Flourishing in Medicine: From Surviving to Thriving
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Flourishing in Medicine: From Surviving to Thriving explores ways that health professionals- physicians, nurses and nurse practitioners, physician assistants, mental health providers, therapists, and others- can truly flourish in the complex and challenging world of health care.The ability for physicians and other health professionals to practice high quality care and attain professional satisfaction and meaning in their work has been under continued challenge. These critically important members of our communities experience ongoing threats to their well-being and hence to the quality of care they deliver. The recent pandemic has only exacerbated changes that have occurred over the preceding years in the practice of medicine, exposing even further the fragility of our imperfect health care systems. This podcast explores the many ways that physicians can and do flourish, including a deeper exploration of what it means to work at the frontier of human frailty and suffering, while applying biomedical science and compassionate care to address the complexities of the human condition. It is the hope that this podcast can help support these health professionals and ultimately translate into improved care of themselves, their patients, and our communities.Your host, Mick Krasner M.D., F.A.C.P, is a Professor Emeritus of Medicine at the University of Rochester School of Medicine and Dentistry. Dr. Krasner has been teaching Mindfulness-Based programs to patients, medical students, and health professionals for more than 23 years, involving over 4000 participants and more than 2000 health professionals, and continues to facilitate Mindfulness-Based Stress Reduction for employees and dependents of the University of Rochester. He was the project director of Mindful Communication: Bringing Intention, Attention, and Reflection to Clinical Practice, sponsored by the New York Chapter of the American College of Physicians, funded by the Physicians Foundation for Health Systems Excellence, with results reported in JAMA in September 2009. This program led to the establishment of Mindful Practice in Medicine Programs at the University of Rochester which he co-directs, offering continuing educational programs to health professionals and educators locally and internationally for the past 13 years, and includes a multi-year teacher training program for future facilitators of Mindful Practice. He has been engaged in a variety of research projects including the investigations of the effects of mindfulness practices on the immune system in the elderly, on chronic psoriasis, and on caregivers of Alzheimer’s patients. His most recent project, The Healer’s Journey, is a documentary film in production that explores the professional identity formation of our newest health professionals, the medical students.Dr. Krasner graduated from the University of California, Berkeley in 1983 and received the Doctor of Medicine degree from the University of California, San Diego School of Medicine in 1987, completing residency in both Internal Medicine and Pediatrics at the University of Rochester School of Medicine and Dentistry where he continued as a full-time faculty member, engaging in medical student and residency education, post-graduate medical education, and research. He has shared his work in peer-reviewed publications, scientific assemblies, workshops, visiting professorships, and intensives throughout the world, focusing primarily on the roots of Hippocratic medicine through the cultivation of attention, awareness, and reflection on the health professional- healing relationship. Having recently left clinical practice, he now devotes all his time to the pursuit of helping physicians and other health professionals flourish.
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Today, we are joined by Colleen Camenisch, MBA, Executive Director of the Nevada Physician Wellness Coalition. Colleen Camenisch, MBA, is an experienced Chief Executive Officer with a demonstrated history of working with leaders in the mindfulness industry and in the higher education industry and Medicine. She has a wide range of skills that include Management, Strategic Planning, Marketing Strategy, Mindfulness Based Interventions, and Public Speaking. Her strong business development experience with a post graduate training in International Business and Trade Law from United Nations' International Labour Organization (ILO) in conjunction with the University Institute of European Studies adds depth and a worldview rarely found in leaders of a community organization like the NPWC. She is a certified Mindfulness Based Stress Reduction Teacher and Teacher Trainer who regular teaches programs for the University of Massachusetts and Brown University. In the conversation, Colleen shares the deeply personal story of how losing her father to a likely medical error led her on a healing journey through mindfulness and eventually into transformative work supporting healthcare professionals. We also cover: * The grassroots evolution of the Nevada Physician Wellness Coalition from responding to physician suicides to a dynamic statewide organization * How mindfulness practice informs her leadership in navigating uncertainty and holding space for difficult conversations * The coalition's innovative programs including peer support networks, hospital leadership collaboratives, and medical student mentorship Colleen concludes by envisioning a future where healthcare professionals feel safe, valued, and have time for meaningful patient care, while sharing her hope to replicate the coalition model nationally. Links: Nevada Physician Wellness Coalition: https://www.nevadaphysicianwellnesscoalition.com/ [https://www.nevadaphysicianwellnesscoalition.com/] Colleen Camenisch’s LinkedIn: https://www.linkedin.com/in/colleen-camenisch-mba/ [https://www.linkedin.com/in/colleen-camenisch-mba/] TEDx Reno Talk: https://www.youtube.com/watch?v=hQo-CQzoW24 [https://www.youtube.com/watch?v=hQo-CQzoW24] EmPro Website: https://www.myempro.com/ [https://www.myempro.com/] EmPro Peer Support Program: https://www.myempro.com/peer-support/ [https://www.myempro.com/peer-support/] Physician Support Line: +1(888) 409-0141 Physician Support Line Website: https://www.physiciansupportline.com/ [https://www.physiciansupportline.com/] Dr. Krasner’s Website: https://mickkrasnermd.com/ [https://mickkrasnermd.com/] Mindful Practice in Medicine Website: https://mindfulpracticeinmedicine.com/ [https://mindfulpracticeinmedicine.com/] Chapters: (00:00) Introduction (03:00) Personal Origin Story and Loss (08:00) Finding Calling in Healthcare Support (11:00) Evolution of the Nevada Physician Wellness Coalition (15:00) Coalition Programs and Services (18:00) Collaborative Working Groups (24:00) Assessment and Net Promoter Score (25:00) Mindfulness and Leadership (30:00) Balancing Training with Broad Impact (33:00) Envisioning the Future of Healthcare (40:00) Conclusion
Today, we are joined by Dr. Todd Hill and Dr. Ward Flemons. Dr. Todd Hill is a clinical psychologist, professor and Director of Behavioral Medicine in the Dept of Family Medicine at the University of Calgary's Cumming School of Medicine (CSM). He is also the Director of the CSM's Centre for Mindfulness (C4M). Dr. Ward Flemons is a Professor Medicine, Cumming School of Medicine and Department of Medicine Vice-Chair, Health Analytics and Safety. He is the former Head of Respiratory Medicine at the University of Calgary and former Medical Director of the Foothills Medical Centre's Sleep Clinic. He was a Medical Director for the Health Quality Council of Alberta (HQCA) for over 10 years. In the conversation, Dr. Hill and Dr. Flemons share how their personal journeys and formative experiences led them to discover mindfulness as a vital tool for fostering compassionate care and culture change within medical education. We also cover: * How childhood experiences and early mentors shaped their commitment to helping others flourish * The evolution from individual mindfulness practice to institutional culture change through breaking down silos * Their vision for cultivating a culture of compassionate caring where meaning in medical work is recognized Dr. Hill and Dr. Flemons conclude by envisioning a future where leaders embody mindful practice naturally, creating institutions where people care not because they have to, but because they want to. Website Links & Phone Numbers: Dr. Todd Hill’s LinkedIn: https://www.linkedin.com/in/todd-hill-56b61573/ [https://www.linkedin.com/in/todd-hill-56b61573/] Dr. Ward Flemon’s LinkedIn: https://www.linkedin.com/in/w-ward-flemons-740244121/ [https://www.linkedin.com/in/w-ward-flemons-740244121/] Centre for Mindfulness, Cumming School of Medicine: https://cumming.ucalgary.ca/centres/centre-mindfulness/home [https://cumming.ucalgary.ca/centres/centre-mindfulness/home] EmPro Website: https://www.myempro.com/ [https://www.myempro.com/] EmPro Peer Support Program: https://www.myempro.com/peer-support/ [https://www.myempro.com/peer-support/] Physician Support Line: +1(888) 409-0141 Physician Support Line Website: https://www.physiciansupportline.com/ [https://www.physiciansupportline.com/] Dr. Krasner’s Website: https://mickkrasnermd.com/ [https://mickkrasnermd.com/] Mindful Practice in Medicine Website: https://mindfulpracticeinmedicine.com/ [https://mindfulpracticeinmedicine.com/] Relevant Publications: Flemons WW, Feasby TE, Wright B. Building a safety and quality culture in healthcare: where it starts. Healthc Pap. 2011;11(3):41-7; discussion 79-83. doi: 10.12927/hcpap.2011.22552. PMID: 21952026. Chapters: (00:00) Introduction (03:00) Origin Stories in Healthcare (10:00) Todd's Path to Medical Education (13:00) Ward's Journey to Patient Safety (17:00) Discovering Mindfulness for Healthcare (22:00) Conceiving Culture Change (26:00) Building Leadership Support (35:00) Collaboration and Mindfulness (42:00) Envisioning Future Success (49:00) Conclusion and Reflection Exercise
Today, we are joined by Dr. Susy Stirling, a Public Health Physician and Associate Dean based in Yorkshire & Humber, and Dr. Sandy Miles, a GP and Medical Educator in Devon, both from the United Kingdom. Dr. Susy Stirling MBChB, MSc, MPH, DCH, FFPH trained in medicine and after early career jobs in hospital medicine in the NHS, worked as a General Medical Officer in rural South Africa for 2 years. She returned to the UK to train in Public Health and was previously Lead for Migrant, Asylum Seeker and Refugee Health across the Yorkshire & Humber region. Dr. Sandy Miles is a GP and Medical Educator in Devon. Alongside her clinical role as a GP, she works in Postgraduate GP training, was Clinical Director of Eastleigh Primary Care Network and, together with Dr. Sam Powell, established popular retreats for doctors. In the conversation, Dr. Miles and Dr. Stirling share their journeys from early medical careers through personal challenges and discoveries that led them to focus on supporting healthcare professionals through storytelling, coaching, and addressing shame in medical practice. We also cover: * How personal experiences with inequality, family history, and burnout shaped their paths toward supporting healthcare professionals * The transformative power of medical humanities education and its impact on professional identity * Their collaboration on the National Health Stories experience, creating platforms for healthcare workers to share narratives of hope and humanity Dr. Sandy Miles’ LinkedIn: https://www.linkedin.com/in/sandy-miles-4552a294/ [https://www.linkedin.com/in/sandy-miles-4552a294/] Dr. Susy Stirling’s LinkedIn: https://www.linkedin.com/in/susy-stirling-469976146/ [https://www.linkedin.com/in/susy-stirling-469976146/] Relevant Publications: Miles S. Addressing shame: what role does shame play in the formation of a modern medical professional identity? BJPsych Bulletin. 2020;44(1):1-5. doi:10.1192/bjb.2019.49 Podcast Interview: https://youarenotafrog.com/episodes/152/ [https://youarenotafrog.com/episodes/152/] Website Links & Phone Numbers: EmPro Website: https://www.myempro.com/ [https://www.myempro.com/] EmPro Peer Support Program: https://www.myempro.com/peer-support/ [https://www.myempro.com/peer-support/] Physician Support Line: +1(888) 409-0141 Physician Support Line Website: https://www.physiciansupportline.com/ [https://www.physiciansupportline.com/] Dr. Krasner’s Website: https://mickkrasnermd.com/ [https://mickkrasnermd.com/] Mindful Practice in Medicine Website: https://mindfulpracticeinmedicine.com/ [https://mindfulpracticeinmedicine.com/] Chapters: (00:00) Introduction (03:00) Origin Stories: Why Medicine? (08:00) Susy's Path from Medicine to Medical Education (11:00) Sandy's Journey Through Burnout and Recovery (17:00) The Transformative Power of Medical Humanities (31:00) Understanding Shame in Medical Identity Formation (38:00) The Genesis of National Health Stories (43:00) Using Shame as a Compass for Core Values (51:00) The Importance of Connection in Healthcare (59:00) Envisioning a Future Healthcare System (01:07:00) Conclusion
Today, we are joined by Dr. Will Bynum. Will Bynum, MD, PhD., is an Associate Professor of Family Medicine in the Duke University School of Medicine. Prior to arriving at Duke in October 2017, he served for seven years on Active Duty in the US Air Force. Will's military service included four years of faculty duties in the NCC Family Medicine Residency Program, a deployment to East Africa as the senior medical director of a special operations command, and multiple overseas trips providing medical support to traveling congressional delegations. Will currently serves as the Duke Family Medicine Residency Program Director and Faculty Advisor to the Duke School of Medicine Student Wellness Committee. Will's primary academic interest centers on the role of self-conscious emotions (shame, guilt, and pride) in the medical learning experience. He has conducted some of this research through his PhD work in health professions education at Maastricht University in the Netherlands. In the conversation, Dr. Bynum shares his journey from a service-oriented upbringing to becoming a leader in addressing shame in healthcare, exploring how authentic human connection forms the foundation of his work as both clinician and educator. We also cover: ● His experiences in military service and the paradoxical psychological safety he found there compared to healthcare environments ● The personal crisis that led him to study shame in medical education and healthcare ● How storytelling and narrative serve as powerful tools for addressing shame ● The concept of "shame competence" and shame-sensitive practices in healthcare ● His vision for a more connected, authentic healthcare system that integrates humanities and creativity Dr. Bynum concludes by reflecting on finding joy in his life through connecting with his family, building new experiences with his children, and creating work that feels meaningful enough to blur the line between profession and passion. Dr. Bynum’s LinkedIn: https://www.linkedin.com/in/william-bynum-698a1889/ Website - Shame Space Consortium: https://www.theshamespace.com/ Chapters: (00:00) Introduction (01:45) Dr. Bynum’s Background (04:00) Dr. Bynum's Path to Medicine (07:15) Service-Oriented Family Influence (10:30) Military Service Experience (16:00) Journey into Medical Education (18:45) Origin Story of Studying Shame in Medicine (24:15) Storytelling as a Tool for Addressing Shame (28:30) Comparing Military and Healthcare Environments (34:30) Shame Competence and Shame-Sensitive Practices (38:30) Creativity, Arts, and Humanities in Healthcare (42:00) Imagining a Transformed Healthcare Future (47:45) Personal Life and Finding Joy (50:15) Conclusion Resources/References: The Shame Conversation Film: https://www.theshamespace.com/film Dr. Brene Brown Ted Talks on shame and vulnerability: https://www.youtube.com/watch?v=psN1DORYYV0 https://www.youtube.com/watch?v=iCvmsMzlF7o Bynum WE 4th, Sukhera J. Perfectionism, Power, and Process: What We Must Address to Dismantle Mental Health Stigma in Medical Education. Acad Med. 2021;96(5):621-623. doi:10.1097/ACM.0000000000004008 Bynum WE 4th, Varpio L, Lagoo J, Teunissen PW. 'I'm unworthy of being in this space': The origins of shame in medical students. Med Educ. 2021;55(2):185-197. doi:10.1111/medu.14354 Bynum WE 4th, W Teunissen P, Varpio L. In the "Shadow of Shame": A Phenomenological Exploration of the Nature of Shame Experiences in Medical Students. Acad Med. 2021;96(11S):S23-S30. doi:10.1097/ACM.0000000000004261
Today, we are joined by Charles Pfeffer. Charles is an organizational consultant and executive coach with over 30 years of experience helping leaders harness their own and their organization's inherent ability to create change through learning and adaptation. He guides partly through his listening skills, honed through a life-long engagement with self-awareness approaches and group dynamics training, guiding his clients to clarify what they want – for their enterprise, their teams, themselves, and the world. Has assisted executives across many varied industries and organizations, including FedEx, Xerox, DuPont, and Medifast, to align teams, develop leaders, communicate rigorously, and produce results, and has coached teams with assignments ranging from bringing the world's first production digital color printer to market to safely closing the NASA Space Shuttle program. Collaborating with Nvolv Partners, Charles worked with Starbucks and Save the Children to align leadership, strategy, and talent, and has teamed with Brimstone Consulting on strategic change initiatives at the New York Times, ExpressScripts, and the State of Maine. Working with the pioneering DEI firm, The Kaleel Jamison Consulting Group, Charles helped to bring the power of inclusion to accelerate strategy deployment at Merck, United Airlines, and EcoLab. In the conversation, Charles shares insights from his "accidental" journey into personal growth work and executive coaching, highlighting how he helps leaders navigate complexity and change while maintaining authentic purpose. We also cover: * The fundamental question he poses to clients: "What do you want?" and how this simple inquiry can unlock deeper purpose * How organizations navigate change through disruption and the role of leaders in transforming systems * The parallels between executive leadership challenges and healthcare professionals' experiences * The connection between oath, authenticity, and purpose in professional identity * His vision for healthcare environments that provide calm, competent care through better alignment of capacity and demand Charles concludes by sharing his personal approach to flourishing, which includes time in nature - walking in the woods, kayaking, and skiing - as restorative practices that help him maintain balance while supporting leaders through complex challenges. Website: https://www.charlespfeffer.com/ [https://www.charlespfeffer.com/] LinkedIn Page: https://www.linkedin.com/in/charlespfeffer/ [https://www.linkedin.com/in/charlespfeffer/] - Chapters: (00:00) Introduction (01:15) Charles Pfeffer’s Background (04:15) Charles' Journey into Personal Growth and Coaching (08:00) Early Influences and Moving Beyond Blame (10:30) The Concept of Polarities: Freedom and Responsibility (13:00) How Executive Coaching Works (17:00) Understanding Leadership and Organizational Complexity (22:45) The Challenge of Integration in Healthcare Systems (26:45) Complexity, Disruption, and Organizational Change (33:45) Flourishing Through Authentic Purpose (37:30) What Allows Charles to Flourish in His Work (41:00) Imagining a Better Healthcare Future (45:15) Personal Wellness Practices (46:15) Conclusion
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