Flourishing in Medicine: From Surviving to Thriving

Today, we are joined by Dr. Donald E. Moore, MD, MPH, a Yale-trained physician, longtime Brooklyn primary care doctor and hospital attending educator at Weill Cornell, Downstate and Pace.Dr. Donald E. Moore earned his M.D. and M.P.H. from Yale in 1981. He is an Adjunct Professor of Biology at Pace University and a Clinical Assistant Professor at Weill Cornell Medicine and Downstate Health Sciences University. For more than 30 years, Dr. Moore served as an Attending Physician at New York Presbyterian Brooklyn Methodist Hospital while also managing a primary care practice in Brooklyn for over 35 years. He is the former President of the Provident Clinical Society of Brooklyn and currently holds leadership positions in the Medical Society of the State of New York (MSSNY), including Chair of the Wellness and Resilience Committee and Chair of the AI Taskforce. Additionally, he has served as the past Chair of the Committee on Physician Health. Dr. Moore advocates for a healthcare system focused on patient care, access to quality medicine, and ethical doctor-patient relationships rooted in trust and beneficence.In the conversation, Dr. Moore traces his calling to medicine from a transformative college biology class through his humanistic education at Yale, sharing how ethics, trust, and beneficence guide his practice.We also cover:Making over 20,000 house calls and what horizontal care taught him about doctor-patient relationshipsHis leadership in physician wellness and moving from downstream treatment to upstream prevention of burnoutArtificial intelligence in medicine and the essential role of curiosity in medical practiceDr. Moore concludes by reflecting on medicine as a calling rather than just a job, emphasizing that physicians are healers and teachers who must maintain curiosity and dedication throughout their careers.Links:Dr. Donald Moore Website: https://donaldmooremd.comDr. Donald Moore LinkedIn: https://www.linkedin.com/in/donald-e-moore-m-d-m-p-h-a3868868/Pace University Advisory Board: https://www.pace.edu/dyson/about-dyson/advisory-board/donald-moore-76EmPro Website: https://www.myempro.com/EmPro Peer Support Program: https://www.myempro.com/peer-support/Physician Support Line: +1(888) 409-0141Physician Support Line Website: https://www.physiciansupportline.com/Dr. Krasner's Website: https://mickkrasnermd.com/Mindful Practice in Medicine Website: https://mindfulpracticeinmedicine.com/Chapters:(00:00) Introduction(03:00) Dr. Moore’s Calling to Medicine(08:00) Yale's Humanistic Medical Education(12:00) Ethics, Trust, and Beneficence in Practice(21:00) The Art of Making House Calls(28:00) Horizontal Care and Patient Relationships(30:00) Leadership in Physician Wellness(36:00) Embracing Artificial Intelligence in Medicine(42:00) The Central Role of Curiosity(47:00) 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 flourishThe evolution from individual mindfulness practice to institutional culture change through breaking down silosTheir vision for cultivating a culture of compassionate caring where meaning in medical work is recognizedDr. 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/ Dr. Ward Flemon’s LinkedIn: https://www.linkedin.com/in/w-ward-flemons-740244121/ Centre for Mindfulness, Cumming School of Medicine: https://cumming.ucalgary.ca/centres/centre-mindfulness/home EmPro Website: https://www.myempro.com/ EmPro Peer Support Program: https://www.myempro.com/peer-support/ Physician Support Line: +1(888) 409-0141 Physician Support Line Website: https://www.physiciansupportline.com/ Dr. Krasner’s Website: https://mickkrasnermd.com/ Mindful Practice in Medicine Website: 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. 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 creativityDr. 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) ConclusionResources/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=psN1DORYYV0https://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 Dr. Carter Lebares.Dr. Lebares is an Associate Professor of Surgery in the Division of General Surgery and the Director of the Center for Mindfulness in Surgery at the University of California, San Francisco. She is a gastrointestinal and bariatric surgeon who specializes in treating gastrointestinal disease, using minimally invasive surgery, such as robotics and surgical endoscopy. Her expertise includes treatments for reflux disease, obesity, early esophageal or gastric cancer, esophageal motility disorders, hernias, gallbladder disease and some kinds of biliary disease.Lebares' research interests include resilience and mindfulness in surgery, mindfulness and nutrition in metabolic syndrome and obesity, the neuroendocrine and cognitive effects of stress on learning and performance. She has developed and studied a customized curriculum specifically designed for surgeons, the Enhanced Stress Resilience Training (ESRT), which has been demonstrated to improve burnout and global executive function.In the conversation, Dr. Lebares shares her journey from biochemistry to academic surgery, driven by a deep commitment to advocacy and empowering others through resilience-building approaches.We also cover:Her early experiences advocating for disadvantaged youth that ultimately led her to medicineThe evolution of surgical training environments and challenges to physician wellbeingDevelopment of the Enhanced Stress Resilience Training (ESRT) specifically designed for surgeonsHer vision for systemic changes in healthcare to preserve medicine as a "pillar of civilization"Dr. Lebares concludes by reflecting on finding joy in the simplicity of everyday life - being outdoors, connecting with people outside medicine, and appreciating ordinary moments that meditation helps bring into focus.Guest: Carter Lebares, MDAssociate Professor of Surgery, Division of General SurgeryDirector, Center for Mindfulness in SurgeryPrincipal Investigator, The Lebares Resilience LabUniversity of California, San FranciscoFaculty webpage: https://generalsurgery.ucsf.edu/faculty/acute-care-surgery/carter-lebares,-md.aspxLebares Resilience Lab Website: https://carterlebares.org/LinkedIn Page: https://www.linkedin.com/in/carter-lebares-a3970b8/Selected Resources/References:About Ann Masten PhD: https://en.wikipedia.org/wiki/Ann_MastenLibby Zion Law: https://en.wikipedia.org/wiki/Libby_Zion_LawLuton OW, James OP, Mellor K, Eley C, Hopkins L, Robinson DBT, Barlow E, Lebares CC, Lewis WG, Egan RJ; Welsh Surgical Research Initiative (WSRI) Collaborative. Enhanced Stress Resilience Training for UK Surgical Trainees; Effect and Evolution Evaluated. J Surg Educ. 2023 Oct;80(10):1395-1402. doi: 10.1016/j.jsurg.2023.07.017. Epub 2023 Aug 9. PMID: 37567800.Luton OW, James OP, Mellor K, Eley C, Hopkins L, Robinson DBT, Lebares CC, Powell AGMT, Lewis WG, Egan RJ. Enhanced stress-resilience training for surgical trainees. BJS Open. 2021 Jul 6;5(4):zrab054. doi: 10.1093/bjsopen/zrab054. PMID: 34323917; PMCID: PMC8320339.Lebares CC, Coaston TN, Delucchi KL, Guvva EV, Shen WT, Staffaroni AM, Kramer JH, Epel ES, Hecht FM, Ascher NL, Harris HW, Cole SW. Enhanced Stress Resilience Training in Surgeons: Iterative Adaptation and Biopsychosocial Effects in 2 Small Randomized Trials. Ann Surg. 2021 Mar 1;273(3):424-432. doi: 10.1097/SLA.0000000000004145. PMID: 32773637; PMCID: PMC7863698.Lebares CC, Guvva EV, Ascher NL, O'Sullivan PS, Harris HW, Epel ES. Burnout and Stress Among US Surgery Residents: Psychological Distress and Resilience. J Am Coll Surg. 2018 Jan;226(1):80-90. doi: 10.1016/j.jamcollsurg.2017.10.010. Epub 2017 Oct 26. PMID: 29107117.

Today, we are joined by Dr. Janine Kirby, an integrative medical doctor, homeopath and mindfulness teacher based in East London.After completing her medical degree, she obtained a Diploma in Child Health, a Diploma in Obstetrics and a Masters in Family Medicine. She worked in the public sector for many years before starting her own integrative medical practice and acquiring professional qualifications in Homeopathy. She has a passion for helping her patients understand the importance of the intimate connection between the body, thoughts and emotions in healing.Janine enjoys teaching, having facilitated both under- and post-graduate Family Medicine training. She has been teaching the 8-week Mindfulness Based Stress Reduction Program (MBSR) with psychologist Barbara Gerber since 2010. She also co-facilitates mindfulness-informed programs for healthcare practitioners dealing with stress and burnout, and is the current Chairperson of IMISA, the Institute for Mindfulness South Africa, involved on national and international levels in promoting mindfulness programs and developing teacher training standards.In the conversation, Dr. Kirby shares the profound impact of her early life experiences and the environment of apartheid South Africa on her journey into medicine and mindfulness.We also cover:How her brother's illness shaped her holistic understanding of healingThe challenges of integrating traditional and modern medical practicesHer work with the Institute for Mindfulness of South Africa (IMISA)Dr. Kirby’s mindfulness programsThe balance between professional challenges and personal fulfillmentShe concludes by sharing her desire to expand mindfulness programs and contribute to the global mindfulness conversation and reflecting on the balance between professional challenges and personal fulfillment.-Chapters:(00:00) Introduction(03:31) Dr. Kirby’s Medical Journey(04:39) Janine's Experiences with Her Brother’s Illness(08:52) Traditional Healing in South Africa(14:19) Challenges in South African Healthcare(22:54) Burnout and Mindfulness in Medicine(26:33) Janine's Personal Journey with Mindfulness(38:17) Future of Mindfulness in South Africa(43:14) ConclusionGuest: Janine Kirby, MBChBFamily Practitioner / Homeopath in private practice; Chairperson of IMISA (Institute of Mindfulness SA)LinkedIn Page: https://www.linkedin.com/in/janine-kirby-525b595a/Institute for Mindfulness South Africa website: https://mindfulness.org.za/Facebook Page, Institute for Mindfulness South Africa: https://www.facebook.com/instituteformindfulnesssouthafrica/Resources/References:Kirby JM, Milligan PD, Conradie HH, McIntosh BM. A mindful approach to physician self-care. S Afr Fam Pract (2004). 2024;66(1):e1-e4. Published 2024 Jan 30. doi:10.4102/safp.v66i1.5836