In this special episode, Chief Operating Officer and Co-Founder of Panacea Financial and practicing physician, Ned Palmer, MD, MPH, takes the guest seat to share his unique journey through medical training. He and Dr. Michael Jerkins dive into the often-overlooked realities of becoming a doctor—from the evolving role of medical ethics in education to the complexities of student debt and inefficiencies of residency training.

If you knew the financial burden of medical school, would you still pursue it? Is the current structure of residency training efficient or disparaging? Can integrating ethics into medical education create more well-rounded physicians?

Join us as Dr. Palmer reflects on the shifting role of doctors in patient care, the haunting moments from his training, and even his past life as a bicycle cab driver. This is a conversation you won’t want to miss!

Here are four takeaways from the discussion with Dr. Ned Palmer:

1. Residency Is the Only Time with Protected Work Hours

Dr. Palmer highlights a common misconception: while many are aware of residency work-hour restrictions, few realize that this is the only phase in a physician’s training where such protections exist. Before and after residency—during medical school, fellowship, and as an attending—physicians often work longer hours without formal limits.

2. Medical Debt Is Higher Than Most Expect—and Poorly Understood

Dr. Palmer shares his personal experience with medical school debt, which ballooned from an expected $250,000 to over $400,000 due to interest accumulation during training. He emphasizes how many students underestimate the long-term financial burden and how little guidance exists to help them make informed decisions.

3. Medical Ethics Education Has Evolved—and Empowered Physicians

A major shift in medical training has been the integration of ethics as a core competency. Dr. Palmer notes that this shared ethical language allows physicians to engage more confidently with ethics boards and advocate for patients, transforming ethics from a punitive concept into a collaborative tool.

4. Humility and Teamwork Define Modern Medicine

Reflecting on his journey, Dr. Palmer admits that his younger self overestimated the physician’s role in patient outcomes. He now sees healthcare as a team effort, where nurses, techs, and other staff often have a greater day-to-day impact. This shift in perspective underscores the importance of humility and collaboration in clinical practice.

Transcript

Ned Palmer:

I cringe for multiple reasons because I’m so disappointed—like the field of medicine, that that was an acceptable practice, that you can only learn and teach people by humiliation. I cringe at myself for accepting it, from being in a position of having so little power—or the perception of having so little power.

Michael Jerkins:

Welcome back to another episode of The Podcast for Doctors by Doctors. I’m Dr. Michael Jerkins, your host. And actually today, I don’t have a co-host. Technically, I have a guest—Dr. Ned Palmer. Very excited to be able to interview him. He has no idea what questions I’m going to be asking him. We’ve spent a lot of time together over the years, both as co-residents and co-founders. But I tried to change it up and ask him some things that even I don’t know the answer to.

If you don’t know much about Ned, you will after today. Not only is he a physician, but also a world traveler, pilot, and he’s sailed across the Atlantic. He does all these really interesting things. And in contrast, I’m one of the most boring, basic people. So it’s a nice combination, I think, of personalities. Dr. Palmer is also a medical ethicist. I’m very excited to talk to him and hear more about his story as a medical trainee—going through the match and residency—and his views on certain hot topics in healthcare and medical education today.

So without further ado, I’m going to welcome our guest, Dr. Ned Palmer. We are excited. Actually, ChatGPT wrote this intro for Dr. Ned Palmer because I felt like I was going to be biased. Let me just read it for you all:

We have the pleasure of welcoming Dr. Ned Palmer to the podcast. Dr. Palmer is a distinguished physician and entrepreneur currently serving as the chief operating officer and co-founder of Panacea Financial, a company dedicated to providing tailored financial services to doctors. Dr. Palmer earned his doctor of medicine degree from Ross University School of Medicine, followed by a residency at the University of Cincinnati Medical Center and Cincinnati Children’s Hospital. He further specialized by completing a fellowship in global health and obtaining a Master of Public Health in global health from the Harvard T.H. Chan School of Public Health.

How’s it going so far? Is it accurate?

NP:

Really good. Way nicer than any other intro you’ve given me before. So, so far.

MJ:

Currently, Dr. Palmer practices as a hospitalist in Boston and Montana and holds a faculty position at a school in Boston that I won’t say. In addition to his medical practice, Dr. Palmer co-founded Panacea Financial to address the unique financial challenges faced by doctors. His personal experiences with financial struggles during medical training inspired him to create a better banking and financial solution for doctors and doctors in training. Welcome to the podcast, Dr. Ned Palmer—what an honor to have you here today.

NP:

Thank you, Dr. Jerkins. This is the only time I’ve been described as “distinguished”—ever. I gotta know, what prompt did you put in? I’m going to flip it and interview you starting now.

MJ:

Nope, that’s not how this goes. That’s not how this goes. Palmer, let me just dive in here, okay? Let’s give the audience what they want. The questions are for you. What is something about doctors that most people get wrong?

NP:

So I’ve actually come to a realization lately about what a lot of people get wrong about doctors. And I think it’s the idea of when our time is protected. It took me a long time to understand. A lot of people have heard about the federal work hours restrictions for residents, right? What I think few people realize is that’s the only time in a decade of your healthcare training when your time is actually protected.

I think about our own training—it was only during the four years we were residents together that you actually had any time protections. Before then, as a student, and after then, typically as a fellow or attending, you have no work hour restrictions, and the hours actually go up on either side. I think that’s something most people don’t get. And even many trainees don’t necessarily understand that that’s the expected lifecycle. I loved it, but it’s something you kind of have to know going in.

MJ:

So are you saying that most people don’t realize that your hours are protected in residency?

NP:

Most people don’t realize your hours are only protected in residency. A lot of people—even those outside of medicine—have heard of the residency work hour restrictions. They’ve been in place for 30-plus years and come up pretty frequently. But what people don’t realize is that’s the only time in your career those protections apply. In med school, in fellowship, as an attending—you don’t have those protections.

MJ:

Well, there was recently this idea floated that doctors should be mandated to practice 15 years of full-time clinical work after training or face some sort of financial penalty. What do you think about that?

NP:

Fifteen?

MJ:

One-five. Fifteen. Full time.

NP:

Oh, I didn’t even know that was floated. I mean, I think nothing but negative thoughts about that because physicians can do so many things with their training. So what do we define as “acceptable” practice right off the bat? I’m going to argue this as an internist, which means I’m going to chip away at the roots of that question—how did you set this up, what are the definitions and terms you’re using?

What counts as clinical practice? Could you go work in novel drug development? Could you go into biotech or entrepreneurship like we did? Do you have to support patients directly? What if 10 years in, you’re offered a job as CEO of a hospital? Does that not qualify because you’re not practicing clinically anymore? Do you then—what?—get penalized? Jail time? I think we should absolutely impose jail time with it.

MJ:

Yeah, it’s funny—like what if you go work for an insurance company? You’re not working clinically. That’s its own career. Does that not count? And what is the penalty? It was something I saw in a tweet—so take that for what it’s worth—but it was from a congressman who is a physician. And the idea was that doctors should pay back the benefit the government gave them to go to medical school. Like… that’s called a loan. And that is what I was paying off.

NP:

7.3% interest I’m already paying on that…

MJ:

I mean, I get liking the idea of creative thinking around building the workforce, but the idea itself just maybe isn’t quite as sound.

NP:

I like your optimism, even though I hate everything about that recommendation. If you peel it back, that comes from badly misunderstanding CMS’s role in how residents generate value for hospitals. If you’re saying we should pay back the extra money CMS gave the hospital to train us—that’s insane. Hospitals make, on average, something like $250,000 per year per resident. There’s complex accounting and lots of arguments about where the money flows, but it’s definitely not to the trainee. So let’s not pretend they’re the ones carrying all that wealth forward.

MJ:

Tell us about your medical education journey.

NP:

I think GPT did a great job. No notes. Just kidding. So—I was a second-career physician. I worked for a couple years as a research chemist and in chemical engineering. And then I realized I needed something more connected to humans. So I switched careers. I was on a very stable, comfortable career path at the time.

Hello? Movers are coming right now—sorry. Yeah, yeah, another time would be great.

MJ:

I hope we don’t edit that out.

NP:

No, let’s keep that. Everything’s going exactly as I planned today. If there’s one takeaway from today, it’s that this tightly constructed, logistically nightmarish day is going perfectly.

MJ:

So you had a second career, is what you were telling us.

NP:

Second-career physician. Or maybe a third, depending on how we’re counting things today. But I had to decide: how do I get ready for med school? Do I do a post-bac or take an alternate route? I went the alternate route. I went to Ross University School of Medicine in Dominica at the time. Did four years there, fell in love with Med-Peds, and ultimately joined you in Cincinnati for residency.

During residency, I really became enamored with global health and international health delivery, so I went on to do a fellowship at that unnamed Boston school you like to poke fun at.

MJ:

It’s not that I don’t like it. It’s just… funny.

NP:

At every step, I never planned more than one step ahead. I didn’t start med school knowing I’d go into global health. I didn’t even know Med-Peds existed at the time. I went in pluripotent—totally undifferentiated.

MJ:

That’s the first time someone on this podcast has used the word “pluripotent.” Congratulations. I did want to ask: what parts of your medical education now seem obsolete?

NP:

Histology—now that I just mentioned stem cells. Histology and microscope slides. I remember being tested on pink and blue slides, different staining mechanisms. Distinctly obsolete.

Beyond that, I think a lot of the subject-based, non-patient-focused approach feels outdated. My med school was structured that way—separate pharmacology, anatomy, physiology courses. A lot of med schools now have systems-based training. Even the one I went to has changed. Now it’s like: here’s cardiology; here are the drugs, anatomy, physiology, disease states—all together. I’m not sure if that’s perfect, but at least it centers something human, or a human system. And that’s a big shift I’ve seen in the last 10–15 years in medical education.

MJ:

Yeah, that was my experience too. Actually, I think I was there when our school transitioned from the subject-based divisions to the more systems-based approach. Let me ask you this—how much debt, if you’re comfortable talking about this (which I actually already know you are, so that’s why I’m asking), how much debt did you have from your medical education?

NP:

Yeah. So I accumulated $320,000 of debt on the day I graduated. Pretty much exactly $320,000. Then I did six years of postgraduate training—four years in residency and two in fellowship—during which time I continued to accumulate interest on that debt at a weighted average interest rate of 7.3%. So I added $100,000 in interest by the time I graduated from fellowship and got my first “adult doctor” job. All in, I consider it $411,000 by the day I left fellowship.

MJ:

Is that how much debt you expected to incur at the outset of your training?

NP:

No, I expected half of that. When I was looking at going to med school—probably a solid 15 to 18 years ago—every year the tuition rates went up stratospherically. Along the same timeline, interest rates were rising or protections were being peeled back. So, I unfortunately caught it on the bad end of an investment curve.

MJ:

Really.

NP:

And it really ballooned the costs. I’ll also say that when numbers are reported, they almost never include what happens during residency. People say, “$300,000 in med school debt.” Sure, I left with $320,000, which was more than I expected. I’d maybe gone in thinking $250,000. But then what? Everyone has to enter a training program to become a practicing doctor.

The SAVE program was the first plan that actually addressed the fact that interest accumulates way faster than you can pay it off. And now that plan has an injunction against it and may go away. So I think we’re already back to the bad old days, where you have to factor in how much ground you’ll lose during residency. It’s not that you can’t meet your student loan obligations as a physician—you absolutely can. But going in with eyes wide open is really important. I just hope others are doing better math than I did.

MJ:

Well, let’s say you could go in with eyes wide open, knowing exactly how much debt you’d have by the end of training. What’s the number that would’ve made you say, “Nope, I’m not doing this”?

NP:

Probably five or six hundred thousand dollars.

MJ:

What about back then?

NP:

Back then, if you told me $500,000 or $600,000, I don’t know if I would’ve walked away because I had no concept of how much money that was. That’s the problem, right? If you told me “half a million dollars” at that point in my life, I had never spent anything close to that. I didn’t own a house. I’d never made a purchase with that many zeroes. I wasn’t even operating in that universe.

So how do you make it real to make that decision? Every car I’d bought at that point was worth less than $10,000. So I don’t know—give me 50 of those and maybe I would’ve understood.

MJ:

And you’d have gone back to the lab, I guess? The chemistry lab?

NP:

Something along those lines, yeah. I probably would’ve pursued a career in academic science.

MJ:

Let me ask you this—tell us about your Match Day story. As much as you want to share, and maybe give a little context for those who don’t understand how the Match works.

NP:

So the Match—especially the main residency Match—occurs in the third week of March every year. It’s where over 90% of medical students find out where they’re going for residency. And not just what city and state—they find out what specialty they’ve matched into and, frankly, what their future is.

If we extend that out, about 80% of doctors practice within 100 miles of their residency program. So it really sets a path for your life—geographically and professionally—in terms of what you’re going to learn. It’s an incredible moment. A massive emotional thing every fourth-year med student goes through.

The way Match Day is handled at different schools varies a lot. I don’t know the American med school experience firsthand, but I’ve heard about it. In the Caribbean, schools don’t get advance notice of where students match, so they aren’t prepared and can’t really organize a ceremony.

So as a Caribbean med grad, I stood around in the library refreshing my Gmail, waiting for an email at 12:00 PM Eastern on March 17. That’s when and how I found out I was going to Cincinnati. We had room-temperature Faygo—because it was Michigan—and room-temperature Jets pizza. But everyone was too nervous to eat or drink anything.

It was a weirdly isolating experience. Everyone was doing the same thing, refreshing their inbox. Somebody would get an email and squeal or cry, and everyone else would stay hyper-focused on their own screen. It was a lot of parallel play, to borrow a pediatric term. So much emotion—good, bad, and ugly.

I was thrilled. Cincinnati was one of my top choices, and I was absolutely thrilled to match into Med-Peds there. But it was hard being right next to people who weren’t as lucky.

MJ:

That’s difficult. What’s one thing you look back on from your medical training and still cringe about?

NP:

This is a real answer, but it’s so embarrassing. One of the first times I got completely dressed down by a surgeon in the OR—it was because I didn’t know the layers of the abdominal wall during surgery. I couldn’t name them fast enough or in the order he wanted.

Then I broke scrub. And then a scrub tech yelled at me. All in the same procedure. I think I went to the stairwell and cried.

And I cringe for multiple reasons. I cringe at the field of medicine—that it was considered acceptable to teach through humiliation. I cringe at myself for accepting it—being in a position where I felt I had so little power, or perceived I had so little power. I still reflect on that sometimes, even in the middle of the night. I’m still embarrassed that it happened. It’s not great.

MJ:

I think we all have those stories—especially in medical training. I probably have more than you do. But this is your interview.

NP:

Why do you have more than I do?

MJ:

Yeah, I don’t know. That’s for a different episode. One thing about you, if people don’t know—you’re a student of history. So let me ask: Who do you think the real father of medicine is? Is it Osler? Hippocrates? Who would you consider the true father of medicine?

NP:

Oof. Can I ask a clarifying question?

MJ:

Sure.

NP:

You said “father of medicine” or “father of modern medicine”?

MJ:

See, I didn’t specify that.

NP:

If we’re talking father of medicine, I’d go way back to Hippocrates. He was one of the first to lay out what a physician’s duty was—patient responsibility, physician responsibility, and society’s responsibility to the sick. There’s a reason we still take the Hippocratic Oath. It was groundbreaking writing about that tripartite responsibility.

But Hippocrates also said physicians should not take money for treating patients. So his involvement with modern medicine and the $4 trillion in U.S. healthcare spending today is… a different question.

MJ:

Would he call us hypocrites?

NP:

He might—perhaps ironically.

MJ:

Touché. That was a softball. Maybe that was the whole setup. I was playing 3D chess just then.

Let me ask you this. As I was doing research on you, trying to ask better questions, I noticed something online. It turns out Ned Palmer has written a book I’m very interested in. It’s called A Cheesemonger’s History of the British Isles—by Ned Palmer. Tell us about that.

NP:

If you haven’t been cheesemongering in the British Isles, I couldn’t recommend it highly enough. And if you’re going—pick up the book. It’s the definitive guide. Distinguished guide, some might say. Some ChatGPT models might say. About how to cheese your way through the British Isles.

MJ:

It’s a different Ned Palmer. I’m so sorry.

NP:

I don’t think that’s true at all.

MJ:

Sorry, if you Google Ned Palmer cheesemonger, it turns out that doesn’t look like you. But my mistake—I’m still learning this whole interview thing.

NP:

Okay. It’s a pseudonym that I write under actually—like Mark Twain. You know, like how his real name was also Mark Twain. He just pretended it was a pseudonym.

MJ:

Let me ask you this: What is the last UpToDate article you had to read for patient care?

NP:

Acute diverticulitis in the inpatient setting—just about five or six days ago. And this one’s embarrassing, speaking of recent cringe moments—not from training. There’s actually a pretty strong recommendation to avoid antibiotics in mild to moderate diverticulitis. And I still—you’re nodding because you knew this and I did not.

I love it, though, because look, antibiotics were thrown at everything for so long—any inflammation, anything the body was going through. I was happy to see that being walked back. I had a septic patient and was trying to figure out where the line was—when to start antibiotics for diverticulitis. But I was glad to read there’s increasing resistance to just throwing Flagyl at every episode. I think that’s going to be great for patients.

MJ:

Yeah, and I will say this is where inpatient and outpatient have different flavors. My understanding is the evidence reaches a similar conclusion in outpatient care. However, when you’re inpatient and you’re being monitored 24/7 and you have support if something goes south—that’s a different conversation than in outpatient, where someone walks into clinic with diverticulitis and you say, “Hey, you don’t need antibiotics.”

I think it’s healthy. I try to have those conversations as openly and honestly as I can with patients—but it’s a little bit harder.

NP:

Considerably harder. I mean, we could talk about pneumonia for the rest of the hour, right? What are the indications for antibiotics in adults and children? And then, what are the patient-side effects? They feel terrible, they’re stressed, they can’t breathe—all of that, just like with diverticulitis.

MJ:

What do you think—going back to UpToDate—what do you think your most-read article has been since you became a subscriber?

NP:

I’m going to stay on the cringe theme here: amoxicillin dosing. I use UpToDate a lot for drug prescribing recommendations, and amoxicillin dosing—especially between pediatrics and adults—has never stayed in my brain, no matter how hard I’ve tried. I don’t feel good about that. So that is absolutely my most-read article.

MJ:

That’s okay! That’s why you have a resource and you use it. As a medical ethicist, what do you think the most important development in medical ethics has been in recent memory?

NP:

I think one of the most important recent developments in medical ethics is the socialization and elevation of ethics as a core competency taught in medical schools. I think you and I were taught it. I don’t know about you—were you guys taught that in Tennessee?

MJ:

Yes, though I don’t think it was a separate course. It was just kind of woven in. Maybe that’s what you’re getting at?

NP:

It was. So, it wasn’t a requirement just a couple of years before we went to medical school. You and I started around the same time, but just a few years earlier, it wasn’t part of the curriculum. It was supplemental education you could opt into if you were interested.

When I was in medical school, we took it just to answer questions on Step 1. That was the only goal—to survive the next step in training. But what that’s meant is now there’s an entire generation of doctors with a shared language to talk about ethics.

So now, people aren’t afraid to call the ethics board. You can have the conversation, you have the vocabulary, you’re an informed consumer of the service. You can talk about ethics with patients, families, other providers, or ethics board members. And it’s no longer seen as a punitive board that’s going to hurt you or take your license—it’s seen as a patient advocacy and support network. That’s a really important shift. Just educating everyone—even if not deeply—lets us all speak the same language. And that immediately changes how we engage with ethics in practice.

MJ:

So not having a set or separate class in med school, how did you go about gaining interest and experience in medical ethics?

NP:

I stumbled into it—like so many things in my career. I wasn’t particularly interested in med school. Like I said, I just wanted to get through and answer the questions. I didn’t get it.

Then during residency, someone said, “Hey, why don’t you come down and sit in on an ethics committee meeting?” As residents, we were allowed to observe. So I sat in and listened to conversations that directly impacted how we practiced medicine.

They were about things like drug rationing, IV fluid rationing—how we distribute resources, not just in the hospital, but across the region. You and I trained at the University of Cincinnati—a major training institution—but there were six other big hospitals in the city. So how do you make sure Cincinnati gets what it needs without taking from others and creating scarcity?

That night opened my eyes to how medicine works at a systems level. From top-level decisions—like who gets the box of drugs—to individual patient care, it all flows downstream.

I’d invite everyone to check it out. So many ethics committees I’ve worked with have open spaces for residents and trainees—even med students. All it takes is raising your hand and saying, “Hey, I’d love to sit in on a meeting.” That’s what I did. And honestly, it really changed the non-clinical side of my career.

Even during residency, I ended up joining the residency committee and stayed on for the rest of our time. It was an absolute value-add to my training.

MJ:

Pretty cool.

NP:

Yeah, it is the coolest.

MJ:

No, I mean—it’s a cool opportunity. I didn’t realize you could do that as a resident. But I think your message to trainees out there—to look into these opportunities and be assertive about gaining experience—might open a lot of doors and eyes to a deeper understanding of the system.

NP:

I think residency, more than anything—and this is not a question you asked—but residency is where I learned the most about the diverse ways medicine is practiced. Now, nearly 10 years out of residency, I can say I learned more in that four-year period than any other stage.

As a practicing attending, you’re more isolated—almost on an island. So in residency, when you’re invited to try new services or join new committees, take the opportunity. It’s an amazing time to learn about how health care is actually delivered.

I miss that a lot. There’s a lot about residency I don’t miss, but being able to see and experience so many different areas of the hospital—that was pretty incredible. I couldn’t even tell you what floor imaging is on at the hospital I work at now. No clue.

But we knew in Cincinnati, right? You got called there, you might respond to a code or go to a procedure. You’d be in a procedure. I couldn’t tell you what floor imaging is on in Boston. Not a clue.

MJ:

Interesting. Well, let me ask you this: If you had ultimate authority, how would you go about fixing the student debt issue that doctors face?

NP:

Okay, I’m going to go with a non-traditional answer here. Actually, it’s probably an incredibly traditional answer. I like a service model where a couple of years of general practice service before residency pays your loans back. There are a couple of ways to do it, but models exist—elsewhere and even here in the U.S.—where we know there’s a general practice shortage, especially in rural and underserved areas. For a couple of years of that type of practice, your loans are forgiven, and then you go start your specialty training.

Whether that training is med-peds, orthopedic surgery, or whatever you want to go into, you start with a couple years of independent practice, far more confidence, and a better understanding of how medicine is actually delivered. And you’ve given back to the country that helped train and educate you by serving in an underserved area.

And if you don’t want to do that, then you just pay your loans back. It seems like a fair trade. You’re not required to serve, but if you opt out, your loans go on a 20-year repayment plan and you pay them back when you can. I really like the model of service for tuition. It’s a reasonable model—it works elsewhere, and we actually use it already in some sectors.

Like the Montgomery GI Bill—we do a great job of that for military service members, but we haven’t extended it to medicine or other public service careers.

MJ:

Very interesting. And before I move to the next question—I like that idea in theory. Again, in the question, you were given ultimate authority, but obviously there are so many other interest groups that wouldn’t like that model for many reasons.

NP:

If you gave me ultimate authority, I’d Harry Potter–wand away $1.8 trillion and reset everybody. But honestly, there are so many second-, third-, and fourth-order effects—I’m not smart enough to understand what that would do. It would create a ton of harm.

So I tried to use that ultimate authority to create something that might do some good. It would probably fail. People would undercut it and say, “Let’s see—those doctors aren’t trained. How do you let them practice on me?”

You’d have to be graduating medical students who could practice independently, or within a very tightly prescribed scope. We’re not really set up for that—from a liability standpoint, for example. The first time you miss a prescription in your first year, were you wrong or were you undertrained? I’ve been wrong. I’ve also been undertrained. It’s tough to tell where that line is.

MJ:

What is one opinion you hold now that the med student version of you would find upsetting?

NP:

My joke answer is that doctors are overpaid.

MJ:

That is a bad joke. Bad joke.

NP:

I think, as a med student, I believed doctors were far more important to patient outcomes and success in healthcare delivery. Now, I recognize—it’s not just “it takes a village,” it takes an entire healthcare system.

Frankly, as a doctor, I spend some of the least time at the bedside. So even if I make the right decision or choose the right treatment plan, there are 20 other people on any given day who are actually executing that plan. In many ways, they’re more important.

I might know the right IV antibiotic, but I still don’t know how to give it. I don’t know what I’m doing! So I find myself far less important—and I like it. I like the team mentality. I like that it takes all of us. I like working together.

MJ:

Which medical educator has made the biggest impact on your clinical career—and which one has impacted the non-clinical side of your work?

NP:

Clinically, definitely Dr. Caroline Mueller. And this isn’t a bit—Caroline, I don’t know if you’re listening, but two of your former graduates are on this call. Going to Cincinnati was probably one of the most important things in my clinical career. The other options I had weren’t nearly as strong.

Everything Cincinnati brought—my clinical training, what I learned, and how I was able to move into fellowship and attending practice—none of that would’ve happened without Caroline Mueller. She didn’t just accept me into the residency program; she continued to mentor me as our program director in Med-Peds. She took a chance on me.

Non-clinically… that’s a bit harder.

MJ:

You’ve talked about medical ethics, global health, policy. Has someone mentored you in that non-clinical skill set?

NP:

Yes—Michelle Nishirenko. She’s the program director for the Global Health and Population program in Boston. I knew of her before I started fellowship. She’s a titan in international health delivery.

Again, it was another case of saying yes to the opportunity to learn from people smarter and better than me—and she is both. A lot of global health is non-clinical. Sure, you see diseases you’ve never treated before, but much of it is: What happens when the system breaks? When power doesn’t work? Water doesn’t run? Or when it’s a health system you’ve never used?

It asks big questions about what healthcare is. Some people might consider that clinical, but I don’t. How we deliver care is different from what we deliver. And that’s what I love about it.

MJ:

What amount of money would it take for you to go back to being a bicycle cab driver?

NP:

Is that from ChatGPT? Did ChatGPT find that?

MJ:

ChatGPT, yeah—it read your bio and told me.

NP:

I have an expired taxi cab license in the great state of Massachusetts. You had to be licensed—come on, these weren’t anarchists! How much money would it take? Honestly, it’d be a great retirement career. I’d gladly do it again if I had enough money to live comfortably on the Cape.

MJ:

I wonder why I don’t see more retirees doing that. Maybe it’s the osteoarthritis or something. Not the easiest job on the body.

NP:

Look, the bike I had had a tiny electric motor for assist. Those little motors are only getting better—that was 20 years ago. I’m sure we’ve got better setups now.

Also, it depends on the size of the average American riding in the back of your bicycle. So it’s a battle between the obesity epidemic and the rise of electric motors. We’ll see who wins.

MJ:

An interesting battle I hadn’t thought about. But thank you, Dr. Palmer. We’re wrapping up—I know you’re a busy man. I want to end with our standard closer: What is one thing you’ve changed your mind about recently?

NP:

I knew you were going to ask me this. I’ve known for weeks. Still not prepared.

MJ:

That’s great. Stumped him! For those listening at home—I stumped him.

NP:

Almost speechless. Even harder to do.

MJ:

You can just say you never change your mind.

NP:

Yeah. I’m pretty firm in my old age—I’ve just stopped changing my mind.

Okay. I’ll say this—on a personal note, we’re taking this call about eight weeks before the birth of my first child—my partner’s and my first son, we believe.

MJ:

Congratulations.

NP:

Thank you. You, Dr. Jerkins, know this about me—I’ve considered myself very independent for many years. I’ve always thought I could handle things on my own.

Even in the run-up to this, I’ve already started to realize how wrong I was. It probably doesn’t take a village every single time—but it sure helps to have a support network. Friends, family, colleagues, all around us—even before the baby is here—it’s already clear how much harder this would be without them.

So I’ve definitely changed my mind. I thought I could do it all. I was like, “I can handle anything.” Wrong. Dead wrong.

MJ:

A humbling experience. Well, thank you so much for joining us, Dr. Palmer.

And thank you all for listening to another episode of For Doctors, By Doctors. We actually have an email—I forgot to mention this at the top. If you have questions for us or for a guest, or suggestions for someone you’d like to hear on the show, email us at [email protected]. That’s right, right, Ned?

NP:

It is, yeah. Yeah, yeah.

MJ:

Appreciate it—and we’ll see you in the next episode.

As always, thanks for listening. And next time you see a doctor, maybe you should prescribe them this podcast. See you next time.

Check it out on Spotify, Apple, Amazon Music, and iHeart.

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Send us an email at [email protected].