Questioning Overdiagnosis: A Conversation with Dr. H Gilbert Welch

In this episode of The Girl Doc Survival Guide, Christine speaks with Dr. H Gilbert Welch, a general internist and senior researcher at the Center for Surgery in Public Health at Brigham and Women's Hospital. Dr. Welch is known for his critical views on the medical profession, particularly around the issue of overdiagnosis in cancer screening. He explains the concept of overdiagnosis, shares a compelling personal anecdote from his career, and discusses the complexities and consequences of early cancer detection. They also explore the differing patient perspectives on diagnosis and treatment, emphasizing the importance of balanced understanding between medical professionals and patients. The conversation sheds light on the unintended impacts of too much medical care and advocates for a more thoughtful approach to screening and diagnosis.

00:00 Introduction to Dr. H Gilbert Welch

01:31 Understanding Overdiagnosis

03:24 A Personal Anecdote on Overdiagnosis

07:48 The Complexity of Overdiagnosis

11:09 Challenges in Medical Screening

20:24 Final Thoughts and Reflections

Thanksgiving Reflections and Insights on Perception and Overdiagnosis

In this episode of The Girl Doc Survival Guide, Christine expresses gratitude for listeners and contributors, especially highlighting recent enlightening discussions. Dr. Claudia Mello-Thoms shared insights on subconscious perception in dermatopathology, while an upcoming episode will feature Dr. H. Gilbert Welch discussing over-diagnosis and the limitations of static tissue samples in cancer diagnosis. The importance of accurate diagnosis and mindful treatment in dermatopathology is emphasized. Listeners are encouraged to tune into these valuable conversations.

00:00 Introduction and Thanksgiving Gratitude

00:25 Subconscious Perception in Dermatopathology

00:48 Upcoming Conversation with Dr. H. Gilbert Welch

01:19 Overdiagnosis in Pathology

01:38 Dynamic Nature of Cancer Diagnosis

02:07 Closing Remarks and Community Thanks

Dr. Scott Binder on Life Lessons and Medical Philosophy

Dr. Scott Binder, MD, shares his journey from a dermatopathology residency at UCLA to directing his own practice. He recounts challenges such as his first autopsy during the AIDS crisis and discusses overcoming prejudice, emphasizing the significance of resilience and putting patients first. Dr. Binder highlights the importance of moral integrity in medicine, continuous learning, and staying relevant through life's stages. He also touches on coping mechanisms like meditation, understanding the big picture, and the necessity of letting go of control. The conversation underscores the unique doctor-patient relationship and the enduring pursuit of purpose and passion in both personal and professional life.

00:00 Introduction to Dr. Scott Binder

01:04 A Personal Anecdote: First Autopsy Experience

02:44 Overcoming Challenges and Prejudice

04:22 The Importance of Putting Patients First

07:36 Balancing Career and Personal Life

09:05 Adapting to Different Career Stages

10:50 Finding Purpose and Fulfillment

13:39 Final Thoughts on Control and Resilience

Understanding Visual Perception in Medical Diagnoses: A Deep Dive with Claudia Mello-Thoms

In this episode, Christine continues the conversation with Claudia Mello-Thoms, an expert in visual perception as it relates to medical diagnosis. The discussion delves into the use of templates by experts to quickly recognize abnormalities in medical images, despite their large size and complexity. Claudia explains how perception operates at a subconscious level, often leading to perceptual errors in medical practices like radiology and pathology. The conversation underscores the need to understand the human element in diagnostics to reduce errors and improve accuracy. The episode also explores the difference between rapid (fast) and deliberative (slow) processing in the assessment of medical images, emphasizing the importance of fresh perspectives when diagnostic clarity is lacking.

00:00 Introduction to Visual Perception in Medical Diagnoses

00:40 Understanding Templates in Medical Imaging

01:34 Expert vs. Novice Diagnoses

02:13 The Role of Clinical History in Pathology

06:48 Fast vs. Slow Processing in Diagnoses

09:42 Perception and Cognition in Medical Imaging

10:31 Teaching and Learning in Medical Imaging

21:48 Challenges and Future Directions in Radiology

23:09 Conclusion and Final Thoughts

Visual Expertise and Diagnostic Accuracy with Claudia Mello-Thoms, PhD

In this episode of The Girl Doc Survival Guide, Christine interviews Claudia Mello-Thoms, PhD, an Associate Professor of Radiology and Biomedical Engineering at the University of Iowa. Claudia discusses her research on visual search, medical image perception, and why errors occur in reading radiological images. Key topics include the use of eye tracking to detect unconscious viewing patterns, the different diagnostic approaches of experts and novices in pathology, and the concept of visual templates aiding rapid diagnosis. Claudia shares insights into how experts efficiently use low magnification to guide further detailed inspection, and the cognitive load differences between experienced and inexperienced diagnosticians.

00:00 Introduction to Claudia Mello-Thoms

00:47 Eye Tracking in Radiology

02:12 Pathologists and Microscopic Slides

06:56 Visual Search Strategies in Medical Imaging

09:42 Expert vs. Novice: Cognitive Processes

11:35 Templates and Rapid Recognition

20:48 Conclusion and Next Episode Teaser

The Sacred Duty of Healthcare: A Conversation with Theresa Brown

In this episode of The Girl Doc Survival Guide, Christine interviews Theresa Brown, PhD, RN, a registered nurse, New York Times bestselling author, and cancer survivor. The discussion delves into Brown's experiences as both a clinician and a patient, highlighting the emotional challenges and the need for compassion in healthcare. Brown shares insights from her books, 'The Shift' and 'Healing,' and talks about her upcoming book, 'A Nurse Finds Hope in Healthcare.' The conversation explores the significance of listening to patients, the emotional toll of illness, and the struggles healthcare professionals face within a corporatized system. Both agree on the importance of empathy, self-care, and the need to improve the patient-caregiver relationship.

00:00 Introduction to Theresa Brown, PhD, RN

00:52 Theresa's Journey from Academia to Nursing

01:09 Insights from 'Healing': A Nurse's Perspective as a Patient

01:56 The Emotional and Physical Challenges of Cancer Treatment

04:06 The Importance of Compassion and Communication in Healthcare

05:20 Balancing Information and Emotional Support for Patients

06:16 Personal Stories and Reflections on Patient Care

07:14 The Impact of Personal Illness on Healthcare Professionals

17:23 Finding Hope and Purpose in Healthcare

20:28 Final Thoughts and Reflections

Career Planning and Wellbeing for Doctors with Dr. Naomi Elton

In this episode of The Girl Doc Survival Guide, Dr. Naomi Elton, a systemic therapist and retired consultant psychiatrist, discusses her career journey and the importance of career planning and self-care for doctors. She talks about her new book with co-author Caroline Elton, PhD: 'Career Planning for Doctors: An Evidence-based Guide,' which provides practical exercises and methods inspired by Daniel Kahneman's cognitive decision-making strategies. Dr. Elton emphasizes the value of mentoring, coaching, and addressing emotional labor in career development. She also highlights the differences between therapy, coaching, and mentoring and provides tips for defining career success. The episode concludes with a recommendation for another career advice book, 'A Job to Love.'

00:00 Introduction and Guest Welcome

00:57 Personal Anecdote: Career Support in the 1980s

02:31 The Harsh Culture of Medical Training

03:54 Career Planning and Wellbeing

04:22 Tips for Effective Career Planning

11:33 The Importance of Mentoring and Coaching

14:48 Defining Career Success

16:30 Final Thoughts and Book Recommendations

Navigating Autism and End of Life: A Conversation with Dr. Caroline Elton

In this episode of The Girl Doc Survival Guide, host Christine invites back psychologist Dr. Caroline Elton, who has extensive experience supporting doctors' emotional wellbeing. Dr. Elton discusses her new book, Looking After: A Portrait of My Autistic Brother, and touches on end-of-life care.

00:00 Introduction and Guest Welcome

00:59 Discussing 'Looking After: Portrait of My Autistic Brother'

01:22 Lionel's Early Life and Autism Diagnosis

02:51 Mother Blaming and Historical Context

05:09 Lionel's Leukemia Diagnosis and End of Life Care

05:57 Challenges of Communicating About Death

11:42 Autism Hospital Passport and Caregiving

13:03 Reflections on Lionel's Life and Impact

16:42 Final Thoughts on End of Life Care for Autistic Individuals