A Physician’s Guide to Interviewing | Dr. Bradley Block, MD

Transcript

Dr. Taylor Brana: Shopping for disability insurance is a complicated task and takes too much time for busy doctors. Pattern simplifies disability insurance with a simple online process. You can request quotes, you can compare prices and you can buy risk free. You can be confident you have the right policy and that your income is protected with Pattern. Get started today by requesting your free quotes at www.patternlife.com.

Welcome to The Happy Doc, the voice of fulfilled physicians. Sharing life stories from physicians, health professionals and entrepreneurs, so that you can live your happy life.

[00:00:48] Dr. Taylor Brana: Hello guys, my name is Dr. Taylor Brana and this is another episode of The Happy Doc. I am always excited for my guests, but I’m doubly excited because we are live on Facebook. We’re recording this live, and I have Brad Block with me. He is an otolaryngologist. He has a podcast called the Physician’s Guide to Doctoring, and I’m going to learn so much from Bradley today. It’s going to be an amazing experience, Brad, can you say hi to everyone?

[00:01:15] Dr. Bradley Block: Hi everyone. Thanks so much for watching us. 

[00:01:18] Dr. Taylor Brana: Awesome. Awesome. So Brad, were you speaking to me from? 

[00:01:21] Dr. Bradley Block: My basement on Long Island. Finished my work day, came home, put the kids to bed and here I am.

[00:01:32] Dr. Taylor Brana: Wonderful. So let’s start off on the journey for you. I’m always very interested about why medicine and not some other field? Medicine is crazy hard. You put in crazy long hours, you had to study so much in college, so much in medical school. And then obviously, you went into a surgical subspecialty. So, you’ve been in the schooling process for forever. Why are you so crazy? 

[00:01:57] Dr. Bradley Block: So, it wasn’t for me some like, epiphany moment. And I wasn’t one of those kids that knew for a lifetime that they wanted to be a healer. And I want to call a little BS on those people, because I don’t think anyone should be taking career advice from a five-year-old.

Right. Like, if you knew at five that you wanted to be a doctor and, now like this generation, like Doc McStuffins, like I always wanted to be like Doc McStuffins, you know what? Maybe you should stop and reflect a little bit when you get some maturity and think like, Are there other paths out there? Right.

So I was never that, I was just, I was good at science. Right. So, that was my path. I was a science major. And when I ended up studying abroad in Jerusalem, which is just an incredible city. And so actually, that kind of made me reflect on my decisions. Cause I thought I was going to go into like pharmaceutical sales or something, with the goal of just making money.

Like, you know, I’m good at science, I’m smart, I can be successful at that. And then living in a place like that gives you a little bit of perspective. It can give you a bit of a 30,000 mile view on what’s important. I decided, you know what I do have these – God, it makes me sound really arrogant, but like, I was good at school.

You know, I was good at taking tests. I can do this. So why don’t I, I use this, the skills that I have for you or something more than just benefiting myself. And the easiest answer was medicine, because honestly I just didn’t have the maturity at the time to think of anything else. Like, I didn’t have the prospective outlook on all these other potential careers that were out there. It was a pretty safe path. What’s my next step? Oh, I’ll apply to medical school. I could do that. So I did.

I didn’t have some like prophetic experience. It was fine. It was a bit of an epiphany, I guess, in Jerusalem, that adds a little bit of color to the story.

It was like, it was a pragmatic decision. It wasn’t like I wanted to spend my life as a healer because in medicine really it’s, it’s a pretty safe decision, or at least so we thought before COVID, right, as we’re seeing physicians getting furloughed and getting huge pay cuts. Prior to this, you could find a job. You’re never going to have to worry about having a job as a physician and you know what, you’re still never going to worry. You just might not be able to live in the place you want to live, but it’s a pretty safe occupation. You’re going to have a good income. Fine, our debt is high and you can do all those calculations, but you know what. Ultimately you’re going to be fine. I guess you could also argue, it’s easy for me to say as an otolaryngologist because we’re well compensated. But still, you’re going to have a job, and you’re going to be fine. And you can’t necessarily say that about someone opening up a restaurant or, someone in the creative arts or, you know, lots of other different occupations.

[00:05:06] Dr. Taylor Brana: Yeah. I mean, so it sounds to me like for you, you’re a smart kid. You went through the process. You might as well go for the top or leadership position or something that’s going to take you to that next level. You had that experience in Jerusalem. I’m curious, was there a moment in there, or was it just like you just realized I want to do something a little bit bigger?

[00:05:24] Dr. Bradley Block: No, one of my friends – and Seth, if you’re listening, you remember this – he was applying to medical school. His dad’s a Pediatrician, he’s a spine surgeon now. And he was actually on, I interviewed on one of my episodes for my show a while ago. And, it was like, he’s going to med school? Sure. That sounds, that sounds like a reasonable thing to do.

And I wasn’t like a people person, which is interesting because a lot of what I do on my podcast is the soft skills, like being able to engage with your patients better. Then my parents were like, Wait, you know, you’re going to have to see patients, right? Like a bunch of them per day, and interact with a bunch of people, you sure you want to do this? You know, that’s not really your forte. Like, I was the grumpy metalhead that dressed in black and stood in the corner, not talking to anyone. I wasn’t, I wasn’t the belle of the ball.

[00:06:13] Dr. Taylor Brana: Maybe that’s why surgery is what she ended up going into for a little bit, right?

[00:06:18] Dr. Bradley Block: Oh no. Otolaryngology, I spend about a half a day to a day in the operating room and the rest of it is seeing patients outpatient. In otolaryngology, it’s a lot of – unless you’re a head and neck cancer surgeon where you’re, you’re in the operating room a lot – you’re in the office seeing patients.

[00:06:36] Dr. Taylor Brana: So, I’m curious, when did the grumpy part of you fade away a little bit, or when did you start to really appreciate more of the soft skills? 

[00:06:46] Dr. Bradley Block: So I think those are two different occasions. I think when I was done with residency, I stopped being so grumpy. Maybe it was after high school or after college even, it kind of started to fade. Then once I became an attending, everything got a bit nicer. So for all your trainees listening out there: My grumpiness definitely faded quite a bit when I became an attending. But my attention to the soft skills came later. 

One thing I noticed about my wife is she can float through a room at a cocktail party, hopefully we’ll have those again one day, and at the end, everyone will think they’re her best friend. She just engages with everyone, and is so good at it, and does it so seamlessly, or it would seem she does it seamlessly. She can be methodical about it too. She’s actively trying to do it.

So I saw her doing it and I also saw that some of my partners were able to see many more patients than me an hour. I thought, how are they able to do this? So I started looking into things like social engineering. There are dating coaches out there that teach you how to interact with other human beings when you’re bad at it.

Executive coaches that coach people, but there aren’t really people that do that for us engaging with our patients. So I thought, you know what? There are skills to be taught and people that can teach them, but they’re missing us as an audience because we’re too busy learning other things.

Why don’t I find those people? but I couldn’t find those people without having a platform. So then, I was going to write a book. Never wrote a book. I was going to start a blog, didn’t write a thing. And I was like, you know what? I’ll just ask them. I’ll just start a podcast. And the good thing about the position that we’re in, is we’re surrounded by experts.

Like my friends from, I went to the university of Pennsylvania, very good school, friends from college became experts in their fields, friends from med school, clearly experts in their fields. And actually, for everyone in there, who’s in medicine, like don’t sell yourself short, don’t have imposter syndrome.

You’re an expert. You are an expert in your field. You might not be the world’s expert. And I think we kind of get bogged down on that sometimes. Like, I didn’t write a textbook on the subject, so I’m not really comfortable. I’m not really the expert. You have an MD. You talk about this stuff all the time. You’re an expert.

So, that’s how I started with the show and now I get to call strangers and ask them things that I want. And sometimes they are willing to appear on my show. I’ve got one that I’m super excited about. Sorry I keep plugging my show. One coming up. Not sure if you’ve heard of him, he’s in your field, you might have, he’s a behavioral psychologist.

His name is BJ Fogg. He wrote the book Tiny Habits. 

[00:09:40] Dr. Taylor Brana: Yeah. That name definitely sounds familiar. I’ve definitely heard of that book before.

[00:09:45] Dr. Bradley Block: I’ve heard him on podcasts that get like, hundreds of thousands of downloads, mine currently gets a few hundred, and I emailed him and I made an argument for why doctors need to learn from him. And he’s like, yeah, that’d be great. I’ll do it.

[00:10:00] Dr. Taylor Brana: You bring up such a good point, which is, and I don’t think people realize this is, people love to be promoted and people love to talk about their subjects. And honestly, whether you have a huge podcast or even a small thing, if you have a niche, if you have a group that you’re providing to? People want to talk about it.

I love when people ask me to hop on, it’s super fun. I don’t know if that’s the same with you, but, you readily wanted to come on the podcast. So, I think it’s just a fun interaction and I’m very excited to actually, I’ll have to listen to that episode. 

[00:10:28] Dr. Bradley Block: It’s like Dale Carnegie, right? The sweetest sound is the sound of your own voice. There are few things I like to talk about more than myself, and then ask any parent, they’ll talk forever about their kids. 

[00:10:39] Dr. Taylor Brana: Absolutely

[00:10:40] Dr. Bradley Block: Yeah. So I don’t think it’s hard. But, still, when someone’s super busy, they need to be strategic about their time.

[00:10:49] Dr. Taylor Brana: Yeah, absolutely. So, tell me more about the podcast. Obviously, you’ve gone through this process. You mentioned you had some ideas, doing a blog, writing a book, you ended up on podcasting. How did you sort of stumble into this sort of concept? How long have you been doing this for? and what has this experience been like for you?

[00:11:09] Dr. Bradley Block: Well, so in order to find the time to be able to do it, because I put it off for like two years, I’m going to do it. I’m going to do it. I’m going to do it. And then it just never came to fruition. And it wasn’t until my second son was born that I was like, Oh, now I’ve got all this free time. I mean, it was kind of the opposite.

But what I did is I took the free time. I decided rather than going on a paternity leave, I would just work four days a week instead of six days a week. I still haven’t gone back to working weekends and now, even one kid later, I don’t know if I ever will, well, I don’t know. We’ll see. But I went from six days a week to four days a week.

So that one work day, at some point the two kids were napping and I could just sit down and do it with no distraction. So, that gave me the ability to actually sit down and start recording, carving out some times. And that led to evenings and, and I was fortunate enough at the beginning.

I didn’t know anything about podcast editing and thankfully I never will because, one of my wife’s best friends is a professional voiceover artist and she’s like, sure. I’ll edit it. Like I do this stuff all the time. It’ll be super quick. I love podcasts. It’s the intersection of my favorite things. And so she started editing the podcast, which was a huge pain point and that let it start happening. And I just, I started out with experts. My first three episodes were, one of my friends from residency, his wife, one of my friends from medical school is Program Director of GI.

And then my brother, who’s been on my show three times cause he has a PhD in health policy and he wrote some of the Affordable Care Act. So, I think something that we all have to realize is that we are surrounded by experts. We’ve put ourselves in a position in life that we are surrounded by experts and that’s something that you can leverage.

[00:13:05] Dr. Taylor Brana: That’s great. So it sounds like once you really decided to go for it, the pieces fell into it right away. I’m curious, after starting it, do you feel like you’re kind of kicking yourself you didn’t start a little sooner?

[00:13:19] Dr. Bradley Block: Oh yeah. It’s the analysis paralysis that we all get. It’s gotta be perfect. And whenever someone asks for podcasting advice, the answer is always: just start, just make an episode. Just make an episode, and if it’s terrible, you will have learned a ton from just sitting down. Cause you’re, at some point, you’re going to have to hit record.

Okay. What do I need to hit record? Okay. I need a mic. Well, do I need a mic? Okay, we’ll get this, fine, I’ll just buy this mic. Like, I’m just going to buy it. Then like, what platform? Oh, I need a media host. Okay. Now I’m going to get a media host.

Dave Draghinas who’s the host of Doctors Unbound, he and I spoke and he said, well, at the beginning I just took a webinar. Oh, I should’ve done that. Cause then like, all of those answers are just in one place. You can kind of cobble them together from different parts of the internet for free, or you can just, pay for a webinar and then they have all the answers and, and then you could always change things later on.

[00:14:18] Dr. Taylor Brana: Yeah, absolutely. You bring up a really good point around fear in general. I mean, the fear aspect of doing this and putting yourself out there. Quite honestly, I just realized people don’t have the attention to focus on just you. You’re not that important. Like, yes, you’re kind of important, but when you put content out there, just have fun, do a good job. Start the process. It’s really not a big deal.

And then, you also mentioned something along the lines of, you can kind of figure it out as you go. It doesn’t have to be perfect right away. You don’t have to have all the tools. You don’t have to do anything crazy. Obviously, I’m sure you’ve found a utility from podcasting. Clearly, if it wasn’t a process that was enjoyable for you, if you weren’t getting something out of it, you wouldn’t continue. So what are some of the aspects of your journey doing this thing? What have you found fulfilling about the process, or, what are some things that you’re really getting from this?

[00:15:10] Dr. Bradley Block: Well, one is I’m part of this community, right? That you’re a part of. We know a lot of the same people, even though you and I have never met face to face, we’ve certainly interacted many times, that we know who each other are. And we have this, this community of podcasting physicians, this community of online physicians. And so it’s just another circle of acquaintances, friends, colleagues, which is great. You’re part of another tribe that you wouldn’t have been otherwise. And what I really seek to gain from it is, is improving my own abilities.You have to know who your audience is.

My audience is really me. Like, I’m my avatar. I’m the person that I’m speaking to. I’m the person that I’m interviewing for. And so I get people on the show that have questions that I want answered. And so, even if they might be an expert in something that’s a little different, if I’m the one writing the questions, they have to be something that I’m genuinely curious about. And so I’m looking to improve.. That’s what the podcast is about. It’s like personal development and professional development for physicians. What do we need to do? What do we need to learn, to be better physicians, community members, professionals, business owners, everything that comes with being a doctor, personal finance – and I certainly don’t claim to be an expert in that.

[00:16:49] Dr. Taylor Brana: There is a lot. Yeah, for sure. 

[00:16:53] Dr. Bradley Block: I have [finance experts] on my show to just, you know, see what their major points that they want to get across are.

[00:16:59] Dr. Taylor Brana: You brought up a really good point there, which I really want to highlight, which is the fact that you’re doing this also for your own enjoyment, right? You’re kind of doing this for your curiosity. You’re doing this to ask the questions that you want. And I think that’s really important to highlight, because especially with physicians and physician burnout, a lot of times, one of the reasons we’re burnt out is we don’t have autonomy.

We don’t have freedom. We don’t have the ability to express ourselves. We don’t have something that’s fun for us. And this is one of the things I love to highlight about podcasting specifically, is when I do this, you know, I can probably say the same thing for you, I really enjoy this process. I’m loving, just talking to you right now.

Right? We’ve never talked. You’re kind of like a new acquaintance or friend. I’m learning about you and learning about your style and what you do. So I, like you said, I ask questions because I’m literally legitimately interested and this is fun for me. And so, you get to build that out for yourself. And that totally locks in to one of the key points of The Happy Doc. To find different opportunities to make us happy, to make us more fulfilled. Do you find that this has been a key component of your fulfillment? 

[00:18:08] Dr. Bradley Block: Oh yeah. So, it wasn’t like a fiscally savvy decision to start a podcast, because if I had spent this time seeing patients, I would be making a lot more money. Maybe not a lot, but this is not a business decision. I’m doing it to scratch an itch, really. But on the other hand, there are things that I’m learning that I take. Personal finance, that financially will make sense. And also, my professional development, I feel like there are things that I take back to the exam room that allow me to connect with my patients better, which then makes me more popular, which makes my schedule busier, which then does end up paying for the time that I spent. It’s not an economic calculation, but I think it’s paying off. It’s certainly paying off after COVID, because as New York is slowly getting back on its feet – our practice, we were really, really slow. We closed for a month, we were only seeing emergencies.

We’re now opening back up and I’m seeing my practice ramp up quicker than I think it otherwise would have, would I not have learned the skills from my guests to better engage with my patients. 

[00:19:32] Dr. Taylor Brana: Yeah. 

[00:19:33] Dr. Bradley Block: Make them into evangelists. 

[00:19:35] Dr. Taylor Brana: You brought up a couple of good points that I want to talk about. A couple of things you brought up, but one thing is the skills.

What are some impressive skills or maybe, obviously there’s a huge list. I know you have a whole podcast on them, but what are like a couple of tight takeaways that you’ve gotten from your podcasts, maybe that you wouldn’t have realized? and how have you been maybe able to apply them, or what’s something you’ve taken away from the podcast?

[00:19:58] Dr. Bradley Block: Well, there’s one that you’re actually illustrating and are really good at. right now. I did an interview with someone who, nonverbal communication is his area of expertise. So he actually teaches nonverbal communication for poker, to win at poker. And he’s also consulted with physicians before in hospitals on conveying and interpreting nonverbal communication.

And I had him on the show to talk about communication from behind the mask. Now that we’re all masked, our patients can’t see – our patients can only see half of our face. So if we’re smiling at them, they’re not able to see that. If we’re frowning, or if they’re frowning.

So, we’re missing a lot of the cues. So I talked to him, and one takeaway – and I’ve actually spoken to him before. I found him and hired him to lecture to my group once quite a few years ago – and one of the big takeaways was, it’s really just here to here that you really need to focus on your own nonverbal cues.

So, when you’re listening to your patient, it’s really important. I have a tendency to do this, furrow my brow, like I’m concentrating, but this can be misinterpreted as like, he’s upset. Really like squinting more. I don’t know. Now that I’m seeing myself, maybe I should have tried this in the mirror before I do it with my patients.

[00:21:33] Dr. Taylor Brana: This is live, guys. 

[00:21:35] Dr. Bradley Block: But, concentrating on this, to let them know and the thing, big takeaway, and I’ve heard this before and I really liked the term, is being present. And his point is, you can’t fake being present, just be present. So in med school, I remember learning like, listen, make sure you’re listening. Be a good listener. Listen, listen, listen, listen. But like being a good listener, fine. It’s not something you can concentrate on. But being present, at least the way I interpret those words, being present is something that you can concentrate on. So like, don’t be distracted. Don’t be looking at your computer, right?

Look at them and be present. Focus on what they’re saying. Don’t be distracted. Don’t think about the last patient. Don’t think about the schedule. Don’t think about the next patient. Don’t think about what’s going on at home. Just be present with your patients, and you can’t fake that, they will pick up on that a lot of the time. They won’t pick up on it all the time. There’s some patients that are so in their heads that you can sit there and type on your computer and they’ll be talking and talking and talking, but I wouldn’t assume that that’s happening. You really have to be present, and you know, squint rather than not, or furrow your brow. So let them know that you are present. 

[00:22:57] Dr. Taylor Brana: Well, you bring up a really powerful point. And I want to highlight this because a lot of times, some of my patients, and, and you obviously know this, one of the big things that you can do when you’re interacting with patients, that’s really effective, is literally to grab the chair and sit down, right?

Because that already exhibits a form of, like you said, nonverbal communication  which says we’re on the same level. I’m with you right now. You’re making eye contact. And that just calms the situation. But what I’ve noticed is if I just, like you said, be present with patients and it doesn’t even have to be a long time. It just has to be quality time. A lot of times they’re like, wow, you’re such a good doctor. Wow. You did such a good job. 

[00:23:39] Dr. Bradley Block: It makes it feel like a long time. Perception is reality. So if you sit down and you’re present, it really makes it feel like the visit is much longer than it is. And for all the people that are like, Oh, I don’t have time for that. It actually makes your time more efficiently used because they’re less likely to feel like they have to repeat themselves. And it just, I think it makes the visit go a lot smoother and ends up, you know, it’s a small investment in time in the front end is going to pay off in the backend.

[00:24:07] Dr. Taylor Brana: Well, it’s very paradoxical because you’d think that if you’re in a rush and you’re trying to ask all these questions fast and get all this data information, you’d think it’d be more effective. But in fact, a lot of times when you rush. They feel rushed. They might not actually give you the proper information.

Maybe you miss something. Maybe there’s going to be a clinical error based on the fact that they said no to a question, the review of systems, might’ve been actually a – you know, all of this stuff, as opposed to chilling out relaxing, being with them, letting them feel comfortable. You know, obviously in inpatient units and all that stuff we do have, there is a pace to it obviously, clearly in New York, that pace is going to be faster too, I feel like. But, um, but yeah, I think it’s a really good point that you highlighted.

[00:24:51] Dr. Bradley Block: And if you can get the diagnosis, like, for something that I see a patient comes in with dizziness. Oh yeah? When they lie down and they turn to the left side, they feel the room’s spinning for like 10 seconds.

Right. That is classic benign paroxysmal positional vertigo (BPPV). All I need to do is do a – for all you med students out there, look this up – do the Dix-Hallpike maneuver, which is where I lie them down and turn their head to the side, I can see the rotary nystagmus. And then I turn that into the Epley maneuver. I fixed their dizziness and they’re out the door and I can do that in five minutes. 

[00:25:23] Dr. Taylor Brana: It’s one of the coolest things 

[00:25:25] Dr. Bradley Block: and it’s, I’m like a magician. Like, I love that diagnosis because they leave there and they’re like, [gasp] No medicine, no surgery, and they’re great. They’re a little off for a couple of days. They feel a little foggy, but it’s one of my favorite diagnoses, because they’re like, you’re a magician. But, if I take just a little bit more time to hear their story, if I take a little more time with the explanation, if I’m not rushing, then on the backend, they’re gonna be like, he listened. Not only did he fix my problem, but he really listened and he cared about me. That’s the person that’s going to go on Facebook and every time someone goes, Hey, in their town, I need an otolaryngologist. Does anybody know anyone in Garden City, New York? Does anybody know anybody in Nassau County, in New York? They’ll be like, Oh, Brad Block, you got to see him.

Certainly I have my fair share of bad reviews. Look up my Google reviews. Not everybody loves me. In fact, Google has a search of keywords that repetitively pop up in your reviews and sarcasm apparently pops up a lot in my reviews, which can be interpreted a couple of different ways, like my patients either like my sense of humor, and sometimes I maybe overdo it a little bit, but I try to learn from it. I’m kind of bobbing and weaving. I’m trying to like, did they think that was funny? Did they think was that a little too much? Maybe I’ve got to pull back a little bit. I’m constantly trying to interpret their reactions as well. Some people are like, this is my style. and if they don’t like it, they can suck it. I try to make sure like, yeah, fine. It is my style. 

[00:27:16] Dr. Taylor Brana: I mean, look, realistically, we’re all people, we all have different styles. We’re all interacting differently. There’s just going to be, and this is the thing we have to always realize, like, there’s not a human that everyone’s going to like. There’s going to be a portion of the population that are just, they’re just going to hate you. And it just doesn’t work. And that’s something I’ve learned in psychiatry, definitely, just learning about groups and learning about individual interaction. There’s just different personalities. And like, your style is going to be hilarious for some people. Like, I think you’re funny just by who you are.

[00:27:48] Dr. Bradley Block: Oh, thank you.

[00:27:49] Dr. Taylor Brana: No, I am really saying, I’m smiling and laughing the whole time and I’m authentically doing that because I think you’re a funny guy, but some other people are just going to be like, He needs to not do that sarcasm thing. Very like, concrete people that don’t like that like lighter stuff. But look, there’s lots of different people in this world and it is what it is. 

[00:28:08] Dr. Bradley Block: I heard someone, I can’t remember his name. He’s the author of The Dip [Seth Godin]. He’s a marketing guru. And he said, don’t look at the one star Yelp reviews, never look at the one star Yelp reviews. You know what? That’s not your audience. They shouldn’t be eating at your restaurant. If you really want to get a good, like, slice of maybe some things that you can improve on, look at the three, maybe the four star Yelp reviews. Right. But you look at the one star reviews. That’s not your audience, because you’re never going to make them happy and they shouldn’t be coming to your restaurant and, you know, to some degree that’s right.

But in medicine it’s a little different because it’s not a restaurant. I really think you should reflect on those reviews and not just be like, ah, this is a crazy person. Like you should think, Was there something that I could have done better to not have this person and have that experience?

And sometimes the answer is no, you know what? I practiced good medicine. And maybe it wasn’t the outcome that they’re looking for, or maybe it was like, maybe I did miss something. Maybe I didn’t. And they were just, I don’t know, looking for antibiotics and I wasn’t giving them their antibiotics. But I think there is an opportunity in those reviews to reflect and say, is there something that I could have done better?

[00:29:30] Dr. Taylor Brana: And I think that’s like, you know, we could have a whole hour conversation about this, but I think what you just said is a great sign of an effective leader and physician is self-reflection. Because the self reflection piece, regardless of whatever it is that you do, number one, self reflection is just so powerful to improving your operating system and how you think about things.

But number two, and I think also very powerful for leadership, there’s a great book called the Culture Code and it talks about this for great leaders, it’s the aspect of using the self reflection process and then sharing the vulnerability to a group to let them know that, Look, I make mistakes too. This is what I learned. And what other vulnerabilities, or what other things can you guys share that you guys made mistakes from, and how can we grow in this process together? It’s one of the key components of a great leader. So, I love that you shared that. That’s awesome. And for anyone listening, I would say to improve your leadership skill, please. Talk about some uncomfortable stuff. It’s okay. We’re human. It’s fine. 

[00:30:39] Dr. Bradley Block: And the humility I think is important there, it’s important to have the humility to recognize that you will make mistakes and they’re an opportunity for growth. 

[00:30:48] Dr. Taylor Brana: Something that I wanted to go back to. You mentioned earlier that it was a point you just kind of made on the side, but I think it’s just for listeners who are not clinicians, I’m not in New York. I’m in Philly. So, what I’d like to ask you is COVID in New York has been a very different experience in general. Now in a surgical subspecialty, like you, and specifically with otolaryngology, I’m just curious, how did that really affect what you were up to with medicine? 

[00:31:16] Dr. Bradley Block: So. It’s interesting. Once things got bad, my practice – we shut down. So we still had offices open, we did telemedicine and we shunted all of the patients to a few offices in order to minimize everyone’s exposure. So the thought was like, everything needs to be shut down. We can’t have people in the waiting room. We can’t have people exposing our staff and exposing other patients. We can still take care of emergencies because we don’t want to leave people hanging, but we’ll handle everything we can over telemedicine at least temporarily and then go from there.

So, I was on call for my hospital that week. So, that means that any otolaryngology emergencies I get called for. I got called once the entire week. And the reason was, it was all COVID, all the time in the hospital. Everything dried up, apparently strokes, heart attacks, appendicitis, peritonsillar abs disease, bad nosebleeds, everything dried up, except for COVID, everything that they were seeing was COVID.

Maybe they were staying home because they were afraid to go to the hospital and suffering in silence, maybe, for whatever reason, it was some phenomenon that, from everyone sheltering in place, a lot of those pathologies just didn’t come to fruition. But, you know, our role as an otolaryngology in an inpatient setting would be really limited.

I think trachs on COVID patients is really the only thing. And in my hospital, there’s an inhouse head and neck cancer specialist who does most of the trachs. And so I wasn’t called upon, and that was it.

From an outpatient perspective, the anosmia I think is the big thing that we’re seeing. We are seeing patients that it became apparent early on that anosmia was one thing that happened, especially in younger patients. And sometimes it was the only symptom that they would have of COVID, and it comes back the overwhelming majority of the time. We are seeing patients now where it’s not coming back.

[00:33:36] Dr. Taylor Brana: How about the, I forgot the exact name of it –

[00:33:41] Dr. Bradley Block: Dysgeusia. It’s not happening. So the reason is, most of your taste comes from your sense of smell. You have five different senses of taste.

It’s salty, sweet, sour, spicy and umami, which is the savory, I’m sure I’m mispronouncing that, the savory flavor. So those are the five colors of flavor that happen on your tongue, and everything else is sense of smell. So, they feel like they don’t have a sense of taste, but it’s because they just have a completely absent sense of smell.

And so there’s no depth to any of the flavors that they’re tasting. It’s just, maybe a little sweet and a little spicy and that’s it. Now, we do have protocols that can help them. There’s something called smell retraining. And it seems like the mystic arts, because what you do is you smell things like coffee beans, and actually we recommend essential oils.

This is the only time you’ll ever hear me recommending essential oils. But, what you do is you, you visualize –

[00:34:51] Dr. Taylor Brana: wait, what flavor of essential oil?

[00:34:52] Dr. Bradley Block: We don’t recommend, I mean, I think our protocols might, I actually have a handout for the patients and I don’t remember off hand what flavors we’re recommending, but we are, but they have to be familiar flavors, because what you try to do is you smell it and you try to think about what it smelled like.

You’re trying to reestablish the connections between your smell receptors and your brain. And actually, and we had those from before we had this protocol from before COVID, but it is just becoming more popularized now because it is a phenomenon, post-viral anosmia, you would catch a cold and then your sense of smell would just vanish.

And so this was something that we’ve seen before, and it’s a safety issue too, because you can’t smell smoke. You can’t smell if your food is rotten. So, it’s important, and so this visualization thing actually helps. It actually helps, it’s amazing. And so that’s mostly what we’re doing, and then maybe some nasal steroid sprays on top of that.

[00:35:52] Dr. Taylor Brana: Very interesting. Again, anosmia is just such a common symptom with what’s going on and I didn’t even realize that there was an option in terms of retraining so that you brought something to awareness that I wouldn’t even even thought about. 

[00:36:09] Dr. Bradley Block: Come see me in the office, Garden City, Long Island.

But yeah, we do, and this is one of the fortunate things about being part of my practice. So my practice, I’m going to plug the practice here, it’s called ENT and Allergy Associates. We are the largest ENT practice in the country. We’re actually, I think about five times bigger than the second biggest practice in the country.

We’re over 200 physicians. We’re ENTs and allergists, but we’re mostly ENTs. Because the practice model is every office has a bunch of ENTs and one allergist. And so we’ve got this listserv and if someone has a question, you’re just going to email 200 physicians that have the same specialty, same two specialties. And say, Hey, does anybody know the answer to this? And inevitably, you’re going to get some answers. It’s a great way to crowdsource information.

And I remember I got an email about an anosmia right before I saw my first COVID patient with anosmia in the office. And they had no, I just like I, had no idea. They had no idea that they had COVID, they had no idea, and we couldn’t get them tested because it was New York at the onset, where the only way you could get tested is if you almost definitely had it, or like the question was, do you need to be admitted to the hospital, where we could only test the sickest of the sick. We couldn’t get tested.

Back then, we’d just tell, I had to tell people with symptoms of COVID, you have to quarantine.

[00:37:47] Dr. Taylor Brana: I think something that’s so amazing about what you said was 200 ENTs in this one location? It’s I just think that’s fascinating 

[00:37:56] Dr. Bradley Block: Well we’re 44 offices.

[00:37:47] Dr. Taylor Brana: Oh, okay.

[00:37:58] Dr. Bradley Block: We’re 44, spread, New York is humongous, North Jersey. It’s upstate.

[00:38:05] Dr. Taylor Brana: But you guys are all still connected, which I think is really interesting from an attending perspective, especially like a new attending, because you just have such a huge resource of knowledge at your base. So, if you ever have a question, like you said, you just float it to the group and then you have the collective wisdom of all of these ENT specialists. So I think that’s an awesome experience. 

[00:38:28] Dr. Bradley Block: Yeah. It’s super beneficial. It is. And, remarkably, we’re not flooded with emails.

I mean, in some ways we are, but like questions like that, it’s not like there are tons of questions and statements constantly flying around. People are pretty judicious about using the – cause what you’d probably do is you’d probably go around to your office, right? Like the other, your other partners in your office, which you might have like three, four, seven, eight. And if they don’t have the answer, then you know, then you, then you float it to the larger group. 

[00:39:01] Dr. Taylor Brana: Wow. Well, Dr. Brad, I think we definitely need to have a round two and technically we might actually have a round two later, but, what I’d love to just have you offer at this point is, was there any question or any thoughts that you wanted to provide to the listeners today? Something that I might not have asked you? 

[00:39:20] Dr. Bradley Block: I guess my epiphany moment in my career.. I’m in private practice, clearly. So what happened was, high school, you work real hard to get the best college you can, you work real hard to get into medical school. Maybe it takes some time in between, you work real hard in med school so you can get to the best residency program, then maybe do fellowship after that. And then you get your first job. And I did that, and I looked at my two exam rooms and I was like, this is where I’m going to spend the next 40 years. Like, I hung up my diplomas on the wall and I was like, okay, what happens now?

There was no next step. Like in academia, fine, you can be an associate professor and then assistant professor and then full professor and then department chair, and you want to climb that ladder, if you choose to. But in private practice, like yeah, fine, I made partner but that, that wasn’t, you know, there was no like – that didn’t change my life. I was still just seeing patients in the same place every day. And so what, one other thing that the podcast brought to me was, it a way to develop myself professionally, such that those two rooms, those, you know, eight walls, weren’t so claustrophobic anymore.

It was a way to, to branch out and continue to improve myself. And I think that’s important, to have some type of creative outlet beside the things that we do every day. And I’m sure, you might’ve mentioned this on previous shows, you’ve got so many episodes. Things like Nobel laureates are more likely than their colleagues to play an instrument or speak multiple languages or something like that. Like having something that is for me, it is related to my profession, but something that’s either peripherally related or completely unrelated that, I think, it’ll help you professionally. Even if it doesn’t seem like it would. 

[00:41:27] Dr. Taylor Brana: I love what you just said. I’m not going to even say anything more. I think what you alluded to and what you talked about is very true and I’m excited that you took that on yourself to do this creative process. Dr. Brad, where can we find you? 

[00:41:44] Dr. Bradley Block: So the website is physiciansguidetodoctoring.com. And from there, it’s a jump off point for a bunch of podcasts platforms. It is nothing but a website to access the podcast. I don’t have a blog. I don’t have anything else, it’s just a podcast, but physiciansguidetodoctoring.com is where you can find it. I’m on Twitter @physiciansguide, where I will basically just tweet out my episodes and very little else.

It’s just about the podcast. So please find me there. Download it, leave a nice review. Leave a nice review for Dr. Brana’s episodes too, please. And, thanks a lot for having me. It’s been fun.

[00:42:32] Dr. Taylor Brana: That was great. We’re definitely going to have to talk some more. I’m very excited to meet you through a live Facebook feed while we’re recording, I think it’s super cool. This was my first time, I know it was your first time, really doing this live. And I thought that was a lot of fun. 

[00:42:46] Dr. Bradley Block: Yeah, a lot of fun. Thanks, great interview. 

[00:42:50] Dr. Taylor Brana: Thank you.

And that’s the episode for today. I want to thank you so much for listening to the Happy Doc Podcast. Again, this is a podcast that is going to inspire you as a physician, as a health professional, as an individual to be fulfilled in your life, so please look out for the other episodes in The Happy Doc. If you enjoyed today’s episode, please leave a five star review on the podcasting application of your choice. You can also reach out to us by emailing the happydoc1@gmail.com. I’ll see you on the next episode.