Baptist HealthTalk

Episode 100: A Glimpse Behind The Scenes

April 11, 2022 Baptist Health South Florida, Dr. Jonathan Fialkow
Baptist HealthTalk
Episode 100: A Glimpse Behind The Scenes
Show Notes Transcript

After a brief hiatus, the Baptist HealthTalk podcast is back with a special edition to mark a milestone: our 100th episode.

Join us as we turn the tables on host Jonathan Fialkow, M.D., to get his unique perspective on the podcast's evolution during two of the most tumultuous years in modern medicine. 
Originally intended to cover common healthcare concerns like backaches and vaping, Baptist HealthTalk made a major pivot to deliver reliable information about COVID-19 from Baptist Health leaders and experts.

Dr. Fialkow reflects on some of the most impactful episodes to date and talks about where the podcast is headed in the future - with the help of input from listeners.  To leave feedback about the podcast or suggest a topic, please send an email to BaptistHealthTalk@BaptistHealth.net. 

We thank our listeners for your support.


Announcer:

At Baptist Health South Florida, it's our mission to care for you when you're injured or sick and help you stay healthy and fit. Welcome to the Baptist Health Talk Podcast, where our respected experts bring you timely, practical health and wellness information to improve your family's quality of life.

Dr. Fialkow:

Welcome, Baptist Health Talk Podcast listeners. I'm your host, Dr. Jonathan Fialkow. I'm a preventative cardiologist and lipidologist at Baptist Health's Miami Cardiac and Vascular Institute, where I'm also chief of cardiology at Baptist Hospital and chief population health officer at Baptist Health.

Dr. Fialkow:

Today marks a major milestone for the Baptist Health Talk Podcast. This is episode number 100. So we're trying something a little different for this episode. The show's producer, the wonderful Carol Higgins, is turning the tables to ask me some questions about the first 99 episodes, as well as what the future may hold for the next 99. Let's see how this goes.

Carol Higgins:

It's going to be fine. It's all good to try new things, right?

Dr. Fialkow:

I'm ripe and ready, Carol. I'm ripe and ready.

Carol Higgins:

Okay. Well, when we talk about new things, this was new about two years ago. Can you take us back to the beginning and tell us how it came about and how did you come to be the host?

Dr. Fialkow:

When I reflect on two years ago and 100 podcasts and the work done behind the scenes, I always felt that if we had a way to communicate to really patients, to the lay public, and a way that they would understand and about things they want to hear, it'd be very viable. It'd be very popular. And in my own practice, I always put myself in that patient position when I'm talking to them, what I would want to know, what I would want to hear, how I'd want to understand why recommendations are made.

Dr. Fialkow:

They say that everyone and their mother has a podcast. The reality is everyone and their mother does have a podcast these days, but it really is a great forum. I mean, I find I listen to podcasts at night when I'm trying to go to sleep. I listen when I have car rides sometimes in the afternoons and people can listen to them at their convenience.

Dr. Fialkow:

So I felt connecting the desire to communicate with people at their level about the things they would want to know as well as using the podcast format. And then of course the Baptist Health innovative marketing teams and you guys, and you and Steve, especially being able to put all this together was a great opportunity and I'd like to think it was well received.

Dr. Fialkow:

Certainly, I had a lot of good feedback from folks in the community and certainly my mother is a good advocate telling all her friends to listen and it's always good working for you. But I think it was just a matter of trying to find a new form to connect with people at levels that are easy for them about things that they would otherwise want to hear about.

Carol Higgins:

So as far as you becoming the host, how did that happen?

Dr. Fialkow:

I've also had a lot of patients who were in marketing, who would say to me, "Hey, you should be on TV," or "You should do podcasts," or "You should do X, Y, and Z." And of course they wanted me to hire them to help promote me. And again, I think the balance of the Baptist support in our podcast is that I can do this because I like it. I can do it because I think I'm providing something impactful. I can do it because I like providing exposure to the wonderful talent we have in the Baptist system, doctors, nurses, therapists, dieticians. It's just great to talk with these bright, motivated, passionate people.

Dr. Fialkow:

But I didn't want to make it into a true career. I didn't want to make it something that I had to spend all day worrying about a podcast. And again, with your guys' help and with the help of a lot of our guests, it just became something that became fun. In fact, Carol, over two years, and you certainly know all my other roles within the health system and how I'll say in demand I am, but I don't mean that in anything other than just as a lot of opportunities for things I can do, people, "Why are you wasting time on that? Why are you spending time on it?"

Dr. Fialkow:

And quite frankly, I like it. Why can't I spend some time doing something that actually I enjoy? So I thought about something that I just enjoy doing the podcast. I enjoy the evolution. I think I've evolved and grown as well over the podcast, both in delivery and figuring out what the message should be to learning from the guests we have on and coming up with new topics. So again, it's just something I just find very enjoyable and I'd like to think that the listeners find value in it as well.

Carol Higgins:

I believe they do. When I was first told that a doctor was going to host the podcast I was a little apprehensive because not all doctors would be capable of sitting there and interviewing people and keeping the discussion going and not getting so technical. Because that has been my career, is a video producer for many, many years. It's my experience that a lot of physicians aren't that great at being able to take it down to the level of the average person.

Dr. Fialkow:

The doctor rabbit hole, it could be. And as you know, as we prep guests, I say to them, "Hey, listen, it's not a place for you to show off your extreme knowledge. We know it's there, no reason to get technical and start quoting journal articles and whatnot. Put yourself in the role of your patient or a family member." And not all but the vast majority are quite able to do that. And that's how I try to direct them as well if they start going off on tangents.

Dr. Fialkow:

It's just the doctor has knowledge they want to express. And as I said, they're so passionate about trying to connect their knowledge to help people, they sometimes lose sight and focus of what's happening on the other end [crosstalk 00:05:38].

Carol Higgins:

It's true. Communication is two way, but I've found so many impressive guests as we've gone through this in the last couple years, just really impressive people. And it's been a pleasure to hear from them firsthand. So you're a preventative cardiologist by training. You also have the title of chief population health officer for Baptist Health. What is that role? What do you do for that?

Dr. Fialkow:

If I step back, it's an interesting synergy between my cardiology and cardiovascular leadership role and the population health role. And I think the way it evolved is going back to being a preventative cardiologist, that means my job was to keep people away from procedures, not generate procedures, angioplasty, stents, bypass surgeries. Of course, when people needed those, I was certainly going to support them and help them get through it.

Dr. Fialkow:

But in prevention you want to recognize when people are developing certain things that could lead to problems in the future that are preventable and more commonly the patients aren't even aware they're developing those things. So I think that background and that focus in helping people with better lifestyle or avoiding bad things like strokes and heart attacks and heart failure always was primary in my mind as I would more holistically approach the patients, getting into diet, and sleep, and stress, and their activity levels beyond just "Take this pill."

Dr. Fialkow:

I always recognize that I can have an impact with the patient for the 20, 30 minutes of a visit three to four times a year, but they spend most of their life not in front of me in my visit in my office. So my first focus was how, in the cardiovascular space, I could work towards developing processes, programs, apps, support, and just availability and education for patients when they go home and when they're home and help them understand, "Hey, don't worry about that. Don't run to the emergency room. Let's help you recognize when there's a problem, when there's not."

Dr. Fialkow:

And then that led into the population health space, which is not just around a patient that I follow, who needs a cardiologist, but when we're talking about broad populations, employees of the health system, certain populations of certain companies that we have relationships with. So the population health strategy is how we can identify these groups of people and how we can help them apply resources and knowledge to, again, avoid bad downstream concerns. That could be things like mammography screening and colonoscopy screenings to getting sugars under control, to exercise, to treatments for hypertension or lipid abnormalities or diabetes and whatnot.

Dr. Fialkow:

So I think it was evolution of being a holistic cardiologist, looking at the full aspects of the patient's lifestyle, extrapolating that towards the patient's life at home, and then taking it past the cardiology space, into how we can really manage and help populations broadly. And that's my story and I'm sticking to it. I don't know if anyone else feels that way, who works with me, but that's why I think I had that trajectory.

Carol Higgins:

Well, some of those topics that you just mentioned we've covered in the podcast and I'm thinking back through some of the episodes, the very first one was the buzz around caffeine and that one published in February 18th, 2020, some of the other topics we covered really early were back pain, heart palpitations, vaping. And then, and then in the first week of March, we had to take a major pivot because there was a new number one healthcare topic in the world, and that was coronavirus. So what was that like and why was it so important for us to change our focus?

Dr. Fialkow:

My original intent with the podcast, speaking to the broad topics you brought up are the kind of things that, again, people, part of their lifestyle, again, coffee, vaping, "My back hurts," and what's the resources they have to get those questions answered. We don't want Dr. Google and we don't want them using emergency room rooms unnecessarily. And I thought we just keep it broad.

Dr. Fialkow:

I listened back to those, and Carol, you're certainly a help in that. My first goal, if you remember, was I wanted to keep them under 50 minutes. So I was flying. My mom was saying, "Slow down, slow down." And then when I realized that, let's have a better dialogue and see where things go. And I think we evolved in that space. But when COVID hit, we recognized that this podcast was something that was relatively popular and there were people listening to it and thousands at times. And it could be a good vehicle to provide information.

Dr. Fialkow:

I think in general, the podcast, but in the COVID situation in particular, the lack of information drives the anxiety, and the anxiety drives unhealthy behaviors or bad behaviors. We could always talk about the evils of misinformation, which may be worse than not having information.

Dr. Fialkow:

So the podcast became a great vehicle for bringing in experts, and in real time, exploring what we were learning about coronavirus and COVID. And even when we look through the evolution of our first podcast and the topics versus the later ones, man, what have we learned? And what have we been able to adapt and address? And through those COVID podcasts, I love, because again, I think I represent the patient, "Hey, what do we know? What don't we know? What do you think things are going?"

Dr. Fialkow:

And not infrequently we were right and sometimes we were wrong, but the listeners were able to experience it in real time as we were experiencing it, as I was learning, as the guests were with their incredible expertise, learning from the scientific community and from the CDC and from the organization. So the COVID pivot was extraordinarily gratifying in terms of learning and exposing as well as a great example of where a podcast is one of many forum where we can bring information to people, but again, in a way that they wanted and at their convenience.

Dr. Fialkow:

And I would like to think that the ability to have a lot of these COVID-related podcasts, including, again, as we've said, these incredible guests, was part of the way we've got through this. And if we're able to help people be a little more assured, take proper actions, give perspective regarding some of the controversy, we had one on masks and we had one on vaccines and even updates on that.

Dr. Fialkow:

So just where's the controversy out there, but let's get down to what do we really know and what don't we know, and then people can make their appropriate decisions based on that information. I found it again, it was fortunate that we had already had the podcast infrastructure, but wow to take off on the coronavirus and COVID experience was really rewarding.

Carol Higgins:

It was very rewarding. And like you said, you learned from the guests. I know Steve and I, listening and learned from the guests and just overall we found in not just the podcast, but with the blog and other areas, people were turning to us in record numbers to Baptist because they wanted a trusted source. They were confused and they were looking for somebody that they trusted and they wanted to hear from. Any of those episodes about COVID, did any of them stand out in your mind?

Dr. Fialkow:

I get some talk by leaving things out. I think the focus on the myth busting was wonderful. Like I said, masks, vaccines, there were two that resonated the most with me. One was the COVID and kids, the COVID and children, because I think as parents, again, my kids were in their 20s and well, I'm certainly concerned about them through the pandemic. It's not the same level of uncertainty and anxiety as parents who have little kids and kids in grade schools enough.

Dr. Fialkow:

But I think our guests did a wonderful job in exploring that and providing that kind of reassurance. And we touched it in other ones. And I think the ones we did on the behavioral health about the anxiety and stress of COVID, I think those were quite helpful to let people know you're not unique, you're not alone. Let's talk about some mechanisms to help you get through this.

Dr. Fialkow:

And the one that I think was most emotional for me, if you will, was the ones we did on the front lines. We had a lot of Baptist Health leaders, doctors, and nurses. And some of the shared experience of the nurses were just incredibly moving, especially in the early phases of COVID, family members sick and couldn't have family members with them and having to work with iPads and quite frankly, people critically ill and even passing away and alone and how they just were just totally supporting and the incredible work they did under intense pressure. I mean, I still get a little bit choked up when I think about those frontline workers.

Dr. Fialkow:

I think as a leader within the health system, I'd like to think that I was instrumental in adapting and providing resources, even the COVID experience. But I wasn't in that emergency room. I wasn't in that ICU. I wasn't at that frontline like they were. And man, the under-appreciation of those people, if I have to go back on a two year reflection, those episodes were the most impactful to me. So I think the kids, the behavioral support and anxiety and stress, and then the most importantly, the frontline workers sharing their stories and experiences.

Carol Higgins:

I couldn't agree more, those really moved me too. And I know they were very effective and also trying to get out, again, the message that this is serious, take it seriously folks.

Dr. Fialkow:

And frankly, in my practice, and again, I was a cardiologist, but I still speak with people at length and get to know them well, these were the things that people don't know. These were the things that people weren't sure of, these are the questions that people ask and they ask me, and I have family members asking me the same things.

Dr. Fialkow:

And that's, again, the perspective I try to bring, is what would I want to know if I weren't a medical practitioner? And then with my medical knowledge guide and direct certain conversations and directions into certain areas. And I'd like to think that we accomplished those goals for most of the podcasts.

Carol Higgins:

I think so too. Stepping away from COVID, we have covered a wide range of topics and physical, and as you said, emotional and mental health, and in fact, one of the most downloaded episodes was about coping with stress unrelated to COVID. Do you remember that one?

Dr. Fialkow:

Sure, I do. Sure, I do. Sure, I do.

Carol Higgins:

Coping with election stress. Election was huge in that year.

Dr. Fialkow:

And again, I'm sure, you guys, just in your community, a lot of tension, stress aggravation, a lot of confrontation in our community. And as physicians we were seeing a lot of it and its effect on patients as well. And certainly when we brought in Dr. [Rahedi 00:16:22] a psychiatrist, we brought in a lot of support of people to guide people through that. I think that was well received as well. We weren't the only ones, I think there was a lot of stuff going on in the medical community nationally addressing it.

Dr. Fialkow:

But being very focused on our Baptist Health community South Florida and making it more specific versus general, I think was a great success. And as we said, election stress, the stress of election, we talked about not watching stressful news before going to bed, we talked about sleep impacts, staying active, having tough conversations and getting out of tough conversations.

Dr. Fialkow:

And these are real things that people live, but don't step back and say, "What's going on here? Why am I feeling this way?" Or "what do I do about it?" So at least for those listeners and maybe some of their family members and friends who they were able to communicate with, again, I think that was a great topic.

Carol Higgins:

Definitely. Well, we've talked about what makes a good host or what your background is brought to being a good host. So generically, we don't have to call out any names, but what makes a good guest?

Dr. Fialkow:

Again, something I think about, and we know that our guest selection, again, I don't think we've had any guest that weren't incredibly passionate and knowledgeable, and great experts in their field. But some can get in the weeds as we said. I think the idea is that we have to listen to what the question's being asked and know the audience.

Dr. Fialkow:

So the best guests are the one who can engage, can use metaphors and anecdotes to relate to the patient. You may have found et cetera, et cetera. And we haven't had bad guests, but sometimes we do have guests that get a little too technical and it's because their comfort level. It's not inadequacy, it's just, they know it and they want people to understand the level that they understand because they think it'll provide benefit for both getting yourselves taken care of and knowing what's not important.

Dr. Fialkow:

So I think going back to the original question, the best guest are ones that can understand [inaudible 00:18:16] the level of the audience, and just read the audience, which is me, for these in terms of, hey, if I'm pulling in a different direction or this is an audio podcast, but we do usually do them with Zoom. So I'm making eyes or I'm putting the cut sign under my [crosstalk 00:18:30] following that lead a little bit.

Dr. Fialkow:

But as we go through, I think some of that, Carol, quite frankly, is topic dependent as well. We're doing really broad, very general type of topics. The guests we're going to invite are going to have that message. If we're doing something that's really to promote something really wild and cool with doing in one of the institutes of the hospital, which is great, it's incredibly innovative and exciting.

Dr. Fialkow:

But then, again, that might be someone who's a little bit more technical and less patient-centric in how they communicate stuff. So like I said, we have not had any bad guests and I'm not just saying that glibly, we really have not. It's up to the host to make a guest good. So if anyone ever listened to a podcast said, "Boy, that's a real loser," then that's on me.

Carol Higgins:

Well, I wouldn't [crosstalk 00:19:16].

Dr. Fialkow:

Some make it easier than others.

Carol Higgins:

Well, and it's not a natural thing. I mean, you think it is, we're just sitting here talking, but people get self conscious and that's something that is totally understandable.

Dr. Fialkow:

Carol, and I'm saying this to the listeners, because Carol and Steve hear it every time, I give a little prelude to the podcast, to the guests and they always say, listen, you're going to have so much information you want to share. It's very easy in that to just, I'll ask a question and you'll just go on for 20 minutes, let's break it up, let's make it conversational.

Dr. Fialkow:

And sometimes they do and the information can be fantastic. But when it's a conversational tone, it's much more, I'll say, impactful. It resonates with people than when it's just a laundry list of things that they can read on Dr. Google or find on their own. So again, most of the time the folks are incredibly understanding and most of it's intuitive just based on the natural empathy of the guests we've had. Every once in a while I got to earn my pay, which is nothing folks.

Carol Higgins:

Which is nothing. This is part the goodness of Dr. Fialkow's heart. You mentioned that we have been doing it via Zoom. We were always planning and the first few were done in a studio where, so you're sitting more face to face in the same room, which is maybe a little more natural. What are some of the challenges you found of doing it remotely instead?

Dr. Fialkow:

It's a great question. And I think it's always a better experience for both the guest and me, when we're in the same room, there are some non-verbal communications and facially, I could say, keep going with that, it's great, versus, and we're able to do a little bit in Zoom, it's not the same.

Dr. Fialkow:

On the other hand, I think it's enhanced our ability to get guests. Because if you recall at the very beginning, when the guests had to take time off and come into the studio and prep, I mean, seriously, we could bang out a podcast from the guest standpoint in 30 minutes, they log in and 30 minutes they're back to work. So there are benefits in doing it remotely. I would like to think that maybe for some of the more broader dialogue type of ones that we have planned, maybe being in the same room will be a benefit.

Dr. Fialkow:

But I'd say the main limitation is that you don't get that non-verbal dialogue in a conversation as easily as you might when you're in the same room, which is part of a conversation, how the viewers think when they're talking to someone, how often are your eyes closed? You're looking down, how valuable is that? You're looking at the person and you're looking at the responses to what you say, and you're looking when to jump in and when to back off. And it's a little more trying under Zoom.

Dr. Fialkow:

I think we got it down pretty well. But at the same time I could tell you that I'm a little more tired after a Zoom podcast than in person, because the brain's working a little bit harder to follow those cues through a video screen.

Carol Higgins:

Well, as a communication major, I was taught early on that nonverbal communication makes up the most of communication, that's really where you get so much of your context.

Dr. Fialkow:

And that's true actually, we've even done a podcast on virtual visits and using technology. And as someone who does them as well in my practice, it's great because of the access. People don't have to leave their houses, they don't have to get babysitters, they don't take time off of work. They can still have a doctor's visit and not have to go and travel. And why not, you still lose something, especially in my practice where I try to really connect with the patients and get in to the message behind the words. And it's not ineffective, it's just harder. So it does speak towards many areas, not just a conversation that can affect your medical visit as well to some degree.

Carol Higgins:

For sure. So with the 100 episodes under your belt, do you have any thoughts about the future of the podcast? I know you'd probably like to talk about New York sports, the jets, the [inaudible 00:23:06] but-

Dr. Fialkow:

Actually, I don't want to talk about, unless it's to my psychiatrist because it's a thankless group of teams to root for. But one thing I was thinking about and some of this was actually in the original thoughts, but again with COVID and all the things that came into play, we did that pivot, but I think it'd be a good idea to have certain podcast topics that might not be as clear cut. So not necessarily controversial, but I like the idea of having, let's say a topic and we have two guests that have different views on things and it's not necessarily one.

Dr. Fialkow:

So maybe I'd like to have a lot of podcasts diet for example. And we've talked about that. And one of the reasons I haven't is because I don't want a guest to only talk about their understanding and view of a particular diet when it's really not established that there is one diet for everyone. So maybe having more two guests talking about something with different approaches, and to that end, it'd be wonderful if the listeners would be able to send to us topics for, "Hey, I'm not sure about this, I hear this and I hear this, what is it?"

Dr. Fialkow:

And it wouldn't just be me interviewing someone answering a question, but we could have two people with different kind of approaches. So I think that'd be something we'd want to do. I'd like to really continue the prevention stuff. I'm so passionate that people really can just be made aware of certain aspects of their lifestyle or things that are going on that are early signs of things that could be problematic in the future and just helping them identify, and educate, and prevent the problems in the future. I think we're so busy that people don't spend a lot of time thinking about their own health like others might. So that would be something we want to continue.

Dr. Fialkow:

But like I said, if anyone does have any topics, we will jump on finding the right guest with the expertise within the Baptist Health system. I don't think there's anything that we don't have some expertise in and make sure that we're able to articulate the proper questions and dialogue that would be worthwhile for the listeners. I'm sorry.

Carol Higgins:

That sounds great. We'll definitely work on that. So would you like to wrap this up with a message to the listeners?

Dr. Fialkow:

Yeah, absolutely. And certainly I want to give thanks to Carol and Steve [inaudible 00:25:14] who are the two folks that make this enterprise work for me, they're the ones telling me, "Slow down," or "Put your mouth further away from the microphone," or all the tips that would hopefully make for a good podcast listening experience. You guys rock.

Dr. Fialkow:

And to the listeners, again, thanks to the wonderful, privileged opportunity to be able to share ideas, thoughts, and expert information with you on behalf of the Baptist Health family. And as I mentioned previously, please, if you have any comments or suggestions for future topics, email of them to us, Baptist Health Talk at baptisthealth.net.

Dr. Fialkow:

Please give us reviews, hopefully they're good reviews, five stars works. It gives us some feedback. Are we doing a good job? Are we meeting the needs of the listeners? So again, please, Baptist Health Talk at baptisthealth.net. We'd love to hear from you guys. Again, it's been a privilege. Thanks again, Carol and Steve, and thanks for listening and stay safe.

Carol Higgins:

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