Life as a Nephrologist Series

Providers and their LGBTQ+ patients – the importance of creating an affirming environment

For many in the LGBTQ+ community, fear of discrimination and harassment can get in the way of seeking medical care when they are sick and can put them at increased risk of serious health problems, including kidney disease. In this episode, we discussed how to create an inclusive and affirming environment in a healthcare setting for LGBTQ+ patients such as how a provider earns trust, what qualities a gender affirming provider has, understanding patient’s identities, how you can make your dialysis units more comfortable for LGBTQ+  patients, and how HCPs can participate in advocacy. Our speakers are Dr. Dinushika Mohottige and Dr. Mitchell R. Lunn, two experts in sexual and gender minority health, as well as living kidney donor and the first openly gay elected state legislator in Pennsylvania history, Rep. Brian Sims.

In this episode, you will hear from:

Dinushika Mohottige, MD, MPH:

Dr. Mohottige is a Nephrologist and Medical Instructor in the Division of Nephrology at Duke University Hospitals. She received a B.A. in Public Policy and a Health Policy Certificate from Duke University in 2006, where she was a Robertson Scholar. She then earned an MPH in Health Behavior/Health Education from the UNC Gillings School of Global Public Health and a medical degree from the University of North Carolina at Chapel Hill School of Medicine, followed by Internal Medicine and Nephrology training at Duke University. She now works under the mentorship of Dr. Ebony Boulware and Dr. Clarissa Diamantidis to engage in patient and community-centered, inequity-focused research around the impact of socio-structural factors on kidney health and kidney transplantation.

 

Mitchell R. Lunn, MD, MAS, FACP, FASN:

Dr. Lunn is an Assistant Professor in the Division of Nephrology of the Department of Medicine at Stanford University School of Medicine. As an internist and nephrologist with a strong interest in technology and sexual and gender minority health, Mitch’s research is designed to characterize the health and well-being of these populations. Mitch is the co-director of PRIDEnet, a participant-powered research network of SGM people that engages SGM communities at all stages of the biomedical research process: research question generation and prioritization, study design, recruitment, participation, data analysis, and results dissemination. He currently serves on the American Society of Nephrology’s Diversity and Inclusion Committee.

 

PA State Representative Brian Sims:

Brian Sims is a member of the Pennsylvania House of Representatives in the 182nd district. Elected in 2012, Sims is also a lawyer and activist on LGBTQ+ civil rights. Sims is the first openly gay elected state legislator in Pennsylvania history. In January of 2020, he donated his kidney to his friend. He has been vocal about supporting organ and tissue donation. Currently, he is a candidate for Lieutenant Governor of Pennsylvania in the 2022 election.

The NKF Patient Network

After almost two years of collaboration with volunteer advisory committees—comprised of nephrologists, patient advocates, and researchers in academia and the private sector—the NKF Patient Network is live!

On this episode of Life as a Nephrologist, we are joined by Kerry Willis, Lesley Inker, Alexander Chang, Cari Maxwell and Curtis Warfield. Our guests begin the episode by explaining how the patient network journey started and the purpose of creating it. It is the only kidney disease registry that has both patient-entered data and electronic medical records for patients with all stages of kidney disease. By joining the network, patients will not only help build this important data set, but they will have access to on-going clinical trials; health tips; individualized patient education for their specific stage of the disease; and a community of other patients.

The user friendly and secure Network collects both rigorous clinical and laboratory data from electronic health records (EHR), in addition to patient-entered data, which together allow for a complete picture of the patient experience. This model is innovative in that most research initiatives follow one path or the other—EHR or patient self-reporting. The NKF Patient Network will compile data on demographics, medical history, lifestyle, medications, blood and urine test results, in addition to extensive data on patient perceptions, challenges, and priorities. Overall, this network will allow patients to grow their voice, be transparent about their struggles and advocate for themselves. 

 

 

Palliative Care and Nephrology with Dr. Holly Koncicki

On this episode, Corey is joined by our guest, Holly M. Koncicki, Associate Professor of Nephrology and Palliative Care at Mount Sinai. Dr. Koncicki is in the Division of Nephrology and Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai.

First, Dr. Koncicki discusses what inspired her to become a nephrologist and how she became interested in palliative care. Corey and Dr. Koncicki review data from To Dialysis and Beyond: The Nephrologist’s Responsibility for Advance Care Planning. She offers advice on decisions about modality for advance kidney disease patients and dialysis. She notes how is it not only important to work well with the interdisciplinary team, but it’s crucial to coordinate with the patient’s other providers, such as their cardiologist, oncologists, etc. The conversation about the patient’s care needs to continue overtime and the care team must be on the same page in order to make it less difficult for the patient.

In relation to advanced care planning and dialysis, they talk about over discussing and reflecting on conversations to match patient values.

They expand upon dialysis versus conservative management:

How do you objectively tell your patients they would not do well on dialysis?

How do we assess who is at a high risk of having poor outcomes on dialysis?

How do we get doctors to think about conservative kidney management?

They wrap up by discussing Dr. Koncicki’s AJKD article Opioid Management in CKD and how doctors should appropriately select opioids as well as the importance of setting expectations for patients.

 

 

Get Involved with our Kidney Outreach Team

The National Kidney Foundation's Kidney Outreach Team is a growing group of professionals and community leaders who use their experiences and expertise to inform elected officials and other key decision makers on kidney-related legislation, policies, research, programs and education.  

We need YOU to make better kidney policy possible. To find out more information or get involved go to https://www.kidney.org/advocacy/advocate or email nkfadvocacy@kidney.org

 

Women in Nephrology

The faces of leadership in nephrology are changing, what was once a playing field for exclusively men, is slowly transforming to include a diverse group of men and women.  

In this episode, we are joined by women who have traversed the leadership ladder. This group includes a current President, two incoming presidents of nephrology societies and an industry executive:   

Dr. Holly Kramer, National Kidney Foundation President, clinical nephrologist at Loyola University Medical Center

Dr Lisa Curtis Associate Professor of Medicine at UAB and incoming Women in Nephrology President

Dr. Susan Quaggin, Canadian nephrologist and incoming American Society of Nephrology President

Dr. Reshma Kewalramani, CEO and President of Vertex Pharmaceuticals

These women discuss their journeys, the importance of mentorship, taking risks, kindness, and keeping prospective. Also, they talk about finding your purpose, perseverance, and how to bounce back from failure and rejection. We hope you enjoy this episode with significant insights and advice from each guest. Please share this episode and let us know your thoughts on Twitter @NKF_NephPros or email nkfpodcast@kidney.org

Episode 20: International Medical Graduates in Nephrology: A Guide for Trainees and Programs

In this episode, we discuss the recently published ACKD article, “International Medical Graduates in Nephrology: A Guide for Trainees and Programs” Our guests are the authors, Javier Neyra, Maria Clarissa Tio, Silvia Ferrè and the co-editors Matthew Sparks and Samira Farouk.

 

Although international medical graduates are offered opportunities for training and professional growth that are beyond those available in their countries of origin, they typically encounter barriers to transition from training to practice and early-stage career development. The authors describe the exchange visitor and temporary worker visas granted to foreign trainees in the U.S, focusing on the transition from training to nephrology practice and/or research. They provide recommendations and encourage trainees to seek continuous support from their programs/sponsors and assistance from immigration representatives at their training institutions. This episode provides a positive message that there are many pathways to arrive at the desired post-training destination and emphasizes how additional funding opportunities are there! Ultimately, these authors will not let you navigate blindly.

 

We are bringing on a new co-host for this month’s episode, please help us welcome Natasha Dave, MD! She is a nephrologist at the Bruce W. Carter Miami Veterans Affair Medical Center. She completed her internal medicine residency training at Mount Sinai Hospital in Chicago and then completed her Nephrology fellowship and chief year at Baylor in Houston. Post-fellowship she joined Baylor as an assistant professor of medicine primarily practicing at the Michael E. DeBakey VA Medical Center prior to moving to Miami.

Dr. Dave's other clinical and educational interests include mentorship, social media/educational content generation and as her Twitter profile (@NatashaNDave) suggests electrolytes. She serves on the Executive Council of Women in Nephrology and is involved in a number of online projects and roles that begin after she completed a one year social media internship with the Nephrology Social Media Collective (NSMC). Some of these roles include being a faculty contributor for the Renal Fellow Network and American Journal of Kidney Diseases blogs as well as partaking in committees with the American Society of Nephrology, Nephrology Business Leadership University, Kidney Medicine journal and NSMC. Outside of medicine her other passions include long distance running, meditation and travel.

 

 

Episode: 19: Telehealth with Eric Wallace, M.D., FASN

This episode we bring on Eric L. Wallace, M.D., FASN, Director of Home Dialysis at the University of Alabama at Birmingham and Medical Director of Telehealth. Telehealth allows patients to teleconference and/or have telephone conversations with their existing doctor(s).  In today’s environment, with many provider offices still closed, this may be a good solution and/or alternative for patients to continue their existing care under the direction of their provider via teleconference. Dr. Wallace discusses his journey to becoming an expert in telemedicine and the challenges that come with the territory. He explains how you can accomplish a lot over the phone in nephrology, but there can be issues with technology, internet connection (especially for patients in rural areas), and tech literacy. Lastly, he explains how socioeconomics play a huge role in Telehealth, public health and public education issues, techniques to improve your phone calls with patients, and the future of Telehealth. 

 

 

 

Episode 18: AJKD Editorial Interns

This episode features the the second cohort of interns from the American Journal of Kidney Diseases (AJKD) Editorial Internship Program. This one-year program is an opportunity for nephrology fellows to participate in journal editorial processes. Tune in to learn more about their experience!

The 2020 interns are:

Harish Seethapathy - Massachusetts General Hospital

Bethany Roehm - Tufts Medical Center

Amy Yau - Icahn School of Medicine at Mount Sinai

Ryann Sohaney - University of Michigan

 

The application for the 2020-2021 is due May 30, 2020! Applicants need to be current first year neph fellows or second year fellows staying on for a third year, with an interest in academic writing and publishing. 

Music by Scott Holmes “Follow Your Dreams” licensed under CC BY-NC 4.0

Episode 17: Kidney Medicine with Dan Weiner (Life as a Nephrologist Series)

In this episode, Editor-in-Chief Daniel E. Weiner, MD, MS, discusses Kidney Medicine, a peer-reviewed, open access journal focused on clinical research in nephrology and hypertension launched in 2019. Listeners will more about how Kidney Medicine provides content that encompasses all clinical nephrology while additionally providing a platform for highlighting the patient-reported outcomes research and qualitative research that are essential for improving patient care. Follow @KidneyMed on Twitter and visit kidneymedicinejournal.org to check out the current issue and submit manuscripts! 
 

Please help us welcome our new host of "Life a Nephrologist", Corey Cavanaugh, DO! Corey Cavanaugh, DO, is a nephrologist specializing in glomerular diseases or diseases that impact the kidneys. These include lupus, vasculitis, membranous nephropathy and focal segmental glomerulosclerosis (FSGS), among others. Cavanaugh attended medical school at the Heritage College of Osteopathic Medicine at Ohio University, where he met his wife. They both completed their internal medicine training at the University of Louisville. Cavanaugh then went on to pursue a nephrology fellowship at Yale University before settling in Virginia. 

 

Music by Scott Holmes “Follow Your Dreams” licensed under CC BY-NC 4.0

Episode 16: Pediatric Nephrology (Life as a Nephrologist Series)

I’m delighted to share a conversation we recorded between two wonderful people, Dr Patty Seo Mayer and Dr JJ Zaritsky. Dr Seo Mayer is Medical Director of Pediatric Nephrology at Inova Children’s Hospital and Pediatric Specialists of Virginia, and an Associate Professor of Pediatrics at Virginia Commonwealth University School of Medicine. Dr. Zaritsky is Associate Professor of Pediatrics at Thomas Jefferson University and Chief of Pediatric Nephrology at Nemours duPont Hospital for Children in Wilmington, DE. They have an engaging discussion about pediatric nephrology as a newer field of medicine and describe the people who are drawn to it as naturally empathetic problem solvers.

Music by Scott Holmes “Follow Your Dreams” licensed under CC BY-NC 4.0

Episode 15: Rural Nephrology with Dr. Lisa Weber (Life as a Nephrologist Series)

Dr. Lisa Weber is a fascinating and extremely busy person, a nephrologist and dialysis medical director in Wichita, Kansas. Dr. Weber has a multifaceted career involving caring for CKD and transplant patients in the city of Wichita, and travelling to oversee dialysis clinics in the surrounding areas. She attended medical school at the University of Kansas and completed Nephrology Fellowship at the University of Alabama at Birmingham. We talk about some of the joys and challenges of practicing as a rural nephrologist and how she “wears a lot of hats” by necessity.

Music by Scott Holmes “Follow Your Dreams” licensed under CC BY-NC 4.0