Today I am interviewing Steven Brown, MD, Family Medicine Physician and creator of the American Family Physician Family Medicine Podcast, which has been in biweekly production since July 1st, 2015.
Tell us about your roles with Banner University Medical Center and the AFP.
I’m the Program Director of the University of Arizona College of Medicine Phoenix Family Medicine Residency. Since starting the American Family Physician Podcast 4 years ago, I’ve been an Associate Editor at American Family Physician.
What do you enjoy doing when you are not working at BUMC-Phoenix or organizing this podcast?
Most of free time is spent with my two kids, in 7th and 11th grade. Their activities keep our lives busy! We just adopted a two-year-old terrier mix. I also enjoy running and taking pictures.
In an interview with AFP published in 2018, you stated that it was a combined idea that Dr. Luke Peterson and yourself came up with for the AAFP podcast. Could you tell us more about that story [1]?
Dr. Peterson and I were both podcast nerds and realized American Family Physician, the #1 journal in primary care, didn’t have a podcast. We came up with what is surely a crazy idea to pitch the idea that our residency, mainly residents, should host the podcast. We knew we would need plenty of support, mainly from some kind of audio and technical guru and that this would cost money. We knew if we were going to keep this thing going for the long haul we wouldn’t be able to do the sound editing ourselves. I “pitched” the idea to the Editor of American Family Physician, suggested a budget, and sent his editorial team two pilot episodes. They liked it and signed us up!
What inspired you to use podcasting as your medium for a medical podcast?
Our creators listen to a lot of podcasts. There is so much great work in podcasting now. We realized there was a huge vacuum for a primary care educational podcast for students, residents, and practicing family physicians.
Do you know who the primary audience is for the podcast? Has the audience changed over time?
The largest group of listeners are practicing family physicians after residency. Many listeners are medical students and residents. The audience has really grown over time. We have over 100,000 episode downloads per month from dozens of countries, although by far the most listeners are in North America. Early on we asked listeners to record the end credits, inspired by one of the icons of podcasting, RadioLab. We’ve now had listeners, mainly students, residents, and practicing family physicians, read the credits from all 50 states!
What are some of the challenges of producing a podcast biweekly for the past 4 years?
It’s relentless. It’s hard to get 3-5 residents and faculty and our audio engineer together in an evening twice per month. Just when you’ve put out one episode you have to start thinking about the next episode. Also we’ve now had 22 resident hosts. Our residents volunteer to take hosting duties in their third year of residency. It can be a steep learning curve to welcome new hosts every July. It takes a while to get comfortable with the microphone and trying to be natural.
If your podcast was a resident; it would be finishing its first year of practice post residency. How do you feel that experience reflects your own journey through medical training?
It’s pretty different. I had a very steep learning curve my first and second year of residency. Third year you start to feel like you know stuff and the learning curve maybe flattens a bit while still heading upward. My first year in practice, working in the rural Indian Health Service in Northern Arizona, was again a very steep learning curve. It shot up again. It’s so different when you are making decisions mostly by yourself without guidance from attendings. I guess the podcast is kind of more like a mid-career physician at this point for me. Although for the new resident hosts, it’s a steep learning curve every year. The podcast is similar to a medical career in that it has taken an incredible amount of hard work and support from many people including our sponsoring organization American Family Physician to make it happen. A successful medical career requires incredibly supportive colleagues and loved ones.
What’s your favorite change added to the podcast over time? Other than the catchy jingle!
I love it when residents get creative, like introducing a new game or rhyme. I’m really proud of the interviews we’ve done with over 20 family physician leaders. I’d hoped they’d be inspiring for medical students considering a career in family medicine. I’ve heard from many students that they appreciate the podcast and it makes them see the breadth of our specialty and what family medicine can be.
For our non-medically oriented, what are POEMs? What are some ways we could use medical education more effectively to communicate with our patients?
POEMs are Patient Oriented Evidence that Matters in contrast to Disease-Oriented Evidence (DOE). Outcomes that matter for patients, not just a lab value or radiologic measurement or other number. We should guide our patients based on outcomes of quality of life, morbidity and mortality. Evidence alone, however, does not make decisions for patients. It’s important to incorporate a patient’s preferences into a medical decision. A long-term relationship with a family physician is important for this type of communication.
How do you think we can shift the paradigm of research in the clinical setting to include more POEMS and less DOE? What are some holdups or problems with incorporating this kind of research into the clinical setting?
Primary care physicians should only use high level evidence patient oriented evidence to help patients make decisions when it’s available. American medicine is too attracted to the new, fancy, expensive medicines and procedures. Our reimbursement system pays for doing things TO patients rather than FOR them. It is more useful to apply the simple proven treatments to everybody that some new fancy unproven therapy to those patients that have resources. Unfortunately, that’s not how American medicine works. We underestimate the value of a long-term healing relationship with a trusted family physician.
If you could give advice for our upcoming generation of physicians currently in medical school, what would you want to say?
Follow your passion. Remember that we are here for our patients and communities. We have been given an incredible privilege. Remember that it is not only our job to take care of our individual patients but help improve health for all. Our system needs improvements to be more equitable and patient centered. It is our professional obligation to improve our health system and advocate for social justice and equity.
If you would like to learn more about the podcast, please follow the link at: www.aafp.org/afppodcast
- Mitchell, D. (2019). Medical Educator Is Keen on Evidence. Aafp.org. Retrieved 4 September 2019, from https://www.aafp.org/news/family-doc-focus/20180806fdf-sbrown.html
Mohammad Khan is a fourth-year medical student in The University of Arizona College of Medicine – Phoenix, Class of 2021. He graduated from Arizona State University in 2014 with two bachelor's degrees in biochemistry and biology. He then worked as a teacher and completed a Master's in biomedical diagnostics in 2017. For fun, Mohammad (who also goes by Mokha) likes to practice at the archery range, work on calligraphy, game, and fountain pen writing, and read science fiction novels. He is interested in medicine with a focus on educating patients.