Surgical Communication: A Podcast with Gretchen Schwarze, Justin Clapp and Alexis Colley
episode
GeriPal - A Geriatrics and Palliative Medicine Podcast
51 min
3 speakers
8 chapters
transcribed 8 hours ago
Transcript
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Transcript generated automatically by AI and may contain errors.
What is the main focus of the Surgical Communication podcast episode?
Welcome to the JerryPal podcast. This is Eric Wadera.
This is Alex
Smith. And Alex, who do we have with us today?
Today we are delighted to welcome back Gretchen Schwarzy, who's professor of surgery. She's a vascular surgeon and bioethicist at the University of Wisconsin. Gretchen, welcome back to JerryPal.
Thank you.
And we're delighted to welcome Justin Clapp, who is assistant professor of anesthesia and critical care and medical ethics and health policy. He's a linguistic and medical anthropologist at the University of Pennsylvania. Justin, welcome to GRIPAL.
Hello, great to
be here. And as a guest host today, Alexis Collie, who's a palliative care fellow here at UCSF and also a surgical resident. Alexis, welcome to Jericho.
Thanks for having me.
We're gonna be talking about surgical communications really based off a series of four wonderful articles uh in JAMA Surgery titled Innovations in Surgical Communication. Uh we will have links to all of those, but we're gonna dive into that topic after we get a song request. Justin, I think you have a song request.
The song request is John Mayer say.
Uh are you a John Mayer fan?
No.
What? How did you pick a job mayor song?
We were looking for a uh thematically appropriate song and uh Gretchen offloaded the task to me because my wife is a musician and so I asked her, and this was the uh song that she found quite quickly. uh as as the most thematically appropriate. And Gretchen had also mentioned it herself. So there seemed to be it seemed to be a You know, just made to be, I suppose.
Okay. All right, here's a little bit.
Take out all your wasted honor. Every little past frustration. Take all of your so-called problems. Better put him in quotation. Say what you need to say. Say what you need to say. Say what you need to say. Say what you need to say. Say what you need to say. Say what you need to say. Say what you need to say. Say what you need to say.
Is there some foreshadowing with those lyrics in this podcast?
Just say it. Say what you need to say.
Well, our last podcast was actually on uh not using the word need, by the way. Oh yeah. I don't know how
We are well aware of your last podcast.
Yep.
We gotta ask we gotta go back to Bob Arnold and say, Well, if we're not gonna say need, then what are we gonna say? Jackie, Cruiser, yeah, what do we say instead? Yeah. Say what s these are the options of what you could say.
I think what we want to say is don't say this, say that. That is our entire structure.
Yeah, so just to kind of jump in, I'm I'm sort of curious to hear from you, Gretchen, just how this series of four articles from JAMA Surgery um formed and came about. If you could say a little bit about that.
Yeah, I think, you know, the probably the underlying story here is that I'm really good at doing negative randomized clinical trials. Um, but there is a good thing about doing a big clinical trial, which is that you get tons of data, even if you don't end up with the result that you want. So we did this very large P.CORI study and audio recorded over 450 conversations from surgeons all around the country talking to older adults about. about high-stakes surgical decisions with a lot of medical problems. And we had these amazing audio recordings and we're like, well, what are we gonna do with them? So we actually applied for a grant from the Greenwall Foundation to try and map out what surgeons were saying.
And I have to tell you, when we first went through all the data, it was pretty clear that the patterns of communication are really robust, meaning they're like very consistent across the entire cohort. Um, there's this awesome quote from Einstein. It's if I had 60 minutes to save the world, I'd then spend 55 minutes trying to figure out what's wrong with it. And so that's basically what we said to Green Mall, which is like, let us map out what's going on in these conversations. And then what we want to do after we've mapped that out is develop a new strategy. Like, how can we make these conversations better? So we did all that. And it took like three years.
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Chapters
8 chapters
1
What is the main focus of the Surgical Communication podcast episode?
0:00–6:57
2
How did the hosts introduce the “fix‑it” language problem in surgical consultations?
6:57–14:33
3
What did Gretchen Schwarze reveal about the patterns found in high‑risk surgical conversations?
14:33–20:36
4
Why is the term “fix‑it” considered harmful for patient‑centered decision making?
20:36–26:06
5
What are the four possible goals of surgery that surgeons should discuss with patients?
26:06–33:49
6
How does the “bin of bad stuff” framework help clinicians talk about surgical downsides?
33:49–39:52
7
What strategies did the guests suggest for promoting deliberation over technical education?
39:52–45:44
8
How can surgical training programs incorporate these communication tools into everyday practice?
45:44–51:53
Speakers
3 identifiedMore from GeriPal - A Geriatrics and Palliative Medicine Podcast
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