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Could coaching be the key to overcoming burnout and moral injury that plagues the medical profession?
In this episode of Pediatric Meltdown, Dr. Lia Gaggino welcomes back Dr. Adrienne Mann and Dr. Tyra Fainstad, pioneers in physician well-being research, as they unpack the results from their studies on the impact of group coaching on physicians. Drs. Mann and Fainstad share their journey from a "cute little study" to a groundbreaking national program that offers a lifeline to medical students, residents, and faculty. As they study the struggles and triumphs of physicians battling burnout, moral injury, and self-compassion deficits, they reveal a whole new approach to healing and growth.
Hear how their innovative program is providing solace to thousands and lighting a path to flourishing in medicine.
[00:05 - 01:17] Transforming Physician Wellness through Coaching
Explore the origins of a simple idea during the pandemic that blossomed into a renowned coaching programUnderstand how pivoting to online platforms expanded their coaching reach significantly beyond initial expectationsDiscover the importance of addressing burnout, moral injury, and imposter syndrome in healthcare professionalsLearn about the innovative group coaching model and its profound impacts versus traditional one-on-one methods[01:18 - 03:54] Impactful Outcomes of Group Coaching
Recognize the need for a targeted approach focusing initially on women due to higher burnout representationEvaluate the coaching methodology's evolution from novice trials to thousands of residents in randomized control settingsAppreciate insights into baseline distress levels and how these reveal prevailing systemic issuesAnalyze how group coaching effectively elevated self-compassion, reduced moral injury, and tackled burnout[03:55 - 06:06] Inclusivity and Institutional Partnerships
Grasp the expanding scope to now include men and diverse genders, enhancing coaching accessibilityReveal the collaboration with institutions to democratize coaching, offering programs at low costs per participantExamine how privacy and anonymity are maintained to encourage participation without stigmaRecognize the structural evolution from restricted groups to open participation for trainees at all career stages[06:07 - 8:52] The Future Direction of Physician Coaching Programs
Investigate the ongoing research into why and how coaching uniquely benefits medical professionalsThe potential restructuring of medical leadership to address autonomy and eradicate systemic burnoutAppreciate the continuous refinement and adaptation of the coaching model based on participant feedbackFact-check how empirical evidence supports the coaching method's resilience against challenges posed by modern healthcare[48:51-32:50] Dr. Lia’s TakeAways
Connect with Dr. Adrienne Mann
Instagram: @amw1983
Connect with Dr. Tyra Fainstad
Instagram: @Tyraindenver
Resources Mentioned in the Episode
Better Together Coaching https://bettertogetherphysiciancoaching.com/
-Major updates: You can see our website here for research and peer-reviewed evidence updates.
Of high interest is our most
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Are today's youth the missing voice in mental health advocacy?
In this episode of Pediatric Meltdown, host Dr. Lia Gaggino invites passionate mental health advocate Ria Babaria to talk about the unique struggles and strengths of today's youth. In her journey from high school advocate to college policy specialist, Ria emphasizes the need for youth representation in mental health decisions. She discusses the Youth Power Project's initiatives, access to mental health resources, and the importance of bridging societal and systemic gaps. From personal challenges to state-wide advocacy, Ria highlights the transformative power of youth voices in policy-making. Join us as we explore the potential changes when youth are given a platform to be heard.
The future of mental health is their future— but are we ready to listen?
[00:05 -15:21] The Birth of Youth Advocacy
The significance of amplifying youth voices in education and policy through advocacy organizationsImportance of bridging education gaps and providing resources for low-income and vulnerable youthEmpowering youth to assert confidence and influence in advocacy spacesThe transformative impact of including diverse backgrounds in policy discussions[15:12 -22:22] Mental Health Advocacy and Cultural Challenges
Addressing mental health struggles within POC households and breaking cultural taboosThe importance of emotion integration for personal growth and social interactionsBuilding confidence to engage in mental health advocacy at a young ageShaping policy through lived experiences and peer discussions[22:23 -38:50] Expanding the Youth Power Project Reach
The national evolution from initial state-focused youth groups to broader advocacy at YPPStrategizing for impactful health reform through youth collaboration and legislative workNavigating peer-to-peer networks to bolster the youth advocacy movementTailoring mental health and educational policies around authentic youth voices[38:51-48:50] Enhancing Access and System Reforms
Addressing consistency and discrepancies in mental health resource access nationwideInnovative strategies to demystify access and eliminate stigma around mental health supportStrengthening first aid mental health training to improve communication and supportDeveloping legislative frameworks to integrate youth insights within mental health policy48:51-32:50] Dr. Lia’s TakeAways
Connect with Ria [email protected]
Resources Mentioned:
PHQ-9 Screening Tool for Depression:PHQ-9 QuestionnaireYouth Power Project Website:Youth Power ProjectMental Health First Aid Training:Mental Health First AidYouth Power Project
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Saknas det avsnitt?
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Have you ever wondered what to do when traditional treatments for chronic pain in children don’t seem to help?
In this episode of Pediatric Meltdown, Dr. Lia Gaggino chats with Dr. Lonnie Zeltzer and Kim Poston Miller about innovative ways to address pediatric chronic pain. They discuss CHYP (Creative Healing for Youth in Pain), an organization offering hope to families through a creative, holistic approach to healing. Kim shares her personal story of supporting her son Grant’s remarkable recovery, showing how creativity can play a powerful role in pain management.
Tune in to learn how these approaches are opening new doors for children and families. Could creativity be the missing piece in chronic pain care?
[00:02 - 08:46] From Suffering to Hope – Introduction to CHYP
Kim talks about her personal journey as an advocate for CHYP, and the pivotal role creative arts played in her child's recovery.Unpack the story behind Dr. Zeltzer’s influence in reshaping pediatric pain management.Learn about the resourcefulness of a mother navigating her child's illness in a segmented medical landscape.Understand CHYP’s role as a free, accessible solution to complex chronic pain issues for any child worldwide.[08:47 - 14:53] Kim’s Inspiring Journey: Transforming Tragedy into Triumph
See the power of combining modern medicine with creative healing arts.Examine the interconnected struggles of family members often overlooked in medical treatments.Discover how social engagement became a lifeline for healing and improved quality of life.Find out how a mother's intuition and creative willingness conquered skepticism in professional medical advice.[14:54 - 23:30] The Creative System: Dr.Zeltzer's Vision and CHYP’s Foundation
Explore Dr.Zeltzer's 30-year journey of treating kids with chronic pain and the birth of the CHYP initiative.Appreciate the need for an online platform providing holistic, no-cost care to children globally.Grasp the significance of the biopsychosocial model in comprehending pediatric pain.Understand the empowerment and education process for both children and parents under the CHYP program.[23:31 - 54:36] Creating Magic: Camp as a Vessel for Change and Connection
Highlight the access to interactive platforms and workshops designed to enhance creative healing for youth.Recognize the significance of larger social networks in managing pain through shared lived experiences.Celebrate the impactful break-through of barriers, from timidity to friends on social platforms.Appreciate CHYP’s strategic growth with events uniquely catering to different age brackets for maximal impact.
[54:37 - 1:00:53] Dr. Lia’s TakeawaysConnect with Lonnie Zeltzer
https://linktr.ee/mychyp
https://www.instagram.com/my_chyp/
https://www.linkedin.com/company/creative-healing-for-youth-in-pain/
https://www.facebook.com/creativehealingforyouthinpain
Connect with Kimberly Miller
LI Kimberly Miller, MBA
FB
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Did you know that nearly twenty-five percent of adolescents suffer from chronic pain, and for some, it’s severe enough to impact daily life?
In this episode of Pediatric Meltdown, Dr. Lia Gaggino and guest Dr. Lonnie Zeltzer talk about the complexity of chronic pain in children and adolescents—a subject often misunderstood and inadequately addressed in pediatric medicine. Through personal anecdotes and expert insights, Dr. Zeltzer shares her journey from a curiosity about adolescent medicine to specializing in pediatric chronic pain using modern pain science. This conversation not only unravels the preconceived beliefs surrounding chronic pain but also offers potential pathways and methods to manage and reframe the experience of pain in young individuals.
The episode is an eye-opener for anyone seeking to understand and support children grappling with chronic pain.
[00:00 - 17:02] Prevalence and Challenges of Pediatric Chronic PainChronic pain affects 15–30% of adolescents globally, with 15% experiencing severe impairment. 70% of adolescents with untreated chronic pain develop adult chronic pain. Pediatricians often lack training in modern chronic pain management concepts. Subspecialists frequently struggle to address chronic pain after ruling out organic causes.
[17:02 - 27:55] Neurobiological and Psychosocial Factors Chronic pain correlates with limbic system hyperactivity and prefrontal cortex underdevelopment in adolescents. Neurodiverse individuals may experience heightened sensory sensitivity, amplifying pain perception. Hypnotherapy and cognitive behavioral therapy (CBT) retrain pain-related neural pathways. POTS (postural orthostatic tachycardia syndrome) reflects autonomic nervous system dysregulation linked to chronic pain.
[27:56 - 21:06] Gastrointestinal and Autonomic Dysregulation Irritable bowel syndrome (IBS) stems from brain-gut axis dysfunction, not structural gastrointestinal issues. Autonomic dysregulation in POTS requires salt intake, hydration, and compression garments for management. Acupuncture and acupressure offer nonpharmacologic relief, particularly for needle-tolerant patients. Abdominal pain often involves muscular tension, addressed through targeted physical therapy.
[21:07 - 48:48 ] Practical Clinical Interventions Brief in-office mindfulness exercises (e.g., guided breathing) provide immediate stress relief. Motivational interviewing helps adolescents identify achievable goals, like gradual physical activity. Parent-child dyads benefit from joint mindfulness apps (e.g., Insight Timer) to reduce household stress. The "five golden minutes" of non-directed play or connection improve emotional regulation.
[48:49 - 54:23] Dr. Lia’s TakeawaysConnect with Lonnie Zeltzer
https://linktr.ee/mychyp
https://www.instagram.com/my_chyp/
https://www.linkedin.com/company/creative-healing-for-youth-in-pain/
https://www.facebook.com/creativehealingforyouthinpain
Resources mentioned in the...
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Could a simple cash transfer program hold the key to reducing child poverty?
In this episode of Pediatric Meltdown, host Dr. Lia Gaggino chats with pediatrician and advocate, Dr. Brittney Tayler, about an innovative program called Rx Kids. Together, they explore how cash transfers can improve child health and well-being, especially in communities facing deep poverty. Dr. Tayler shares her firsthand experience in Flint, Michigan, detailing the transformation she's witnessed through the Rx Kids program. From addressing housing issues to boosting educational outcomes, this episode uncovers the impact that a single initiative can have.
Connect with the importance of advocacy and how one person can drive significant change, leaving a lasting impression on the entire community.
[00:00 - 05:07] From Pediatrics to Advocacy: Dr. Tayler's JourneyFind out how an accidental advocacy led to Dr. Tayler’s increased involvement in health policy.Understand the significance of Dr. Tayler’s meeting with a senator, and the impact it had on health legislation.Learn about the challenges of navigating advocacy as a medical professional.Appreciate the support Dr. Tayler received from experienced mentors to sharpen her advocacy skills.
[05:07 - 12:32] Understanding Poverty's Impact on Child HealthExplore the key aspects of poverty affecting child health, including housing and food security.Recognize the critical role of parents' stress levels in influencing children's well-being.Explore the widespread effects of poverty on all domains of health and life.Analyze how poverty can deeply affect educational outcomes and opportunities for children.
[12:32 - 21:07] Rx Kids: Transforming Communities Through Direct Cash TransfersThe transition from expanded child tax credit to the creation of Rx Kids.Discover the pivotal role of expanded child tax credits in reducing child poverty during the pandemic.How small studies and data informed the large-scale development of Rx Kids.Discover the impactful results seen so far in communities participating in direct cash transfer programs.
[21:07 - 30:21] Pioneering Change and Empowering CommunitiesUnderstand why Flint, Michigan, became the perfect place to pilot the Rx Kids program.Uncover the logistical aspects and eligibility criteria of the Rx Kids cash transfer program.The importance of dignity, trust, and community-wide benefits in program implementation.Future aspirations: how Rx Kids aims to expand and sustain its impact in Flint and beyond.[30:22 - 35:21] TakeAways
Connect with Dr. Brittney Tayler
Facebook – https://www.facebook.com/RxKidsUS
Instagram - https://www.instagram.com/rxkidsus/
LinkedIn - https://www.linkedin.com/company/rx-kids/
Resources mentioned in the show:
https://rxkids.org/about/communities/flint/
Chevy in the Hole by Kelsey Ronan https://www.amazon.com/Chevy-Hole-Novel-Kelsey-Ronan/dp/125080390X
Luke Shaefer PhD -
Ever wonder how the current chaotic world and the state of healthcare are affecting our children, the most vulnerable members of society and those of us who care for them?
Listen to this episode as Lia shares her angst and hope with the complexities of a world facing climate disasters, political strife, physician burnout, and a dwindling trust in science. This solo episode is a self-reflection about building the courage, commitment, and resilience required to safeguard children's health in these turbulent times.
As Lia recounts her own experiences during the pandemic and advocates for unwavering integrity in pediatric care, she challenges listeners to reflect on their role to protect the wellbeing of ALL children.. This episode is a call to action—will you answer it?
[00:05- 04:27] Insights on Pediatric Practice
The rigorous process of policy creation and revision within the American Academy of Pediatrics (AAP).Importance of adhering to evidence-based practices and adapting policies based on scientific discoveries.The challenges pediatricians face, including making life-and-death decisions.Commitment to upholding the Hippocratic Oath despite mounting difficulties.[04:28 -11:54] Challenges in Pediatric Healthcare
Long hours, difficult on-call shifts, and emotionally taxing decisions faced by pediatricians.Inequities in healthcare access, especially for marginalized children.Disinformation surrounding vaccines and its impact on parental decisions.Concerns over administrators dictating healthcare delivery without medical expertise.[11:55 - 17:58] Challenges in Pediatric Healthcare
The exhaustion and disheartenment experienced by pediatricians.Unfair contracts, financial pressures, and charting demands that intrude on family time.Pediatricians' dedication despite overwhelming demands, driven by a sense of calling.The public's misconceptions about pediatricians' financial motivations regarding vaccines.[17:59 - 22:30] Call to Action and Advocacy
A rallying message for pediatricians to support one another and remain resilient.Reinforcement of the commitment to doing what is best for children.The importance of unity and collective efforts to address healthcare challenges.Encouragement to engage with future episodes featuring interesting guests.
Resources Mentioned in the EpisodeWebsite: PediatricMeltdown.comAAP (American Academy of Pediatrics): Highlighted as a trusted source for pediatric guidelines.Dr. Anthony Fauci: Mentioned as a prominent figure in guiding healthcare during the COVID-19 pandemic.https://pediatricmeltdown.com/episodes
120 ADHD: Part 4 Executive Function
119 ADHD Part 3: Executive Function
109 ADHD Symptoms: Executive Functions Part II
ADHD: Strategies for Boosting Executive Function
Tweetable Quotes:
"To my pediatric colleagues, we cannot be intimidated. We cannot be afraid. We have to lean into each other and have each other's backs."... Dr. Lia Gaggino on the power of solidarity
"Despite the insanity of misinformation, hyperbole, and conspiracy theories, he prevailed even when he and his family were threatened and continue to be threatened."...Dr. Lia Gaggino on what Dr. Fauci had to...
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Raising Good Citizens Through Conscious Parenting
What does it take to raise thoughtful citizens and build stronger communities while navigating the challenges of parenting, aging, and personal growth?
In this episode, Dr. Robert Saul], an author and pediatrician, shares his insights from his career dedicated to advocating for children, families, and communities. Dr. Saul discusses his journey of writing books that cater to parents, children, and physicians, including one described as "Goodnight Moon with a message," using vivid illustrations and meaningful text to engage families. Through relatable examples like managing tantrums, school avoidance, and making tough decisions as both parents and children of aging parents, Dr. Saul emphasizes the importance of fostering responsibility and kindness. Drawing wisdom from the "5 M's" of mentoring, mediating, mobilizing, monitoring, and motivating, Dr. Saul inspires listeners to embrace their roles as sages and positive influences.
Will this be the conversation that reshapes the way you see parenting and citizenship?
[00:05- 11:27] Foundations of Conscious Parenting
Key realization: “I am the problem, I am the solution, I am the resource.”The role of community engagement in addressing societal issues like teenage pregnancy and disengagement.Introduction to the “Five Steps to Community Improvement.”Impact of Columbine (1999) and its role in inspiring advocacy and writing.[11:28 -20:54] Overcoming Adverse Childhood Experiences (ACEs)
The significance of nurturing, safe, and stable relationships (SSNRs).Introduction to SSNRs as a buffer against toxic stress.Role of parents in creating environments that foster resilience in children.Emphasis on pediatricians' responsibility to guide and support parents.[20:55 - 35:58] The Parental Awareness Threshold (PAT)
Concept of being "above the line" (curious and open) vs. "below the line" (closed and defensive).Strategies for managing stress and frustration as a parent: pause, assess, choose.Frameworks for addressing challenges like tantrums and teenage rebellion.Balancing empathy with practical parenting techniques.[35:59 - 46:30] Advocacy and Community Engagement
Role of pediatricians in supporting families facing poverty, domestic violence, or instability.The importance of advocacy for systemic changes to improve family support.Encouraging involvement in organizations like the American Academy of Pediatrics (AAP).The significance of professional networks for mutual support and advocacy.Connect with Dr. Saul:
https://mychildrenschildren.com/ to learn more.
Resources mentioned in the show:
Books
My Children’s ChildrenThinking DevelopmentallyConscious ParentingBowling AloneConscious Leadership -
This episode was actually published in June 2022, but this is STILL a huge issue, so we thought we would take another listen …
How can pediatric primary care effectively integrate mental health services amid insurance barriers and coding complexities?
In this episode, we tackle the significant obstacles impacting the compensation and delivery of mental health services for children. By examining Medicaid, CHIP and commercial insurance coverage for mental health, we highlight challenges that hinder pediatricians and affect their young patients and families. The conversation sheds light on potential solutions, such as integrated behavioral health and group therapy, which may offer new avenues for improving care and financial viability. Through shared experiences from industry experts, we explore potential strategies to both navigate and potentially reform the delivery of pediatric mental health services.
Considering the significant implications this has on future generations, what steps must we take now to ensure a sustainable and effective approach that genuinely meets the needs of children and their families?
[00:05- 19:41] Financial and Operational Burdens
Household income criteria affect eligibility for Medicaid, impacting family financial planning.Pediatric practices bear costs of unrecognized mental health work because of inadequate reimbursement.Parents' financial stress increased by the lack of integration between medical and mental health services.Complex insurance landscapes necessitate physician adaptability in operations.[19:42 -29:58] Pediatric Practice Challenges
Mental health visits require more time but yield less reimbursement compared to physical ailments.Physicians provide extensive unpaid follow-up care via phone calls and messages.Insurance systems do not adequately support mental health coding for pediatricians.Complexity in billing for mental health services creates administrative challenges.[29:59 - 38:51] Economic and Qualitative Outcomes
Coordinated care allows pediatricians to manage comprehensive patient care plans.Insurance company partnerships needed for sustainable pediatric mental health initiatives.Effective systems require data to demonstrate long-term cost benefits and outcomes.Organizations should engage with insurance companies to carve out necessary screening costs[38:52 - 1:05:50] Advocacy and Reform Efforts
Reform needed in coding and billing processes to reflect the true nature of mental health support.Integrated care models as a potential less visible, but essential cost benefit.Engaging with insurance companies on mutual goals can lead to practice sustainability.Systems must prioritize patient-centered care, integrating mental and physical health.[1:05:51 - 1:13:48] TakeAways
Connect with our guests
Jenna Vallejo
Facebook,
Instagram,
LinkedIn
Dr. Jon Price
nationwidechildrens.com
Go to https://lifeaftercorporatepodcast.com/ for all episodes
166 Chronic Illness and...
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In 2020, I had the privilege of being a guest speaker on Sandy Fowler’s podcast “Mighty Parenting” for a candid discussion about youth mental health, suicide prevention, and the critical role parents play in supporting their children through emotional challenges. I thought it would be interesting to blow the dust off this episode where I was being interviewed by Sandy.
As a medical professional deeply committed to improving mental health care in primary care settings, I shared insights specifically for parents about how to recognize warning signs, have difficult conversations, and access appropriate resources. That conversation became a pivotal moment in my career, sparking my desire to reach a broader audience through podcasting… Pediatric Meltdown was born!
Today, as the host of Pediatric Meltdown, I continue to build upon that mission, but I thought it would be worth revisiting this discussion that served as a catalyst for my current role as a podcast host. During our conversation, we tackled the crucial topic of youth suicide prevention, breaking down barriers to communication, and providing practical tools for parents to support their children's mental well-being. Unfortunately, with the impact of the Covid-19 Pandemic, this discussion remains as relevant today as it was then, perhaps even more so.
[00:05- 21:59] Brain Development & Behavior
Teen brains function differently from adult brainsRole of prefrontal cortex in decision makingImpact of developing brain on behaviorUnderstanding cognitive limitations[22:00 -32:45] Suicide Prevention Strategies
Proper approach to discussing suicidal thoughtsImportance of staying calm during difficult conversationsAvailable crisis resourcesSteps for emergency[32:46 - 42:51] Mental Health Statistics
25% of youth screen positive for depressionAnnual screening recommendations for ages 12+15% experience suicidal thoughtsImplementation of 54321 coping technique[42:52 - 53:02] Action Steps for Parents
Creating safe environment for emotional expressionUnderstanding brain development impactUsing emotional scale assessments (1-5)Knowing when to seek helpGo to https://lifeaftercorporatepodcast.com/ for all episodes
169. Lisa Durante's Strategy for Mastering Your Content Marketing Plan!
153 A 3-Step Guide to Skyrocketing Your Income
137 Marketing, Management, and Metrics: The Keys to Consistent Success
Tweetable Quotes:
"But in terms of completed suicides, it's firearms, and the really sad thing is, suffocation mostly by hanging is the most common and becoming more common and that one, of course, is really hard to restrict because you can hang yourself with so many items." … Dr. Lia Gaggino on the harsh reality of suicide methods
“"If you set the stage that it's okay to talk about your thoughts and feelings, then and and that's just a habit that you've had all along, then I think it makes the conversation easier." … Dr. Lia Gaggino on communicating with kids about Mental Health
**TRANSCRIPT AVAILABLE UPON REQUEST**
SUBSCRIBE & LEAVE A FIVE-STAR REVIEW and share this podcast to other growing entrepreneurs!
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What happens when a physician who regularly discusses wellness and burnout finds herself in need of her own advice?
In this personal episode of "Pediatric Meltdown," host Dr. Lia Gaggino candidly shares her journey through an overwhelming period in late 2024, marked by her father's death, her mother's hip surgery and subsequent move-in, and the unexpected loss of her beloved pet. Despite having a strong support system that includes her husband Rodger, adult daughters, and one-year-old grandson George, she acknowledges her exhaustion and struggles with sleep, nutrition, and exercise habits.
This episode is an honest confession of how even wellness advocates can find themselves needing to replenish their own spirit, in other words, to walk the walk in self-compassion. Some deep soul searching led to Lia’s decision to take a month-long sabbatical from the podcast while still ensuring weekly content. You can look forward to surprise episodes specially curated by her team just for you.
Key Takeaways:
1. Self-awareness and vulnerability are crucial steps in addressing burnout, as demonstrated by Dr. Lia's honest acknowledgment of her own struggles despite being a wellness expert.
2. Setting boundaries and making concrete changes (like designated phone-free zones, scheduled exercise, and sleep routines) are essential components of self-preservation during challenging times.
3. A strong support system and a temporary “leave of absence” makes space for her mental health re-boot. Dr. Lia is privileged to be able to take this break, and recognizes that a break like this may not be an option for many, but she offers some baby steps for herself that can be added to your own self-kindness tool-box. Making time for self-reflection may be the key to long-term sustainability in both personal and professional life.
Make sure to tune in all month long for some episodes that you most likely have not heard. They were curated by Dr. Lia, and her team and they hold a special place in her heart.
**TRANSCRIPT AVAILABLE UPON REQUEST**
SUBSCRIBE & LEAVE A FIVE-STAR REVIEW and share this podcast to other growing entrepreneurs!
Get weekly tips on how to create more money and meaning doing work you love and be one of the many growing entrepreneurs in our community. Connect with me on LinkedIn; https://www.linkedin.com/groups/12656341/ or on Instagram or our website at www.lifeaftercorporatepodcast.com .
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What does it truly mean to cultivate resilience and well-being in today's challenging world?
In this insightful episode of Dr. Lia Gaggino's podcast (episode 227), she thoughtfully explores seven fundamental pillars of well-being while reflecting on the transition into 2025. Drawing from both professional expertise and personal experience, particularly while caring for her aging mother, Dr. Gaggino presents a comprehensive approach to health that encompasses sleep, nutrition, movement, family connections, friendships, creativity, and spirituality. She authentically acknowledges the struggles many face, from avoiding overwhelming news to managing daily stresses, while offering practical, judgment-free advice that balances aspiration with self-compassion.
Her message resonates particularly strongly when she emphasizes that relationships are the ultimate antidote to loneliness, fear, and sadness, demonstrating a deep understanding of human nature and the complexities of modern life.
Key Takeaways:
1. Well-being is multifaceted and requires attention to both physical aspects (sleep, nutrition, movement) and emotional/social components (family, friends, creativity, spirituality).
2. Perfection shouldn't be the enemy of progress - it's important to maintain healthy habits while showing yourself grace during challenging times.
3. Strong relationships and social connections are crucial for emotional resilience and long-term health, whether these connections are with family of origin or chosen family.
Let’s make 2025 the Best Year EVER!!
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Ever wondered what it's like to blend personal traditions with familial expectations during the holidays?
In this episode of Pediatric Meltdown, Dr. Lia Gaggino shares her experiences with Christmas celebrations, highlighting the unique blend of Polish traditions from her husband's heritage and her own family's rituals.
Family Rituals: Dr. Gaggino discusses the significance of family rituals, such as sharing a wafer similar to the Catholic host and wishing each other well, despite some family members finding it cringey.Meal Traditions: She talks about the specifics of their holiday meal, including mushroom soup and homemade pierogies, and how these traditions evolve over time to accommodate changing family dynamics.
Importance of Traditions: Dr. Gaggino reflects on the deeper meaning of traditions, emphasizing their role in creating predictability, routine, and reassurance for children.Merry Christmas and Happy holidays to all of you.
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Ever wondered how a simple injury can change the course of one's life?
This episode explores the fascinating journey of a sports enthusiast turned medical professional, inspired by a personal encounter with a sports medicine provider after a college injury. The conversation delves into the complex world of concussions, discussing the evolution of treatment protocols, the importance of individualized care, and the severe risks of prematurely returning to play. You'll learn about tools like the SCAT symptom score and the VOMS for monitoring recovery, and the often-overlooked psychological impacts of concussions on young athletes. But perhaps the most crucial takeaway is the stark reminder: concussions are no joke, and honesty about symptoms can be a matter of life or death.
Are you ready to rethink what you know about concussions?
[00:33- 10:59]Initial Assessment and Management of Concussions
The SCAT (Sport Concussion Assessment Tool) is mentioned as a crucial tool for evaluating concussions.The importance of understanding the broad nature of concussions and their varied symptoms.Reassuring patients and their families about the management plan.An emphasis on the need for individualized treatment plans for concussions.[11:00 -16:47] Red Flags and Immediate Concerns
Red flags that indicate a more serious condition, such as worsening symptoms and unusual behavior.Specific symptoms like nausea, vomiting, and severe headaches that should raise concern.Trusting your instincts and gut feelings when assessing a concussion.Immediate action is needed if a patient's condition deviates from expected recovery patterns.[16:48 - 44:47] High-Risk Sports and Gender-Specific Risks
High-risk sports for concussions, including for men: wrestling, basketball, soccer: For women: cheerleadingThere is a potential for prolonged recovery in athletes with underlying medical issues.Initial visits should focus on identifying concerning symptoms and ruling out underlying conditions.A comprehensive approach to managing concussions is needed, especially in high-risk sports.[44:48- 58:16] Treatment Algorithm and Activity Management
Treatment Algorithm and Activity ManagementAn outline of a general treatment algorithm for managing concussions in the first 48 hours and beyond.The importance of gradually returning to activity while ensuring symptoms do not worsen.Provide physical therapy orders and ensuring PT sites treat concussions effectively.Educate patients and families about the expected recovery process and potential setbacks.[58:17 - 01:10:00] Takeaways
Resources:
AAP Sports-Related Concussion Recommendations:
AAP Concussion Recommendations
AAP article and Amsterdam Consensus: Statement: AAP and Amsterdam Consensus Statement
AAP Vision and Concussion: Vision and...
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Ever wondered how to smoothly transition pediatric patients with complex conditions like ADHD into adult care?
This episode talks about the challenges and strategies involved in this critical handoff. Dr. Peter Jensen and Dr. Lia discuss the importance of educating and empowering teens to manage their conditions independently, drawing parallels with other chronic illnesses like asthma and diabetes. They explore the nuances of preparing both the patients and the accepting providers to ensure a seamless transition. Additionally, they discuss resources for understanding adult ADHD and address some of the barriers to care when teens go out of state for college or careers.
This episode highlights the importance of systematic, careful planning and open communication to prevent gaps in care during this transition period.
[00:05- 17:16] Gender Differences in ADHD Diagnosis
Later diagnosis of ADHD in females.Fewer hyperactive symptoms in females leading to delayed diagnosis.Quietly distracted children may be overlooked.Morphing of symptoms towards inattentiveness in teen and young adult years.[17:17 -23:15] Adult ADHD and Mental Health Risks
Reduction of hyperactivity and impulsivity symptoms over time.Increased risk of anxiety, depression, and substance use in adults with ADHD.Challenges in recognizing adult ADHD due to comorbid mental health issues.The role of family practice providers in identifying adult ADHD.[23:16 - 43:50] ADHD Medication and Substance Use Concerns
There is diversion and misuse of ADHD medications.Holding patients accountable for lost or stolen medication.Comparing ADHD medication misuse to other substance abuse issues.Importance of clear communication between providers and patients.[43:51 - 48:50] Recommendations for ADHD
Mention of the book "Driven to Distraction" by Ned Hallowell.The importance of education and awareness about adult ADHD.The role of pediatricians in thinking about ADHD in adults.Emphasis on ensuring pediatricians and healthcare providers are aware of the Reach Institute.[48:51 - 57:47] Take Aways
Connect with Dr. Peter Jensen
Website: https://thereachinstitute.org/
LinkedIn: https://www.linkedin.com/company/the-reach-institute-resource-for-advancing-children-health/
Facebook: https://www.facebook.com/REACHInstitute/
Twitter: https://twitter.com/reach4kids
RESOURCES MENTIONED IN THE EPISODE
The REACH Institute: www.thereachinstitute.org
Driven to Distraction" by Ned Hallowell.
This book is highly recommended for understanding ADHD in adults. It is easily readable and includes stories and checklists of symptoms that can help readers identify ADHD traits in themselves or others.
Go to https://lifeaftercorporatepodcast.com/ for all...
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Have you ever wondered if ADHD is being misunderstood or misdiagnosed in children, leading to feelings of failure and unchecked anxiety?
In this episode of Pediatric Meltdown, host Dr. Lia Gaggino and Dr. Norrine Russell talk about the complexities of ADHD, from its nuances to the pressing need for systemic change in how it's perceived and treated. They shed light on the importance of recognizing ADHD as non-willful behavior, the role of early intervention, and the imperative of individualized education plans. With data-backed insights and real-world anecdotes, this discussion underscores the urgency of a more equitable and comprehensive approach to ADHD treatment.
This is a must-listen for educators, parents, and healthcare providers.
[00:38 - 7:37] Unpacking ADHD and Common MisinterpretationsDefinition of "pure ADHD," described as a potential "gift," affecting a smaller segment of diagnosed children.Discussion on comorbidities like dyslexia, dysgraphia, mood disorders, and autism, affecting two-thirds of ADHD-diagnosed children.Issues of whether anxiety stems from late-diagnosed ADHD or contributes to its symptoms.Emphasis on early intervention to prevent ADHD from triggering anxiety and encourages proper diagnosis to avoid misunderstanding behaviors.
[07:38 - 14:07] Individualized Educational Approaches and Social SkillsImportance of personalized educational strategies for neurodivergent children, avoiding a "one size fits all" methodology.Benefits of involving children in solution-finding processes for tailored educational support.Highlighting social delays in children with ADHD and the role of structured activities in fostering social interactions.Allowing children to build on their strengths and interests to enhance self-esteem and personal growth.
[14:08 - 21:15] Challenges in Diagnosing and Treating ADHDDiscussion on the misconception of oppositional defiant disorder (ODD) and its potential misinterpretation as ADHD symptoms.Need for differential diagnosis to distinguish between ODD and ADHD, particularly in the context of trauma.Advocacy for multimodal ADHD treatment plans, integrating medication, parent education, and school plans as per American Academy of Pediatrics guidelines.Addressing systemic inequities in healthcare affecting children on Medicaid and the impact of racial biases on ADHD treatment.
[21:16 - 28:22] Tools, Resources, and the Path ForwardDiscussing genetic links and familial patterns discovered during psychosocial intakes.Importance of early identification to prevent negative academic cycles and enhance engagement.Promoting ADHD acceptance and self-advocacy by normalizing brain differences.Recommendations for educational materials, like "ADHD is Awesome" and "The Anxious Generation," and promoting Norrine’s podcast for further insights.Resources Mentioned:
Vanderbilt and Connors Symptom Trackers (Symptom Trackers) Vanderbilt ADHD Diagnostic Rating Scale (VADRS) - Psychology ToolsBook: ADHD Is Awesome - ADHD is Awesome: A Guide To (Mostly) Thriving With ADHD: Holderness, Penn, Holderness, Kim, Edward Hallowell: 9781400338610: Amazon.com: BooksBook: -
Can a doctor's strongest medicine be kindness to themselves?
In this candid conversation, Dr. Kathy Stepien, physician coach and advocate for medical wellness, challenges the notion that self-criticism leads to better performance. Speaking with host Dr. Lia Gaggino, she unpacks how physician coaching has evolved from executive suites to mainstream medicine, backed by clinical trials from institutions like Mayo Clinic and Stanford. Dr. Stepien shares powerful stories about identity transitions in medicine, from early-career challenges to retirement questions, while offering practical ways to find the right support.
Her remarkable work in bringing hidden struggles to light proves that no physician needs to walk their professional journey alone.
[00:05- 15:07] Challenges Physicians Face in Their Career
Isolation despite being surrounded by accomplished colleagues, leading to internal strugglesDemanding nature of the profession requiring significant self-sacrifice beyond typical 9-to-5 hoursStruggle with maintaining autonomy, especially when transitioning from private practice to employed positionsDifficulty in managing time and energy while trying to balance multiple responsibilities[15:08 -26:02] Navigating Challenges in Medical Training and Practice
Seek safe persons to confide in when facing discrimination or difficult situations, particularly those slightly removed from your immediate environmentRecognize that no medical professional needs to handle struggles alone - it's acceptable and beneficial to ask for helpAddress issues strategically and wisely, especially in situations with significant power differentialsRemember that supporting each other is crucial - medical professionals need connection and understanding from peers who share similar experiences[26:03 - 39:24] Power Dynamics and Professional Growth in Medicine
Early career physicians often feel vulnerable during training periods, but gain more ability to advocate for change as they advance in their careersThe transition from clinical practice to administration reveals different cultural challenges, including slower decision-making processes and risk aversionThe importance of speaking up against inappropriate behavior, such as public humiliation, despite the professional risks involvedThe value of having witnesses and support systems when addressing workplace issues[39:25 - 57:43] Benefits of Physician Coaching
Data shows solid evidence of improved physician well-being and quality of lifeLeads to profound improvement in emotional exhaustion reductionEnhances self-compassion among medical professionalsResults in better patient outcomes when physicians are well-supportedConnect with Dr. Kathy Stepien
Website: https://www.instituteforphysicianwellness.com/
Instagram: www.instagram.com/kathystepienmd
Facebook: https://www.facebook.com/physicianwellness
LinkedIn:https://www.linkedin.com/in/kathystepienmd/
Important Links To Share:
Anti-Burnout Program for Women Physicians:
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What happens when a pediatrician hands a free book to a parent and changes the trajectory of a life?
Meet Claudia Aristy whose first encounter as a new immigrant mother with “Reach Out and Read” sparked a remarkable transformation. Through her work with the Health Education and Literacy for Parents (HELP) Project, Claudia demonstrates how pediatricians can encourage literacy through books while supporting immigrant families. Her personal story describes the power of how parent-child reading led to her own high school completion and college graduation. Her work showcases how simple interventions can create lasting impact on children's development. Her conversation with Dr. Lia Gaggino explores innovative ways to promote bilingual literacy and to strengthen parent-child interactions through reading, while turning waiting room time into valuable learning opportunities.
This episode proves that when healthcare meets literacy, extraordinary changes happen in families' lives.
[00:05- 17:39] Impact of Early Reading Programs in Pediatric Settings
A powerful moment of transformation occurs when pediatricians gift books to families during well-child visits, creating a bridge between healthcare and literacyThrough programs like Reach Out and Read, medical providers effectively communicate how daily reading routines contribute to brain development and school readinessFree book distribution in medical settings removes financial barriers, especially beneficial for immigrant families who may find traditional bookstores inaccessible or unaffordablePediatricians serve as trusted messengers, helping parents understand the connection between early reading and cognitive development[17:40 -24:13] Bridging Healthcare and Literacy Through Reach Out and Read
Pediatricians serve as crucial advocates for child literacy by incorporating books into medical visits, creating meaningful connections with families beyond just medical careThe program transforms routine medical checkups into opportunities for promoting parent-child reading interactions, making healthcare settings more welcoming and educationalFree book programs integrated into medical visits help break down barriers to literacy, especially for families with limited resourcesPediatric literacy initiatives become more effective when healthcare providers take time to make genuine connections and offer encouragement to parents[24:14 - 35:20] Effective Parent-Child Reading Engagement
Positive interactions during reading sessions go beyond literacy - making eye contact and smiling are simple yet powerful ways to connect, requiring no formal education or special trainingParents don't need advanced degrees to make meaningful contributions to their children's development through reading and storytellingCreating joyful memories around books is more valuable than perfect reading skills, especially for parents who may struggle with literacy themselvesDaily reading can be adapted to busy family schedules, acknowledging real-world challenges like multiple jobs and time constraints[35:21- 53:07] Empowering Parents Through Healthcare-Based Literacy Initiatives
The HELP (Health Education and Literacy For Parents) project maximizes waiting room time by conducting health literacy activities, transforming passive waiting into active learningPediatricians serve as trusted authority figures who can effectively encourage and validate parents' roles as their children's first teachersFree resources are available through greenlighthelp.org, offering evidence-based information aligned... -
How can we help teens with bipolar disorder manage their symptoms and transition successfully into adulthood?
In this (part 2) episode of Pediatric Meltdown, host Dr. Lia Gaggino and child psychiatrist Dr. Jeanette Scheid discuss managing bipolar disorder in young adults during major life transitions. From medications for bipolar disorder in youth to support resources, they explore how parents and healthcare providers can identify early signs of a bipolar manic or depressive episode and implement effective treatments. Dr. Scheid shares practical strategies for maintaining stability, including sleep schedules, substance use prevention, and the vital role of college support services.
Whether you're a healthcare provider or parent seeking to understand bipolar disorder treatment for teens, this conversation offers clear guidance for helping young people thrive.
[00:33 -10:28] Critical Warning Signs and Transition Risks for Young Adults with Bipolar Disorder
Poor sleep patterns often emerge as one of the earliest indicators of potential manic episodesEarly symptom recognition training for both parents and youth helps prevent severe episodesRegular psychoeducational conversations with everyone in the youth's support system enhance management successLiving independently introduces new challenges that require careful monitoring and support[10:29 - 19:29] FDA-Approved Medications for Youth Bipolar Disorder: A Primary Care Guide
Key antipsychotics including aripiprazole, quetiapine, risperidone, olanzapine, asenapine, and lurasidone are FDA-approved, for adults with bipolar disorders. There are fewer medications approved for youth due to lack of clinical studies. No anti-seizure medications currently hold FDA approval for bipolar disorder in youth, though some are approved for adultsMost common lithium side effects include headache, nausea, increased thirst, and mild tremorsRegular thyroid function monitoring is essential, often requiring collaboration between pediatricians, endocrinologists, and psychiatrists[19:30 -39:22] Understanding Lithium Treatment in Youth Bipolar Management
Therapeutic window for lithium is narrow, ranging from 0.6 to 1.2 milliequivalents per liter, requiring careful monitoring and frequent lab workDehydration and changes in salt balance can trigger dangerous lithium toxicity levelsFamily medical history plays a crucial role in treatment decisions, as demonstrated by cases where lithium proved more effective than second-generation antipsychoticsRegular lithium level monitoring (1-2 times yearly) is necessary for stable patients, with more frequent checks during dose adjustments[39:23 - 50:50] Building Knowledge Bridges: What Primary Care Needs to Know About Youth Bipolar Care
Utilizing child psychiatry access programs as learning resources for medication managementUnderstanding safety profiles of common medications, even when not directly prescribingRecognition of medication effects similar to monitoring diabetes care in primary practiceValue of ongoing consultation with psychiatric specialists for medication questions[50:51 - 1:04:37] Closing segment Takeaway
Links to resources mentioned on the show
Resources Part 1:
AACAP Facts for Families: Facts for...
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In this episode, child psychiatrist Dr. Jeanette Scheid joins Dr. Lia Gaggino to discuss the complexities of pediatric bipolar disorder, and sorting through the diagnostic possibilities is central to making an accurate diagnosis Dr. Scheid offers insights to tease out what are the childhood behaviors that are developmentally normal, for example imaginary friends, and what are concerning symptoms such as auditory hallucinations. Dr Scheid highlights the critical role pediatricians play in the early identification of youth bipolar disorder with enormous implications for decreasing serious illness in adulthood.
With mental health in children becoming increasingly important, this conversation offers practical guidance for pediatric clinicians.
[00:33 -10:49] Key Diagnostic Criteria for Bipolar Disorder
Major depressive episodes often appear as the first signs, lasting at least 2 weeks with predominantly low moodGrandiosity and racing thoughts are significant indicators, particularly when accompanied by uncharacteristic risk-taking behaviorsSleep patterns change dramatically, with some people feeling rested after less than 3 hours of sleepIncreased talkativeness, faster speech, and heightened distractibility are common symptoms[10:50 - 19:01] Challenges in Early Identification
Distinguishing between normal childhood behavior and pathological symptomsComplexity increases when combined with autism or intellectual disabilitiesInitial misdiagnosis as oppositional defiant disorder or treatment-resistant ADHDNeed to differentiate between typical defiant behavior and true mood episodes[19:02 -31:42] Understanding Trauma's Relationship with Mental Health Symptoms
Trauma symptoms can overlap with other mental health conditions, making diagnosis complexFlashbacks from trauma can present similarly to perceptual disturbances or hallucinationsContent of experiences often connects directly to past traumatic events and safety concernsBoth trauma and other mental health conditions can coexist - it's not an either/or situation[31:43 - 32:13] Adapting Primary Care to Modern Mental Health Challenges
Pediatricians can't opt out of mental health care, just as they didn't opt out of COVID carePrimary care providers are being called upon to manage medications when psychiatric access is limitedProfessional relationships and collegial connections make difficult cases more manageableThere's a growing recognition that early intervention in mental health can prevent future complications, including involvement in the juvenile justice system[50:51 - 58:26] Closing segment Takeaway
Links to resources mentioned on the show
AACAP Facts for Families: Facts for Families
AACAP Resource Center Bipolar Disorder
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What happens when the wealthiest nation in the world fails its children?
In this short but important solo episode, Dr. Lia Gaggino, speaking as a mother, grandmother, and pediatrician, shares her concerns about the state of children's welfare in America. She addresses multiple challenges facing our youth today, from healthcare and poverty to gun violence and education. As the November 5th election approaches, Dr. Gaggino makes an impassioned plea to voters to consider the impact their choices will have on the next generation. Her message transcends political lines, focusing instead on fundamental human values and the moral imperative to protect and nurture our children.
After all, as she poignantly asks, “who will lead, teach, build, and protect our nation if we continue to fail our children today?”
Links to resources mentioned on the show
CDC https://www.cdc.gov/maternal-infant-health/infant-mortality/index.html
Commonwealth Fund: https://www.commonwealthfund.org/publications/issue-briefs/2024/jun/insights-us-maternal-mortality-crisis-international-comparison#:~:text=Recent%20Maternal%20Mortality%20Trends,deaths%20per%20100%2C000%20live%20births.
Annie E. Casey Kids Count: https://datacenter.aecf.org
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Key quotes for Twitter:
"In the United States, 25% of children live in poverty. 50% are covered by Medicaid insurance."... Dr. Lia Gaggino on the child poverty crisis
"Should they bleed out on waiting room floors? Should they die of sepsis because they can't get the care they need to treat a miscarriage because doctors are afraid in states that ban all abortion?".... Dr. Lia Gaggino on the reality of abortion bans
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