141. Kendalle Cobb, Medicine Woman

Show Notes:

Kendalle Cobb, a family physician, has been practicing in Cleveland since 2004. She graduated from George Washington University School of Medicine in Washington, DC and completed her family medicine residency at Kaiser Foundation Hospital in Fontana, California. After a year in Boston, she returned to serve on the faculty at her former residency program. She met her husband, who taught at a boarding school in Claremont, California, and after they got married, they moved to Cleveland to be closer to his family.

Family Physician and Physician Advisor

Kendalle shares that family medicine, as a primary care specialty, takes a more holistic approach with the inclusion of counseling and a “cradle to grave” mentality that follows the patient through different stages of life. She sees patients 50% of the time in a family health center in the community. The rest of her time is spent as one of the associate chiefs of staff and as a physician advisor at Cleveland Clinic Lerner College of Medicine, a five-year program that trains students to be physician investigators, focusing on research, scholarship, personal and professional development, and reflective practice. The physician advisor attests to the students’ competency report is representative of the feedback that the students receive.

Supporting Medical Students

Kendalle talks about working as a physician advisor. She shares what she has learned in this role. One aspect she has realized is that people are often used to being self-sufficient, making it challenging to ask for help or to work in collaborative environments. She explains what some students struggled with in terms of peer-to-peer interaction, challenges of the assessment system, and accepting that there will always be areas of improvement. Kendalle helps normalize expectations for students. She also talks about the connections between her work as a physician advisor and as a family physician.

The Partnership Aspect of Medicine

When Kendalle first thought about becoming a doctor, she initially had an idea of being able to fix things, but now she appreciates the partnership aspect of medicine where she accompanies people along their path. She mentions that there is often a difference between the textbook ideal treatment and what’s best for the patient in front of her. She explains that medicine is a team sport, and group work requires trust and collaboration, and while she didn’t like group work in school, she realizes that, in medicine, no individual can do everything, and doctors rely on others to answer phones, send messages, and process refill requests. By understanding and addressing these challenges, doctors can help their students navigate the challenges they face and become better doctors.

Counseling and Family Medicine

Kendalle talks about how family medicine and her approach to counseling has evolved over time. During her residency, one afternoon a week was dedicated to mental health, in addition to didactic sessions, she had two hour-long patients, supervised by a family physician and psychiatrist. Over the course of her residency, she had an increasing number of clinic sessions to see an increasing number of patients with various physical and mental health concerns. She learned that some people just want to share their feelings without wanting to change anything. She shares a story of a patient who was upset about a situation, and although their conversation was not health related, it helped Kendalle support the patient in figuring out next steps. In addition to counseling, she also learned to use tactical phrases and questions to help patients make decisions that align with their goals. This approach allows for more effective communication and understanding of patients' needs and concerns.

Creating a Safe Space for All Patients

Kendalle discusses the importance of understanding and addressing various health issues in healthcare settings. She shares her experiences with the stub toe theory, which is really "broken arm theory,"  which is when a doctor attributes any concern with which a patient presents, to some other risk factor (smoking, obesity, gender identity). She also discusses the importance of considering factors that can affect health in interacting with patients. She shares a case of a woman with previously well-controlled blood pressure whose blood pressure was high. Kendalle uncovered a social stressor.  Kendalle emphasizes the need to consider different priorities and the reasons behind people's decisions regarding their health. She avoids asking the question "why" and instead asks "what factors contributed" to the patient's decision or thoughts about their health issues. This approach helps patients feel less defensive and allows Kendalle to better partner with patients to manage their health.

Confidentiality in the Doctor’s Office

Kendalle explains that she is often the doctor for more than one generation in a family,  and she shares a story that stresses the importance of confidentiality in the doctor's office. She also talks about how difficult it can be when extended family members want to become her patients, but the fact that the family entrusts the doctor with their loved ones is special. She also talks about the trust, gratitude, and grace shown by the patients, and how these are the moments that stay with her.

Influential Harvard Professors and Courses

Kendalle mentions history professor Michael McCormick, who helped her develop confidence in analyzing primary sources from medieval and early modern Europe. She also mentions fundraising for CityStep by organizing a formal event in Memorial Hall.

Timestamps:

01:26: Kendall Cobb's Career Journey 

02:28: Understanding Family Medicine 

04:12: Teaching and Advising at Cleveland Clinic

05:40: Learning and Adapting in Medical Education

12:02: Counseling and Patient Interactions 

13:57: Handling Patient Health Issues

25:21: Patient Relationships and Trust

29:10: Personal Life and Interests 

31:33: Harvard Memories and Influences 

Links: 

LinkedIn: https://www.linkedin.com/in/kcobbmd/

Featured Non-profit:

The featured non-profit of this week’s episode is the Houston Learning Network recommended by Huang Quan Vu who reports: 

“Hi. I'm Huang Quan Vu, class of 1992. The featured non-profit of this episode of The 92 Report is the Houston Learning Network. HLN helps Houston area educators grow their practice and transform their classrooms by providing funding and support so they could attend in person professional development at Harvard, participate in virtual Harvard educational programming from Houston and learn from Harvard educators who passed through Houston. I was a founding member of HLN, and I'm currently the Vice Chair of the Board of Directors. You can learn more about their work at Houston learning network.org, and now here's Will Bachman with this week's episode.”

To learn more about their work, visit: HoustonLearningNetwork.org.