Latest / HAVE FAITH LET IT BEGIN® / “PHYSICIANS CRITICIZING OTHER PHYSICIANS TO PATIENTS”

Transcript

“PHYSICIANS CRITICIZING OTHER PHYSICIANS TO PATIENTS” · HAVE FAITH LET IT BEGIN®

0:00
Welcome to Citizens Reunited to Overcome Cancer, a show to make your survivorship
0:06
an easier journey by providing information and advocating for you.
0:11
A show to help practitioners up their game and their level of performance.
0:16
This is the Kroc Podcast.
0:19
Here is your host, Dr. E, and alongside him to share some hope and inspiration.
0:25
From the Have Faith, Let It Begin podcast, co-host, Angel Santana.
0:31
Hi, everybody. This is Dr. Tommy and Ellie, the founder and director of Citizens
0:35
Reunited to Overcome Cancer.
0:38
Tonight, I am humbled and grateful that you decided to join this week's podcast.
0:42
I truly believe that today's program will resonate with all of us as it's about
0:48
a phenomenon we all have either witnessed or perpetuated.
0:53
Today's podcast is entitled physicians criticizing other physicians to patients.
0:59
I know it should never happen, but sadly, it happens too often,
1:03
and it diminishes all of us.
1:05
It diminishes the physician by exposing our insecurities and our own personal
1:11
anxieties, which diminishes our patients by making them feel confused and distressed.
1:17
Join me, as always, my co-host, Angel Santana. Angel, welcome.
1:23
Hello, everyone, and welcome back to the Citizens United to Overcome Cancer.
1:27
I'm excited because This is something that I think anyone can relate to,
1:31
so I'm looking forward to today's episode, and I hope everybody had a blessed
1:34
and an amazing Thanksgiving week.
1:36
Yeah, thank you, Angel, and I know you worked hard, and you worked all through
1:40
Thanksgiving, and we appreciate you, but as you said, let's dive right in.
1:44
Although we will discuss four scenarios that I personally experienced in the
1:50
clinic, I want to first start by doing a shout-out to our paper's authors.
1:57
I owe a great deal of assistance to Dr. Susan McDaniel and Dr.
2:02
Diane Morse from the University of Rochester, whose scholarly article by the
2:06
same title was instrumental to my understanding of this atrocity.
2:10
Let's start with the AMA's description of what constitutes a disruptive physician.
2:17
So a disruptive physician is one who uses language that is belittling,
2:22
berating, disrespectful, and inappropriate.
2:26
It accumulates in the destruction of the most important aspect to patient care, the aspect of teamwork.
2:33
Angel, as the director of the switchboard, you know how important it is to bring people together.
2:40
All departments, all situations and circumstances, you need that teamwork.
2:46
And in medicine, on the clinical side, teamwork is the first step in a survivor's
2:51
cure, as no one physician can manage all aspects of patient care.
2:56
So good teamwork involves the exchange of information, the coordination of referrals,
3:03
the evolution of a multidisciplinary evidence-based treatment plan consensus.
3:09
And continuity of care, starting with diagnosis, proceeding through planning
3:15
and execution of the treatment, and follows the survivor indefinitely through their survivorship.
3:20
But what happens when teamwork is tainted by the stain of interprofessional, I call it trash talking.
3:28
So you get now poor coordination, you have destruction of trust,
3:33
you get conflicting information, which causes confusion and distress that these
3:40
patients are survivors.
3:42
They realize that their serious life-threatening illness is being managed like a bad reality TV show.
3:49
The patients feel they are being squeezed like in a rugby scrum of,
3:54
you know, of immaturity of their physician's immaturity.
3:58
So all of these factors lead to a very concerning outcome.
4:02
It causes ineffective treatment due to delays in noncompliance.
4:07
If I was a patient, I wouldn't listen to doctors who were confusing me.
4:12
It may cause patients increasing pain.
4:16
So not just physical pain, although physical pain is something that they studied
4:20
in this paper, but also psychological pain.
4:23
It increases the medical legal ramifications. So there's higher amounts of lawsuits.
4:27
It reduces patient satisfaction, it reduces quality of health care,
4:33
and it reduces staff well-being.
4:35
But the most important thing it does is it increases patient mortality.
4:40
So actually outcomes are worse when physicians are talking bad amongst themselves.
4:45
So exactly how ubiquitous is the situation?
4:49
So according to the paper, which involved the taping and recording of conversations
4:55
between physicians and their patients, according to McDaniel's paper,
5:00
only 29% of the interactions were rated as supportive.
5:06
67%, greater than two-thirds, were reviewed and rated as critical,
5:11
and 4% were rated as neutral.
5:15
So Angel, there's four categories of the physician-physician criticism,
5:19
and as well as I'm going to add to my personal vignette.
5:23
So my own personal experiences in the clinic.
5:27
So first question that I would ask and which I'm going to ask everyone is, why do it?
5:33
Why do our doctors talk trash amongst themselves?
5:36
So physicians are educated, extremely educated, extremely well-trained who take
5:45
an actual oath to put the needs of their patients above their own needs.
5:49
So why would they ever resort to just, you know, such be such immature and infantile
5:56
behavior? And the fancy psychobabble name to this phenomenon is called triangulation.
6:03
So what this means in simple terms is physician anxiety is caused by stress.
6:11
It's caused by responsibility.
6:13
It's caused by time restraints. And it's caused by our own human frailties.
6:19
And believe it or not, when you talk trash about another physician,
6:23
you're actually relieving some of this. you're kind of blowing off some steam.
6:27
You're relieving this by allocating blame to others, right?
6:32
Unfortunately, the anxiety that's being lost by the physicians is being passed
6:37
on to the anxiety of the survivors.
6:39
So we'll get to the anecdote, which is called detriangulation shortly,
6:45
but let's start with understandable situations which can cause this cascade.
6:50
So why doctors might be, you know, motivated to start trash talking.
6:56
So number one, say a patient comes to you without a clue. So as a tertiary care
7:01
referral, I'm not, I'm sorry, as a, as a, as a referring physician, you're.
7:07
Who gets, you know, who wants their patients to see me.
7:12
It's their responsibility to let them know why, what they have,
7:16
what their stage is, what their prognosis is, and why they're coming to see
7:19
a radiation oncologist.
7:21
But more often than not, ANGEL, patients come to us without a clue,
7:25
at times not even knowing they have cancer.
7:27
So when a patient steps in the room and we go in to talk to them about what
7:31
we're going to do for them, they're asking, why am I here?
7:34
So that's certainly a great opportunity for me to start bashing their referring physician.
7:40
A patient can come to you being told by a non-specialist of the care that they
7:45
should receive by the specialist. So I can't even count how many times a doctor
7:51
will say, oh, you just go see Ian L.E.
7:54
He's going to give you five days of radiation. And of course,
7:57
that's never the case, right?
7:59
And of course, the patient's very upset because they have expectations which
8:03
are not aligning with the reality.
8:05
A patient can come to us with unrealistic expectations about cure or about,
8:11
you know, as I said, mentioned before about their treatments that we can't achieve.
8:16
And that would certainly frustrate you. And a patient can come to us with what
8:21
I call a half-ass workup.
8:23
That means the patient comes to us and they haven't done all the physician referring
8:27
the patient hasn't done their job.
8:29
So then we have to kind of pick up the slack and do our job plus their job and
8:34
which causes frustration. And of course, starts the wheels turning as to,
8:39
you know, oh my God, wait till I get my hands on this guy.
8:42
And sometimes that bleeds over to the conversation with the patients.
8:46
So Angel, I'm going to give you four vignettes and I want you to tell me,
8:50
because this is very visceral, how you would feel if you were the patient, right?
8:55
So the first category is criticism of another speciality.
8:59
So I'll call the first patient, Elizabeth, who is a lovely 87-year-old breast
9:05
cancer survivor with widespread metastatic disease.
9:09
Oh, did I mention she's 87 years
9:11
old. She also has a ton of other medical problems, so she's very sick.
9:16
And she's got this ulcerating, painful, draining, malodorous, smelly breast mass.
9:22
So radiation therapy was recommended by the oncologist. The patient saw me.
9:26
I recommended the radiation as well.
9:29
And the surgical oncologist said, why would you get radiation?
9:33
I'll just chop your breast off. Angel, how would that make you feel?
9:37
Wow. Well, I've got a couple of comments, but I guess I'll just go away from this first.
9:41
I think that there's a fine line between how it's not what you say, it's how you say it.
9:48
And it all stems back to the beginning. And forgive me if I'm kind of backtracking
9:51
just a little bit, because that intro that you gave about teamwork really resonated
9:55
with me. And I think it holds true to what you just gave me that you want an opinion on.
10:00
And that is a good teamwork means communication.
10:04
And the communication between the staff, the doctor and the doctor staff and
10:08
the patient really fits like a glove, right?
10:11
So to be very clear and honest with you, respectful communication,
10:14
it means being willing to listen even when you disagree.
10:19
So in this situation, when a patient is already older, maybe already filled
10:25
with anxiety of her own, Elizabeth, and with all this stuff that's coming in
10:30
for the doctor to just come out and say, well, we're going to do this and use words like chopped.
10:34
It's just not something that would resonate with me as a family member or the patient, as a patient.
10:39
Right. I mean, you know, so all the other stuff, all I want is your visceral response.
10:44
So this, you know, your doctor tells you, exactly.
10:48
Well, that's what I'm trying to get at is that your doctor tells you that,
10:51
you know, you need to have radiation because your quality of life is terrible
10:56
and, you know, you get 16 days of radiation and it'll help you.
10:59
And then your surgeon, you know, says, well, why are you going to this guy for radiation?
11:03
That's the dumbest thing you could ever do. Just come to me.
11:06
I'll put you to sleep and I'll just chop your breast off.
11:08
You know, I'm asking you how you feel in your, like, just, just that specifically how you would feel.
11:15
I would be nauseous and really angry. Yeah.
11:19
Right. So that's what I thought. The next subcategory is criticism of a prior treatment.
11:24
So Susan is a lovely 67 year old breast cancer survivor with all favorable prognosticators,
11:31
which is just a fancy word for all of her features were perfectly, you know, low risk.
11:37
So small tumor, low grade, good margins, favorable receptors,
11:42
no nodes, low OncoDX, which means that no chemotherapy was being recommended
11:47
by the medical oncologist.
11:49
And the family practitioner saw the patient, oh, Susan, I understand that you
11:53
had surgery for your breast cancer and now you're getting radiation.
11:57
To be honest with you, I don't know why your medical oncologist didn't give
12:01
you chemo, I would have given you chemo. Angel, how would you feel?
12:06
I would be confused and say, what do you mean? What?
12:10
And I'm stunned by that. I don't even know why it was.
12:13
I'm just, I'd probably be speechless,
12:15
but I would respond in anger and say, what? Why am I here then?
12:19
Exactly. I mean, the point is, is that these are real. This is,
12:22
this happens. I've seen, this is what I've seen in the clinic.
12:26
And that's the motivation for the podcast. So third category is criticism of physicians in general.
12:33
So Marie is a lovely 74-year-old newly diagnosed lung cancer patient who unfortunately
12:38
presented with metastatic disease right from the beginning.
12:41
So it wasn't like a stage one or two, it was a stage four, and she had metastasis
12:47
to the liver and to the bone.
12:48
And after four months of chemotherapy, they did some films to see how she was
12:52
doing with the chemotherapy.
12:54
Now, the radiologists said that the tumor had gotten worse, but they were comparing
12:59
the films from October to November, instead of looking at the films,
13:03
the original films from July, where there was a huge response from July to November.
13:09
The medical oncologist said to Marie, your cancer is progressing,
13:13
and this is a really bad thing, and we need to change your chemotherapy immediately.
13:17
And then the cover oncologist, who just happened to be on call,
13:21
who actually took the time to look at the films and review all the films,
13:25
said, Marie, you're actually doing very well.
13:28
You're responding very briskly to your therapy. Your other doctors were just
13:32
too lazy or too busy to take the time to review all of your films.
13:37
Angel, how would you feel about that?
13:39
Wow. I think, man, I'm telling you, I think the first thing I would be concerned
13:44
about is why is this person bad-mouthing another doctor?
13:47
And then I would say, wait a minute, I don't know what to do.
13:50
Who do I trust? If one can talk about the other, who's trustworthy here?
13:54
Well, not only that, but think about this. I mean, talk about confusion.
13:58
You know, one doctor is telling you pretty much to go by your cemetery plot.
14:03
And the other doctor is saying, well, things are not as bleak as you think.
14:07
I mean, these are things that are huge.
14:10
I mean, you know, now what we're going to get to when we talk about the antidote
14:14
is how the physicians could have handled these four scenarios a little better,
14:19
getting back to your original point about communication and it's how you say things.
14:24
And we'll go back and we'll look at those things as well. As a matter of fact,
14:27
I think that's a great idea.
14:28
The fourth category is what's called ad hominem.
14:32
And I've never heard of this, actually never heard of this before,
14:35
but if you watch TV and you watch the news or you watch anything political,
14:39
we're seeing this now on a daily basis.
14:42
So let's, let's in the American political arena. So let's break down what ad hominem means.
14:47
So it means that a person is being attacked or a person is attacking an opponent's
14:52
character or characteristics rather than addressing the, the issue or the statement.
14:57
So there's a statement, there's an issue, there's a, there's a point,
15:01
you know, to be debated, but instead of debating the point, everyone's attacking each other.
15:06
So they're attacking each other's quality and their candidacy and just whatever,
15:12
you know, their, their intelligence, they're attacking the person.
15:15
They're not getting to the meat of the subject.
15:18
So this actually personally involved me. So Matt's a 33 year old fine young
15:23
man, or he was a 33 year old fine young man who had lung cancer diagnosed very early.
15:28
He successfully received preoperative chemotherapy and radiation.
15:33
Perfectly delivered to the latest standards of care with an excellent and brisk response.
15:40
Patient had the surgery, but he died of a surgical complication.
15:43
The surgeon called me to berate my care and blame me for the young man's death
15:48
so he wouldn't be blamed.
15:50
And he documented in his chart that it was the radiation therapy's fault that
15:54
the patient died, not because of the surgery.
15:57
And I did everything possible to protest this.
16:00
I actually sent him articles and NCCN guidelines, which are basically the standard of care guidelines.
16:09
And luckily, I had a really great relationship with the family.
16:12
Otherwise, I would have definitely been sued for sure. But this is called ad hominem.
16:18
Angel, your thoughts about that? I'm just, my first question to you is,
16:22
what was your first reaction? I know you want mine, but what was yours? I have to ask you first.
16:26
Yeah, I was angry, but I don't care about how I felt, I want to know how you
16:31
would feel as the patient or the patient's family.
16:34
I deliberated. I just completely stride struck.
16:39
I can't even get the words out of all these stories. And this one is the icing
16:43
on the cake for me. I would just be like,
16:45
pardon my French, what the hell is going on here? Well,
16:48
I would be, you know, to the point, I mean, if you lost your 33-year-old son
16:52
and you were told by one of your doctors that you trusted enough to crack your
16:56
son's chest open and you're told that he's only dead because of his radiation,
17:01
I would be kind of like, you know,
17:05
you know, I would say, but you're in that situation,
17:09
sorry, but I would not be happy that that's for sure.
17:12
And I think, you know, I don't mean to cut you off, but I guess I'm,
17:14
I'm, I don't know. I'm just don't know.
17:17
It's hard because I'm trying to think as a dad right now, even though I have
17:21
a youngster, I don't, I just don't know where my anger would be first.
17:24
Yeah, no, it's, these are, you would agree that all of this is unacceptable.
17:29
Yes, absolutely. Absolutely.
17:30
Okay. So let's talk about solutions. So for the survivors, you know,
17:35
it's crucial that the survivors know that they do not deserve to be put in that position.
17:41
They need to be empowered. And hopefully by listening to this podcast every,
17:46
every week or every two weeks, they get this information.
17:48
So they feel empowered to stand up and advocate for themselves.
17:52
So I'll give you a little sort of role playing.
17:55
So excuse me, doctor, but your statements about my other doctor,
17:58
doctors are making me feel very uncomfortable.
18:02
And I feel you're being inappropriate and unhelpful. Would you please consider
18:06
restating your analysis?
18:09
And if you feel there is a problem, please contact your colleague directly without involving me.
18:14
So for the, I think for the survivor, if they know this and they know this is
18:20
not a thing that they should accept, you know, they need to stand up for themselves.
18:25
And I would hope that the doctors who do this, and I think we all do it at some
18:30
point, we But, you know, forget about doctors and patients, but just in life,
18:34
I think we're always kind of trying to, you know.
18:37
Slather the blame elsewhere. I think it's part of our nature.
18:41
I just think that survivors have to know that that's not something they need to accept.
18:45
So that's for the survivors. For the physicians, it's much more complicated.
18:50
So as a physician, we need to remember our oath and responsibility is always
18:55
first about our patients and not about ourselves. and we need to elevate our
19:00
behavior above our own demons and insecurities and frustrations.
19:04
And we never need to have a situation where we need to bad mouth or trash talk a colleague.
19:11
We need to really seep ourselves like tea bags into the warm water of compassion,
19:18
empathy, and non-reactivity.
19:20
And we need to suppress our own personality dysfunctions and our habitual holier-than-thou
19:27
attitudes and take the extra time when we do disagree with a colleague.
19:32
And we have to actually pick up a phone, imagine this, Angel,
19:36
and actually call the doctor and find out what they're thinking and actually
19:41
solve the rift without involving the patient.
19:44
So you would be shocked because I'm actually shocked how many times I go into
19:49
a discussion convinced that I'm right and I'm not.
19:53
So you might even learn something by doing this.
19:57
And you need to learn diplomacy rather than to be incendiary and be that incendiary
20:03
device that starts this cascade of bulls.
20:08
Dookie, right? Is that a fair, this is a family show.
20:13
Now we're going to go backwards. We're going to go back to those four, four scenarios.
20:18
You and I are going to try to see how we can solve this, how it could have been
20:22
done better to your point, Angel.
20:24
So Elizabeth, 87 year old breast cancer survivor who was going to have radiation,
20:30
but the surgeon said, why would you ever have radiation?
20:33
I'm going to chop your breast off. So if the surgeon didn't agree with the radiation
20:38
for whatever reason, they certainly could have called me and said,
20:42
hey, listen, I know you saw Elizabeth and I know you want to give her radiation.
20:46
Not that there's anything wrong with that, you know, because if they thought
20:50
there was something wrong with it, then we're dealing with someone who's not
20:54
logical and it's just going to be a circular conversation.
20:57
But if it's someone who's reasonable, you can say,
21:00
well, surgery doesn't seem reasonable to the medical oncologist nor to me to
21:06
try to have an 87-year-old terminally ill woman who's got six months to live, you know,
21:14
put them through anesthesia, surgery, and all this kind of stuff with the wound
21:18
care and trying to recover when I could give them 16 days of non-invasive therapy.
21:23
You know, try to convince me otherwise.
21:25
And perhaps, again, if the patient, if the person was a logical colleague,
21:30
we can have a very profitable discussion about it and not have to involve the patient.
21:37
So, and if you do give your opinion to the patient, use words other than chop your breast off.
21:44
Say radiation may be appropriate, is appropriate, but I want to give you another
21:48
option. I could do what's called the toilet mastectomy.
21:51
You can be out of the hospital in three days and, you know, that would be another
21:54
option. So I wouldn't have a problem with them stating their opinion as long
21:58
as it wasn't done in the way that they did it, where they criticized another
22:02
specialty's, you know, effectiveness.
22:05
Susan, criticism of prior treatment. She is our 67-year-old breast cancer survivor
22:10
who was not offered chemotherapy appropriately, so whose primary care physician
22:17
thought she should have gotten chemo.
22:18
So my advice for the family practitioner is stop pretending you're a medical oncologist.
22:24
If you are confused as to why your patient didn't get chemotherapy and you just
22:29
feel like she should have gotten chemotherapy just because, you know,
22:34
quote unquote, just because not for any scientific reason, call the medical oncologist.
22:39
Ask why they didn't give your patient chemotherapy, if that's something that
22:44
really is concerning you.
22:45
So that's the way that scenario I think should have gone.
22:49
Criticism of physicians in general, that whole radiology mess. So,
22:54
Everything was perfect. Well, first of all, the oncologist and the radiologist did a shit job.
23:01
They really did a terrible job. They didn't look at all the x-rays,
23:04
so that's unforgivable.
23:06
But the covering oncologist could have been a hero here instead of being the
23:12
goat, right? They should have been the hero.
23:14
They should have stepped up and said, hey, listen, I have some really good news for you.
23:18
I want to double check this, but from my review of your x-rays,
23:22
which go back to July, not back to October, there's actually some good news
23:27
that your tumor is responding to the treatment.
23:31
You may have to change treatments because maybe it's not starting to be effective
23:35
now, but you're way better off now than you were several months ago.
23:39
And let me talk to the radiologist so they can serve an addendum to the report
23:44
and then talk to the oncologist to review all the x-rays as well,
23:47
and then talk to you about showing you the films and going on with your new
23:52
treatment perspective or your new treatment regimen.
23:55
So I think that would be a good way of approaching that without bashing the other doctors.
24:01
And the ad hominem with my friend, the thoracic surgeon,
24:05
I'm not sure if there's an explanation on that because it just appears that
24:09
this was a very mean-spirited and terrible individual who just basically cared
24:16
more about their own reputation and about their outcomes and about them potentially
24:21
getting sued and just tried to basically, they were the ugliest,
24:25
they were the ugliest woman in, in the lifeboat on the Titanic.
24:29
They put on a, they took a mop, they took the top of the mop off,
24:33
put it on top of their head and pretend it to be a, be a woman in distress so
24:36
they can get on the life raft.
24:38
So I don't know if I have any, have an answer to that, but I do have a conclusion to this podcast.
24:44
So there is a caveat emptor, which means let the buyer beware.
24:49
There are situations when we encounter deficient decisions by our colleagues
24:54
or even clearly inappropriate care,
24:56
meaning care that does not meet the evidence-based criteria,
25:01
and a change in providers is going to be necessary to protect and serve our patients.
25:08
But we can perform this task with dignity and elegance and professionalism without
25:13
bashing or criticizing.
25:15
So Memorial Sloan Kettering is a great example of diplomacy.
25:19
Most of the time, you know, there are some turkeys amongst these practitioners.
25:24
I said that metaphorically for Thanksgiving, but it is a world-class cancer center.
25:29
And on the whole, they're doctors. I have found them to be simultaneously outstanding
25:34
practitioners and outstanding ambassadors for quality of care.
25:39
They love to work with, and I use the term, manage up the referring community
25:45
physicians because we don't have all their access to the things that they have.
25:50
Rather than bashing us, they actually manage us up and they teach us.
25:54
And they are supportive and appreciative
25:56
of us because we refer them to patients. And as a result, it's a.
26:01
It's no surprise to me that the outcomes at Memorial are excellent.
26:06
They provide higher quality of care. They reduce pain and length of stay.
26:11
They increase patient functionality, and they have a very, very good safety profile.
26:16
So my hat tips off to Memorial for doing it the right way.
26:21
And then finally, in closing, as we as hospitals and as practitioners and physicians,
26:28
as we become more focused on the patient.
26:30
So we call that patient-centric care. The training of our student doctors and
26:35
house staff, so the residents,
26:37
we have to make sure that they are self-aware and monitor their own expressions
26:43
of frustration, and we have to monitor our own.
26:46
Expressing one's own opinions about diagnoses and treatments with acknowledging
26:52
disagreement with other doctors, if necessary, for evidence-based patient care
26:57
can be accomplished, as I said, without.
27:01
Constigating or insulting words.
27:03
But I know it's not going to be easy. We are human.
27:07
We are frail. No matter how extensive our education and our training,
27:12
we need to be forever vigilant to provoke and prevent any endeavor that may
27:18
cause our survivors any pain or suffering,
27:21
or especially confusion.
27:23
As Shakespeare once said, the fault lies not in our stars, but in ourselves.
27:28
Angel, your thoughts about the podcast?
27:31
Okay, so I've had a few seconds to take a breather. You hit me with this crazy thing.
27:36
Let me just start off by saying this.
27:39
Not every doctor behaves this way, right? We can agree to that.
27:42
But in the stories we heard, some used words that frighten patients or create a confusion.
27:49
Doctors must choose their language carefully and avoid criticizing or blaming colleagues.
27:55
Instead, they should communicate, communicate directly to work together,
27:59
to find clearer, safer, and less invasive options before considering surgeries.
28:06
When two professionals collaborate, patients receive better understanding and better care.
28:12
Unity, not ego, produces the best outcomes. In the end, doctors must remember
28:18
their purpose, to guide, to comfort, to provide the highest level of treatment
28:23
through compassion, respect, and teamwork.
28:26
You can tell I'm already going. I feel like this is a sermon.
28:28
You're doing great, baby.
28:29
Keep it up. Why are you still in your life? Let me close off on my spiritual
28:33
aspect that I bring to the show. to every doctor.
28:37
Remember that your words carry weight. Your tone carries power.
28:41
Your compassion carries healing.
28:43
And before you speak, pause.
28:46
Let wisdom guide your tongue and humility guide your actions.
28:50
Work together, not apart.
28:52
For one who heals alone, when you join your gifts, your knowledge,
28:58
your hearts, you become instruments of grace for every patient you serve.
29:03
So think before you speak, unite before you judge, and let your care reflect
29:09
the light that you are called to share.
29:11
Angel, I cannot add anything to that beautiful conclusion.
29:15
However, I will add our Kroc blessing on behalf of you, myself,
29:19
and the Board of Directors at Citizens Reunited to overcome cancer.
29:23
We wish all of our survivors a long, healthy, happy, and cancer-free life.
29:27
God bless you. God be with you. Peace.
29:30
We thank you for listening to today's episode of the Kroc podcast.
29:33
We want to let you know that because of this episode, you'll have a special
29:37
opportunity tomorrow on Half-Faith Let It Begin podcast, where Dr.
29:42
Ionelli will be joining myself and to share his thoughts and personal views
29:47
on everything we just discussed today.
29:49
We're collaborating. And here's something exciting. If you head over to tomorrow's
29:53
Half-Faith Let It Begin episode and listen for the special giveaway detail,
29:57
the first five people who interact with us on social media and sharing what
30:02
they've learned, how this episode spoke to them, and how their own stories relate.
30:06
We will receive an autographed prize. We hope you enjoyed today's conversation.
30:11
We truly hope you'll join us again tomorrow.
30:15
Thank you. Have a blessed day, and we'll see you next two weeks for another
30:18
episode of The Croc Podcast.
30:20
Hey, Croc Nation. If today's message inspired you, please subscribe,
30:26
download, and share this episode with your friends or someone who you believe needs it.
30:32
Visit us at crockvip.com to connect, learn, and join the fight.
30:38
Let's spread hope one story at a time. Until next time, remember,
30:44
we are not just a podcast.
30:47
We are a movement.