill us all. They protect themselves with pigments, phytonutrients, and in consuming them we have conveyed to us antioxidant and anti-inflammatory elements that protect our brains, hearts, bones, and metabolism. As a Board-Certified endocrinologist, he works especially with patients with diabetes, thyroid disease, and obesity, and obesity related conditions. He conveys to professionals and patients that life and longevity comes from consuming plants and that red, blue, green, and orange foods attract us for a reason: they give life! The Color Code, the first book, focused on beneficial elements within the rainbow of foods whereas The Color Cure, the second book, will focus on body systems such as the skin, brain, heart, intestinal system, etc. and how to optimize their health with brightly colored fruits and vegetables.

This is one of the more mind-blowing episodes we've recorded. So much we hadn't heard about before. Light pollution at night suppresses melatonin and can lead to cancer and the lighting industry deep state tried to intimidate and silence Dr Motta in 2016. That's just the tip of the information iceberg that Dr. Motta reveals. Blue light is great during the day, but stay away from 469 - 489 nanometers at night. Dr. Motta had been in practice at North Shore Medical Center in Salem, Massachusetts, since 1983, recently retiring in 2022. He is a graduate of Boston College, with a BS in physics and biology, and of Tufts Medical School. He is board certified in Internal medicine and Cardiology, and is a fellow of the American College of Cardiology, and of the American Society of Nuclear Cardiology. He is an associate professor of medicine at Tufts University School of Medicine. Dr. Motta has long been active in organized medicine, both in the American Medical Association (AMA) and in the Massachusetts Medical Society (MMS), holding a number of posts through the years. He is a past President of the MMS. He was elected and served 8 years on the AMA council of Science and Public Health, and then was elected to the Board of Trustees of the AMA in 2018, recently completing his term. In May of 2023 at its annual meeting, the MMS awarded Dr Motta its highest honor, the “Award for Distinguished Service.” Dr Motta also has a lifelong interest in astronomy, and has hand built a number of telescopes and observatories through the years to do astronomical research, including his entirely homemade 32 inch F6 relay telescope located in Gloucester, MA. He has been awarded several national awards in astronomy, including the Las Cumbras award from the Astronomical Society of the Pacific in 2003, and also the Walter Scott Houston award from the northeast section of the Astronomical League, and in 2017 the Henry Olcott Award from the American Association of Variable star Observers (AAVSO). He has served as a president of the ATM's of Boston, and has served as a council member of the AAVSO, and is a past president as well. He has also served on the Board of the IDA. He has worked on light pollution issues, and published several white papers on LP as a member of the AMA council of science and public health. He served on a UN committee (COPUOS) representing the AMA on light pollution for a worldwide effort to control LP and satellite proliferation. Finally, several years ago the International Astronomical Union awarded Dr Motta an asteroid in part for his work on light pollution as well as amateur research, asteroid 133537MarioMotta. 

Curious about how cosmetic surgery can restore confidence during midlife? In this episode, we uncover the most popular procedures and what they can do for women navigating the changes of menopause and beyond.Dr. Sameena Rahman welcomes her longtime friend and renowned plastic surgeon, Dr. Azra Ashraf, for an insightful conversation about cosmetic surgery for midlife women. Dr. Ashraf shares her journey as a surgeon and discusses the most common procedures sought by women in their 40s and 50s, from breast lifts to tummy tucks and facial rejuvenation. Together, they explore how hormonal changes, such as the loss of estrogen, impact the body and why cosmetic surgery can often help women feel more like themselves again.They also talk about the importance of reconstructive procedures for women undergoing mastectomies, including breast reconstruction options that have transformed recovery for cancer survivors. Dr. Ashraf shares her personal experiences of helping women regain their confidence and improve their quality of life.Episode Highlights:The rise in cosmetic procedures among perimenopausal women.Breast lifts, tummy tucks, and liposuction as part of the "mommy makeover."How hormonal changes during menopause affect body shape.The importance of breast reconstruction for women post-mastectomy.Why some cosmetic procedures are shifting toward more natural, proportioned results.Don't forget to subscribe, rate, and review the podcast on your favorite platform! Share this episode with friends who might benefit from learning more about midlife cosmetic procedures and recovery options.Dr. Ashraf's Bio:Dr. Azra Ashraf is a double Board-Certified Plastic Surgeon, boarded by the American Board of Plastic Surgery and American Board of Surgery. She has worked on east and west coasts with over 10 years of cosmetic surgery expertise. Dr. Ashraf was a recognized physician in the Washington DC area, voted a Top Doctor. She is a Californian at heart and loves practicing in her home state.Dr. Ashraf completed a BA in Public Policy from Brown University, focusing on gender equity in healthcare. This led her to pursue an MPH from Harvard School of Public Health while jointly attending Brown Medical School. She has always loved working with her hands, and knew she wanted to pursue surgery as soon as she started medical school. She is a highly skilled surgeon with an artistic eye for detail.She trained in general surgery at Saint Elizabeth Medical Center (Boston, MA), an affiliate of Tufts Medical School. She completed her plastic surgery training at Temple University Hospital (Philadelphia, PA). Dr. Ashraf has distinguished herself by completing an additional year in comprehensive breast reconstruction, including microvascular and aesthetic breast surgeries at Beth Israel Deaconess Medical Center, an affiliate of Harvard Medical School.She is recognized as a beauty expert by both the community and media. Schedule a consultation and work with Dr. Ashraf to diversify the idea of beauty.Get in touch with Dr. Ashraf:WebsiteInstagramGet in Touch with Dr. Rahman:WebsiteInstagramYoutube

In this week's episode of the Gaining Health podcast, host Karli Burridge catches up  with obesity specialist Dr. Florencia Ziemke about the membership-based comprehensive obesity care program that Dr. Ziemke has developed at Evexia Medical Nutrition and Weight Management. They also discuss Dr. Ziemke's incredible  involvement with the Florida Obesity Society, the Florida Medical Board, Obesity Matters, her local Chamber of Commerce, and other organizations to advance the field of obesity medicine,  improving access to care, and providing mentorship to other women. Florencia Ziemke, MD, DABOM: Founder and Medical Director for Evexia Medical: Nutrition and Weight Management. Dr. Ziemke has nearly two decades of clinical and research experience in the field of Obesity & Nutrition Medicine. She completed her internal medicine residency, clinical nutrition fellowship, and clinical research, in Boston, MA. She has worked at top national centers such as Boston Medical Center and Beth Israel Deaconess Medical Center with affiliations at Boston University, Tufts Medical School, and Harvard Medical School. She is board certified in Internal Medicine and a diplomate of the American Board of Obesity Medicine. She serves on the Network Advisory Committee of The Obesity Society, Editorial Board of Obesity Pillars, and is a Scientific Medical Associate for Obesity Matters. She lives in Jupiter, FL with her husband and two children. She enjoys outdoor activities, swimming, and creating fun recipes with her family.Facebook: https://www.facebook.com/evexiamedLinkedIn: https://www.linkedin.com/company/evexia-med/Support the showThe Gaining Health Podcast will release a new episode monthly, every second Wednesday of the month. Episodes including interviews with obesity experts as well as scientific updates and new guidelines for the management of obesity.If you're a clinician or organization looking to start or optimize an obesity management program, and you want additional support and resources, check out the Gaining Health website! We offer monthly and annual Memberships, which include live group coaching, a community forum to ask questions and post resources, pre-recorded Master Classes, digital resources inlcuding patient education materials and office forms, and much more! We also sell our popular Gaining Health products, including a book on developing an obesity management program, editable forms and templates, and patient education materials in our Gaining Health Shop! If you are loving this podcast, please consider supporting us on Patreon

In this interview, Heather discusses with Eric (Rick) Leskowitz, MD his most recent book "The Mystery of Life Energy" and his holistic and integrative understanding of healing. https: //www.TheMysteryOfLifeEnergy.com/  Eric (Rick) Leskowitz, MD was a psychiatrist with the Pain Management Program at Spaulding Rehabilitation Hospital in Boston for over 25 years, where he founded the hospital's Integrative Medicine Project and was the Principal Investigator of a grant from the Langeloth Foundation to develop a comprehensive integrative medicine program at SRH. He has an appointment at the Harvard Medical School Osher Research Institute, and he organized two HMS Continuing Education conferences on Complementary and Integrative Medicine in Rehabilitation. He was also an advisor to Tufts Medical School's NIH-funded project that introduced evidence-based integrative medicine material into the medical school curriculum. A long-time meditator, he studied energy healing for many years with Rev. Rosalyn Bruyere and received advanced training in clinical hypnosis from the Americal Society of Clinical Hypnosis. His clinical work focused on integrating holistic therapies such as meditation, hypnosis and energy psychology into the multidisciplinary pain management program at SRH. He has edited three textbooks and has published over 50 research articles (on ResearchGate.net). He has lectured and presented workshops internationally. He also has a longstanding interest in Earth energies and global consciousness as catalysts for social transformation. To access some of Rick's medical journal articles related to energy healing: https:/www.ResearchGate.net/profile/Eric-Leskowitz/research/  Heather's website: https://www.risingmoonhealingcenter.com/

Burdock root (Arctium lappa, A. minus) is well known for its ability to support the liver and work as an overall alterative herb. And it's a beloved herb for herbalists. But nobody said medicine couldn't be delicious… and I know you're going to love the delectable recipe for burdock shared by today's guest, Margi Flint!I connected with Margi many years ago at an International Herb Symposium in Massachusetts and I've wanted to have her on the show for a while now. I think you'll agree that the wait was worth it! This episode is sprinkled with herbal gems for you to enjoy. By the end, you'll know:► The important role of listening on your herbal path► What type of herb Margi always recommended to her clients – and why► The breakfast blend Margi often brews (it sounds yummy!)► A tip that will lead to easier harvests of burdock root► How reading the body made Margi more effective as an herbal practitioner (and how you can learn to read the body yourself)► Margi's memories of being mentored by one of the most influential herbal teachers of the 20th centuryFor those of you who don't already know Margi Flint, RH HM, she owns and operates Earthsong Herbals in Marblehead, MA. Her filters of wisdom include over twenty years of labor coaching, certification in Polarity Therapy and Reiki, and forty-plus years of herbal practice. She is on staff at Pacific Rim College in British Columbia. She has been caught lecturing at numerous amazing herb schools, Bastyr University, Tufts Medical School, and Massachusetts College of Pharmacy. She is author of The Practicing Herbalist IV. The plants and her clients are her revered teachers. She is retired from active practice, focusing now on teaching and learning how to play.If you'd like to hear more from Margi, which I highly recommend, then head to the show notes where you can get an easy link for her website and social media channels. You can also find the transcript for this episode in the show notes.I'm delighted to share our conversation with you today!----Get full show notes and more information at: herbswithrosaleepodcast.comFor more behind-the-scenes of this podcast, follow @rosaleedelaforet on Instagram!The secret to using herbs successfully begins with knowing who YOU are. Get started by taking my free Herbal Jumpstart course when you sign up for my newsletter.If you enjoy the Herbs with Rosalee podcast, we could use your support! Please consider leaving a 5-star rating and review and sharing the show with someone who needs to hear it!On the podcast, we explore the many ways plants heal, as food, as medicine, and through nature connection. Each week, I focus on a single seasonal plant and share trusted herbal knowledge so that you can get the best results when using herbs for your health.Learn more about Herbs with Rosalee at herbswithrosalee.com.----Rosalee is an herbalist and author of the bestselling book Alchemy of Herbs: Transform Everyday Ingredients Into Foods & Remedies That Heal and co-author of the bestselling book Wild Remedies: How to Forage Healing Foods and Craft Your Own Herbal...

The  describes its fundamental mission as promoting human health, with an emphasis on leadership and clinical care. It is looking for students with a strong background in the fundamentals of science who want to apply that work in a clinical setting. The school's curriculum emphasizes early patient contact along with full integration of the sciences.Because the Tufts medical school is focused on classes where there is a dynamic environment with a great deal of peer-to-peer work, you should emphasize your ability to lead and contribute to a medical school class in your application. Tufts Medical School secondary application essay questions Tufts secondary essay #1 Do you wish to include any comments (in addition to those already provided in your AMCAS application) to the Admissions Committee at Tufts University School of Medicine? Please explain briefly. (1000 characters) You can use this space to write about anything not in the AMCAS. Be sure you do not repeat your personal statement. This is a good place to indicate anything specific about Tufts or about your personal background that relates to your med school application. Some applicants use this space to write about a personal experience that is particularly relevant and not included elsewhere in their application. Others write about a personal circumstance, an opportunity or job offer that arose at some point after they submitted the AMCAS primary application. This is also a great place to say why you want to attend Tufts Medical School. Tufts secondary essay #2 Please briefly describe your plans for the coming year. Include in this explanation if you will be a student, working, conducting research, volunteering, etc. (1000 characters) A thousand characters is approximately 200 words – not a lot. Discuss what you plan to do in the upcoming year that most shows your fit with Tufts' vision, mission, and values. If you are a rising senior, will you have any leadership positions? What do you hope to accomplish in those roles? What research, if any, will you conduct? What community service will you do? Where will you participate as a clinician? If you are taking a gap year, show, as discussed in this Admissions Straight Talk episode, that it's going to be a growth year. What will you accomplish at work? How will you immerse yourself in different populations? Will you work as a scribe (excellent clinical exposure)? Will you participate in a research project? Be included as an author? Highlight plans that demonstrate your commitment to medicine as Tufts sees it and that indicate that you will be a valuable member of the school's next incoming class. Tufts secondary essay #3 How might you contribute to the diversity of the student body of Tufts University School of Medicine? (1000 characters) For this question, you should consider diversity in all its forms: race, ethnicity, language, family background, economic circumstances, education, gender identity, sexuality, ability, and past experience. Consider how you might interact with a diverse group of medical students and contribute to your class. It is not enough to simply say that you are diverse; you need to explain how that makes you a more appealing applicant. If you are struggling to come up with ways to describe your individuality, I encourage you to interpret the question broadly and explain how your experiences make you a unique and worthwhile candidate who is going to contribute a special background, perspective, or experience to Tuft's class. Tufts secondary essay #4 Given how the COVID-19 pandemic has altered the world these past few years, please contextualize how your experiences have been affected which might include your personal, professional and educational journey. (1000 characters) It is true, COVID-19 derailed the majority of volunteer work, shadowing, academic research, internships and MCAT plans for medical school applicants. The good news, though,

Doctor Alesh is passionate about the prevention of oral disease and helping patients meet their oral health goals. She is a steward for improving access to care for underserved populations and increasing the diversity of the dental workforce.At four years old she decided she wanted to become a dentist because of the positive impact of her pediatric dentist.As an undergraduate student she triple majored in community Heath, child development, and biomedical engineering. As part of the early acceptance program she attended Tufts University School of Dental Medicine and earned her doctorate in medical dentistry.At Tufts dental she was very involved in student activities serving as president of the Student National Dental Association. Doctor Alesh completed her education at Tufts by earning her masters in public health at Tufts Medical School.In addition to clinical dentistry, Doctor Alesh also serves as an adjunct faculty member at the Community College of RI Dental Health Program and is a member of the RI Dental Association New Dentist Committee. She continues to show her love and loyalty to Tufts as a member of the Tufts University School of Dental Medicine Board of Advisors. 

This episode is brought to you by Rupa Health, ButcherBox, and Essentia. Heart disease, cancer, and stroke are the leading causes of death—and premature death at that—in the US. These diseases all have several risk factors in common, like smoking, physical inactivity, and poor diet, which policy often views simply as personal choices. We need to begin looking at disease prevention beyond individual decision-making. In this podcast, I talk with Dr. Anand Parekh, Senator Bill Frist, and Dr. Dariush Mozaffarian on the need for government policymakers to address disease prevention. Dr. Anand Parekh is the Bipartisan Policy Center's chief medical advisor, providing clinical and public health expertise across the organization, particularly in the areas of aging, prevention, and global health. As a US Department of Health and Human Services deputy assistant secretary for health from 2008 to 2015, he developed and implemented national initiatives focused on prevention, wellness, and care management. He is the author of Prevention First: Policymaking for a Healthier America. Senator Bill Frist is a heart and lung transplant surgeon and former US Senate majority leader. He led passage of the 2003 Medicare Modernization Act and the historic PEPFAR HIV/AIDS legislation that has saved millions of lives worldwide. As the founder and director of the Vanderbilt Multi-Organ Transplant Center, he has performed over 150 heart and lung transplants, authored over 100 peer-reviewed medical articles, and published seven books. Dr. Dariush Mozaffarian is a cardiologist, Dean and Jean Mayer Professor at the Tufts Friedman School of Nutrition Science and Policy, and professor of medicine at Tufts Medical School. He has authored more than 400 scientific publications on dietary priorities for obesity, diabetes, and cardiovascular diseases and on evidence-based policy approaches to reduce these burdens in the US and globally. He has served in numerous advisory roles, including for the US and Canadian governments.⁣⁣ ⁣This episode is brought to you by Rupa Health, ButcherBox, and Essentia. Rupa Health is a place where Functional Medicine practitioners can access more than 2,000 specialty lab tests from over 20 labs. Check out a free, live demo with a Q&A or create an account at RupaHealth.com. For a limited time, when you sign up for ButcherBox, they will send you 2 pounds of 100% grass-fed, grass-finished beef free in every box for the life of your subscription PLUS $10 off at ButcherBox.com/farmacy. Get an extra $100 off your mattress purchase, on top of Essentia's Black Friday sale, which will also take 25% OFF. Plus receive 2 FREE organic pillows (a $330 value) with your mattress purchase at myessentia.com/drmarkhyman. Full-length episodes of these interviews can be found here:Dr. Anand ParekhSenator Bill FristDr. Dariush Mozaffarian Hosted on Acast. See acast.com/privacy for more information.

Erkeda DeRouen talks to Dr. Penny Liu, the Director of Neuroanesthesia at Tufts Medical Center, Boston. She has been a specialist in the field for 10 years. She is also an assistant professor at Tufts Medical School. [00:59] Dr. Liu's Background and Medical Journey [08:07] Why Neuroanesthesia? [12:12] Qualities of a Prospective Doctor  [17:41] How to Talk About Your Weaknesses in Interviews [20:39] Dr. Liu's Advice to Pre-meds and Medical Students  Full show notes

“That badge of honor to say that we finished something is going to be really big. So if you can build that or work with someone to build that into your programs, it's a home run.” -Sarah Tugender Master Certified Coach Jill Farmer talks with Sarah Tugender about helping physicians save time, serve patients better, and earn additional income by creating learning programs for their patients and followers. Sarah is a Certified Online Curriculum Specialist and she designs signature health programs for adult learners. You will hear about Sarah's background and why she is passionate about helping physicians, and specific examples of how she can help you expand your reach and efficiency. Tune in to find out how Sarah can help you take your practice to the next level.   Find out more about Sarah Tugender and her services at SarahTugender.com   Sarah grew up around hospitals and healthcare practices, born when her dad was a first-year medical student at Tufts Medical School. She remembers bringing her dolls to the break room at Sinai Hospital, where her dad was a resident, to get stitched up with real stitches.  After graduating from Boston University with a Marketing and Advertising degree, it was a natural partnership for Sarah to help her dad with those services in his practice. For 15 years, Sarah has helped healthcare providers increase their income and impact by using her passion for health with her drive to leverage time and teach others to do the same. As the host of The Health of Your Business podcast, Sarah has interviewed the most prominent experts in functional and holistic health today. Sarah lives on Boston's North Shore with her husband, Dan, and three children - Ella, Brody and Duke - where they live a plant-based lifestyle and take advantage of all New England has to offer.   Find full transcripts of DocWorking: The Whole Physician Podcast episodes on the DocWorking Blog  How many coaches do you think your favorite actors and athletes have worked with over the years in order to achieve such extraordinary success?   What if you had a team of trusted thinking partners, experienced coaches who have helped hundreds of physicians overcome obstacles and who know what works?    What if you were part of a community of like-minded physicians from across the nation, across specialties and career stages? Your collective brain trust, sharing ideas and experiences, so you would no longer feel like an island, surrounded by people yet alone?   What if you had small group coaching sessions, could interact with your coaches and community as often as you wish, and had virtual courses at your fingertips 24-7 that could help you with things like time and stress management, resilience, and mapping out your future to achieve what matters most to you?   What if you could have all of this for less than the cost of a single 1:1 coaching session per month?   DocWorking THRIVE is the Physician Coaching and Community Subscription Package that Guides You as a Doctor to Embrace Life in the way that is most meaningful to you, integrate that with your work so you can truly thrive, and be a valued member of our growing private community of doctors from across the nation. Join the DocWorking mailing list by clicking here.   At DocWorking, our specialty is Coaching Physicians to achieve the best in life and medicine.    Doctors devote their lives to caring for others. But does that mean they must sacrifice their own health and wellbeing? Absolutely not!   At DocWorking, we have developed a unique way to embrace it all.   The caring for others that you do so selflessly AND the caring for YOURSELF AND YOUR FAMILY that you crave in order to bring it all into the perfect balance specific to YOU.   What if we told you that you CAN have it all? The career you dreamed of when you decided to become a doctor AND the life outside of medicine that you desire?   DocWorking empowers physicians to get back on the path to achieving their dreams.   Coaches and Courses at DocWorking Ace the Boards and Max Your CME Preparing for your board exam or looking for a quick and convenient way to earn CME? Study for your board exam and fulfill your CME requirements with BoardVitals. BoardVitals is the leading online board review platform, with question banks and CME activities available in more than 50 medical and healthcare specialties.   Save Money Now: Refinance Your Student Loan Debt   Take Back Your Time: Get a Virtual Assistant Working in the medical field is fulfilling but it can also be exhausting. Physicians often sacrifice their personal time to carry out their duties. They want to go on vacations, start passion projects, or start side businesses but finding the time seems impossible. Recently, more and more physicians are giving outsourcing a try. Outsourcing allows you to delegate tasks to virtual assistants so you can free up your time and finally do whatever it is you've been wanting to do.   Become a Medical Legal Consultant We at DocWorking are excited to collaborate with Dr. Armin Feldman to bring you this opportunity to develop a side income or even a full time income while using your clinical skills!   Achieve Financial Independence with a Financial Planner/Advisor Change your trajectory: build financial independence and strength by working with our trusted resources. Working with a trusted financial planner and/or financial advisor can help you to create a specific plan that works for you. The right advisor can help you stay on track to reach your financial independence goal and your next vision.   Protect Yourself and Your Family with the Right Insurance Doctors and their families need many types of insurance–and inadequate coverage can cost you dearly. Connecting with trusted insurance professionals in your area is recommended to be sure you're appropriately covered.   Are you a physician who would like to tell your story? Please email Amanda, our producer, at Amanda@docworking.com to be considered. And if you like our podcast and would like to subscribe and leave us a 5 star review, we would be extremely grateful! We're everywhere you like to get your podcasts! Apple iTunes, Spotify, iHeart Radio, Google, Pandora, PlayerFM, ListenNotes, Amazon, YouTube, Podbean You can also find us on Instagram, Facebook, LinkedIn and Twitter.    Some links in our blogs and show notes are affiliate links, and purchases made via those links may result in payments to DocWorking. These help toward our production costs. Thank you for supporting DocWorking: The Whole Physician Podcast! Occasionally, we discuss financial and legal topics. We are not financial or legal professionals. Please consult a licensed professional for financial or legal advice regarding your specific situation.   Podcast produced by: Amanda Taran

If I won the lottery, I would still come back and do this. To me, that's success. - Dallas Reed, MD. Dr. Dallas Reed loves what she's doing with her life and it shows. In this interview, she reveals that a tragic loss early in her life shaped her decision to focus on women's reproductive health and perinatal genetics. Raised in Plano, Texas in a bi-racial home, Dallas was always at the top of her class. She attended Dillard University as an undergrad and won a prestigious scholarship that enabled her to travel to London to attend King's College. Dallas joined the Boston University School of Medicine Early School Selection Program and would go on to graduate from Boston University Medical School. These days, Dr. Reed is using all of her talents as the division Chief of Genetics in the pediatric department at Tufts Medical Center in Boston, MA where she is also the Director of Perinatal Genetics, an attending physician in the OB/GYN department, chair of several leadership positions within the hospital, and Assistant Professor of OB/GYN at Tufts Medical School. But what makes this interview very special, is Dr. Reed's recent experience as the mother of baby boy born 13 weeks early and her devotion to the work being done by the March of Dimes around healthcare inequities for brown and black mothers and babies. For a look into the life a woman driven to do what she loves for the greater good, hit that download button.

Daniel Kinderlehrer, MD is the author of "Recovery From Lyme Disease: The Integrative Medicine Guide to the Diagnosis and Treatment of Tick-Borne Illness". He is also the author of several review articles in medical journals and the Lyme Times. Dr. Kinderlehrer attended Tufts Medical School and is an internal medicine physician. He co-founded the New England Center for Holisitic Medicine and has a private integrative medicine practice in Denver, Colorado, where he treats patients with tick-borne illnesses.

The eyes of fish could help us see the light again. Jenny Lenkowski, associate professor of biological sciences at Goucher College, explains why. After receiving her bachelor's degree at Brown University, Dr. Lenkowski taught in China then worked as a research technician at Tufts Medical School before returning to graduate school. She completed her doctorate […]

In this episode of Veggie Doctor Radio, I interview Sarah Tugender and we talk all about her journey and how she approaches her work, her family and “doing it all”.   About featured guest: Sarah grew up around hospital and healthcare practices, born when her dad was a first-year medical student at Tufts Medical School. She remembers bringing her dolls to the break room at Sinai hospital, where her dad was a resident, to get stitched up with real stitches. She sipped apple juice and nibbled on saltine crackers in the call room at the hospital where her dad worked. After graduating college from Boston University with a Marketing and Advertising degree, it was a natural partnership for Sarah to help her dad with those services in his practice. Facebook was born during Sarah's first year of college. She has been immersed in the evolution of social media and the revolution of communication within the business world. For fifteen years, Sarah has used her passion for health with her drive to free up space in practitioners' schedules to create processes and systems for healthcare practices. This frees up space in their schedule so they don't have to burn the candle at both ends and can avoid the burnout that is prevalent in the industry. She travels up to a dozen times a year to speak on stages across the country. Sarah’s messages include living according to your priorities, incorporating business strategies that work for your network and leveraging the power of social media. Sarah has personally built two online communities to more than 15,000 people. This has been leverage she's used to spend time with her husband, Dan, and three children, Ella, Brody and Duke. Sarah and her family live on Boston's North Shore where they live a plant-based lifestyle and take advantage of all New England has to offer.   SARAH TUGENDER https://sarahtugender.com https://instagram.com/sarahtugender/   Disclaimer: The information on this blog, website and podcast is for informational purposes only. It is not meant to replace careful evaluation and treatment. If you have concerns about your or your child’s eating, nutrition or growth, consult a doctor.     I have an affiliate partnership with Splendid Spoon where you can get $25 off your first order if you want to give it a try! Splendid spoon offers pre-made smoothies, juice shots and delicious bowls that require no preparation besides heating up!  https://splendidspoon.z724.net/c/2360827/774963/9621    Shop my favorite things doctoryami.com/shop   Please support my work, become a Patreon https://patreon.com/thedoctoryami   Mentions: Sarah’s podcast: https://podcasts.apple.com/us/podcast/the-health-of-your-business/id1462237130   A Parent’s Guide to Intuitive Eating: How to Raise Kids Who Love to Eat Healthy by Dr. Yami   Leave an 'Amazon Review'   MORE LISTENING OPTIONS Apple Podcasts: http://bit.ly/vdritunes Spotify: http://bit.ly/vdrspotify   NEWSLETTER SIGN UP https://doctoryami.com/signup OR Text 'FIBER' to 668-66     FIND ME AT Doctoryami.com Instagram.com/thedoctoryami Facebook.com/thedoctoryami Veggiefitkids.com         * * * * MORE FROM ME Read - http://veggiefitkids.com/blog Listen: http://bit.ly/vdrpodcast Watch - http://bit.ly/vfkvideos TEDx Talk - http://bit.ly/DOCTORYAMITEDX   * * * *   Questions? Email me: Yami@doctoryami.com

Episode SummaryCoffee, cheese, chocolate, carbs. We all love to eat, but we don't completely understand how food affects our health and that's what Dr. Dariush Mozaffarian wants to change. A cardiologist by trade and a food scientist by necessity, Dr. Mozaffarian appreciates the complex relationship between food and health and the need to make choices based on individual health needs, not broad guidelines. Put down that diet magazine and get ready to hear the real skinny on nutrition with Dr. Dariush Mozaffarian, in this episode of The Sydcast.Syd FinkelsteinSyd Finkelstein is the Steven Roth Professor of Management at the Tuck School of Business at Dartmouth College. He holds a Master's degree from the London School of Economics and a Ph.D. from Columbia University. Professor Finkelstein has published 25 books and 90 articles, including the bestsellers Why Smart Executives Fail and Superbosses: How Exceptional Leaders Master the Flow of Talent, which LinkedIn Chairman Reid Hoffman calls the “leadership guide for the Networked Age.” He is also a Fellow of the Academy of Management, a consultant and speaker to leading companies around the world, and a top 25 on the Global Thinkers 50 list of top management gurus. Professor Finkelstein's research and consulting work often relies on in-depth and personal interviews with hundreds of people, an experience that led him to create and host his own podcast, The Sydcast, to uncover and share the stories of all sorts of fascinating people in business, sports, entertainment, politics, academia, and everyday life. Dr. Dariush MozaffarianDariush Mozaffarian is a cardiologist, Dean, and Jean Mayer Professor at the Tufts Friedman School of Nutrition Science and Policy, and Professor of Medicine at Tufts Medical School. As one of the top nutrition institutions in the world, the Friedman School's mission is to produce trusted science, future leaders, and real-world impact. Dr. Mozaffarian has authored more than 400 scientific publications on dietary priorities for obesity, diabetes, and cardiovascular diseases, and on evidence-based policy approaches to reduce these burdens in the US and globally. He has served in numerous advisory roles including for the US and Canadian governments, American Heart Association, World Health Organization, and United Nations. His work has been featured in a wide array of media outlets including the New York Times, Washington Post, Wall Street Journal, National Public Radio, and Time Magazine. In 2016, Thomson Reuters named him as one of the World's Most Influential Scientific Minds. Dr. Mozaffarian received a BS in biological sciences at Stanford (Phi Beta Kappa), MD at Columbia (Alpha Omega Alpha), residency training in internal medicine at Stanford, and fellowship training in cardiovascular medicine at the University of Washington. He also received an MPH from the University of Washington and a Doctorate in Public Health from Harvard. Before being appointed as Dean at Tufts in 2014, Dr. Mozaffarian was at Harvard Medical School and Harvard School of Public Health for a decade and clinically active in cardiology at Brigham and Women's Hospital. He is married, has three children, and actively trains as a Third Degree Black Belt in Taekwondo.The Friedman School pursues cutting-edge research, education, and public impact across five Divisions, a cross-divisional Center, and multiple academic programs. Areas of focus range from cell to society, including: molecular nutrition, human metabolism and clinical trials, nutrition data science, behavior change, community and organizational interventions, communication and media, agriculture, food systems, and sustainability, hunger and food security, humanitarian crisis, and food policy and economics. Friedman School graduates are leaders in academia, US and international government, policy, advocacy, industry, public health, community service, and entrepreneurship. The School's unique breadth, engagement with the world, and entrepreneurial spirit make it a leading institution for nutrition education, research, and public impact.Insights from this episode:Details on the two epiphanies that led Dariush, a cardiologist, into the science of food and health.Strategies used to implement dietary guidelines that changed the American diet forever.Difficulties transitioning from the original, single-focus food science into a more complex and broad approach to health.How to characterize the quality of nutrition in your food when different sources provide conflicting information.Differences between the acceptance of nutrition science versus the acceptance of more established sciences.Strategies needed to change the politics, funding, and research of food science to help the population become healthier and less prone to serious medical conditions.How to define a healthy carbohydrate, how they affect your glycemic index, and why that is important to your overall health.The reasons why fat intake was dropped from dietary guidelines in 2015 and why fat continues to be a diet focus.Differences between high- and low-fat dairy and how food science is evolving in that area.How COVID has affected the health and nutrition of millions of Americans. Quotes from the show:“Nutrition science doesn't change or evolve any more or any less than any other science. Every science changes and evolves pretty rapidly.” – Dr. Dariush Mozaffarian“I think that [change] is natural and normal in science. That we have some stuttering and shifts moving toward truth. Science is always improving and, not only is it natural, it should reassure us.” – Dr. Dariush MozaffarianOn the accessibility of food science: “We're in the lab of the kitchen every single day. That's never the case for these other fields [of science].” – Syd Finkelstein“Food and nutrition are the top cause of poor health in this country and on the planet.” – Dr. Dariush Mozaffarian“COVID's really laid bare the fractured food system and unhealthy food system that we have.” – Dr. Dariush Mozaffarian“Most of the fat in your body is from eating too many calories that get converted to fat.” – Dr. Dariush Mozaffarian“The fundamental message is that foods can't be judged based on their calories. Every food is a complex package of physiologic information that comes into our body, and interacts with our body in complex ways.” – Dr. Dariush Mozaffarian”These simple solutions and labels have really brought us into a crazy place where all you look at is calories.” – Syd FinkelsteinResourcesNew York Times article Our Food is Killing Too Many of Us by Dr. Dariush Mozaffarian, August 26, 2019Stay Connected: Syd FinkelsteinWebsite: http://thesydcast.comLinkedIn: Sydney FinkelsteinTwitter: @sydfinkelsteinFacebook: The SydcastInstagram: The Sydcast Dr. Dariush Mozaffarian Website: nutrition.tufts.eduTwitter: @DMozaffarianSubscribe to our podcast + download each episode on Stitcher, iTunes, and Spotify.This episode was produced and managed by Podcast Laundry (www.podcastlaundry.com)

Why Food Companies Make Unhealthy Products, And What We Can Do About It | This episode is brought to you by Four SigmaticHere’s the simple truth: Food companies are in business to make money. If people eat or drink less of their products, they lose. This is the primary reason for why Big Food seeks to hook consumers and keep us coming back for more. The food industry approaches food as “engineering projects,” with the end goal of creating “heavy users”—a disturbing internal term used by food manufacturers that helps them make as much money as possible at the expense of public health. But as more and more consumers demand healthier foods, many companies are working hard to meet that demand. So how can we support this innovation and reward companies who are trying to do the right thing?Dr. Hyman explores these topics in his past interviews with Michael Moss and Dr. Dariush Mozaffarian.Michael Moss is a New York Times investigative reporter turned food-focused journalist, Pulitzer Prize winner for Explanatory Reporting, and author of the #1 New York Times bestseller, “Salt Sugar Fat: How the Food Giants Hooked Us”. He also has another book coming out soon called, “Hooked: Food and Free Will,” focused around food and addiction.Dr. Dariush Mozaffarian is a cardiologist, Dean and Jean Mayer Professor at the Tufts Friedman School of Nutrition Science and Policy, and Professor of Medicine at Tufts Medical School. As one of the top nutrition institutions in the world, the Friedman School’s mission is to produce trusted science, future leaders, and real-world impact. Dr. Mozaffarian has authored more than 400 scientific publications on dietary priorities for obesity, diabetes, and cardiovascular diseases, and on evidence-based policy approaches to reduce these burdens in the US and globally. He has served in numerous advisory roles including for the US and Canadian governments and, in 2016, Thomson Reuters named him as one of the World’s Most Influential Scientific Minds.This episode is brought to you by Four Sigmatic. Right now Four Sigmatic is offering up to 40% off on their best selling Lion’s Mane Coffee bundles exclusively for listeners of The Doctor’s Farmacy. To get this deal, just go to foursigmatic.com/hyman. This is a really incredible deal so it’s the perfect time to branch out from your regular morning cup of coffee and try Four Sigmatic’s mushroom blends to enhance your brain-power, energy, and immunity throughout the day. Find Dr. Hyman’s full-length conversation with Michael Moss here: https://DrMarkHyman.lnk.to/MichaelMossFind Dr. Hyman’s full-length conversation with Dr. Mozaffarian here: https://DrMarkHyman.lnk.to/DariushMozaffarian See acast.com/privacy for privacy and opt-out information.

With the prospect of a universally effective vaccine in doubt, many of us have turned to diet and lifestyle to “shore up our Covid-19 defenses.” While many of the supplement regimens marketed as cure alls for Covid-19 are lacking scientific validation, natural compounds like vitamin D are showing some promise in serious research settings. What other nutrients can battle Covid-19? Are there pharmaceutical drugs that can be repurposed to assist in treating the coronavirus? Our guest today, Dr. Theoharis Theoharides has some answers. Dr. Theoharides is an MD, and member of the faculty at Tufts Medical School, who also holds a PhD in pharmacology, and a master's in immunology, from Yale. We discuss the latest research on how flavonoids and other natural compounds impact the immune system and why this research matters for our approach to treating Covid-19 in the coming months.

Only 12% of us in the US are metabolically healthy—it’s pretty alarming when the healthy population is the minority. And in the age of COVID-19, it’s important to recognize that those with a chronic disease are at an exponentially higher risk of hospitalization than someone who is metabolically healthy. If we as a population were healthier (think less obesity, type 2 diabetes, cardiovascular disease, cancer, etc.), the evidence supports that we’d be faring much better throughout this pandemic. Of course, a major driver of chronic diseases and the risks they create is our food system. We can’t expect to be a resilient population if we aren’t feeding our bodies real food with real nutrients we can use to function optimally. To dig into this topic further, I was excited to sit down with Dr. Dariush Mozaffarian on this episode of The Doctor’s Farmacy. Dr. Mozaffarian is a cardiologist, Dean and Jean Mayer Professor at the Tufts Friedman School of Nutrition Science and Policy, and Professor of Medicine at Tufts Medical School. As one of the top nutrition institutions in the world, the Friedman School’s mission is to produce trusted science, future leaders, and real-world impact. Dr. Mozaffarian has authored more than 400 scientific publications on dietary priorities for obesity, diabetes, and cardiovascular diseases, and on evidence-based policy approaches to reduce these burdens in the US and globally. He has served in numerous advisory roles including for the US and Canadian governments and, in 2016, Thomson Reuters named him as one of the World’s Most Influential Scientific Minds.For context, this interview was conducted on April 30, 2020.Here are more of the details from our interview: Three ways COVID-19 influences food and nutrition, and visa versa (3:28)How our national health and economic outcomes from COVID-19 might be different were we a metabolically healthy society (7:37)We can improve our metabolic health in real time (9:53)Micronutrients and their potential for preventing and reducing COVID-19 severity (11:32)Strategies to address our chronic disease pandemic and problems with our food system (28:41)How obesity is affecting our military and national security (33:23)Why we need a coordinated national organizing office around food and nutrition policy (48:18)Functional Medicine for our food system (54:55)Obstacles to changing and improving our food system (56:12)Educating policymakers through strategic collaboration among stakeholders (1:00:30)Find the “Report of the 50th Anniversary of the White House Conference on Food, Nutrition, and Health: Honoring the Past, Taking Actions for our Future” at https://sites.tufts.edu/foodnutritionandhealth2019/Follow Dr. Mozaffarian on Twitter @Dmozaffarian. See acast.com/privacy for privacy and opt-out information.

Dr. Marta Illueca has over 30 years of experience in the medical healthcare industry which includes pediatric medical education and a decade of clinical research in the pharmaceutical industry. She also holds a Certificate of Advanced Study in Pain Topics from the Public Health and Professional Degree Programs at Tufts Medical School. Additionally, she is an ordained deacon at the Episcopal Diocese of Delaware and has a unique, three-prong approach to achieve her vocational goals. She is on a mission to heal, teach, and reconcile with God while expanding the role of sacramental practices throughout the healthcare industry.   Dr. Marta joins me today to share the four key questions middle-aged people should ask themselves and how it can help them determine their future health. She explains why the death rates for middle-aged people are on the rise, despite the life expectancy rates continuing to climb and why it’s critical for us to pay closer attention and take better control over our health. She also shares interesting research studies regarding the death rate of middle-aged people, the increased rate of suicide, and why she believes the term “middle age” will soon include a younger age group.       “We need to be more proactive and less reactive.” - Dr. Marta Illueca       Today on Mastering Midlife:   How to thrive in a society that is very demanding on middle-aged people. Why death rates for middle-aged people are on the rise - despite the life expectancy rates continuing to climb. Why she believes people are taking more control over their deaths and less over their lives. Interesting data and research regarding death rates for middle-aged Americans. What is the ‘Disease Of Despair’ and how it impacts the life expectancy of middle-aged people. The increased rate of suicide since 1999, as reported by the CDC. The importance of taking stock in your health needs. Why she believes the term “middle age” will soon shift to a younger age group. What is the Health Smart Quiz and how it can help you take control of your health? How loneliness impacts your life expectancy. Why your spirituality is important to your life and health. What’s next for Dr. Marta?     4 Questions That Will Determine Your Future Health:   Do you have a healthy heart? Are you at risk for diabetes? Are you at risk for cancer? Are you happy?       Resources Mentioned:   The disease killing white Americans goes way deeper than opioids - The Washington Post       Connect with Dr. Marta Illueca:   Brandywine Collaborative Ministries LinkedIn           Get FREE Access to the Only 10’s Course   Are you struggling with knowing what, when, and how to focus your efforts to get things done? As a long-time sufferer of severe ADD, I understand the struggle - and that’s why I created the Only 10’s system. This system has helped me and thousands of others clear the clutter and focus their energy on getting the right things done.   The Only 10’s free online course is based on my proven system to help you focus your attention and maintain momentum around your day-to-day life.   Sign up for the Only 10’s free course today!       Mastering Midlife...Together!   Thanks for tuning into today’s episode of the Mastering Midlife Podcast: How to Thrive When the World Asks the Most of You with Mark Silverman. If you enjoyed this episode, subscribe to the show on Apple Podcasts and leave us a review.   Be sure to visit our website and connect with us on Facebook, LinkedIn, Twitter, and YouTube and don’t forget to share your favorite episodes on social media.

Cindy S.H.:                         Hi. Welcome to Discover CircRes, the monthly podcast of the American Heart Association's journal Circulation Research. I'm your host, Cindy St. Hilaire, and my goal is to bring you highlights of articles published in the Circ Research Journal as well as have in-depth conversations with senior scientists and the junior trainees who have led the most exciting discoveries in our current issues. Today is our premier episode, so I want to take some time to introduce myself, give you a little bit of background about the history of the journal, and then have a conversation with our new editor in chief, Dr. Jane Freedman, and my social media editor partner in crime, Dr. Milka Koupenova. Cindy S.H.:                         First, a little bit about me. I'm an assistant professor of medicine and bioengineering at the University of Pittsburgh. My lab is part of the division of cardiology and we're also a member of the Pittsburgh Heart, Lung and Blood Vascular Medicine Institute. I'm still a relatively new PI. I'm still learning as I go. One of the strengths of being a new PI in the current time is the amazing network we have through social media, whether it's through listening to podcasts or through Twitter or through select groups like one of my favorites, New PI Slack. Really one of my personal goals of starting this podcast for Circ Research is to have a career development angle. Because career development is so fresh in my mind and it's really something I want to incorporate into this podcast, we're hoping we can reach out to more junior trainees through these mediums. Really that's the impetus for Dr. Freedman wanting to have specific social media editors at the Circulation Research Journal. Cindy S.H.:                         I'm very honored to be the first host of this podcast and I'm very excited for this opportunity. As a team, Milka and I hope to expose the larger community to not only the most current and exciting discoveries in cardiovascular research but also a behind-the-scenes look of what it takes to get high-impact research done and published and planned and funded, and also talk about some of the maybe the non-bench aspects of this job, the networking, the behind-the-scenes look that really you learn on the fly as you go. Hopefully we can expose more people to these on-the-fly things in a slightly more rigorous manner. Cindy S.H.:                         Before I go into the articles summarized in this week's podcast, I want to give a very big thank you to Ruth Williams. Ruth is the person who writes the content of the In This Issue which is featured in every issue of the journal Circulation Research, and that content is extremely helpful in deciding which articles we're going to focus on in this podcast and also for helping me form the conversations and discussions. Thank you, Ruth, for all your hard work. Cindy S.H.:                         Now I'm going to highlight three articles that were featured in the June 21st issue of Circulation Research. The first is entitled Relationship Between Serum Alpha-Tocopherol and Overall and Cause-Specific Mortality: A 30-Year Prospective Cohort Analysis. The first author is Jiaqi Huang and the corresponding author is Demetrius Albanes , who are both at the Division of Cancer Epidemiology and Genetics at the National Cancer Institute, which is at the NIH in Bethesda, Maryland. Alpha-tocopherol is the more formal name for vitamin E, and vitamin E is an essential fat-soluble vitamin. By essential, that means that while your body absolutely needs it, it does not produce it itself. Therefore we need to consume products containing vitamin E. We do that by eating vegetable oils, nuts, seeds, whole grains and certain fruits and vegetables. Previously, population-based studies have shown inconsistent associations between circulating vitamin E and risk of overall death or death due to specific diseases such as cancer and cardiovascular disease. Cindy S.H.:                         To look more closely at cause-specific mortality, Huang and colleagues studied a cohort of close to 30,000 Finnish men, which is a huge study. Added to that, these men were in their 50s and 60s at the start of the study and then continued for the next 30 years of their life to be in this study. It's frankly an amazing achievement to keep that many individuals enrolled. From approximately 24,000 deaths, so about 80% of the original cohort, the authors adjusted for factors such as age and confounding things like smoking. They found that vitamin E levels were inversely associated with the risk of death from a variety of causes. What that means is that higher levels of vitamin E associated with lower risk of death. All of those causes of death that they found were cardiovascular disease, heart disease, stroke, cancer, and respiratory disease. This large prospective cohort analysis provides very strong evidence that higher vitamin E levels means greater protection. Cindy S.H.:                         It's really interesting to note though that this data did not seem to associate with a reduced risk of death by diabetes or, for that matter, injury and accidents, which I guess kind of makes sense. The authors say these results indicate that vitamin E may influence longevity, but they also highlight the need for further studies, specifically in more ethnically diverse populations and of course in women, because we all know a major limiting factor of a majority of cardiovascular studies is the fact that often there are just not enough women in these studies. But really that's a push now to include not only women but more ethnically and geographically diverse populations. Cindy S.H.:                         The second article I want to highlight is titled Mitochondria Are a subset of Extracellular Vesicles Released by Activated Monocytes and Induce Type I IFN and TNF Responses in Endothelial Cells . The first authors are Florian Puhm and Taras Afonyushkin , and the senior author is Christopher Binder. All three are in the Department of Laboratory Medicine, the Medical University of Vienna, in Vienna, Austria. This group is also part of the Research Center of Molecular Medicine of the Austrian Academy of Sciences. Cindy S.H.:                         I want to talk about this paper because I found that title extremely provocative. Extracellular vesicles or microvesicles are small particles that can be released from cells. These particles can act as cell-cell communicators. They can hold a variety of substances such as proteins and micro RNAs and minerals and all sorts of things that are derived from inside the cell. The matrix vesicle is then budded off. Matrix vesicles released from monocytes after bacterial LPS stimulation, so a stimulus that induces an inflammatory response, these matrix vesicles have been shown to contain mitochondrial proteins. Mitochondrial DNA-containing matrix vesicles have been reported in the mouse model of inflammation. From this premise, from these prior studies, Dr. Puhm and colleagues hypothesized that the mitochondrial content of matrix vesicles might actively contribute to pro-inflammatory effects. Cindy S.H.:                         What they then did was show that monocytic cells release free mitochondria and also matrix vesicles that contain mitochondria within them. These free and matrix vesicle-encapsulated mitochondria were shown to drive enothelial cells to induce inflammatory cytokines such as TNF-alpha and interferon. These circulating matrix vesicles were collected also in human volunteers that were injected with this same inflammatory substance, LPS. These circulating matrix vesicles isolated from humans also induced endothelial cell cytokine production. Very interestingly, inhibition of the mitochondrial activity drastically reduced the pro-inflammatory capacity of these matrix vesicles. Cindy S.H.:                         Together, this result suggests that the released mitochondria, whether it's free or whether it's encapsulated in a matrix vesicle, may be a key player in certain inflammatory diseases. This study shows that in addition to their central role in cellular metabolism, mitochondria, whether encapsulated or free, can actively participate in an inflammatory response in a cell other than the cell it was native in, which is just intriguing to think about. This work provides new insight to the contribution of mitochondria to the content and biological activity of extracellular vesicles. It also might suggest that perhaps targeting mitochondria and their release may represent a novel point for therapeutic intervention in inflammatory pathologies. Cindy S.H.:                         The last article I want to highlight is titled Macrophage Smad3 Protects the Infarcted Heart, Stimulating Phagocytosis and Regulating Inflammation . The first author is Bijun Chen and the senior author is Nikolaos Frangogiannis . When tissues are injured, there is localized increase in the cytokine TGF-beta. However, depending on conditions, this TGF-beta can function to stimulate macrophages to adopt either pro-inflammatory or anti-inflammatory phenotypes. To complicate matters more, the signaling pathway for both the pro- and anti-inflammatory phenotypes involves activation of the intracellular signaling protein Smad3. Inflammation, whether too much or too little, can influence the outcome of injuries, including injuries such as myocardial infarctions. An infarction, for those of you unfamiliar with the term, is a localized area of dead tissue and that results from a lack of blood supply. In this case, an infarction, a myocardial infarction, is essentially a heart attack that stops blood flow through the coronaries and causes death in the cardiac tissue and cells. Cindy S.H.:                         The authors hypothesized that in the infarcted myocardium, activation of TGF-beta and Smad signaling and macrophages may regulate repair and remodeling. They had a very specific question about a very specific cell type in the context of the whole heart. To address the role of Smad3, they utilized mice that were engineered to lack Smad3 in the myeloid lineage which produces macrophage cells. They found that these mice with myeloid cell-specific deletion of Smad3 had reduced survival compared to control mice. Additionally, the hearts from the animals with the myeloid cell-specific deletion of Smad3 exhibited increased adverse remodeling and greater impairment of function. That's a really interesting finding. The heart tissue itself was the same. All that was different were the cells of the myeloid lineage. Then to dig after what cells were mediating this effect, the investigators moved on to in vitro studies. They found that Smad3-lacking cells themselves showed reduced phagocytic activity, sustained expression of pro-inflammatory genes, and reduced production of anti-inflammatory mediators when compared with control macrophages. Cindy S.H.:                         In summary, these results suggest Smad3 is necessary for macrophages in the area of the infarction to transition to an anti-inflammatory phagocytic phenotype that protects against excess remodeling. However, we cannot go after global inhibition of Smad3 as a potential therapy post myocardial infarction, and that's because inhibition of Smad3 in cardiomyocytes is actually protective against the infarction. Inhibition in a macrophage is bad, but inhibition in a cardiomyocyte is good. Any potential Smad3-modifying therapies really needs to be designed to be cell type-specific and be able to be deployed to activate that cell type. Cindy S.H.:                         In addition to science, I love history. I thought I would take this opportunity of the first podcast to share with you a little bit of history about the Journal of Circulation Research. Circulation Research is now in its 66th year, but its origins can be traced to 1944. That was when the AHA established a council that was attempting to organize its research arm and its professional program arms. The AHA journal Circulation was already in existence, but in 1951 the executive committee decided to launch a basic research supplement, and it was called just that: Circulation Basic Research Supplement. But a few years later, Circulation Research was to be its own publication because of the interest and the excitement around the basic research supplements. The quote that I'm going to read is from that first executive committee meeting and there they wanted Circulation Research to be the authoritative new journal for investigators of basic sciences as they apply to the heart and circulation. Cindy S.H.:                         It's a fun little subgroup that they list after that. They list in anatomy, biology, biochemistry, morphology, which I just think is so neat to think about, pathology, physics, pharmacology, and others. It's interesting to think about what that would be today if we were now finding this journal. Biochemistry, genetics, molecular biology. It's fun to think about how much science has changed since they began this journal. Really the broader goal was to integrate and disseminate new knowledge. Leading that was Dr. Carl Wiggers, who was the first editor in chief of Circ Research. At the time, he was the head of physiology at Western Reserve University, and he's often referred to as the dean of physiology, as his research really provided much of the fundamental knowledge regarding the pressures in the heart and the vessels of the body and how they interact. Cindy S.H.:                         I actually went back and looked at some of the first titles in Volume One, Issue One, of Circ Research. It's really kind of neat. Some of them could be completely relevant today. I'm just going to read a few. Nucleotide Metabolism and Cardiac Activity, Fundamental Differences in the Reactivity of Blood Vessels in Skin Compared to Those in the Muscle. That was at the VRIC the other day. Haemodynamic Studies of Tricuspid Stenosis of Rheumatic Origin. Reading these for the first time I actually got chills because my two themes of my lab are both in that first Volume One, Issue One, of that journal. I study the extracellular nucleotide aCD73 and its impact on vascular homeostasis. I also study calcific aortic valve disease and are hugely curious about the role of inflammation and things like rheumatic heart disease in the progression of the disease. It's amazing how much science has changed, but yet how so much has stayed the same. Cindy S.H.:                         Dr. Wiggers wrote a few gems, a few quotes in his biography that I want to share with you. I find them inspiring and also humbling. The first is, "Research is a gamble in which the laws of chance favor the loser. The loser must remain a good sport," which I think is perfect to think about in science. I really wish I had read that after my first RO1 was triaged. The next two are more about the science writing and I think they're great not only for when we're thinking about papers but also grants. The first is, "Readers are greatly influenced in their judgment of a research project by literary style. A poor presentation can easily damage the best investigation," which is so true. No matter how good your science is, if you can't communicate it, it doesn't matter. And lastly, "A good paper, like a good glass of beer, should be neither largely foam nor flat. It should have just the right amount of head of foam to make it palatable." Cindy S.H.:                         With these nuggets of wisdom, we're now going to talk with Drs. Jane Freedman, who's now the editor in chief of Circ Research, and Dr. Milka Koupenova, who is the social media editor. Before I really introduce Jane, I want to recognize all of the former editors in chief of Circ Research, Dr. Carl Wiggers, Dr. Carl Schmidt, Dr. Eugene Landis, Dr. Julius Comroe, Dr. Robert Berne, Dr. Brian Hoffman, Dr. Francis Abboud, Dr. Harry Fozzard, Dr. Stephen Vatner, Dr. Eduardo Marbán, Dr. Roberto Bolli, and now Dr. Jane Freedman. Welcome, Jane. Thank you so much for this opportunity and congratulations on your new position. Dr. Freedman:                   Thank you very much. Cindy S.H.:                         I was wondering if you could just introduce yourself to the listeners and give us a little bit about your background. Dr. Freedman:                   Sure. I am the Budnitz Professor of Medicine at the University of Massachusetts, and I originally became interested in a scientific career while attending Yale University where I was both an architecture and geology major. Cindy S.H.:                         Interesting. Dr. Freedman:                   Yes, very interesting. Then, not exactly knowing what I wanted to do, I worked for a year as a research assistant for my later-to-be mentor Dr. Joe Loscalzo at Brigham and Women's Hospital. There one day he sent me up to the intensive care unit and said we need to get a tube of blood from someone who was in the throes of having a myocardial infarction. Really at that point I became hooked. Why was that person having a heart attack, and using their blood how could I figure out whether they would live, die, do well, not do well, or yield new things that might help us cure or diagnose people with heart attacks later on? After that. I went to Tufts Medical School. I did my residency and cardiology fellowship at Brigham and Women's Hospital and the Massachusetts General Hospital. After working at several different places, I have wound up at the University of Massachusetts where I am in the Division of Cardiology and where my laboratory currently resides. Cindy S.H.:                         Excellent. As the new editor in chief, what do you see as your vision for the journal? Dr. Freedman:                   I'm in a very fortunate position to be taking over a wonderful journal from an incredibly dedicated group of editors and associate editors and other supportive editors. Scientific pursuits and reporting and publications are really evolving at a rapid clip, so we hope to have several things happen over the next few years to survive and thrive. The first thing is we hope to define and expand Circulation Research's scientific identity. We want to extend its already outstanding portfolio of science that really demonstrates how elegant basic and translational mechanisms and pathways are part of a greater web of cardiovascular disease and stroke. This will include an increasingly diverse group of basic and translational sciences and they'll touch on both fundamental studies as well as how they translate to human disease. We also want to continue to pursue the excellence that Circulation Research already epitomizes and we want to extend its brand both to an increasingly diverse group of members, both nationally and internationally. Dr. Freedman:                   Circulation Research already has really wonderful publication metrics such as turnaround time, time to review, and we hope to maintain that so as to be a journal of choice for an increasingly growing number of investigators. We would also very much like to have greater interface with the American Heart Association. A lot of the research on our pages is funded by the American Heart Association, and the majority of science that the American Heart Association currently funds is basic cardiovascular science. We hope to have greater interface and help our users of the journal understand what the American Heart Association can do for them and for their scientific pursuits. Dr. Freedman:                   Last and very importantly, we really want to attract early and mid-career investigators to the journal. We already have some really nice programs that the previous editorship has started, such as Meet The First Author, but we would also like to be a site for education of how you can review papers, have a junior editor program and other types of programs that will help early and mid-career investigators in their future. One of the ways we're going to be doing that is to have enhanced social media programs. Cindy S.H.:                         Great. I really like that idea of having the junior editors because I think the best learning experience I had about how to write a grant did not happen until I actually served on a study section, because it was there you actually can understand all of those comments you got on your first grant that was triaged and why they were said. I think that is a key and really important aspect. Dr. Freedman:                   That's a perfect analogy because you want to remove the black box that people think is happening when they send their manuscripts in. There's so many reasons why manuscripts succeed and don't succeed, and we really do want to be as transparent as possible and we do want to educate investigators as much as possible about the process. Cindy S.H.:                         Actually, could you maybe tell us a little bit about that process? I made all my figures, I formatted my paper according to the instructions, I hit submit. Black box. What happens? What's the next step? Dr. Freedman:                   What's the next step? Cindy S.H.:                         What do you do? What does an editor in chief actually do? Dr. Freedman:                   I do have to say that none of this would happen, especially in the incredibly quick turnaround time, if we didn't have amazing support and help in our office that happens to be in Baltimore. The people there are just incredible. They make sure that papers move through. It's really 24/7. Our group has not been at it for very long, but I know Dr. Bolli's group as well as our group, people are handling manuscripts as fast as they really come in. We see the manuscript, they get quality checked. We try not to be too onerous with the first steps. Then typically they go to one of the associate or deputy editors who will handle them to send out for review. Cindy S.H.:                         Is that based on keywords or the title or how is that decided? Dr. Freedman:                   Sometimes it's based on keywords, so careful with your keywords. A lot of times, because each of the associate editors has an area of expertise that hopefully covers what your science is interested in, they will know experts in the field. We very heavily rely on our editorial board. We have an amazing editorial board at Circulation Research, and amazing contributions from the BCBS council. These individuals have over the years and currently provided just tireless and unsung, devoted help to making the journal run smoothly. It's a pretty quick turnaround time. Then the decision made based on the reviews of the article. Occasionally articles come in and they're not suitable for the journal because they're not what we perceive as what our readers would be interested in. Sometimes those articles don't go up for review. We don't want to keep them caught up, so we send them back right away. Dr. Freedman:                   When the articles come back in with the reviews, we're going to be discussing them at a weekly meeting. Other viewpoints will weigh in, and then we make a decision whether it's an accept, whether it's a revise, whether it needs a lot more science. That's called a de novo. Sometimes we think it's more suitable for one of the other 11 American Heart Journals and we might suggest that you consider sending it to that journal and we consult with that journal's editor. Cindy S.H.:                         Interesting. All that happens with about 14 days. Dr. Freedman:                   That's supposed to happen with 14 days. Cindy S.H.:                         It does pretty regularly based on the stats. That's amazing. One of the initiatives you mentioned was really the role of social media. Now I would like to introduce Dr Milka Koupenova, who is the co social media editor alongside me. Before I let Milka talk, I really have to be honest and say that my graduate school days were some of the best of my life. It was in part because Milka I were both in the same lab. We overlapped by a couple of years under the amazing mentorship of Dr. Katya Ravid. Every time we get together, all we'd talk about was how can we be like Katya? Maybe someday we'll actually have a podcast where we can get Katya in here and actually record all her nuggets of wisdom. Dr. Koupenova:                 I think the same thing about Katya. Cindy S.H.:                         How can it be more like Katya? But for now, Milka, welcome. Thank you. If you could just introduce yourself and give us a little bit about your background. Dr. Koupenova:                 Hi, everybody. My name is Milka Koupenova. I am an assistant professor at University of Massachusetts Medical School. Briefly about me, as Cindy mentioned, I did my PhD at Boston University and I studied at that time metabolism in atherosclerosis. Then I had this great opportunity to join this lab in thrombosis that studied these little cell fragments called platelets, which I knew something but not that much about. I joined Dr. Freedman lab as a postdoctoral fellow, and actually my interest evolved to be very much in platelet immunobiology and how platelets may contribute to thrombotic disease during viral infections. Luckily for me, I had two angels that I wanted to be. One of them was Katya Ravid, as you mentioned, and the other one was Dr. Freedman. Both set up a great example of scientists and how to do science in life. Cindy S.H.:                         Wonderful. Excellent. Thank you. I won't lie. I don't know if you feel this way. I definitely feel a little nervous about being a social media editor. I'm talking in a room to a box with a microphone on me and I don't know who's going to be listening. That's also exciting for me too. I get to disseminate all this cool knowledge and share our basic research with this huge audience. What are you most nervous about and excited about? Dr. Koupenova:                 You're doing the podcast, so I don't have to worry about that, that that particular part. I am quite excited actually about everything that's going to surround popularizing the science at Circulation Research. I think in the time that we live in and when social media is a huge part of our life, we definitely need to engage the community, scientific or lay, and communicate our ideas. I'm super excited about the creative part behind how we are going to achieve this via various social medias. Cindy S.H.:                         Can you talk about the platforms that you plan on using? Dr. Koupenova:                 We currently are using Twitter and Facebook. Please follow us on Twitter and Facebook. And we are going to launch Instagram. Find us, follow us, engage us. That will be great. You can always send us messages and like us, retweet whatever you decide. Cindy S.H.:                         Give podcast feedback on Twitter. Nice comments only. Dr. Koupenova:                 We'd like to hear your comments and we'd like to hear what you envision in certain cases when it comes to your Circulation Research, because this is your journal as much as it is ours. We're here for you. In addition to popularize and advertise the wonderful science that we're publishing in Circ Research, we want you to be engaged. We want you to be able to advertise in your own work and to think of it as something that you own and something you need to communicate to the rest of the world. That is one of the things that we want to do. Dr. Koupenova:                 Finally I'm going to echo on what Dr. Freedman said, is we want to attract truly early career and young investigators and help them be involved, help them own their science and help them communicate their ideas. That's pretty much what our social media platform is and we are going to evolve with you. That is perhaps one of the challenges. Cindy S.H.:                         I think one of the most interesting aspects, at least in academia as I see it, is really the role of self-promotion. It's something you're never taught and it's something that you don't really appreciate until you go to that conference. I remember my first conference as a new PI, I was standing there and I'm just like, "Okay, these are all other PIs. How are they all in groups? How does everybody know each other? Why are they all friends already?" It takes a lot of guts and you have to inject yourself. "Hi. I'm Cindy St. Hilaire and I'm new. Please be my friend," essentially, essentially. But it's important and I really liked the fact that when your journal is published you have that little button, share on Twitter, share on Facebook. I think that's really important. It helps you practice that self-promotion and can help really allow you to embrace your extrovert when you know how to. Dr. Koupenova:                 That's exactly what I was going to point out. Scientists or physician scientists, or physician scientists perhaps are a bit better. But as scientists we're very much introverted. But social media gives you a platform that it's not cheesy to popularize and communicate. Then you see those people on conferences and then you have your little group without- Cindy S.H.:                         It's amazing how many Twitter friends I have. "Oh, I met you on Twitter. It's so nice to meet you in real life." Dr. Koupenova:                 It's a new generation. We at Circ Research want to evolve with it. Is that correct, Dr. Freedman? Dr. Freedman:                   That is correct. Thank you very much. Cindy S.H.:                         It's exciting times. I guess maybe this is a question for all of us to talk about, but how do you think we can, number one, attract people to science, attract diverse people to science, and then really keep them in science and how do you think we can use Circ Research and also the social media aspects of Circ Research to do that? Dr. Freedman:                   I think, first of all, people have to see themselves in the journal. The journal, I think the first point I talked about, about being inclusive, inclusive types of people, way people consume science, types of science. We really want people to feel like Circ Research isn't just a journal that puts out scientific papers, but is a forum. It's a forum for them to exchange ideas and it's a forum for them to understand better about their scientific careers. Cindy S.H.:                         Great. Thank you. This has been an amazing first podcast. I'm so happy to share it with the two of you and I'm super excited for this opportunity. Again, Jane, I want to congratulate you on your new position as editor in chief and I can't help but mention as the first female editor in chief. That's a wonderful, wonderful thing. Cindy S.H.:                         You can find us on Twitter. The handle is @CircRes, at C-I-R-C-R-E-S. We're also on Instagram using the same name, C-I-R-C-R-E-S. We hope to hear from you there. Cindy S.H.:                         Thank you for listening. I'm your host, Cindy St. Hilaire, and this is Discover CircRes, your source for the most up-to-date and exciting discoveries in basic cardiovascular research.

Two of the state's leading health care analysts say they aren't sure whether creating a powerful alternative to Partners HealthCare will reduce health care costs in Massachusetts or increase them. “It's the devil you know versus the devil you don't know,” said John E. McDonough, a professor of public health practice at the TH Chan School of Public Health at Harvard University. “Are we better off having one Partners or two Partners?” Paul Hattis, an associate professor of public health and community medicine at Tufts Medical School, said he also has mixed feelings about the “fight fire with fire” approach advocated by proponents of a merger between Beth Israel Deaconess Medical Center of Boston, Lahey Health of Burlington, New England Baptist Hospital in Boston, Mount Auburn Hospital in Cambridge, and Anna Jaques Hospital in Newburyport. The proposed health care goliath currently goes by the name of NewCo.

Jean Rivera completed his undergraduate studies at the University of Puerto Rico (UPRM) majoring in Chemistry, with minors in Psychology and Biology. His undergraduate research focused primarily on explosives and forensic chemistry in the laboratories of Dr. Samuel Hernandez and Dr. Carmen Vega. He then pursued a 2-year research internship at Tufts Medical School as an NIH-PREP scholar in the Neuroscience Program. There, he studied the downstream mechanisms of BDNF on the control of appetite and affective states in the laboratory of Dr. Maribel Rios. Jean is now a second-year graduate student at Weill Cornell in the laboratory of Dr. Kristen Pleil, where he is interested in studying the molecular mechanisms that regulate addiction and comorbid neuropsychiatric disorders, by identifying and characterizing the sexually dimorphic circuits regulating these complex behaviors.    Any other questions?  Let us know!  We appreciate your feedback. You can now support the podcast at https://www.patreon.com/sfspodcast.  Many thanks to our past and present supporters!  Thanks to Plant Warrior for their support.  Use discount code SFS10 at checkout for 10% off your purchase of plant-based protein.

Please join us Wednesday, August 9, 2017 at 4:00 p.m. PST and 7:00 p.m. EST for a live show with host Denise Messenger. Our special guest is Dr. James M. Greenblatt, MD. We will be discussing his book, "Finally Focused". Dr. Greenblatt is an integrative psychiatrist and leading expert in behavioral and medical disorders such as ADHD, OCD, Eating Disorders – Anorexia, Binge Eating - as well as Depression and Anxiety.  He has been treating patients since 1990 and has dedicated his career to providing patient-centered care and educating his colleagues on integrative psychiatry. Dr. Greenblatt currently serves as chief medical officer and vice president of medical services at Walden Behavioral Care in Waltham, Massachusetts and is on the clinical faculty at Tufts Medical School and Dartmouth’s Geisel School of Medicine. You asked for it and we deliver.  

This week on the Faster Than Normal Podcast, we're listening to the doctor. Specifically, Dr. James M. Greenblatt, head of medicine at Walden! Dr. Greenblatt is chief medical officer and vice president of medical services at Walden. He provides medical management, leadership and oversight of Walden's eating disorder programs in Massachusetts and Connecticut. Working with thousands of children, adolescents and adults, Dr. Greenblatt found that each individual has a unique biochemical profile, range of behaviors and treatment needs. Dr. Greenblatt is board-certified in child and adult psychiatry. He received his medical degree and completed his adult psychiatry residency at George Washington University in Washington, D.C. He completed a fellowship in child and adolescent psychiatry at Johns Hopkins Medical School. In addition, Dr. Greenblatt is a clinical faculty member in the psychiatry department at Tufts Medical School as well as the Geisel School of Medicine at Dartmouth College in New Hampshire.  He lectures extensively throughout the United States and Canada on integrative therapies for mental health. He is the author of “Answers to Anorexia,” which draws on his many years of experience and expertise in integrative medicine and treating eating disorders. He also wrote “The Breakthrough Depression Solution,” which outlines a personalized nine-step method for beating the physical causes of depression, and “Answers to Binge Eating Disorder,” which introduces biological solutions for binge eating and food addiction. Dr. Greenblatt is the author of six books: Answers to Anorexia (2011), The Breakthrough Depression Solution (2012), Answers to Binge Eating (2014), Integrative Therapies for Depression: Redefining Models for Assessment, Treatment, and Prevention (2015), Nutritional Lithium: The Cinderella Story (2016), and The Breakthrough Depression Solution 2nd eds. (2016). His latest book, Finally Focused, describing integrative therapies for ADHD, came out ia few months ago. As always, leave us a comment below, drop us a review on iTunes (PLEASE!) and of course, subscribe to the podcast if you haven't already! Know of anyone you think should be on the FTN podcast? Shoot us a note - We'd love to hear! PS: Don't forget - We have the #1 online video course for turning your ADHD into a superpower - The FTN Course is 38 three minute videos, watchable at your own pace, covering everything from work, to home life, to exercise and health. Check it out!

Session 12 Dr. Chung is a solo private practice Facial Plastic Surgeon. He discusses his path through ENT residency and what he likes and dislikes about his job. Today's guest on Specialty Stories is a solo private practice facial plastic surgeon. It's a great specialty, super sub-specialized specialty of ear, nose, and throat surgeons, or otolaryngology. And Victor, or Dr. Chung, is going to join us and tell us all about it. [02:15] A Personal Choice to Be in Private Practice Dr. Chung practices facial plastics and reconstructive surgery as a subspecialty of otolaryngology; ear, nose and throat surgery. He considers himself as one of the rare breed of private practice, truly private practice solo by himself, the only physician in the office which is an interesting kind of hybrid situation. As a specialist, he is affiliated with a number of the hospitals in the San Diego area, however, he’s not officially on staff who who has to be in the hospital all the time. Nevertheless, he does consultation and coverage for call and operate at those sites. Out of all the fellows who graduated in his year, only two of them went into true private practice and are opening practices. The majority are either joining multi-specialty practice groups. He thinks even looking for academic jobs was a tradition that's fallen by the wayside. As to why he chose private practice, Dr. Chung had his personal reasons. He had phenomenal training and wanted to practice medicine the way he was trained to do. “When you become part of a bigger group or even as small as a partnership,  there's a level of compromise. Otherwise, there's no way for you to be successful.” He further explains that what he likes in private practice is having that freedom to practice without restriction in the sense of delivering care to the best of his ability that gets to order the more expensive supplies and equipment or employ a technique he knows well. So his choice was natural for him and he sees being in a personal situation that he could do it is a luxury. Although joining a bigger group or academics is not a complete compromise, Dr. Chung says that oftentimes, you find that your patient population or the group you're in will dictate your niche and your future. Then you may start doing things that don't make you necessarily happy anymore in medicine. You start doing fewer of the cases that you like to do or take care of the patients that you like. You can find that ideal situation in academics in larger groups, but it's just more challenging. Victor has been out in his own practice just over twelve months. It actually took him a number of months just to get his place set up which involved a lot of logistics as well as a lot of things they don't teach you in medical school, or residency, or fellowship about applying for business licenses, insurance, and all the other type of regulations that are necessary to own and run a successful and safe business. [05:36] His Interest in Facial Plastic Surgery Victor always knew he was going to do surgery when he was in medical school. He enjoyed the aspect of thinking, being hands-on, its culture, and the lifestyle. But honing into a particular specialty was tough. He was looking at a number of sub-specialties that operate in the areas of ophthalmology, neurosurgery, plastic surgery craniomaxillofacial, and the ENT subspecialty, which he found very appealing. “Even within a single focus of the human body, it was challenging. And although facial plastics is a sub-sub-specialty within it, it's still an integrated part.” You will go out in the community and meet physicians who are ENT-trained, but not fellowship-trained, but they are still practicing as facial plastic surgeons. This is actually encouraged by the overall academy. The types of procedures can be reconstructing cancer that may have been excised on just the skin level, but others are doing larger reconstructions or rhinoplasty and face lift based on their skillset and their comfort level. Victor adds that the specialty overall gives you all the skillsets you need, As an individual, you get to pick the things that you are comfortable with  or you really enjoy doing and focus on those. Additionally, you'll meet other physicians in your community who like doing the other procedures that you may feel less comfortable with or ones you don't like as much. Victor points out the good camaraderie that goes on there and you're a lot happier treating the disease states and doing the surgeries that you like to do. [07:50] Traits of a Good Facial Plastic Surgeon Victor explains that you need to be both left brain and right brain. On one hand, you need to be analytical, be very objective, and be able to understand proportions and direct measures and changes. On the other hand, you have to be someone who has an artistic component in how you think about things and how you view them. When Victor performs a rhinoplasty surgery, he is not only looking at this overall picture. So it's just not just a nose and a good-shaped nose, but he has the entire face prepped in the field exposed. He looks at the relationship of the nose to the chin, the forehead, proportions to how wide the eyes are, and that overall aesthetic. Moreover, as a confirmatory measure, he does all these different measurements as to how far the nose projects out, the angles, and those that are within accepted values. So you need to be able to mind both sides and not be locked into either one. It's right in the middle of your face, it's very obvious, so the stakes are a little bit higher. [09:28] Other Specialties in Mind Victor had not picked his residency specialty until very late in the process. He had gone through most of the clinical clerkships of my third year thinking that he was leaning toward orthopedic surgery as just a specialty within surgery. He didn't think he was going to do general surgery, but he knew it was some sort of surgical hands-on one. At that time too, interventional procedures were getting big. Interventional radiologists and cardiologists have very hands-on and very three-dimensional stereotactic type specialties as well. But thinking about which one to hone in on, Victor wasn’t exposed to it until the last quarter of the third year clinical clerkships. And it did turn around having interacted with some very stimulating cases as well as with nice residents and attending physicians who were open to sharing what they were doing and allowing him to participate. If you’re considering ENT, Victor recommends that you see if you're okay with boogers and earwax and all those bodily fluids. If you have no problem with them then you'll be okay. He explains how people have aversions to different things. So you have to pick what you’re comfortable with seeing everyday. You can't just base that purely on a good experience. You need to figure out what is the day-to-day kind of drudgery. “Pick what you are comfortable with seeing day to day, because if you don't like your day to day, you're not going to enjoy the highlights any more.” Victor tells students all the time check out the really dizzy patient that is struggling and you can't get a good exam on, but you still try to figure out how to treat them. It’s really, really tough sometimes to figure out if they're surgical or non-surgical, and yet they can take up more than a full appointment visit. So regardless of your specialty, be sure to examine, find those highlights, but also find what are the low points and if you're okay with those. [12:20] Patient Types and Typical Day in the Life of a Facial Plastic Surgeon Victor sees all kinds of patients, which is something that keeps him captivated and stimulated in his specialty. His patients range from very minor, very cosmetic to no medical emergency about it whatsoever, there's no urgency, it's purely elective, the changes are super subtle, super small, there's no life threatening thing that you're changing. Nevertheless, people gain quite a bit of benefit from them. Their attitudes change and their self-esteems improve with the subtle thing that bothered them that maybe no one else noticed. Moreover, Victor still participates in general ENT call. He does tracheostomies for people who have lost their airway or reconstructions for people who have lost major tissue from skin cancers or other disease or trauma. These are very drastic changes to improve someone's function and there's very little cosmetic aspect of that. So Victor likes that spectrum and he doesn’t see himself giving up on doing all those things. Overall, he likes the full gamut of complexity and simplicity because you can gain benefit for your patient on both ends. Being new in his practice, every day for him is pretty variable at this point in time. The idea is a clinic, a private-based practice, and so the majority of his patients would be seen in the office setting in a combination of consultations, follow-up visits, minor procedures, injections- injectables. Those types of visits are all in the office. “As the trends go, more and more surgeons are doing things in the office.“ Typically, a surgeon in his specialty will have block time or days set aside where they would be operating, maybe two days a week being in the operating room doing a number of cases. But the majority of them would be on the outpatient setting so most of those patients are going home. A select amount would be seen in the hospital as an inpatient and seen on multiple visits in the hospital before they're released. Moreover, Victor stresses how a lot of students and doctors don’t realize the business side of it. You can fill an entire day with administrative tasks, but it is about prioritizing and compartmentalizing. In his case, he picks one night a week where he does it until late of night and he doesn’t go home until everything on the administrative side is done then for the rest of the week, he sets up tasks and completes as many as he can. But when those tasks pile up, they will get all done on that one day. Otherwise, you can get pretty overwhelmed going from task to task to task so it's nice to have some structure in your day. [15:35] Taking Calls As a plastic surgeon, you don't have to take a lot of calls. It actually depends on where you are geographically located. Some hospitals require you to take a certain amount of call depending on the size of the call pool and how busy the hospitals are. But Victor is not required to take any call whatsoever, but it also depends. He explains that there are some financial compensation at some sites while others don’t so it's just part of requirement-maintaining privileges. Although there is no requirement in the San Diego area where he is practicing, Victor is participating. In terms of the percentage of patients he sees ending up in the operating room, his goal is close to 100%. He has seen surgeons who are well-established and basically they are turning patients away. “You want to get to that point in your career where you are selecting patients who they're the most appropriate, that you can exercise and perform the best surgeries for the best results.” Victor has patients who are not good candidates and he tells them that they are not appropriately going to be surgical patients. But he enjoys the fact that he gets to educate a lot of the patients coming in. He spends over an hour in his consultations with patients giving them all the facts including the raw details and the scary things that can happen in surgery in order for them to make an informed decision. At this point, he doesn’t feel that half of them are going to the operating room because they're just still in that information gathering stage. But as careers progress and you become very well known for particular surgeries or techniques, a lot of patients coming in have already done their homework and research. Especially with the availability of resources on the Internet, they've done their background on you. They know where you trained, they know what technique you do, and they've come specifically for that technique or procedure, and that ratio of conversion is much higher. [18:10] Work-Life Balance Victor describes having a good work-life balance whenever he chooses to have a good work- life balance. And that is very different from a lot of other physicians who are at the beck and call of their pager or their schedule, and therefore they don't have the same freedoms as he does. He can choose to work incredibly long hours or he can also choose not to be working those hours based on his specialty. There are still emergencies and so he won't operate for weeks before he goes out of town and out of the country on vacation, but that's the only limitation. Nevertheless, he can choose within his personal setting to take time off to tend to himself and his health. However, he is also participating in community volunteering and spends time with his wife which he thinks are two very important things. “When you start sacrificing your own personal health, your interpersonal relationships, then you're not going to be as healthy of an individual and therefore not a good doctor over the long run.” You're just going to get burned out, and that's an increasingly common phenomenon. Victor adds that good diet, nutrition, exercise, health maintenance, time with family, downtime are all things that should be scheduled and be consciously part of your day-to-day instead of things that are added on if you have time. [20:35] Residency and Fellowship Before you graduate to an otolaryngology head and neck surgery residency, it used to be an early match, and for many years now it's on time with everyone else's. It’s basically a five-year program which has an intern year but it's considered an integrated intern year. Typically at the same institution that you're doing residency, it does have general surgery components and rotations, however, increasingly more focused toward an ENT residency. The elective months would be Anesthesiology. You'll be in the ER and you'll be doing surgical ICU, all geared toward skillsets that will be beneficial for your residency versus a standalone general surgery or where you are on rotations that are purely dictated by the general surgery department. This is commonly seen in orthopedics and other surgical subspecialties. After which, there will be four years of ENT training. This may involve time at a children's hospital, at a VA institution, maybe a research block, but you'll be rotating through different sites and every year you're increasing your skillset. You're learning about all the systems, the ear, the nose, the throat, the different types of surgeries, seeing patients in clinic, and operating as well. But as you go through each year, your level of responsibility, and then as a Chief, you'll be running the service teaching and mentoring junior residents, and before you graduate you'll apply to a fellowship. This is typically within your fourth year. There are a number of fellowships you can pursue such as pediatrics, neuroethology, head and neck cancer, microvascular reconstruction, facial plastic reconstruction, and sleep medicine even. So the fourth year is an application that goes in around January through March and you interview between March and end of May, and then you'll match to a one-year fellowship program that would go after your graduation from your ENT residency. [23:37] An Alternative Route to Facial Plastic Surgery Outside of ENT Victor explains that if you wanted to just do plastics in the face area, you could definitely reach that goal through an alternative route, which is through plastic surgery. There are two pathways through plastic surgery. The first one is to complete general surgery and then apply to a plastic surgery program. The second one is an integrated plastic surgery program that you match right out of medical school knowing you're doing plastic surgery and that has a general surgery component to it. These programs are typically longer with research years as well. Victor believes it can last as long as seven years to finish those residencies. And then most individuals who want to operate in the face area will go ahead and do an additional fellowship on top of that. “You can reach the same goal in a sense, the same practicing setting, but you'll just have other skillsets bringing to that job as well.” [25:00] Competitiveness in Matching Victor describes matching in ENT has gotten to be one of the more competitive subspecialties to match. “I think all of the surgical sub-specialties have gotten difficult because it's just a pure numbers game, just from any type of academic application.” Kids are applying to more colleges. College students are applying to more medical schools. Medical students are applying to more residencies. Even when he was applying, he met people who applied to every single ENT residency in the country just to play the numbers. And so it's more applications on the Residency Director's table to leaf through and make a selection. In Victor’s case, they had a pretty small program. Only two residents are accepted per year, and maybe thirty people were applying per spot. Some programs only have one resident while big programs have four to five residents. And although some may say thirty people may not be a lot, but each one of those individuals have published research, phenomenal USMLE Step 1 score, letters of recommendation from the Chairman, have done research rotations, have really stacked their binder full of accolades. There’s now an ENT student interest group that starts guiding students from the first day they get to medical school. And so it has gotten increasingly competitive to apply to any of these residencies. Victor feels ENT has a popular swing recently. It had a big swing before he applied, but it's always been up there along with the other types of subspecialties that are maybe competitive to get into. [27:32] How to Be a Competitive Applicant Victor outlines that in order to be competitive goes down to all the basic things that everyone is always striving for. This means maintaining good grades regardless if you're a pass or fail system. Getting into AOA as another marker on your application showing that you stand higher in your class than other students. Then the USMLE Step 1 score. Before it was just about generally trying to get in some research but if you can get on a research project that is related to the residency that you want to apply to, that can only help more. Publications, participation, posters, presentations, attending meetings, getting involved in the department, attending conferences because there's always academic conferences every week within that department. Just make a personal connection with the attendings in that department. All of those things can make you more visible and create a level of investment, not necessarily to get you accepted into your home school's department, but also, they may be invested in getting you into their alma mater, or another program that they're aware of that would be a good match for you, or a geography that you're interested in. “It is a time investment because you're spending so much time already studying and trying to do all those basic things. But by investing yourself personally, that will give you an additional edge.” But there's also a gamble. Victors knows of people who've done that and then decided they wanted to actually do a different specialty too so you're not locked into it. But if you know early on, that will behoove you to create those. Create that rapport, create that link to those individuals early so they can really get to know your medical school career. [30:12] Osteopaths and Subspecialty Opportunities Victor says there are only very few osteopathic ENT physicians out there. He has interacted with some and they're all great, but within the world of facial plastic surgery, it is still a very small community. He thinks the majority are going down the MD path. However, the individuals operating in the head and neck facial area is growing. There are oral surgeons who perform cosmetic facial plastic procedures. There are general plastic surgeons who do those and there are those in the field of oculoplastic surgery who want to do face lifts and rhinoplasty. There are dermatologists who want to do more surgical procedures in the face. Then there are general surgeons, other surgeons who take cosmetic courses and get boarded under the Board of Cosmetic Surgery and perform those. “There is an increasing number of individuals out there who have not gone down a traditional path of training and are performing those procedures.” In terms of subspecialties available after ENT, there is a phenomenal opportunity to sub-specialize, not only by pursuing a fellowship but also many departments are strong in all fields within otolaryngology. It's not a necessity to have a fellowship training because it's not as formal. There isn't a required board certification for all the subspecialties, not all of them are ACGME certified either. You can pursue a fellowship in facial plastic and reconstructive surgery, head and neck cancer with or without microvascular reconstruction, pediatric otolaryngology, otology or neuroethology that involves an ear surgery, sinus rhinology, laryngology professional voice. If an individual has graduated and they've had strong training, they can go out and they can become a sub-specialist. They can focus their practice doing laryngology professional voice in an area that needs it and provide that care at that subspecialty level without fellowship as long as they're adequately trained and have a desire to pursue those patients. But Victor says this is rare. Most times, even those who are really focused, even nationally known for a particular field, those guys are always interested in doing other aspects of ENT as well. Some are doing more trauma, some may be doing head and neck cancer or they may be doing endocrine surgery but they're known for voice. They may be filling other roles within their group practice. Most of the otolaryngologists that Victor has met often miss doing other aspects, but find that, there’s no one else who's stronger in ear surgery so a lot of the ear cases go to that surgeon within the practice. Or someone else really enjoys sinus surgery, is savvy with it, is up with the latest techniques, and so that practitioner in that group will see more of those patients. But each and every one of the ENT doctors in that group is less likely to solely focus on a subspecialty and only, only do that. Most of the times it will be a little bit more well-rounded and be doing multiple aspects of ENT, but not necessarily all of them. Victor concludes it's getting tougher and tougher to be in overall general unless you're in a more remote area where there's fewer practitioners around. [35:06] Board Exams, Certifications, and Pass Rates Victor illustrates the board exam as consisting of a written and an oral exam component. The current format are separate examinations. At one point in time, they were done on the same setting, but currently you will take the written exam. I, it is a computer-based test that is administered in September following your June/July graduation from residency, and that is a multiple choice format test that tests all the aspects of ENT medicine and surgery. There is a pass/fail threshold for that test, and those who pass may go on to the April exam which is currently administered in Chicago. There are five rooms with a number of three or four modules in each one, and it's basically a mock simulation clinical case. They're integrating some technology CT scans. They used to give you photographs but now you can get a computer screen and you can flip through a couple slides of a CT scan, or lab tests, or histopathology, and you went through a case from, say, the patient presents as a child or an adult who had a car accident, or someone who's lost their voice, and then you ask questions, you proceed through the case, and you gain points based on your questions and responses. Then hey tally those up and then once you've passed both of those components then you're board certified for ten years. Through that ten years, you're doing maintenance certification through online modules every year, and then at the tenth year, you're re-certified again. So that is the board certification process for otolaryngology. You can also get board certified in neuroethology sleep and facial plastic surgery, and those consist of both of a written exam, an oral exam, and in some cases collecting case reports of patients that you've operated on in the first couple years of practice. The pass rates are pretty high for both exams. Although Victor doesn’t know the exact number, he thinks it’s less than 10% fail because there's quite a bit of preparation for these exams. [38:10] Working with Primary Care and Other Physicians Victor still gets to work with primary care physicians whenever he sees more of the general ENT type patients. He used to give a lecture to family medicine residents about HIV manifestations in the head and neck, and it's shockingly common, and this is from sores on the lip, to frequent sinus infections, to ear infections, skin lesions, lots of different changes in the head and neck area, and a primary care can pick them up if they're looking for them, and make the appropriate referral for both HIV specialists, infectious disease specialists, as well as an ENT doctor to get involved. So that's one of the things Victors thinks that can be missed, and it frequently is missed, but then can be detected and really initiate early care at that primary level. Other specialties he gets to work closely with depends on Victor personally. There could be dermatologists if they're removing skin cancers. This is the closest in his personal practice. However, there are a lot of ENT specialist surgeons who work with the head and neck cancer doctors that will interact with medical and radiation oncologists, the ear doctors. The neuroethology training will interact with neurosurgery for skull-based surgery. In the Intensive Care Unit where you're doing larger surgeries, the head and neck cancer surgeons will see patients again, admitted to the ICU for laryngectomy or tracheostomy management. “A fair number of patients are generally on the healthier side, and a number of procedures we’re doing are for improved quality of life, for better breathing, better functioning.” Victor adds that there is a close connection with ENT doctors in general with primary care doctors for sure. Absolutely, and oftentimes there's an unfair and sort of inverse ratio. There's tons of primary care doctors and you get a lot of their patients into ENT specialists and there are just very few ENT doctors available. And even with jam-packed schedules, there may be months' long wait lists. But all the time, he’d talk to primary care doctors who really need to get someone in urgently they will always make their best effort to get those in and not have them on the waitlist. [41:35] Special Opportunities Outside of Clinical Medicine Victor says there's always lots of research going on with the basic science level looking at wound care, tissue healing, in addition to the types of different injectable products, hyaluronic acids, botulism toxins. There's a lot of these things called PRP, Platelet Rich Plasma, and other types of different materials that are being injected for stability, safety, efficacy, improving them. There is a number of possibilities to pursue research and development of these types of products. Those who are more interested in the business side can become Chief Medical Officers for healthcare related corporations. There's actually a very small and probably should be more encouraged politically active doctors. “There's always lots of different opportunities that you can springboard from your specialty.” There are a lot of different opportunities based on what you're interested in. But there is always that idea of you're giving up that patient interaction and that normal typical doctor schedule, but maybe it's for more regular hours when you're becoming an executive in a corporation. [43:55] What He Wishes He Knew Then “One of the major deficiencies in a doctor's education is the business side.” Victor attended Tufts Medical School and they had a great health professional MBA integrated program that didn't really hold you back from graduating under four years. Although he didn't participate in it, he still thinks it should be part of more the regular curriculum. There are great doctors that can no longer practice because their practices get shut down and closed. Other individuals who have some phenomenal skillset and need to get out there, if there's this barrier that they can't set up their business and they don't think it's possible, or even you don't necessarily have to be a small business owner, but as a component within even an academic group or a multi-specialty group, if you don't understand the metrics of and the financial side of it, you can't practice effective medicine if you're running at a loss, and you're going to get shut down, and then what happens to all your patients? Hence, Victor thinks the economic side of medicine really needs to be a core component in addition to biochemistry, genetics, anatomy, and physiology because it's inevitable. Medicine has become more and more business. It may not be desired to be that way, but it's a reality and physicians really need to understand how to run it effectively and how to protect their business so they can continue to give great care to their patients. [46:05] The Best and Least Liked Part of Being a Facial Plastic Surgeon Victor loves the fact that he has the ability to look at something that a lot of people think they understand well, and bring just another level of understanding, another level of treatment to it. For example, when people talk about breathing through their nose, some may attribute it to allergy while others to structural issue like a deviated septum. Victor stresses that alone takes a higher level of understanding of nasal physiology, and the anatomy, and diseases that affect it. But a lot of really well trained people will stop at that point and they may treat the allergy, they may fix the deviated septum, and the patient still has a breathing problem going on. This is where Victor comes in and he loves understanding the true nuances of the facial structure. He says having that ENT background gives him the understanding of all the functionality, all the moving parts, all the components that need to work day-to-day being normal. “The additional training in facial plastics gives me the side of the aesthetics but also the skillset to create that structure, to improve the functionality while maintaining overall looks.“ Victor claims his best results are noses that have just gone away. The patient no longer notices that it's stuffy or they have difficulty breathing through it when they exercise, and they no longer stare in the mirror and look at their nose that they feel is so prominent, and some people feel like it makes them ugly. And so the greatest success for him is to see patients to have their nose essentially disappear and just be in harmony with the rest of their face. It's still their nose, it's not a beautiful or fantastic looking nose, it's just their nose. He loves the fact that they don't even have to think anymore about picking up a spray bottle, or an allergy pill because their nasal passageways are nice and open, and so they just go about and they do normal tests every day without a thought in their mind. Victor describes it as one of the pure joys of doing it that he notices and that the patient no longer has to worry about anything anymore. On the flip side, Victor thinks trauma is tough but there's a great opportunity to really make a major improvement. Someone breaks their jaw, or shatters their eye socket, but there is a limit of what the end result can be because of the nature of the original trauma. You can always make improvements but you can't really get them to a truly better place. “There’s a major psychological component related to trauma, so even with an improved physical state, mentally there's still a deficiency. There's still a pathology going on.” Victor thinks maybe a multi-specialty kind of care type of thing can get someone who's come back from major trauma to really get them healthy again, because mentally or physically there are just limitations from just those initial insults that they can't really get back to their baseline. If he had to do it all over again, Victor would still choose to do facial plastics. He loves what he does and he says he’s excited to get up every day to go and see what comes through the door and he thinks this will stimulate him for years and years. At the same time, he would look for other additional skillsets such as check out a neuroethology fellowship as well as other things that would complement what he already does. Or he may get into facial nerve reconstruction therapies and then advance outside of that. Victor feels blessed to be able to do this. He could have gone a lot of other ways and would have been fine, but if given the opportunity to go about this again, he would still pick the same residency, the same fellowship, and focus on the same things. Maybe small little tweaks here and there, but overall, that same path has been really beneficial for him. It has really played to his strengths and it has given him the skillset to be a successful practitioner. [52:15] The Future of Facial Plastic Surgery Victor isn’t sure if any major changes are coming to facial plastics whether in the technologies or just fundamental shifts in the way things are practiced. He admits though of being on social media, a lot of people are becoming aware of new products and technologies at a much faster rate. The initiation of that first treatment is getting younger and younger. There are twenty-year-olds getting Botox to prevent wrinkles and people getting surgery at a younger age. But the largest kind of shift going on around a lot of focus on non-invasive therapies such as energy devices, like injections to dissolve fat. “There’s a little bit of oversell on those stuff that get marketed as quick and easy, and when they add on cheap, quick, and easy, those results don't ever really match the promises of the outcome that they get.” They're often short-lived and have unforeseen complications. They affect your ability to do things later. They burn bridges in treatment pathway. One of the things is injection rhinoplasty. People are putting fillers in their nose, but fillers in the nose in that skin area don't behave as well or in the same way as it does in the other soft tissues of the face. Victor has even seen disastrous things like blood vessels being blocked off, and whole areas of the skin and tissue on the nose enclosing. And that can happen in other areas of the face. It will heal and leave with some scarring, but if it happens on the nose or near the eye, then you've lost more function. Victor thinks it’s revving up toward these office procedures, and some are great, but then they're being expanded to use in replacement of tried and true therapies, and he thinks it'll surge but then people will see so many issues with it and then it will come back. There will be better technologies, there will be better equipment, there will be safer mechanisms out there, and all for the good. Victor adds that's how medicine has always been. There's always been sort of a pioneering technology, or thought, or philosophy, and then new techniques come out, and then they kind of push the threshold of risk and complication, and they back off, and then there's a new push as new developments come on the horizon. But that's how you progress, and improve, and come up with new therapies for diseases that previously never had any treatment. So it has to be done but just in a careful way and more informed way. [55:30] Final Words of Wisdom from Dr. Chung Victor’s advice to patients is to take some art classes. It's one thing to understand the anatomy, but if you can translate that anatomy and the structures from your brain to your hands, and using your hands, those are all good basic skills that can translate into being a better surgeon, and choosing when not to upgrade. Everyone will study hard and everyone will get a high score on the test, and everyone will strive to get that letter, but you need to find one or two things like sculpting, or drawing, or it might be music, or something to really keep yourself active and in a unique sense to keep yourself motivated. You may bond with some big name doctor one day who's going to write you a letter based on that unique activity that you do that not everyone else is doing. [56:55] Final Thoughts If you are interested in ENT, or otolaryngology, or even the specialty or subspecialty of facial plastic surgery, I hope this episode was interesting to you. I love these conversations, I learn so much from them even as a physician, so I know that you as a premed or a medical student are going to get a ton of great information from these conversations to help steer you in the right direction for your career. Links: www.TheShortCoat.com

The move by the Tufts Medical School faculty—full-time, tenured doctors and researchers, not part-time adjuncts—to unionize and affiliate with the S.E.I.U. could open a new chapter in the history of organized labor. And it's happening in our own backyard.

Today Laura Theodore, the Jazzy Vegetarian welcomes Dr. Daniel Nadeau, co-author of The Color Code:  A Revolutionary Eating Plan for Optimum Health to talk about a full day of Jazzy Vegetarian summer menus! We’ll share recipes ideas, meal plans and nutritional information for an easy day of breakfast, lunch and dinner menus to share during the warm weather months! Dr. Dan A. Nadeau is Medical Director of the Diabetes and Endocrinology Associates of York Hospital, York Maine and he is former Assistant Professor of Medicine at Tufts Medical School in Boston. Dr. Nadeau received his medical degree from Tufts University School of Medicine and earned a master's degree in nutrition from Tufts University School of Nutrition and he is the recipient the National Research Service Award. He co-authored the book on nutrition entitled The Color Code:  A Revolutionary Eating Plan for Optimum Health which hails the health benefits of eating brightly colored fruits and vegetables.  

Today Laura Theodore, the Jazzy Vegetarian welcomes Daniel A. Nadeau, MD, to talk about how he believes that with a healthy vegan diet, people everywhere can turn their lives around. Dr. Nadeau is Medical Director of the Diabetes and Endocrinology Associates of York Hospital, York Maine, and former Assistant Professor of Medicine at Tufts Medical School in Boston, MA.  Dr. Nadeau has engaged in extensive research diabetes medications, as well as in obesity studies, and lectures widely. Dr. Nadeau received his medical degree from Tufts University School of Medicine and earned a master's degree in nutrition from Tufts University School of Nutrition.  Dr. Nadeau is the recipient the National Research Service Award. His publications the co-authored a book on nutrition entitled The Color Code:  A Revolutionary Eating Plan for Optimum Health in collaboration with James Joseph, PhD, of Tufts University and Anne Underwood of Newsweek magazine, on the myriad health benefits of eating brightly colored fruits and vegetables.  Prior to relocating to join the Exeter Hospital medical staff, he was a health reporter on WABI-TV, a CBS affiliate in Maine.

Dr. Robert Schwartz is a professor emeritus of medicine at Tufts Medical School, and a former deputy editor at the Journal, both in Boston. Stephen Morrissey, the interviewer, is the Managing Editor of the Journal. Supplement to: Schwartz R. The Emperor of All Maladies - The Beginning of the Beginning. N Engl J Med 2011;365:2353-5.

Erythropoiesis-stimulating agents in patients with anemia of chronic kidney disease; interview with Daniel Weiner, MD, MS, of Tufts Medical School. Plus a summary of all the issue's articles.